Ashfield Nursing & Residential Home

Ashfield Nursing & Residential Home Statement of Purpose

A I M S A N D O B J E C T I V E S

Ashfield Nursing & Residential Home is a 32 bed care home providing nursing & residential care to the elderly (persons over 65 years of age). Our Home aims to deliver a high standard of professional care at all times to our service users. The care provision at Ashfield endorses a holistic approach which is sensitive to the needs of every service user and encompasses the following essential aspects of the person:

Privacy

Preserve every service user’s right to privacy at all times by:

 Respecting and keeping confidential all information relating to a service user and their relatives

 Respecting a service user’s preference to be alone and undisturbed

 Discussing personal matters with staff and relatives in private and without violating confidentiality

 Provision of the facility for a service user to make and receive phone calls in private

 Handing over all correspondences to the service user in their original sealed state

Dignity

 Treat every service user with respect and allow each person to live in a dignified manner

 Maintain every service user’s autonomy by empowering each person to consider choices and make their own decisions as far as possible

 Know each service user, develop a good rapport and treat each service user with respect

Independence

 Enable each service user to take calculated risks, to make their own decisions and think and act for themselves. Offer assistance as appropriate

Choice

 Ensure every service user has options over their activities of daily living in accordance with their capabilities

Rights

 Preserve all basic human rights of each service user including consent, confidentiality, safety, equality and autonomy

 Encourage freedom of expression, participation and decision making

 Encourage rights of access to entitlement of services and benefits

Fulfilment

 Enable service users to realise their own aims and create opportunities for them to achieve goals in all aspects of daily living P H I L O S O P H Y O F C A R E

Ashfield Nursing & Residential Home aims to provide its service users with a secure, relaxed and homely environment in which their care, well-being and comfort are of prime importance.

Nursing and Care Staff will strive to preserve and maintain dignity, individuality and privacy of all our service users in a warm and caring atmosphere and will be sensitive to the individual needs of service users. These needs may be medical/therapeutic, cultural, psychological, spiritual, social and emotional. Service users are encouraged to participate in the development of individualised Care Plans in which the involvement of family and friends may be appropriate and greatly valued.

This will be achieved through a programme of activities designed to encourage mental alertness, self-esteem, social interaction with other service users and with recognition of the following core values of care which are fundamental to the philosophy of our Home.

CORE VALUES OF CARE PRIVACY DIGNITY RIGHTS CHOICE INDEPENDENCE FULFILMENT

All staff within the home are appropriately qualified and trained to deliver the highest standards of care. A continuous staff training programme is implemented to ensure that these high standards are maintained in line with the latest developments in Care Practices as set out in appropriate legislation, Regulations, the National Minimum Standards under the Care Standards Act and the Care Quality Commission’s Essential Standards of Quality and Safety. R e g i s t e r e d P r o v i d e r / R e g i s t e r e d M a n a g e r : M r s K a r e n D e a n R N

Company Name: Ashfield Nursing Home Ltd was formed in after being a family owned and managed care home since 1986.

Responsible Individual and Registered Manager: Mrs Karen Dean RN

Experience – 25 years working in care. Qualified Nurse with 17 years experience in managing Care Homes for the elderly.

Professional Development:

 C & G D32 and D33 Work Based Assessor  C & G 325-3 Advanced Management in Care  IIHHT Body Massage Certificate  IIHHT Diploma in Aromatherapy  Diploma in Business Coaching  Advanced Counselling  Bereavement counselling  Registered Managers Award

Home Owners: Mr P Lowcock & Mrs J Lowcock

Mrs Lowcock  Registered Nurse  Sister ‘Care of Elderly’ at St James’ Hospital and Newton Green Hospital, Leeds  Registered provider / manager in residential and nursing care for 28 years  Appointed to the Registered Homes / Care Standards Tribunals  Cert. Ed. Health Care Management. Leicester University  C and G D32, D33 and D34

Mr Peter Lowcock  Registered provider for 28 years, registered manager Residential Care for 8 years

C A R E S P E C I A L I T Y O F T H E H O M E

The Care Home is registered to cater for 32 service users requiring residential or nursing care. O R G A N I S A T I O N A L S T R U C T U R E

D E T A I L S O F S T A F F N U M B E R S A N D S T A F F T R A I N I N G

The home employs 49 members of staff. There are 6 members of staff on the morning shift, one nurse and 5 skilled mix staff. The afternoon consists of 5 staff, one nurse and 4 carers and the night shift consists of 3 staff, one nurse and 2 carers. The staff are selected for their qualities of reliability, integrity, friendliness, professionalism, interpersonal and caring skills. They are carefully screened and references are checked thoroughly. All staff are given a comprehensive induction when they start and are supervised by experienced staff in the following standards:

 Understanding the principles of care

 Understanding the organisation and the role of the carer

 Maintaining Health & Safety

 Understanding the individual experiences and needs of the service user

 Understanding the effects of the care home setting on service provision

Ashfield Nursing Home encourages all care staff to hold a minimum of NVQ level 2 in Health Care and all new staff are supported to achieve this important qualification.

The home also supports staff on internal training for topics such as Food Hygiene, Manual Handling, Fire Safety, Medication Administration, Basic First Aid, Infection Control, etc. External training provision is also resourced for topics such as Safeguarding Adults, Clinical updates for qualified staff, Dementia Care, etc. Mandatory training is compulsory for all staff.

A C C O M M O D A T I O N

Ashfield Nursing & Residential Home is registered for 32 beds, however 2 beds are only utilised for couples who wish to share a room therefore only 30 beds are generally in use allowing for 2 larger sized single rooms.

Ground Floor: 8 single rooms, 5 en-suite

First Floor: 12 single rooms, 4 en-suite

Residential Wing: 4 single rooms

Second Floor: 6 single rooms, 2 en-suite Communal Rooms There are 2 communal lounges, both with a television, a dining room and a conservatory. Service users are encouraged to use these areas to socialise however, service users are free to choose to stay in their own rooms if they wish.

A D M I S S I O N

Prospective service users are encouraged to visit Ashfield to sample to atmosphere and level of service before making a decision to come into care. A trial period of four to six weeks is always offered before taking permanent residency. The manager of the home or another suitable qualified person will carry out an assessment of need prior to any admission to the home, This ensures that the individual care needs of the prospective service user can be met by the home. In the event of an emergency admission, as much information as possible is obtained prior to admission in order for an objective assessment to be made. From this information the service user will then be assessed on admission and a care plan is devised immediately. All criteria of admission are considered such as age, category and dependency levels in line with the registration status of the home.

F I N A N C I A L A R R A N G E M E N T S A N D F E E S

We are committed to providing quality care at Ashfield Nursing & Residential Home. The fees we charge are dependent on:

1. The type of facility

2. The type of care package and needs of the individual service user Depending on the personal financial situation, a service user can either pay the fees privately or have part of full of the fees paid by the contacting Social Services. Specific advice is available from the Home Manager or from an independent representative such as Age Concern.

F E E S – W H A T I S I N C L U D E D

 Care staff in 24 hour attendance

 Good Home Cooking

 Provision of special diets

 Laundry Service

 GP and other Healthcare Professional visits as required

F E E S – W H A T I S N O T I N C L U D E D

 Dry Cleaning

 Hairdressing

 Chiropody

 Some external activities  Private telephone installation and calls

 Private care of the individuals choice

 Hospital escorts

 SKY television installation and ongoing fees

P R I V A C Y & D I G N I T Y

It is emphasised to every member of staff that he/she must preserve and maintain the dignity, autonomy, individuality and privacy of all service users within a warm and caring atmosphere and in doing so will be sensitive to the service users ever changing needs.

S M O K I N G A N D A L C O H O L

The Home does not have an internal designated smoking area however provision has been made outside the conservatory to the rear of the home for residents to smoke. With regard to alcohol, service users will normally make their own arrangements and as with smoking, they may require to be supervised.

F I R E S A F E T Y

The home has a Fire Alarm System fitted with “Fire Exit” notices and “Fire Emergency Instruction” notices displayed at strategic points throughout the home. New staff have induction training that includes: Fire Prevention, Fire Drills, Fire Safety policy, Evacuation Procedures, use of fire appliances, raising the alarm, use of evacuation blankets, etc. This training is updated bi-annually with mock fire drills at periodic intervals. Service users are informed of the emergency procedure during admission. All fire alarm systems are carried out weekly by a designated responsible person and records of these checks are maintained as part of the Proprietor/Managers responsibilities. All fire fighting equipment is checked annually by a qualified fire extinguisher maintenance engineer. Where possible, furniture, fixtures and fittings must be made of fire-resistant or fire retardant fabrics and materials. A fire risk assessment is carried out annually and this can be viewed on request.

RELIGION (WORSHIP/ATTENDANCE AT RELIGIOUS SERVICES)

Service users may attend religious services either within or outside the home as they desire. If the services are outside the home, the service user should, if necessary and where possible, make arrangements for transport and accompaniment with friends or relatives. In the event of this not being possible, care staff may accompany service users on specific occasions if staffing levels permit. Service users have the right to meet with clergy of their chosen denomination at any time. If required, a private room will be made available for such meetings.

CONTACT WITH FAMILY AND FRIENDS Service users family, friends and relatives are encouraged to visit on a regular basis and to maintain contact by letter or telephone when visiting is not possible. In these cases, staff will offer to assist the service user to respond where help may be required. Visitors will be welcomed at all reasonable times and are asked to inform the person in charge upon their arrival and departure from the home. For security and fire safety reasons, visitors must sign the visitors book on each occasion. The service user has the right to refuse to see any visitor, and this right will be respected and up-held by the person in charge who will, if necessary, inform the visitors of the service users wishes.

SERVICE USERS PLAN REVIEW

Once developed the service users care plan will be reviewed monthly and updated to reflect any changing needs and ensure that the objectives for health, personal and social care are auctioned. Any plan that is developed includes the involvement of the service user. Family and relatives will be encouraged to participate in the service users daily routine as far as is practicable, and are invited to 6 monthly formal reviews, or as required. Service users and their relatives are always welcome to chat with a member of staff if they have any concerns. The service user care plan is reviewed at three levels:

 Daily – on a shift to shift basis. At shift changeover the service user’s daily care notes are handed by the outgoing shift to the staff on the incoming shift. Any changes to care plans may be proposed at this point.

 At the end of the four week settling in period.

 A formal review every 4 weeks held with care staff. All amendments to the care plan must be authorised by the Named Nurse or Key Worker. Certain amendments may require the authorisation of the service users GP. All amendments to the service users care plan are recorded in full.

COMPLAINTS

The home operates a pro-active comments and complaints process in the hope of continually improving the service. If as a service user, relative or visitor, you feel there is cause for complaint, you should first discuss the matter with the person in charge, i.e. Manager. If the matter is in your opinion, a serious one, or you remain dissatisfied, you can follow our complaints procedure – a copy of which is available by the main entrance and in each service users room. We also provide a booklet giving details of how and to whom you should complain, copies of which are available in the main entrance or from a member of staff.

THERAPEUTIC ACTIVITIES The Homes policy on ‘therapeutic Activities’ takes into account the service users interests, skills, experiences, personalities and medical condition. The Home offers a wide range of activities designed to encourage the client to keep mobile, and most importantly take an interest in life. Staff will encourage and in certain instances help service users to pursue their hobbies and interests: Service Users can play the following games

 Cards

 Scrabble

 Bingo

 Draughts

 Chess

 Other favourite board games Activities with staff (On a daily basis)

 Chatting to individual service users

 Going for walks

 Manicures

 Playing games, quizzes

 Armchair exercises

 Hand massage

 Reading – letters/newspapers/magazines/books

 Helping to choose library books

 Music and sing-a-longs

 Life history books, memory boxes

 Puzzles – crosswords/jigsaws/word search

 Arts and crafts

 Flower arranging Plus many more Outings All outings are geared towards the service users needs and capabilities and due to this a limited number of service users can go on any one outing. All outings are based on one to one care to ensure that each service user can have a memorable experience. Examples of outings:

 Visits to local pub

 Trips to places of interest – Harlow Carr, Newby Hall, Lotherton Hall, etc  Theatre or cinema

 Christmas shopping

MONITORING AND QUALITY

Within the home there are various systems which ensure that close monitoring is maintained on all of the homes services and procedures. Attention to detail is pivotal to everything we do. An important part of our quality programme is to involve the service users and their relatives. We regularly ask for comments on the home, staff and services we provide. We also circulate monthly surveys on a variety of different areas of the home/services which assists us in assuring that we are continuing to provide a quality service.

PRACTICES OF THE HOME

 To hold a current registration certificate and adhere to its code of practice

 To ensure that bedrooms are treated as each individuals home. Knocking on doors before entering will be respected at all times.

 To ensure service users are addressed by staff in the way the service user chooses.

 The service users independence is promoted and avoiding set rules where possible: i.e. bed times, etc.

 That service users are actively encouraged to participate in their care and the planning of their care.

 That service users are encouraged to be as independent as possible and to make their own decisions about themselves and their home.

 That service users may smoke in appropriate designated areas.

 That service users may choose where they take meals, either in private or in the dining area.

 That service users may have meals with a relative or friend.

 That all care and personal needs are assessed, monitored and evaluated, including the service user and/or their advocate or relatives, as the service user chooses.

PROCEDURES AND RECORD KEEPING

All procedures will be carried out, ensuring the service users privacy and dignity are respected at all times. Where nursing/clinical procedures are required to be carried out, these will be done in accordance with local guidelines and current nursing standards. All service users have the right to refuse any procedure or nursing intervention if they choose to do so. Staff will provide full details of any procedure or nursing intervention clearly, ensuring the service user fully understands what will take place and that the service user has given consent before any procedure or nursing intervention is carried out. Service users have the right to any information they seek regarding:

 The Complaints Procedure

 Access to case records/personal information held by the home All documentation held by the home will be kept confidential at all times. Access to documentation will only be granted to individuals with a right to view records or where the service user has granted access. The Homes GP cover is currently served by Crossley Street Surgery. However, service users may remain with their own GP if that GP is willing to cover the Wetherby area. Any procedure that restricts a service users personal choice or infringes on their rights will be clearly documented in the individuals case records.

MONITORING OF STANDARDS/QUALITY ASSURANCE

Ashfield Nursing Home seeks to maintain high standards of care by:

 Continually talking to service users, relatives, advocates and staff

 Clearly identifying service user needs and care that needs to be provided

 Setting clear standards of care to ensure that professional judgements can be defined

 Providing competent staff with the skills and knowledge suitable to enable them to provide the required standard of care as identified in the individuals care plan

 Continually updating staff knowledge and practices through supervision and appraisal

 Ensuring staff practices are in accordance with professional conduct

 Discussing service users rights, dignity, privacy, choice, independence and fulfilment at staff meetings and individual care plan reviews

 Diligently observing the care practices provided day to day

 Liasing with other care services to ensure all care needs are being met

CONTRACT OF RESIDENCE

Ashfield Nursing Home has a Terms and Conditions of Residency that will be issued to each service user shortly after admission. These terms set out the contact between Ashfield Nursing Home and the service user. A contract is a legally binding agreement so please read it carefully before signing it. You must ensure that all sections of the contract are clear and if necessary seek advice before signing the document. Fees are normally paid calendar monthly and are reviewed on an annual basis. If you have any concerns about your fees then please make an appointment to discuss them with the Manager. Where residents receive funding through a local authority, a breakdown of fees will be clearly listed upon receipt of details from the local authority. Where a service user requires nursing care, a contribution towards the nursing care fee will be paid by the Primary Care Trust following assessment. If you have not been assessed prior to admission then a referral will be made on your behalf by the home. When care needs change significantly the home will discuss referral for further assessment by the Primary care Trust or Local Authority. If you have any queries regarding this then please make an appointment to discuss it with the Manager. If you wish to move to another room following your admission, please discuss this with the manager who will be able to arrange relocation when a suitable room is made available. The reasons for the change must be recorded and you will be asked to sign a record to indicate your consent for the move. There may be a change in your fees when moving bedroom and this should be clearly discussed prior to the move taking place. As a service user you should be satisfied that your care needs are being met and you are receiving the amount and quality of care that you require. The Manager of the home should be satisfied that the home is able to provide the level of care required. It may take time to properly assess these care needs and to allow for understanding to develop between service user and care team.

SERVICES PROVIDED AND INCLUDED IN THE FEE Ashfield Nursing Home provides several levels of care: Residential Care This is day to day care that is required in respect of individual and personal needs. It includes:

 The provision of accommodation, decoration, furnishings, carpets, etc. Plus the use of communal areas – lounges, dining room, conservatory and bathrooms/toilets. These will be suitably furnished and decorated.

 Provision of meals – breakfast, dinner and tea. Mid-morning and mid-afternoon drinks and biscuits. Supper on an evening to include snacks as required. Suitable refreshments and snacks are available 24 hours a day on request. We will assess individuals nutrition and monitor weight on a regular basis to ensure concerns are identified early.

 Domestic services – laundering of personal possessions (not including dry-cleaning), bed linen, towels, etc.

 The provision of heating and hot water, lighting and electrical supply.

 The cleaning of bedrooms and all communal areas.

 The provision of towels, soap, toilet rolls, light bulbs, etc.

 Fair ‘wear and tear’ of furnishings and equipment.

 Provision of personal care 24 hours a day. The type and amount of care will vary depending upon individual needs.  Where required, assistance with washing, dressing, oral care and bathing. Assistance with mobility, helping with the toilet, provision of commode when required.

 Provision of opportunities to participate in social activities including exercise programmes.

 Daily monitoring of health care needs and where required seeking advice or requesting a visit from the service users GP.

 The safe storage and administration of individuals medication as prescribed by the GP and dispensed by the homes contracted pharmacy. Where a service user wishes to retain their own medications and administer them this will be enabled following risk assessment and discussion with the service user and their GP. The home will make provision for the safe storage of medications in the individuals bedroom. Records of all medication received, administered and destroyed by the home will be kept. ADDITIONAL SERVICES NOT INCLUDED IN THE FEE:

 Incontinence supplies – where required the care team will refer the individual for assessment and provision of incontinence supplies from the Primary Care Trust. Any supplies for the service user will be collected by the home for the individual

Nursing Care This relates to care that an individual requires to be given or directly monitored by a Registered Nurse (Level 1). It includes:

 Monitoring of individuals specific health care needs such as advanced disease, chronic diseases, complicated conditions and end of life care.

 A Registered Nurse on duty 24 hours a day.

 Clinical assessment, care planning and evaluation to ensure individual needs are met in relation to their health care needs.

 Provision of clinical interventions such as venepuncture, injections, etc

 Provision of specific equipment to facilitate comfort and quality of care such as specialised beds, mattresses, hoists, etc.

 Provision of incontinence supplies

ADDITIONAL SERVICES NOT INCLUDED IN THE FEE:

 Specialised nursing care such as one to one care, advanced dementia care

End of Life Care This relates to the level of care we will provide to any individual who has reached the end of life stage. It includes:

 Regular monitoring of health condition and ensuring services are altered and engaged at the appropriate time.

 Consultation with individuals, relatives and significant other professionals to ensure end of life wishes are maintained.  Provision of specialised equipment to maintain comfort – syringe drivers, specialised beds and mattresses. At Ashfield Nursing Home we are dedicated to providing care up to the end of life. It is our aim to provide individualised end of life care based on the service users wishes. Where possible, we aim to keep service users ‘at home’ rather than admit an individual to hospital. Following admission you or your representative will be asked to complete a short care plan providing details of your wishes in relation to the end of your life. We want to be able to make sure your wishes are heard and we will work alongside the GP and specialised community nurses to ensure where possible your wishes are maintained. We fully understand that this is not a topic many people wish to discuss however it is much harder to grant an individuals wishes when an emergency arises or health deteriorates suddenly. The staff are trained to help discuss this matter and to assist with completing the care plan if you need help. Where individuals have no relatives to assist with this then the home will seek to provide an advocate to ensure that decisions made are in the individuals ‘best interests’.