Enter & View Report: Ashley House
This is a report of a visit carried out by the Somerset LINk Enter and View team. It presents as part of an ongoing project to identify and share good practice examples relating to the 'Dignity in Care Standards'.
The Visit was conducted by Somerset LINk authorised representatives Eilleen Tipper and Mary Clarke and supported by Jonathon Yelland from the Somerset LINk host organisation on the 1st September 2011.
Ashley House was observed to provide residents with good quality of service relating to the 'Dignity in Care Standards'. In particular the home had many good practice examples relating to social inclusion and the home was found to be innovative at finding transport solutions to enable residents to participate in the wider community.
Many good practice examples were noted at this home. The E&V Team also made several recommendations which it hopes will help the home to make further improvements. All of these are listed in the summary section of the report and the accompanying Recommendations Action Sheet.
A written response from Ashley House Residential Home is required within 20 days of receiving this report and recommendations. We look forward to hearing the home's views of the report and what action they intend to take on the recommendations made.
Good Practice and Recommendations
Hospital Discharge: Good Practice
- The home had developed their own hospital transfer form.
Hospital Discharge: Recommendations
- It is recommended that the home insist that a discharge letter is provided by the hospital before accepting residents home and that the hospitals are made aware of this in advance.
- It is recommended that the manager write to the physiotherapy department concerned to highlight these concerns. We would also suggest that the CQC are informed of concerns.
- It is recommended that the manager meet with the hospital discharge planning team to discuss the difficulties and how a transfer form can be implemented.
Staff – Good Practice:
- All care staff either have a National Vocational Qualification (NVQ) in care, or were working towards the new Quality Credit Framework (QCF)
- Use of social care students on college work placements provides a fresh pair of eyes and up to date knowledge in exchange for experience.
- Training was thought by staff to be, all-encompassing and helping staff maintain good skills and motivation.
- Staff training starts as soon as a new staff member is employed.
- Staff induction includes Health and Safety and key policies and guidance.
- New staff shadow more experienced staff during induction.
- Regular staff supervision was given.
Staff – Recommendations:
Activities Good practice:
- Exercise (by a trained instructor twice a week)
- Music (visiting) at least once a month
- Visits from local falconry/ bird sanctuary
- Staff sometimes bring in their pets.
- Monthly in house church service.
- Musical Entertainers visit twice a month – resident noted that some were better than others.
- Comedian visits
- Visitors and staff bring in pets to visit
- Annual Carol service
- Hand bell ringing
- Arts and crafts.
- Visitor confirmed staff don’t over encourage people to take part in activities or make them feel guilty if they choose to opt out.
It is recommended that the home consider some of the activities from the list below which has been mentioned by residents during the visit or gathered during previous E+V visits:
- Visits by the ‘Old Fashion Sweet Shop’ (based in Taunton)
- Visits by Clothes Direct.
- Visits by the Donkey Sanctuary.
- Model making.
- Visits by the local vintage motorcycle club or classic car club (often these clubs organise charity ride outs and welcome the opportunity to stop of for a tea break).
- Wii exercise.
- DIY group.
- Control and Choice: Good Practice
- GP visits weekly
- Broadband Wi-Fi is available in most of the home.
- Residents may bring their own furniture to the home, space permitting.
- Residents were offered a choice of where to eat.
- The home compiles documentation about a resident’s life history and uses this to support residents to make choices.
- Residents said that staff were very approachable.
Control and Choice: Recommendations
- It is recommended that the home seek expert advice form a lock smith or security specialist.
- It is recommended that the call system is explained to be part of the service offered and the willingness of staff to assist reaffirmed in residents meetings and individually where appropriate.
- It is recommended that Somerset LINK leaflet be placed in ‘Residents’ Packs.
Communication: Good Practice
- Resident meetings are held quarterly and visitors/relatives are encouraged to attend.
- Staff were observed to be respectful, always asking before assistance was offered.
- Residents receive an information pack which includes details of how to complain and contact details for the Care Quality Commission (CQC).
- The home had used the services of a translator in the past for a French resident.
- Written and verbal handovers given.
- Residents’ Information packs were observed to be in a large print and therefore more accessible.
- Staff residents’ and visitors spoken to, all confirmed that they felt they had time to talk to staff and that they were approachable.
- A visitor confirmed staff are receptive to comments from visitors.
- It is recommended that the home investigate the government grant called ‘Get connected.’ More details can be found at http://www.scie.org.uk/workforce/getconnected/faq.asp
- It is recommended that the home seek advice from the RNID regarding use of audio aids and loop systems.
Eating and Nutritional Care: Good Practice
- Nutritional screening was carried out as needed.
- Portion sizes were variable as requested.
- Residents were given plenty of time to eat.
- Privacy was offered and it was observed that some residents chose to eat in their rooms.
- Visitor are welcome to take meals with their relative.
- Staff training covers malnutrition.
- Meal preferences discussed at residents meetings.
- The home observes ‘Best Practice in Food Procurement’ guidance.
- Residents can choose a meal of their choice to be cooked on occasions.
- Residents were enabled to do as much for themselves as they were able during lunch.
- Residents are weighed monthly unless refused.
Hydration: Good practice
- Residents could have a kettle in their room if they wished and it was assessed as safe to do so.
- Training in hydration is covered by the CQF qualification.
- A choice of juice or water was offered at meal times.
- Breakfast can be served early due to need to ensure an opportunity to hydrate after sleep.
Pain Management in Practice: Good practice
- District nurses visit as required.
- Dental checks are received at the home and dentist visits regularly.
- Hearing and sight tests are provided regularly at the home.
- Optician visits regularly
- Staff are trained to be flexible and responsive to pain management both in terms of resident requests and in monitoring through observation.
Personal Hygiene: Good practice
- Residents are supported to bath at least once a week. Baths are also given as requested or required.
- The home is currently installing a wet room.
Personal Hygiene: Recommendations
- It is recommended that an alcohol hand gel dispenser be placed next to the visitor’s book.
- Practical Assistance: Good Practice
- Staff were quick to supply a resident who mentioned they had been cold in the night with an extra duvet.
- Age UK Advocacy details were displayed on notice board.
Privacy in Practice: Good Practice
- Staff always knock before entering a resident’s room.
- Own phone can be arranged in rooms.
Privacy in Practice: Recommendations
- It is recommended that risks assessments relating to bathing are reviewed observing residents choice whenever possible and that residents are asked if they would prefer to bath without staff present on each occasion, so far as risk management permits.
Social inclusion in Practice: Good Practice
- Visitors welcomed at the home and able to eat meals with their relative or friend.
- Staff were encouraged to involve family with care planning and support.
- The Home has developed a good relationship with the local Rotary Club who provide transport and support for residents to access a local school play.
- Annual carol singers visit.
- Regular trips organised out (e.g. Western Supermare and Bristol Zoo.) One resident commented that the drive itself is the best part of a trip.
- Local group called ‘The Langport Friends Society’ visit the home on their annual charity walk and chat to residents.
- Community group uses the home to meet to watch films. Residents are welcome to join in.
- The home made use of community transport and the local ‘Slinky’ buss was used for outings.
- The home support residents to attend the local WI (Women’s Institute meetings.)
- Resident walks daily to shops age 97.
Social Inclusion in Practice: Recommendations
- It is recommended the home research what mobile panic buttons are available which would enable a resident to maintain their independence away from the home while being able to call for assistance if needed. Mobile panic buttons are an optional addition to some call bell systems.
For more information
For more information read the full report or contact Jonathan Yelland on firstname.lastname@example.org.