Care Home: Ashton Manor Nursing and Care Home

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What the care home does well The AQAA states "personal care is delivered according to each service user`s plan of care" this was evidenced by the signing of the carer plans by the monthly review of care plans and the signing and dating of same by care staff. The manager has reviewed the homes working method and has introduced two new posts to enable care staff to focus on care. We were told this has been implemented to make people more accountable for what they do, to take responsibility for carrying out specific duties, to help improve the systems that they follow and help in monitoring the delivery of care services in the home. Care staff spoken to supported this new way of working, saying they felt supported and more responsible for what they are doing and feel they can discuss issues they feel unsure about with the manager. The home is dedicated to raising standards of care and has enrolled seven carers on the National Vocational Qualification NVQ) course. Service users lifestyles matched their needs and preferences and where possible they are able to maintain contact with family, friends and the local community. Service users are able to make choices in accordance with their abilities and were provided with a balanced diet in pleasant surroundings and in an unhurried way. What has improved since the last inspection? To improve the quality of care the home offers they have: Purchased 25 profiling beds, new hoists and new medication trolley. They have reviewed their medication handling and storage systems procedures. Introduce a monthly medication audit. Ensure that references are written in British English to ensure protection of service users are maintained.The home has improved menu planning to stimulate appetite and to help service users with diminishing sight. The Chef has photographed each dish and has made a menu folder. This visual display encourages service users to make an informed choice, as they are able to see what the meal looks like before they make a choice. The home has actively sought the involvement of visitors and relatives, by placing a suggestion box to the front of the home and providing paper and pen. The home has also sought to involve relatives in the activities in the home, and documented proof was made available to support this involvement where relatives have volunteered to participate in activities. What the care home could do better: The home recognises it shortfalls through a thorough self-assessment in their Quality Assurance procedures and plans are in place to rectify issues arising. Ensure that service users/relatives sign the care plans to demonstrate their involvement in the drawing up of the care plans. Ensure that references are written in British English to ensure protection of service users are maintained. CARE HOMES FOR OLDER PEOPLE Ashton Manor Nursing and Care Home Ashton Manor Nursing and Care Home Beales Lane Farnham Surrey GU10 4PY Lead Inspector Mavis Clahar Unannounced Inspection 29th April 2008 10:15 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashton Manor Nursing and Care Home Address Ashton Manor Nursing and Care Home Beales Lane Farnham Surrey GU10 4PY 01252 722967 01252 713180 ashtonmanor@invictanet.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ashton Manor Care Home Ltd Linda Wass Care Home 39 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (39), Terminally ill (6) of places Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2007 Brief Description of the Service: Aston Manor is a large Victorian house situation in the village of Wrecclesham, near Farnham in Surrey. It provides nursing care for up to 39 older people. Accommodation consists of single and shared occupancy rooms, all of which are en-suite. Communal areas include a lounge, a separate dining area and a large conservatory. The garden is laid mainly to lawn and is situated to the rear of the property. There is adequate car parking to the front of the property. Fees at this home are within the range of £625 to £750 per week. Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This unannounced site visit, which forms part of the key inspection to be undertaken by the Commission for Social Care Inspection, (CSCI) was undertaken by Mrs Mavis Clahar on the 29th April 2008 and lasted for seven hours; commencing at 10:15 hours and concluding at 17:20 hours. The CSCI Inspecting for Better Lives (IBL) involves an Annual Quality Assurance Assessment (AQAA) to be completed by the service, which includes information from a variety of sources. This initially helps CSCI (us) to prioritise the order of the inspection and identify areas that require more attention during the inspection process. This document was received by us and is referred to throughout the report. The registered manager of the home has resigned and a new manager has been appointed. CSCI will receive her application to be registered, as manager for the home as soon as she receives her CRB result. The majority of the service users spoken to were able to express their thoughts and feelings about the care they receive. The information contained in this report was gathered mainly from observation by the inspector, speaking with a number of service users, and with care staff. Further information was gathered from records kept at the home. The first part of the inspection was spent discussing and agreeing the inspection process with the manager, followed by a tour of the home, which included time spent in discussion with service users, care workers and the Chef. The manager and staff are aware of the Laws regarding equality and diversity and this was reflected in the staff mix. All service users in this home are Caucasian and reflect the population of the area in which the home is situated. All records sampled were mostly up to date with majority care plans being signed by the service users or by relatives. Two requirements were issued on this visit. Please see Health and personal Care and Staffing outcomes for full disclosure. The final part of the inspection was spent giving feedback to the acting manager about the findings of this visit. The inspector would like to thank all the service users and care staff that made the visit so productive and pleasant on the day. Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? To improve the quality of care the home offers they have: Purchased 25 profiling beds, new hoists and new medication trolley. They have reviewed their medication handling and storage systems procedures. Introduce a monthly medication audit. Ensure that references are written in British English to ensure protection of service users are maintained.The home has improved menu planning to stimulate appetite and to help service users with diminishing sight. The Chef Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 7 has photographed each dish and has made a menu folder. This visual display encourages service users to make an informed choice, as they are able to see what the meal looks like before they make a choice. The home has actively sought the involvement of visitors and relatives, by placing a suggestion box to the front of the home and providing paper and pen. The home has also sought to involve relatives in the activities in the home, and documented proof was made available to support this involvement where relatives have volunteered to participate in activities. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Prospective service users and their relatives have the information needed to choose a home, which will meet their needs and service users are being assessed to ensure the home is capable to meet the needs of the service users prior to being admitted into the home. People feel they will be able to live the life they choose in the home. This is because the assessment is person centred and shows an understanding of and respect for equality and diversity issues relating to their needs. EVIDENCE: Review of service users documents and identified policies demonstrated the home has a policy and procedure on admission and discharge of service users. Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 10 Within the admission policy all service users must have an assessment prior to being admitted into the home. The Manager, and in her absence, the deputy manager who are both trained in the principles of assessment of service users’ needs based on what the care the home says it will provide carries out all pre admission assessments of service users prior to them being admitted into the home. Where the assessment has been undertaken through care management arrangements, the service has a copy of the assessment and the care plan. If at all possible prospective service users are encouraged to spend time in the home or the relative is encouraged to visit the home on more than one occasion prior to the service user being admitted into the home. Review of a random sample of service user’s files including one recently admitted service user, demonstrated that pre admission assessments are being carried out and relatives were being involved in the assessment process. Discussion with the newly admitted service user confirmed that both service user and relative were involved in the pre assessment. Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10. People who use the service experience good quality outcomes in this area. This judgement has been using a range of evidence including a visit to this service. People receive personal healthcare support, using a person centred approach with support provided based upon the rights of diversity, equality, fairness autonomy and respect. Personal healthcare needs including specialist health, nursing and dietary requirements are clearly recorded in each person centred plan of care. This gives a comprehensive overview of their health needs and acts as an indicator of change in health requirements. The home’s medication policy on receiving, storing and administering of medication was in place and being adhered to thereby ensuring the safety and protection of the service users. Care workers treated service users with respect and maintain their dignity and privacy when delivering personal care. EVIDENCE: Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 12 The randomly selected care plans, which included equality and diversity and human rights issues were clear and easy to read, identifying potential and actual risks to service users and detailing how these risks would be managed. The daily work sheet along with discussion with service users and care workers demonstrated that service users care needs are met. It was noted that care plans are not being signed by either the service user or relative to indicate their involvement in deciding what care they received. A requirement was made on this standard to ensure service user/relative involvement in the planned care for the service user. It was evidenced that care staff undertaking the development and monthly review of the care plans also signed and dated them. In discussions with service users on the day of the visit they confirmed they were involved in the planning of their daily care. The AQAA states, “Care plans are reviewed at least monthly or sooner if changes take place”. Information contained in the home’s Annual Quality Assurance Assessment (AQAA) states “Residents have full and regular access to optical, dental and podiatry visits which can be arranged by the nurse. Audiology referrals are carried out by the residents’ General Practitioner (GP)”. Documented records of visits are kept of specialist health professionals who support the home in meeting the needs of our service users. All service users are registered with a local GP of their choice and visits are recorded in the service user’s folder. Service users are offered access to chiropody service and weekly hairdressing facilities are available at a cost to the service users. In discussion with the registered nurse and care worker they were extremely proud of the high standard of care they provided to all service users in the home. We were told on the day of the visit that no service user at present was risked assess as capable to self medicate. However, the home had a policy on selfmedication should it becomes necessary. We were told Registered nurses, who have all received training in the receipt, recording, storage handling and administration and disposal of medicines, administer medication. We observed medicines being administered from a lockable drugs trolley, which is stored in a locked medication room when not in use. The home keeps Controlled Drugs (CD) register. Control Drugs were checked against the balance as recorded in the CD register and this was found to be correct. We were told the home also keeps a daily record of the temperature of the medication fridge and medication room. We evidenced this as correct during a tour of the home, when medication was checked. Care staff identified as capable to administer medication are requested to leave a sample of their signature, which is dated in the medication trolley. All service users have a recent photograph included in their personal folder and medication record, to reduce the risk of mistakes happening during medication administration. We observed that care workers wore name badges to enable visitors and service users with memory impairment to be sure of whom they are speaking with; and we also observed Service users being treated in a friendly but respectful manner by care workers. Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 13 In discussion with service users who were able to understand the questions, they told us that they are treated with respect and dignity, and that they are able to make their own choice. One service user told us “I am very happy here. Everything is so nice. I have my own room; I can have as much privacy as I want”. Another service user said “We have good staff here; they do not ill treat me. I choose my own clothing every day. Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Service users lifestyles matched their needs and preferences and where possible they are able to maintain contact with family, friends and the local community. Service users are able to make choices in accordance with their abilities and were provided with a balanced diet in pleasant surroundings and in an unhurried way. EVIDENCE: The manager told us that the home has had no suitable candidate applied for the vacant post of activities co-ordinator and so a management decision has been made to train two members of staff for the role. They have sought advice from NAPA and have since trained one member of staff with NAPA. Documentation was provided to support the advised training dates for the other member of staff. Currently the hone has planned activities on a personal basis with service users and in discussion with some service users, we were told activities takes place in the afternoon and that is when the service users want to have their rest so many of them do not undertake this activity. However, other service users told us they enjoy the freedom to do what they want in the afternoon, as they do not want to sleep. Many of them had puzzle books, Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 15 which, they told me if I were not speaking with them they would be doing their puzzles. We observed care staff spending time with service users in the lounge speaking with them and offering help in a non intrusive way. We were told that wherever possible relatives are encouraged to participate in the planning and carrying out of service users’ activities and this was supported when reviewing the activities planned for the month of May. Service users and Relatives acting on behalf of service users were asked to complete a choice list of places they would like to visit in May and for any relative who would like to accompany their relative to indicate the dates that are convenient to them. The relatives’ response rate was very good. The AQAA states “ We now have an activities budget and transport is provided, but service users are asked to pay admission charges to places of interest”. We were told by the manager “by creating and maintaining a stimulating lifestyle for our service users we hope to minimised the risk of a decline in their mental and physical health, through boredom, depression and lack of exercise, hobbies and games.” We observed the activities programme displayed in the reception area of the home. The home is situated next door to a Church of England Church, which those service users who are able to walk can attend. We were told the path to the Church is not suitable for wheelchair users and so the Vicar comes to the home once per month to give Holy Communion. The Roman Catholic Priest visits on a weekly basis also. In discussion with service users some told us their spiritual needs are well met whilst others told us they do not mind that they are not able to attend Church services as they were not regular Church goers. In discussion with service users they were spoke very positively about the visiting arrangements at the home and were appreciative of the fact that their visitors can visit anytime that is suitable to them. One service told us “My daughter works full time and so it is nice that she can visit at her convenience”. Service users told us that they are independent as they can be and that they are able to make choices in their life. None of the service users spoken to knew if they were registered for voting in the local elections due on 1st May 2008, and they could not remember if they had completed any voting forms. Carers spoken to were not sure if service users would be able to vote and in discussion with the manager (new in post) she promised to look into this. The AQAA states, “The daily menu with choices are displayed in the lounges”. We observed that mealtimes played a very important part in the service users’ life. They have created a very attractive and welcoming dinning room; with tables being dressed with freshly laundered and colour coordinated table linen and napkins for the more able service users and tabards for the others. On the day of the visit we observed daily menus which includes four alternative choices to the main courses are displayed for the use of our service users.” We observed jugs of fruit juices and squash with glasses were placed in the lounges whilst service users were present, and staff was seen offering drinks to service users. We observed staff helping service users with their meal in a non intrusive way, moving away from the service user after they had offered help, but still within easy contact should the service user require more help. The inspector did not sample the lunch, but service users said the food was very good, tasty and the right amount. The inspector observed the presentation of the food was Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 16 done in a way to stimulate appetite. Some service users had supplements as ordered by their GP or dietician, to maintain body weight or increase appetite. Fruit juices were served with lunch, which was served in the dinning room unless a service user requested to have their meals in their bedrooms. We observed care workers interacting in a friendly but dignified manner with service users during the lunch time, sitting down beside service users and speaking to them whilst helping them with their lunches. Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The home has a satisfactory complaints policy and procedure and training in place that evidenced that service users and relatives concerns are listened to and acted upon. The home is clear when an incident needs to be referred to the local authority as part of the local safeguarding procedures. It is open and transparent when discussing incidents with external bodies. Robust Safeguarding adults’ policies are in place to protect the service users from abuse. EVIDENCE: CSCI received two complaints about the home which were referred to Surrey County council Safeguarding Adults team, who dealt with this satisfactorily as the records demonstrated on the day of the visit. The AQAA stated the home received seven complaints in the last year all of which were dealt with within the home’s time frame for dealing with complaints. Four were upheld, two unsubstantiated and one is ongoing. This was verified on the day of the visit by reviewing their complaints records. The manager told us that she is in touch with service users on a daily basis and issues raised are dealt with immediately; this reduces the incidents of formal Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 18 complaints. Service users spoken to said they know how to complain and will do so if they are not happy. Their complaint is always dealt with immediately and they were satisfied with the outcomes. It was observed that service users information pack situated in their bedrooms contained a complaints procedure and policy; whistle blowing policy and the homes’ statement of purpose and service users guide. It was noted that the home received a number of compliments from relatives of service users commending the staff on their kindness and understanding and for the high quality of work they perform. A copy of the most recent CSCI report was made available for visitors to the home in the reception area. In discussion with care workers, it was apparent they are aware of the homes’ policy and procedure on Safeguarding Adults and felt secure in the knowledge that if they had to use the whistle blowing procedure the manager and the Owners of the home would support them. During discussion with care workers it became apparent they did not have a full knowledge on Equality and Diversity issues relating to the service users they were responsible for, and in discussion with the manager documented proof was seen that there is training planned to take place during the second week in May 2008 on Equality and Diversity and Mental Capacity Act 2005. A random sample of care workers training record demonstrated that care workers are being trained to undertake the duties of meeting the service users assessed needs, thereby protecting them from abuse. The manager has had training in Safeguarding Adults in another County and has made enquiries to undertake the Surrey Multiagency course as soon as a place is available. Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 26. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables service users to live in a safe, well- maintained and comfortable environment, which encourages independence, and protect their privacy and dignity. EVIDENCE: The manager told us that the management and staff encourage service users to see the home as their own home. It presents as a comfortable, attractive home, which has all the specialist adaptations needed to meet the service users needs and were serviced and records kept verifying this. The home has attractive gardens, which are well maintained and there is good access to the gardens from various parts of the home. The home employs a gardener to maintain the grounds and garden in good condition for the use of the service users. Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 20 It was noted that service users were able to personalise their bedrooms with small items of furniture, paintings on the wall and many family photographs. Generally, the home presents as clean, safe, pleasant, hygienic and tidy and free from offensive odours. Random review of care workers training record demonstrated they have had training in infection control and this was evident in the storage of waste. Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of the service users. EVIDENCE: Review of the staff rota demonstrated the number and grade of staff on duty to provide care and attention to service users for any twenty-four period was suitable to meet the assessed care needs of the service users. The manager told us the home had gone through a period of loss of staffing but is now in the good position of having the correct numbers of staff to meet the needs of the service users. We reviewed the home’s programme of planned training, and staff files reviewed evidenced members of staff have an individual training record. A number of care workers have attained the National Vocation Qualification at Level 2 (NVQ L2). We were told Care workers are encouraged and enabled to undertake developmental training as well as the mandatory training. All newly appointed staff undertakes the Skills for Care Common Induction programme. The home ensures that staff undertakes the mandatory training with yearly updates as necessary to maintain their competency to fulfil their duties. This was evidenced through discussion with the manager and care workers and from review of care workers training records. It was noted that one staff member had two references in their personal file written in French. A requirement was made to have the references translated into English and Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 22 to ensure all future references are obtained in British English. We were told all care workers are Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checked prior to commencing employment, and they are in receipt of terms and conditions of employment, as evidenced in their randomly selected files, which contained the information required under care Homes Regulations 2001 Schedule 2. The manager told us that supervision records were up to date and this was verified during random sampling of care workers files. In discussion with care workers some were able to give examples of how the home applied equality and diversity to the different needs and wishes of the service users in their care, and also within the diverse staff group. Staff files contained their up to date training records and it was noted that Equality and Diversity training was not done. In discussion with the manager she provided evidence that this aspect of training was booked to commence in May 2008, along with Mental Capacity Act training as well. Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 38 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. The manager has the experience to run the home and works to continuously improve services and provide an increased quality of life for the service users. There is a strong ethos of being transparent and open in all areas of running the home. The views of service users and their relatives are actively sought in the running of the home and The service provides training on health and safety issues for all staff and service users are involved in the running of the home. Service users financial interests are safeguarded. EVIDENCE: Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 24 The new manager is a registered nurse with long managerial and nursing experience in caring for elderly people. The manager has demonstrated that she has kept herself updated on issues relating to care of the service users and staff in her charge. In discussion, it was evident she was knowledgeable about the training needs of the care workers to meet the identified needs of the service users. There are clear lines of accountability within the home, each member of staff spoken to on the day of inspection aware of their role and responsibilities. Regular residents meetings are arranged and minutes of the meetings are passed to the owners who will action requests as soon as possible. The home does not become involved in service users finance except for service users spending money, which the home oversees. Receipts are kept and logged for all transaction carried out on behalf of service users. Review of documented records demonstrated that health and safety checks are routinely carried out at the home. All equipment examined on the day was properly maintained. Records indicated that fire drills, fire alarm, water temperature fridge and freezer recordings were regularly checked. Bathrooms and toilets randomly checked were in good clean state and free of mal odours. Random sample of care workers’ training files demonstrated that up to date and relevant training were carried out by care workers to protect service users’ health, welfare and safety. In discussion with care workers they discussed their understanding and implementation of appropriate procedures to safeguard service users. Further more they spoke about their understanding of promoting safe working practices based on their health and safety training. In discussion with the manager she was able to produce evidence of records for domestic, catering, standing hoists, bath hoists, wheelchairs, fire, electricity, boiler and central hearing checks and repairs since the last inspection. We reviewed their record of Regulation 26 visits to the home as well as their record of Regulation 37 within the last six months. Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 (1) Requirement Ensure that service users/relatives sign the care plans to demonstrate their involvement in the drawing up of the care plans. Ensure that references are written in British English to ensure protection of service users are maintained. Timescale for action 01/07/08 2 OP29 19 (4) (c) 01/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ashton Manor Nursing and Care Home DS0000067977.V363513.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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