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Inspection on 25/11/09 for Fountain Court

Also see our care home review for Fountain Court for more information

This is the latest available inspection report for this service, carried out on 25th November 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service is located on a larger complex, with an alternative facility of a day centre open to the people using the service. The people using the service can access all the areas of the premises, which were warm, comfortable and well maintained. We evidenced the comfortable approach by the staff and the response of the people in their care. Interaction was often spontaneous and based on the needs and knowledge of individuals. The environment we saw was well maintained and thought out to promote stimulation. We saw things such as memory boxes at each bedroom door. The continued refurbishment and upgrading of the premises provided a high standard for the people. The environment was a credit to the housekeeping staff. From the records provided and evidence seen, the service had a staff training programme, which included The Mental Capacity Act, Dementia, Deprivation of Liberties, plus all the required mandatory training. We evidenced from the individual activity diaries we saw that people were offered a varied activity programme, interests and hobbies were promoted; including painting and gardening. We evidenced this during the inspection and from the pictures seen in the service. The service promotes a normal lifestyle for people, with the people`s involvement the service had designed a bar, (for drinks and socialisation)which was used on a daily basis. The menus we saw provided the people with a daily choice, staff assisted in a sensitive manner. Menus displayed a nutritional and a well balanced diet. The service is operated by a committed and dedicated manager, who demonstrated to us the people in her care were her priority. Her understanding of the National Minimum Standards, Key Lines of Regulatory Assessment (KLORA) were part of her future plans to ensure staff have the same knowledge.

What has improved since the last inspection?

Following the last key inspection and over the last twelve months the service had upgraded the environment and had purchased. New dining room chairs. Memory boxes at individuals bedroom doors. On going decoration of bedrooms and communal areas. The garden had been re-thought and more slabs laid. Two rabbits had been purchased. New lounge chairs had been purchased. New signage for rooms. Details for the fire evacuation and co-worker information with pictures had been hung in bedrooms.

What the care home could do better:

This report made one recommendation identified during the overview of the staff training matrix, by entering the date the training had taken place and not to use a `tick`

Key inspection report Care homes for older people Name: Address: Fountain Court Millpool Way Bearwood Smethwick West Midlands B66 4HW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Wendy Grainger     Date: 2 5 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Fountain Court Millpool Way Bearwood Smethwick West Midlands B66 4HW 01215652427 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.sandwell.gov.uk Sandwell Metropolitan Borough Council care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 16 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 16 Date of last inspection Brief description of the care home Fountain Court is owned and managed by Sandwell Metropolitan Borough Council. It is a newly built single storey property specifically designed to care for older people with dementia. The accommodation is arranged in two units, each having a separate lounge/dining area. All bedrooms are single and have an en suite toilet and shower. There are safe and secure gardens. Staff receive ongoing training on the needs of people with dementia. Fees charged at the home are £528 per week. The reader may wish to contact the service for the current fees. 16 Over 65 0 Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The overall quality rating for this service is 3 star. This means that the people who use the service experience excellent quality outcomes. One inspector carried out this unannounced key inspection on one day between 7:30 and 15:00 hours. We used the National Minimum Standards for Older People as the basis for the inspection and the outcomes for the people using the service. We had changed the planned date for the key inspection, the inspector had sent out an Annual Quality Assurance Assessment (AQAA) for the manager to complete. The date for its return did not coincide with the unannounced inspection. The inspection was completed without the AQAA information. We were assisted by the manager and the staff in collating information. We were provided with documents, which included: care plans, risk assessments, Care Homes for Older People Page 5 of 25 training records for the staff, medication records, menus and activity records in the form of individual diaries. We spent time with the people using the service, observing their interaction with the staff and management. We spoke to the staff on duty, each one felt supported by the management, their training needs were met and each one was aware of the complaints procedure. We looked around the premises to see the standard of comfort and safety. We looked at the menus and the meals served, we spoke to the catering staff, who confirmed their qualifications. We spoke to one visitor who told us, I dont know what I would do without this home, the staff are fantastic, I am sure he would not be as well if he were not here. We spent time with the management who operate the service to the best interests of the people using the service. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? Following the last key inspection and over the last twelve months the service had upgraded the environment and had purchased. New dining room chairs. Memory boxes at individuals bedroom doors. On going decoration of bedrooms and communal areas. The garden had been re-thought and more slabs laid. Care Homes for Older People Page 7 of 25 Two rabbits had been purchased. New lounge chairs had been purchased. New signage for rooms. Details for the fire evacuation and co-worker information with pictures had been hung in bedrooms. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People moving into the service can be confident that a full assessment of their personal and health needs will be undertaken to ensure the service can meet their needs. People were provided with information to enable them to make an informed choice about the service. Evidence: We were not able to collate information from the AQAA, which was to be returned after the inspection. The service had a current Statement of Purpose and a pictorial service users guide, the manager was in the process of creating a new Statement of Purpose in a pictorial format. We discussed the need to review the current details to collate the information available within the documents. The service had a robust system for collecting information prior to any placement. The Care Homes for Older People Page 10 of 25 Evidence: manager and or deputy take the responsibility for assessments. Information is gathered from social workers, general practitioners, psycho-geriatrician, community psychiatric nurses and other agencies prior to admission. We evidenced the planned care for the person recently admitted to the service. From the information in the file the service had gathered the relevant information to enable the service to care initially for the person. The plan of care will be built upon during the trial period. The file contained the single assessment form, which indicated personality, habits and interests. The persons choice of having curtains open or closed, time to rise and retire, dietary likes and dislikes. This information would be shared with the staff during one of the three daily hand overs. This practice ensures that information is shared verbally and in the written plan. The service does not provide intermediate care. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that the health, personal care and support they receive will be met based on individual needs. Evidence: We had no AQAA to cross reference the information against the evidence. The AQAA was to be returned following the inspection. We looked at two peoples care plans they were extremely detailed with information that enables the staff to meet the individuals needs. The care plans demonstrated that the service identifies peoples individuals needs, and provides the staff with information regarding how the needs were to be met. Risk assessments were in place covering the recognised needs of individuals. The plans to simplify the risk assessments will further enable the staff to meet individuals needs. We observed the staff address the needs of all the people and in particular, one person who was unwell when they demonstrated their understanding of this person. Care Homes for Older People Page 12 of 25 Evidence: Records demonstrated that the service is aware of the physical and mental health needs of each individual. Staff are trained in supporting the people with dementia, this was confirmed by the staff when they were spoken with, and from the records provided. The service had an impressive new medication system, which had been designed to contain liquids. A number of the people were prescribed liquid medication. Each pot was labeled with the persons name, time of administration and name of the medication. Medication was delivered monthly and then placed into a weekly container. Records were accurate, areas where creams were to be applied were recorded, eye medication had been dated when opened. Medication was stored in a small cupboard, the only comment was that it was warm. However the service had a quote in to rectify the temperature and as a safe guard had a thermometer in the room with daily records maintained. The new system ensures that people received the full amount of medication in liquid form. We observed the staff respect the peoples privacy and dignity, staff told us that it was a priority that people were encouraged to live a normal lifestyle with their support. This means that doors were knocked and closed when assisting individuals, this was evidenced during the morning and upon arrival at the service. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that the service will support them in their chosen life style and are offered activities they may wish to experience. People are provided with meals that give them alternatives and variety Evidence: We had not received the AQAA, which was planned to be returned later. It is the philosophy of the service to support the people using the service to enable them to live a lifestyle of their choice. We evidenced care plans, which contained information about peoples interests. We saw in one persons bedroom delicately painted pictures of flowers. Staff spent time with people in both lounges activities today included musical bingo, two memory boxes containing gardening, and sea side items. We observed the people enjoying the garden box together with the staff. We received few verbal comments from the people, however we observed the body language and response to the support from the staff all of which was positive. The service had a Christmas Fayre planned for the month of December, families and friend were invited. Entertainment for the people using the service will include a variety show put on by staff and managers from Fountain Court and other homes in the company. Plans were being made to take people out to a local area, which had a Care Homes for Older People Page 14 of 25 Evidence: street of Christmas lights open to the public. One of the impressive areas in the service was the area created and designed after consultation with the people, which is the The Jolly Inn. This area was used by people who use the service to socialise. We saw pictures of one person whose gardening skills had produced vegetables. The garden is contained and safe. There are flowers and seating in the garden along with the homes rabbits, which give great pleasure to people who use the service. The service operates an open door policy for visitors, we spoke to one person told us that I dont know what I would do without the home, the staff are fantastic, I am sure that he would not be as good if he was not here, I come everyday and always feel welcome I would speak to the manager or staff if I had a problem. Menus covered a four week period, the service provided a varied menu that provided choice and took account of peoples preferences. Comments were limited in response to the food, however there was little food returned to the kitchen. People were offered a choice for lunch, today the service was celebrating one of the theme days. Today was America, with flapjacks, freshly made pancakes with syrup. Later the evening meal was planned to be hot dogs. The service can and do provide a soft diet and a diet for people with a health condition. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are able and supported to make a complaint and are protected by the procedures in place. People who chose to use the service were protected by the staffs knowledge of safeguarding issues. Evidence: We had no AQAA to triangulate evidence, the AQAA was to be returned after the inspection. From the complaints procedure we evidenced the service had the current information to contact the company and or the Commission in the event they had a concern. We spoke to some of the staff employed who confirmed they were aware of the need to protect people in their care and how to follow the the guidelines. The service had two issues referred to the safe guarding team, one issue was on going, the service was waiting for the social services to implement a strategy meeting. The other issue had been dealt with and found unsubstantiated. The service had instigated two deprivation of liberty documents, each one had been reviewed and renewed since they were created and followed the required protocol. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are provided with a warm comfortable environment, which is maintained to a very high standard. Evidence: We had no AQAA to cross reference information, the AQAA was due to be returned after the inspection. We saw that the service provides a high standard of accommodation, with rooms pleasantly decorated, and furnished. The service had an ongoing decoration and refurbishment programme. Recent improvements had included new dining room chairs, new furniture, extra signage for the doors. This enabled a person to locate their bedroom and areas within the service. Outside each of the bedrooms,which were personalised to individuals taste, there was a memory box with many personal photos. The service was divided into two areas, each one with separate facilities but all accessible to people using the service. The larger lounge/diner had a small kitchenette where snacks and drinks can be prepared. Bedrooms were for single occupancy, each with an en-suite. There was a bathroom with assisted facility to enable people to get into the bath. The service was a credit to the housekeeping staff who maintained high standards. Care Homes for Older People Page 17 of 25 Evidence: Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the service can be assured that staff have the training and knowledge to support them. People are protected by the services good recruitment practices. Evidence: We did not have an AQAA to cross reference information. The AQAA was to be returned following the inspection. We saw that the service provides sufficient staff at any one time to support the people using the service, levels can be adjusted to accommodate appointments; these levels do not reduce the number of staff supporting others. The ratio of staff is one staff to support four people. We evidenced staff that were motivated, knowledgeable and positive about the care of the people and the work they do. Staff are well trained, this was confirmed from the records provided and included Health and Safety as well as training specific to the care of the people using the service plus the required mandatory training. The manager was looking into more staff training to further enhance the knowledge of the National Minimum Standards, the Key Lines of Regulatory Assessment (KLORA), the Annual Quality Assurance Assessment (AQAA). Staff confirmed their training needs were met. All the staff including the housekeeping staff, senior care and management had the National Vocational Qualification levels 2,3,and 4. We looked at two staff files and the manner in which the service recruits and Care Homes for Older People Page 19 of 25 Evidence: supervises staff. The records confirmed that all the required checks were made prior to employment. Files show that the service obtains two written references, date the employment commenced, application form, Criminal Record Bureau (CRB), Protection of Vulnerable Adults (PoVA) checks. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service was operated to the best interests of those who use it. People can be assured they are protected by competent management and staff. Evidence: The manager is registered with us, she is qualified in care and management she attends mandatory training to enhance her knowledge and skills. Her style of management was relaxed, it was obvious that she operated an open door policy, which was confirmed by the staff spoken with. Qualifications of the manager includes : The Registered Managers Award, Level 4 as an Advanced Dementia Care mapper, a BETEC in management studies, City and Guilds in advanced management. We evidenced her insight into her knowledge of the commission and the related documents, which she intends to bring to the in house training for the staff. The service had instigated two deprivation of liberty documents, each one had been Care Homes for Older People Page 21 of 25 Evidence: reviewed and renewed since they were created and followed the required protocol. Management and staff had received training in the completion for the Deprivation of Liberty understanding and documentation. We checked the funds held by the management for two individuals who use the service. Records were accurate and comprehensive. The manager has the responsibility for the service and was supported by an area manager for the company. The service could evidence that certificates for the servicing of equipment in lines with the manufacturers and other guidelines were current. We evidenced the detailed fire records , which were current, a fire drill was due in the next few weeks. The service had a current fire risk assessment and contingency plans in place in the event of an emergency. The service used the ISO 9000 and 14001 ISO as part of the external accredited quality assurance systems. Internal audits ensure that all the relevant checks on the service and premises are undertaken by the management . Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 28 To enter the dates on the matrix when training had been completed, to make sure that training is on going and to meet the peoples futures needs. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!