Care Home: Ashview Nursing Home

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What the care home does well All the residents appeared well cared for. Those in the lounge seemed relaxed and content. A resident said, "I am very happy here. I have no complaints." Their visiting partner added, "Since my relative came here their condition and speech have improved and they are totally at ease. I am really grateful to the manager and all the workers. The care is excellent." Another visitor commented, "The staff are all very friendly. We can visit anytime. The care is good." Other comments received from residents interviewed include: "They are very good. I am very happy with the nurses and carers. The manager is very good. The gardener is going to clear the space outside my window so that I can have some lovely plants. I look forward to that." "I go to the pub and village hall for lunch with the others. It is good. I enjoy it." "The food is excellent." "I get on well with all the staff. No complaints."Residents have influence in the home and their input is actively sought through the residents` meeting. This ensures that no individual will be overlooked. The residents have close links with the local community and volunteers from the local community offer support in arranging and helping with coffee mornings. Some residents attend church services and village hall functions. Pub lunches, arranged by a member of staff, are a favourite among some residents. Relatives are welcome to join in the outings. The `Ashview News` is a regular feature in the local parish paper and includes residents` experiences of living at the home. What has improved since the last inspection? The home manager is waiting to be registered with the Commission. The home has implemented a `named nurse and key worker` system, to personalise the care planning process and ensure continuity in the care provided. The activity programmes include more variety and more frequent and varied outings. Residents now have access to a computer website for communication via e-mails to their friends, family members including their grandchildren. What the care home could do better: The management agreed that there is work to be done to improve the interior of the building. Some bedrooms have been redecorated and the rest will be carried out as the rooms become vacant. The provider has agreed to replace the old carpet in the hallway and other communal areas and work is due to be carried out over the next few weeks. CARE HOMES FOR OLDER PEOPLE Ashview Nursing Home Ware Road Widford Nr Ware Hertfordshire SG12 8RQ Lead Inspector Yoke-Lan Jackson Unannounced Inspection 21st April 2008 10:30 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 Ashview Nursing Home DS0000019272.V362798.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. Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashview Nursing Home Address Ware Road Widford Nr Ware Hertfordshire SG12 8RQ 01279 842 458 01279 841 108 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) Mr P Patel Mrs Anjani P. Patel Manager post vacant Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home may accommodate 32 older people, who are frail, in need of nursing care. This home may accommodate 32 older people for respite nursing care. Date of last inspection 27th April 2007 Brief Description of the Service: The current proprietors were first registered in respect of Ashview Nursing Home in 1997 under the Registered Homes Act 1984, subsequently under the Care Standards Act 2000 in 2002. The home is registered to care for up to 32 physically frail service users in need of nursing care over the age of 65 years. Qualified nurses and carers provide twenty-four hour staff cover. The home is a large, old country house situated in a rural area on the outskirts of the village of Widford, between Much Hadham and Ware in East Hertfordshire. The building has been extensively refurbished to provide accommodation on two floors served by a lift. Assisted bathing facilities are provided. Because the home was not purpose-built there are varying floor levels, which have been rendered safe for wheelchair users by means of ramps in corridors. There is a large garden to the rear and limited car parking for staff and visitors to the front of the building. The home charges £538 - £750 per week. Information about the home and the service it offers is contained in the Statement of Purpose and Service Users Guide. A copy of these and the most recent CSCI inspection report are available in the home. Ashview Nursing Home DS0000019272.V362798.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 two star. This means the people who use the service experience good quality outcomes. The unannounced inspection was carried out on 21/04/08. The home manager was present. The home has 25 people in residence. The inspection included a tour of the premises. Time was spent observing how the staff interacted with the residents during lunchtime. Staff, residents and some visitors were interviewed and documents were examined. Information received by us since the last inspection was reviewed.This included the Annual Quality Assurance Assessment (AQAA) which providers of registered services are required to complete. The AQAA focuses on how the outcomes are being met for people using the service. What the service does well: All the residents appeared well cared for. Those in the lounge seemed relaxed and content. A resident said, “I am very happy here. I have no complaints.” Their visiting partner added, “Since my relative came here their condition and speech have improved and they are totally at ease. I am really grateful to the manager and all the workers. The care is excellent.” Another visitor commented, “The staff are all very friendly. We can visit anytime. The care is good.” Other comments received from residents interviewed include: “They are very good. I am very happy with the nurses and carers. The manager is very good. The gardener is going to clear the space outside my window so that I can have some lovely plants. I look forward to that.” “I go to the pub and village hall for lunch with the others. It is good. I enjoy it.” “The food is excellent.” “I get on well with all the staff. No complaints.” Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 6 Residents have influence in the home and their input is actively sought through the residents’ meeting. This ensures that no individual will be overlooked. The residents have close links with the local community and volunteers from the local community offer support in arranging and helping with coffee mornings. Some residents attend church services and village hall functions. Pub lunches, arranged by a member of staff, are a favourite among some residents. Relatives are welcome to join in the outings. The ‘Ashview News’ is a regular feature in the local parish paper and includes residents’ experiences of living at the home. What has improved since the last inspection? 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. Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 7 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 Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 8 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): Standard 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective clients can be assured that a thorough assessment will be carried out before admission into the home to ensure that all their care needs can be met. EVIDENCE: The home manager carries out a pre-admission assessment and only those clients whose care needs can be met are admitted. The care plans examined included the pre-admission documents for each resident. Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 9 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): Standards 7, 8, 9and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that they will be treated with respect and their health, personal and social care needs will be positively met. EVIDENCE: Each resident has a person-centred care plan. The care plans examined were informative and were kept up to date. Risk assessment documents were seen in the care plan folder. A trained nurse carried out the review of care needs and any changes of care needs were documented. On the day of the site visit, all the residents appeared well cared for. The residents on bed rest appeared very comfortable and relaxed. They were being nursed on nursing beds with pressure relieving mattresses. One resident requires percutaneous endoscopic gastronomy (PEG) feeds, which are administered by a trained nurse. The care workers assist and have a raised awareness of safe practice and alert the nurses of any complications. A dietician is available to ensure that this resident has a balanced diet. Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 10 Residents have access to their own doctor and other healthcare professionals if required. The provider employs its own physiotherapist who visits the home when required. On the day of the inspection, a speech therapist visited one of the residents following a referral by the home manager. Nutritional screening is carried out on every resident and all the residents are weighed monthly. Any resident with a weight loss is referred to their own doctor and the dietician. Their food intake is monitored. The incidence of falls is minimal and there is currently no one with pressure sores. The home uses the Monitored Dosage System for individual residents. A nurse administers the medicines, which are stored in a medication trolley that is kept secure in the storage room when not in use. The local Pharmacist provides regular training on the administration and storage of medication. The Medication Administration Record charts and the Controlled Drug Register examined were correctly filled in. There have been no medication errors. Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 11 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): Standards 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are encouraged to maintain close links with their friends and relatives and have a degree of contact with the local community. They are helped to exercise choice and they receive a wholesome and balanced diet, which they enjoy. EVIDENCE: On the day of the site visit, there were a number of visitors in the home. They gave very positive feedback about the care and service provided. The manager said that visitors can visit at any time and that the home has received a number of complimentary letters from relatives. A relative was so please with the progress made since the resident was transferred from the hospital to the home that he expressed them in poems, which were on display in the home. The management is currently recruiting a full time activity co-ordinator in addition to the two part-timers. Activities include painting, knitting, one-to one reading and reminiscence time and games such as bingo, quizzes and skittles. Residents have access to a computer with a website with an Email resident button on the Ashview Nursing home page and a member of staff will read the e-mails to individuals. A monthly church service is held at the home, which all Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 12 residents enjoy. Birthdays and important cultural events are recognised and celebrated. The chef ensures every resident has a home-baked birthday cake. The home has strong links with the local community who offer support in arranging and helping with coffee mornings. Some residents attend church services and village hall functions. Pub lunches are arranged on a regular basis. Relatives are welcome to join in the outings. The manager said that the home offers three meals a day. There are snacks and drinks throughout the day. Residents are offered a full breakfast each morning. The home has regular deliveries of fresh meat, vegetables and fruits. Each day the chef consults individual resident and offers them a choice of hot and cold dishes. The residents spoken to about their lunchtime menu gave positive comments about the food served. Members of staff were readily available to assist those residents who needed some assistance with their meals. Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 13 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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that they will be listened to and that their views will be taken seriously and they will be protected from harm. EVIDENCE: Residents’ meetings are held regularly and any concerns raised are dealt with immediately. Since the last inspection, the home has not had a written complaint. Those residents and relatives that were asked said that they knew how to make a complaint. A relative said, “I will speak to the home manager if I have concerns.” Staff appeared to be knowledgeable about the correct processes to follow if they received a complaint or a safeguarding issue. They have training on issues regarding abuse and the Whistle-Blowing Policy. Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 14 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): Standards 19, 22, 23, and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service live in a safe and comfortable environment with access to all communal facilities. EVIDENCE: The manager conducted a tour of the premises, which appeared clean and tidy. There is a rolling maintenance programme. Some bedrooms have been redecorated and the manager said that as each room is vacated, it would be re-decorated. On the day of the inspection, a workman was busy adjusting the carpet in the hallway to remove any tripping hazards. There is a rolling maintenance programme and the old carpets in the hallway and other communal areas will shortly be replaced with new ones. Currently work is being carried out to change the ground floor bathroom into a shower room. All the bedrooms examined have personal items on display and they all have television and power points. There is a mobile phone system to ensure that all Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 15 incoming calls for residents are taken in private. Residents interviewed said that they were satisfied with their accommodation. The large garden at the back of the building is well maintained, with seating for residents and their relatives. The manager confirmed that there is sufficient equipment for residents, including profiling beds, hoists and wheelchairs. The home is in close contact with the Hatfield Wheelchair Service. The basement has been renovated into two flats to provide accommodation for two care workers. Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 16 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): Standards 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that the home has an effective staff team who will support them. They can be confident that they will be safeguarded by the home’s recruitment policy and procedures. EVIDENCE: The home manager ensures that the skill mix of nurses and care workers is adequate and that the staffing level is maintained. There is an established workforce. Staff confirmed that they work well together and that there were clear lines of accountability. Appropriate professional support and supervision is available to all staff. The manager continues to be the second nurse on duty for the current group of residents whose care needs are being met. Some bank nurses cover annual leave and emergencies. Regular staff meetings are held and good practice issues are raised and discussed. The manager said that in-house training by professional trainers is organised for all staff. There are robust recruitment processes in place. The staff files examined were complete. Members of staff interviewed confirmed that they were given Criminal Record Bureau checks and clearance before working in the home. Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 17 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): Standards 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that the home is run in their best interests and that their health, safety and welfare are promoted and protected. EVIDENCE: The current manager is a trained nurse and she has submitted her application and is waiting to be registered with the Commission. The management continues to ensure that the standards of administration and management of the service are well maintained and all issues on equality and diversity are addressed in accordance with the home’s policy and procedures. Such issues include regular religious services, dietary needs, cultural celebrations and environmental adjustments to cater for wheelchair users. Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 18 The home is not involved with the residents’ finances, but management oversee the personal allowances for a resident and proper accounting records are kept. All servicing records are well maintained. There is a quality assurance system, which incorporates the views of residents, relatives and others. Feedback from the recent survey conducted by the home has been very positive. Other records required by legislation are kept secure and handled in accordance with the Data Protection Act 1998. In a recent inspection by the Environmental Health officer, the home was awarded four stars. The home has complied with a recommendation issued by the Hertfordshire Fire and Rescue Service following a recent inspection by the Fire Officer. The Annual Quality and Assurance Assessment (AQAA) forms issued by the Commission were returned on time for this inspection. The AQAA has detailed information and is summarised in this report. Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 19 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 3 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 2 X x 3 3 X x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? Yes 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. Standard Regulation Requirement Timescale for action 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 Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Ashview Nursing Home DS0000019272.V362798.R01.S.doc Version 5.2 Page 22 - 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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