Latest Inspection
This is the latest available inspection report for this service, carried out on 21st May 2009. it is an annual review prepared by CQC after examining previous reports and information from the provider. At the time of this report, CQC judged the service to be Good.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
For extracts, read the latest CQC inspection for Ashley Down Nursing Home.
Annual service review
Name of Service: Ashley Down Nursing Home The quality rating for this care home is: The rating was made on: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.
Has this annual service review changed our opinion of the service?
Yes You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Kim Rogers Date of this annual service review: 2 1 0 5 2 0 0 9 Annual Service Review Page 1 of 7 Information about the service
Address of service: 29 Clarence Place Gravesend Kent DA12 1LD 01474363638 01474363638 ashley.down1@btinternet.com Telephone number: Fax number: Email address: Provider web address:
Name of registered provider(s): Conditions of registration: Category(ies) : old age, not falling within any other category Conditions of registration: Ashley Down Care Home Ltd Number of places (if applicable): Under 65 Over 65 0 19 That from time to time the service may admit service users under the age of 65. Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Ashley Down is situated in a residential area near to the town centre of Gravesend. The property is a detached, Grade II listed building, with seventeen single bedrooms, and one shared room. It is owned by Ashley Down Care Home Ltd., and the company have one other care home in the area. The company took over the home in 2004. The Director, Mr. Mahomed, is the named Responsible Individual for the home for regulatory purposes. He takes an active role in all aspects of the running of the home. The premises provide accommodation on two floors, with a large passenger lift providing easy access between floors. Ten of the single rooms have en-suite toilet facilities. There is a lounge with patio doors leading out into the front garden, a separate dining room, and a large reception area. The home has a patio area at the rear of the property, and parking spaces for several cars. It is close to usual town
Annual Service Review Page 2 of 7 The registered manager has left. facilities, such as banks, shops, post office, pubs and places of worship. The current fee levels range from about 550.00 to 625.00 pounds per week, depending on the assessed needs of individual residents. Additional charges are payable for items such as chiropody, hairdressing, newspapers and toiletries. For more information please contact the Provider. Annual Service Review Page 3 of 7 Service update since the last key inspection or annual service review:
What did we do for this annual service review? We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included, The annual quality assurance assessment ,AQAA, that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations. What other people have told us about the service. What has this told us about the service? The last key inspection of this service was carried out on 11/06/08. One requirement was made about ensuring people give their consent to being photographed and having bed rails. Bed rails and lap belts must also be risk assessed so people are safe. The AQAA does not tell us if this requirement has been met. The home returned the Annual Quality Assurance Assessment (AQAA) when we asked for it. The AQAA shows what they do well, what could be better and how they intend to improve. The Provider completed the AQAA. In some areas, the AQAA did not give us much detail about how they have improved over the past 12 months and how they intend to improve further. For example, on the management section, which includes quality assurance, health and safety and the management of the home they only give one area they have improved in as maintained good records. They intend to improve over the next 12 months by, maintaining records and keeping up with legislation. There is no registered manager at home and the AQAA does not tell us when they plan to have a manager in post. Without plans to improve, outcomes for people who use the service may not improve. The AQAA shows that the range of ways they use to seek peoples views of the service is limited to residents meetings, one to one meetings and informal meetings with relatives. This means that not everyone may have the opportunity to give feedback about the service provided. Some changes have been made based on some peoples views like changes to the menu and times of meals, more activities and some redecoration. The AQAA does not tell us much about how they support and encourage equality and diversity. It says that they have a policy and service users choose what to wear and what to do. They plan to hold cultural evenings. This means that equality and diversity issues may not be understood and supported. The AQAA says they have found some barriers that have hindered the quality of care. Annual Service Review Page 4 of 7 They plan to overcome these barriers by getting staff involved, recruiting more staff and using a permanent team of bank staff. The AQAA shows some evidence of why and how the home is value for money. They continue to carry out assessments before a person moves in and offer trial visits and stays to help people decide about moving in. They plan to improve by maintaining a good quality of care. The AQAA says they involve service users in developing their care plans. They say they could be better at maintaining consistency in the delivery and recording of care. They say they plan to improve the consistency of care by using a new audit form and involving staff in the, simple decision mechanism, to improve the service. They have an activity person who has organised activities including a barbecue, raffle and fete. They say they plan to make more use of community facilities like the park to watch bowls and tennis. They plan to improve the range of in house activities on offer. There is a complaints procedure and a suggestion box that people can use. This means that people can make suggestions about improvement. Staff are trained in how to recognise and respond to abuse. There have been two safeguarding alerts since the last inspection. This means that concerns were raised about possible abuse. The safeguarding coordinator at social services investigates these alerts. Concerns were raised in December 2008 that the home was cold. The Provider addressed this and the AQAA says that the heating system is now good. Concerns were raised in February 2009 that nutritional needs were not met by the home. This was investigated by the safeguarding coordinator. For more information please contact the Provider. The AQAA shows that no staff is trained in malnutrition care and how to support people with eating. The AQAA shows that 3 people need help with eating. The AQAA says that staff retention and sickness levels have improved. Of 19 staff 12 have left in the last 12 months. There are 10 new staff but none have completed an induction that meets the Minimum Standards. They have no policy or procedure about staff induction. This means that staff may not have the skills and competencies needed to meet peoples needs. The AQAA says they could be better at appraising staff and by having a manager. There has been no manager since February 2009, the Provider is in day to day charge. Improvements have been made to the environment including new flooring in the dining room and four bedrooms being decorated. The carpets have been changed in four rooms and there is new flooring in two rooms. Three bedrooms have new wash hand basins and there are some new curtains, towels, pictures and blinds. The kitchen has been refurbished, they plan to improve the lay out of the laundry and improve the external paintwork. They plan to improve the seating in the garden. The AQAA says that soft matching furnishings, exterior paintwork and additional secondary glazing is subject to the availability of finances. Annual Service Review Page 5 of 7 From the information we have the service may not be as good as it was at the last inspection. We may bring the date forward for the next key inspection. What are we going to do as a result of this annual service review? We may make a change to our inspection programme and will carry out a key inspection before 11/06/10. We can inspect the home at any time if we feel service users are not safe or if there might be a breach of standards or regulations. Annual Service Review Page 6 of 7 Reader Information
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