Inspection on 01/11/05 for 40 Fir Tree Road

This inspection was carried out on 1st November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Other inspections for this house

40 Fir Tree Road 26/08/08

40 Fir Tree Road 16/07/07

40 Fir Tree Road 16/10/06

40 Fir Tree Road 05/04/05

40 Fir Tree Road 20/09/04

40 Fir Tree Road 24/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Fir Tree Road (40) 40 Fir Tree Road Banstead Surrey SM7 1NG Lead Inspector Peter Benthom Unannounced Inspection 1st November 2005 X10029.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 Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 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 and Care Homes for Adults 18 – 65*. 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. Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fir Tree Road (40) Address 40 Fir Tree Road Banstead Surrey SM7 1NG 01737 379242 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) Community Integrated Care Mrs Judith Elanor Conteh Care Home 8 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (5), Physical disability (2), of places Physical disability over 65 years of age (4) Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Up to 5 (five) residents aged over 65 years. Of the 3 (three) adults with learning disabilities (LD) accommodated, 2 (two) may have an additional physical disability (PD). Of the 5 (five) older people with learning disabilities LD(E) accomodated, 4 (four) may have an additional physical disability PD(E). Up to 3 (three) residents aged 47-64 years. Date of last inspection 5th April 2005 Brief Description of the Service: The home is registered as a care home only within the service user category: Learning disability (LD) and Learning disability over 65 years of age. The home is registered to accommodate a maximum of seven Service Users. Community Integrated Care manages the home. It is a large detached house with extensive grounds to the front and rear and is situated on a busy main road, near to Banstead centre.40 Fir Tree Road aims to provide a safe and homely environment that enables Service Users to develop to their maximum potential and where they are treated with dignity and respect. Service Users are very much an integral part of the homes operation despite their profound disabilities. The home provides a good standard of accommodation to its Service Users. Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was the second of the year 2005/6 and was conducted by an inspector from CSCI. The manager was not present for the inspection. The inspection was competently carried out the manager and there were adequate members of staff on duty. Four of the seven Service Users were spoken with. A tour of the premises took place and care records were inspected. What the service does well: 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. Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2,3, 4, 5 and 6 Service users are admitted only following a full assessment undertaken by the manager who is able to demonstrate the homes capacity to meet the assessed needs. EVIDENCE: The home had a comprehensive statement of purpose, which accurately depicted the services provided by the home. All potential service users are assessed prior to admission. It was reported that the service only admits new service users based on an assessment of needs, and appropriateness of placement Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 8 The initial assessment was used to form the basis of the care plan and the support plan, which identified the actions that carers should follow to assist an individual living at the home. Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 The systems in place for Service User consultation are good and access to support from health care agencies is clearly evidenced. The systems for administration of medication are good with clear arrangements in place to ensure that Service Users medication needs are being met. EVIDENCE: Service users’ health needs were well met and medication administration was accomplished satisfactorily. The service plans in place were comprehensive and Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 10 are reviewed on a monthly basis to ensure that they accurately depict service users’ needs. Daily notes were informative and included details about what activities the service user had participated in and their mental status. Staff stated that service users are involved as much as possible with the care plan development and reviews. During the inspection the staff cared for Service Users in a respectful manner. Those Service Users requiring any assistance were helped sensitively. All Service Users have their own bedroom, thus providing the opportunity for privacy when visitors arrive, whether family or professionals. The Homes’ policies and procedures placed particular emphasis on the core values of caring, such as independence, privacy and dignity. Care plans sampled were comprehensive and up to date; there was evidence that regular reviews took place. Encouragement and support was given to service users to promote independence within the limitation of each individual’s capabilities Records showed assessed medical needs were followed up properly and notes taken of the care given. Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 The systems in place for full Service User participation indicated that Service Users views are both sought and acted upon. EVIDENCE: The service assists service users with transport in order to access the local community. Service Users were able to have visitors at any reasonable time in private. Communal areas are utilised by service users to entertain their visitors. Alternatively service users can entertain in their own bedrooms in private, in the quiet lounge areas or in the garden areas (weather permitting). Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 12 Service users in this service are unable to manage their own financial affairs; as a consequence these are usually managed by relatives and advocates which was seen to be the most appropriate process. There is also a choice of menu at lunchtime and suppertime and both meals are sufficient in quantity and appearance. Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Service Users are well protected by the companies training policies and procedures with regard to the protection of vulnerable adults. EVIDENCE: There have been no complaints since the last inspection. The home has a complaints procedure in place in line with Community Integrated Care policies and procedures. All Service users have been supplied with a copy in pictorial format. The service has an adult abuse policy in place. Staff had received training in the protection of vulnerable adults in February 2005. The Local Authority multi-agency procedures for protecting vulnerable adults were in place at the service. The majority of staff have had recent protection of vulnerable adult training updates as an integral part of their ongoing training. Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 The standard of décor and equipment in this home is of a very high standard with evidence of improvement through maintenance and refurbishment when necessary. EVIDENCE: The Home is situated in a large and well-maintained garden and is close to Banstead town centre. The Home has been tastefully adapted from its previous use and has been designed to meet the needs of the service users. All rooms were accessible to Service Users. The home has grab rails and Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 15 adaptations such as mobile hoists and bathing aids in place to support Service Users to maintain their independence. Staff take a pride in maintaining a clean and homely environment for the service users and must be very highly commended. Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Service Users are supported by competent and trained staff who have a good awareness of their needs. EVIDENCE: The Home has a policy whereby all gaps in the staff rota are met by using existing staff. This helps to promote consistency in care for Service Users. The Home has a continual programme of NVQ training for all staff and is committed to staff training. All staff have completed induction and foundation training and there is a good training package for all staff. The Home is working towards meeting this standard. Staffing levels comply with National Minimum Standards. Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 17 There was evidence that the recruitment process had been followed and met the standards for protection of Service Users. There are arrangements to carry out CRB checks and two written references were in place for all staff. Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 and 38 The manager is supported by staff in providing clear and consistent leadership in the home with all staff illustrating an awareness of their roles and responsibilities. The home’s record keeping and health and safety policies protect all service users and staff. Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 19 EVIDENCE: The manager is qualified to NVQ Level 3 and is currently studying for NVQ Level 4 and the Certificate in Management. Monthly meetings were held for staff and all were encouraged to contribute to the development of the home. The following records were examined during this Inspection: Service Users Care Plans, Service Users Medication Records, the Staff Rota, Staff personnel files and Menus. These records were in good order. Staff were noted to receive training in matters of health and safety and ample information was available to advise staff as to safe practice, including lifting and the handling of corrosive materials. There is a Health and Safety procedure in place. Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 20 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 3 2 3 3 3 4 3 5 3 6 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 18 3 ENVIRONMENT Standard No Score 19 4 20 4 21 4 22 4 23 4 24 4 25 4 26 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 37 3 38 3 Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard N/a Regulation N/a Requirement There are to be no requirements from this inspection Timescale for action 01/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard N/a Good Practice Recommendations There are to be no recommendations from this inspection Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 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. Fir Tree Road (40) DS0000013494.V259009.R01.S.doc Version 5.0 Page 23 - 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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