Care Home: Ashmeadows Residential Home

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What the care home does well The home is well managed and run in the best interest of the people living there. People are always assessed before they move in, this is to make sure that their needs can be met at the home. There is information for people to take away giving details about the service provided, this helps people decide if it is the right place for them to move to. The staff know people very well, they have a good understanding of individual needs and preferred daily routines. People are well cared for and their health care needs are being met. There are activities for people to take part in if they want to. People said the food is good and there is plenty of choice on the menu. Staff recruitment procedures are good, all staff are checked before starting work to ensure that they are suitable and people people living there are safe. We asked people to tell us what the home does well. These are some of the comments people made in the surveys they sent to us: " Ashmeadows is a clean, comfortable home which cares well for the residents living there" " The carers are mainly kind and considerate, but overworked" " well trained caring staff with a very good manager" "homely atmosphere and good food" What has improved since the last inspection? Some improvements have been made to the internal environment. New hall and stairway carpets and a new bathroom suite have been fitted since we last visited. What the care home could do better: Make sure that everything is in working order in all bedrooms and the make sure the beds are comfortable and presentable. Staffing levels need to be kept under review to make sure that people`s needs can be met at all times. If people move into the home in the future who need significant support from staff, the staffing levels may need to increase accordingly. When we asked people to tell us if they thought there was anything that could be done better, one person said "It would be better if the carers did not have to spend so much time writing reports about the residents". Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashmeadows Residential Home Westering House Ashmeadows Residential Home Moorbottom Cleckheaton West Yorkshire BD19 6AD     The quality rating for this care home is:   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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lynda Jones     Date: 2 1 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Ashmeadows Residential Home Ashmeadows Residential Home Westering House Moorbottom Cleckheaton West Yorkshire BD19 6AD 01274861049 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Miss Susan Jane Leigh,Mr Stephen John Oldale care home 17 Number of places (if applicable): Under 65 Over 65 17 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 17 The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Ashmeadows is a privately owned and managed care home providing personal care and accommodation for up to seventeen older men and women. Ashmeadows is a detached property set in attractive gardens and grounds. A sloping drive leads to a small car parking area. There is a ramped access to the rear of the property via the conservatory and stepped access to the front. The home is on two levels, the upper level being accessed via a shaft lift or stairs. Care Homes for Older People Page 4 of 28 Brief description of the care home The care home is staffed twenty-four hours a day. The Provider informed the Commission for Social Care Inspection on the 21.4.09 that the fees range from 385.87 pounds per week to 397.65per week. There are additional charges for chiropody, hairdressing, newspapers, magazines, taxis and toiletries. Information about the home and the services provided is available from the home in the statement of purpose and service user guide. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two stars. This means that people who use the service experience good quality outcomes. This inspection was carried out to assess the quality of care provided to people living at the home. The inspection process included looking at the information we have received about the home since the last key inspection as well as a visit to the home. During the visit we spoke to people living at the home and to the staff on duty. We spoke to the manager of the home, observed staff delivering care, looked at various records and looked around the home. Care Homes for Older People Page 6 of 28 We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: Make sure that everything is in working order in all bedrooms and the make sure the beds are comfortable and presentable. Staffing levels need to be kept under review to make sure that peoples needs can be met at all times. If people move into the home in the future who need significant support from staff, the staffing levels may need to increase accordingly. When we asked people to tell us if they thought there was anything that could be done better, one person said It would be better if the carers did not have to spend so much time writing reports about the residents. Care Homes for Older People Page 8 of 28 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive information about the home before they move in. They can visit the home to see if it is suitable for them. Everyone is assessed before they move in to make sure the home can meet their needs. Evidence: In the surveys people told us they were given information about the home and this helped them decide if it was the right place for them. People are invited to visit the home to have a look at the accomodation and meet people, sometimes relatives do this if their family member is unable to get to the home. Four out of five people said they had been given a contract setting out the terms and conditions of residence. This is important because it tells people about their rights and responsibilities and those of the owner of the home. Care Homes for Older People Page 11 of 28 Evidence: We looked at some of the care plans and we could see that everyone had been assessed before they moved in. This is to make sure that each persons needs can be met and to ensure it is the right place for them. The home does not provide intermediate care. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and healthcare needs are met. People are protected by the homes medication administration systems. Evidence: We looked at a selection of care plans because we wanted to see what individual needs had been identified and what action staff are expected to take to meet those needs. The plans are of a good standard, they provide staff with clear information about the care people require. This should ensure that care is provided with some consistency, in a way that suits each individual. In the information sent to us before the inspection, the manager said All plans are tailored to each individuals needs. We make sure that all aspects of care are included and any ongoing care or treatment is provided. Care Homes for Older People Page 13 of 28 Evidence: In the surveys people told us they receive the care and support they needed and they get the medical support they require. They told us the staff listen to them and act on what they have to say. The records indicate that people receive the medical and healthcare support they need and any concerns about peoples health are promptly followed up. We could see that people are receiving health care from a range of people such as doctors, district nurses, opticians, audiologist etc. Risk assessments are included in the plans covering areas such as moving and handling, skin integrity, and other risk factors. The manager said All staff have had in depth training on continence care, some staff have had training on oral health and hygiene and speach and language therapy. This helps us gain a wider knowledge of caring for clients. Care plans are routinely reviewed every four weeks to make sure that they accurately reflect the care and support that people require. They manager said plans are updated straight away if there is any change in individual needs. From talking to staff it is clear that they know people well and they are familiar with the content of the plans. During the visit, all the staff were seen to treat people with respect and maintain their dignity, personal care was delivered with discretion. People looked well cared for, comfortable and relaxed. Throughout the day people were having their hair done in the reception area just inside the front entrance. One of the seats used by people having their hair dried was a tubular framed commode, this did not look very dignified. We were told that it is used because the height of the chair suits people. We asked the manager to find a more suitable chair to use for hairdressing. Medication is generally well managed at the home. The pharmacist supplies medication to the home in a monitored dose system, medication is administered at the correct times and the records are signed when it is given. All medication is safely stored at the home. We did not observe a full medication round. We looked at the Medication Administration Records (MAR) which showed that people are receiving their medication as prescribed. The records were up to date with no gaps. Care Homes for Older People Page 14 of 28 Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities are available and people are encouraged to make their own choices about how they spend their time. Relatives are welcome to visit at any time. Evidence: The care plans contain good information about the sort of life experiences people have had and the sort of daily routine they prefer. This information is useful because it helps staff understand something about peoples backgrounds, families and work experiences etc. It also helps to make conversation with people and to make sure that they continue to live their day to day lives as they want to. The personal support plans contain lots of useful information that helps staff to support people with some continuity. For example, we looked at one plan that told us the person concerned preferred a shower to a bath and liked to shower in the morning. From the information provided we could tell what sort of routine they preferred throughout the day and what they like to wear, what order they preferred to dress in, Care Homes for Older People Page 16 of 28 Evidence: and exactly how much and what assitance they needed when washing. This is helpful to people, it helps them to maintain as much independence as possible and gives some assurance that the care and support they receive will not simply depend upon who is delivering it. Routines at the home are flexible and people are encouraged to make choices about their lives and how they want to spend their time. The staff spent time talking to people, they consulted people about what they wanted to eat and drink throughout the day. The same hairdresser has been going to the home for several years and she knows everyone really well. People said they look forward to her visits and enjoy hearing about her family. Some very animated conversations and lots of laughter could be heard from the hairdressing area. The staff were attentive and complimented people on their appearance after they had had thei hair done. We asked people if the home organised any activities for them to take part in, most people said usually. The information provided before the inspection told us that house meetings take place each month which everyone is invited to attend. At these meetings people are asked about the sort of activities they want to take part in and about trips out. A list of events and activities is on display in the reception area. Participation in activities is recorded in the care plans. Some of the people living at the home wanted to keep a pet. They decided on a rabbit, and Fudge the rabbit took up residence two weeks before we visited. While we were there the handyperson was constructing a run in the back garden, people said they were looking forward to some good weather so they could sit out and see the rabbit. The information provided before the inspection states there are no visiting times in the home, family and friends can come at any stage of the day/evening. While we were there several visitors called, they were all made welcome by the staff and offered a drink. In the surveys we asked people if they liked the meals at the home, two people said always, three people said usually. We saw lunch being served; people were offered a choice of egg and chips or liver and onions, most people chose liver and onions and the concensus was that it was lovely. The mealtime was unhurried, everyone had plenty of time to eat their meal at their own pace. People have whatever they want to eat for breakfast and a choice of menu at tea time. The manager said all menus have been reviewed and more choices are available to Care Homes for Older People Page 17 of 28 Evidence: service users. We hold client meetings to discuss any changes to the menu. We have nutritional assessments for all clients in the care plans and we cater for each clients needs . Care Homes for Older People Page 18 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to make a complaint and are confident that any issues raised would be sorted out. Staff know about adult protection. This means that people in the home are being kept safe. Evidence: The complaints procedure is on display in the entrance area. The manager told us that when people first move into the home, they, and their family members are provided with information about the complaints procedure. We asked people in the surveys if they knew how to make a formal complaint and they confirmed that they did. Each peron completing a survey told us they have someone that they can talk to if they are not happy. According to the complaints log, no complaints have been made over the last twelve months. In the information we received prior to the inspection we were informed that all new staff receive training on their responsibilty to protect people in their care. All staff have had training about safeguarding procedures and are aware that they must report any care practice that is unsatisfactory and unsafe. Staff records confirm that this training has taken place. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, comfortable home. Evidence: On this inspection we looked round all parts of the home, we saw all of the communal areas, kitchen, and some of the bedrooms. All parts of the home were clean, tidy and odour free. In the surveys, people told us the home is always fresh and clean. The kitchen is about to be totally refitted, this will be a big improvement as the fittings are old and difficult to keep clean. The communal areas are pleasantly decorated and comfortably furnished. New carpets have been fitted on the corridors and stairs since we last visited, this is an improvement. In the information we received before the inspection we were told all service users are encouraged to arrange their rooms to their liking. Each client has one to one time with their key worker to arrange their rooms or make any changes to them . Most people have organised their rooms to suit themselves with help from their relatives and staff. All the rooms are different shapes and sizes and each one has been Care Homes for Older People Page 20 of 28 Evidence: personalised with photos, ornaments, pictures and plants. One of the bathroom suites has been replaced since we last visited. The manager said there is a rolling programme of redecoration that is undertaken by the homes handyperson. When we looked round the home we noted some areas needing attention, these included: Ground floor toilet would benefit from redecoration. The second lock on the door shoould be removed, this prevents the door from being opened from the outside in an emergency. The lid on the waste bin in the Parker bathroom was missing. This is unhygienic and needs to be replaced. In one bedroom the sash window was wedged open with a piece of wood. This is unsafe, it poses a health and safety risk. In one double en suite room, the tap top was missing and the second tap on the sink was not secure. Both need to be repaired or replaced. There was no lampshade on one of the central light fittings in one room. In several rooms the bed linen had been put on the beds unironed. This gives the impression that staff dont care. When these issues were raised with the manager she said they would be actioned immediately. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are properly checked before they start working in the home to make sure they are suitable and safe to work with older people. Evidence: When we visited the home there were fifteen people living there. The manager is on duty at the home between 8am and 4pm during the week. In addition, between 8am and 3pm there are two/three care staff on duty. There are two staff on duty between 3pm and 10pm, then two staff on waking night duty until 8am. One person is on call over night. There is domestic cover between 8am and 1pm. There is a cook on duty each day between 8am and 2pm (on two days this cover is until 1pm). The cook also provides cover at tea time, between 3:30 and 5:30pm. When we asked people in the surveys if the staff were available when needed, the responses were mixed. Two people said always, two said usually, one said sometimes. Care Homes for Older People Page 22 of 28 Evidence: One person told us that more people with dementia are now moving into the home. We were told that this means that as some individuals require more support from staff and this inevitably reduces the amount of time they have to spend with others. If this is how some people feel, it would be useful to discuss this at one of the residents meetings and to ask people for their views individually at the monthly care plans reviews. Staffing levels need to be kept under review and adjusted accordingly to make sure that the needs of each person can continue to be met. We looked at a sample of staff records because we wanted to see what checks were being carried out on prosspective staff before they start work at the home. We found that the recruitment procedure is good. Prospective employees complete detailed application forms and all gaps in employment histories are checked with the applicant. References are always taken up and checks are carried out with the Criminal Records Bureau (CRB) before people start work. All of these checks are conducted to make sure that prospective staff are suitable and to make sure that people living at the home are safe and protected. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the best interests of the people living there. Evidence: The manager runs the home in a warm, friendly and open manner. People living in the home and their relatives are consulted about the service and their views affect the way the home is run.The home uses the feedback they get from quality assurance questionnaires and meetings to assist them with this. We looked at some of the feedback and the comments were very positive. People think the home is well managed, they like the staff and say they are friendly, caring, patient and well trained. We have been provided with information which tells us that equipment used in the home is serviced regularly to protect the health and safety of the staff and people living there. The manager ensures that all safety checks and relevant maintainence checks are in place. Care Homes for Older People Page 24 of 28 Evidence: Some people deposit small amounts of money at the home for safekeeping. There are records of purchases made on behalf of anyone and receipts are always obtained. The manager deal with personal finances. The manager ensures that the finances are safeguarded and strict procedures and policies are in place. We looked at a sample of these records and checked the balance of money held, the records were correct and the money held could be reconciled with the finance records. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 19 Staffing levels need to be kept under review and adjusted accordingly to make sure that the needs of each person can continue to be met. Repairs should be noted and dealt with promptly so that all areas of the home are safe for people to live in. 2 24 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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