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Inspection on 22/05/06 for Falcon House Care Home

Also see our care home review for Falcon House Care Home for more information

This inspection was carried out on 22nd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

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 home environment enables people with disabilities to be as independent as possible. There is level access in most areas, wide corridors and doorways. All main corridors have handrails and there are suitable toilets that allow access for wheelchair users. There is a loop system in operation for those with hearing difficulties. A small room off the main lounge has materials for those with visual impairment.The management of the home ensures that a well-trained staff team treats residents respectfully. Residents` individuality, rights and choices are respected. Residents are enabled to take risks and lead fulfilling lives within a risk management framework. There is a commitment among staff to ensure that the views of those that use the service are heard and acted upon.

What has improved since the last inspection?

Staff files are now more organised and contain all the necessary documents to meet a safe standard in recruitment practice. Falls risk assessment and strategies to meet identified risks are now in place.

CARE HOMES FOR OLDER PEOPLE Falcon House Care Home 2 Middle Street Beeston Nottingham NG9 1FX Lead Inspector Mary O`Loughlin Key Unannounced Inspection 22nd May 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Falcon House Care Home Address 2 Middle Street Beeston Nottingham NG9 1FX 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) 0115 922 8151 0115 922 3759 Caredene Limited Margaret Harris Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th December 2005 Brief Description of the Service: Falcon house is a purpose-built modern establishment providing accommodation for up to 40 older people. Accommodation is offered on ground and first floor levels. The first floor can be accessed via a shaft lift, which is slow moving. Individual and shared rooms offer ensuite facilities. The home is located in the centre of Beeston offering access to local shops and amenities. There is parking available to the rear of the premises. Bus routes operate along the road outside the home. The range of fees are from £277.00 to £405.00 per week. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over 6.5 hours. A range of information was used to inform the report; The previous inspection findings, notifications of significant events, and through direct observation and examination of the practices at the home. The records of residents were viewed and through this process, which is called case tracking, the care the person received was measured against the written assessed needs. 6 residents gave an account of their life at the home and all were happy with the care they received. The manager, operations manager and deputy manager provided information and support throughout the inspection. The home has a sustained track record of meeting many of the National Minimum Standards ensuring that the outcome of the care residents receive is excellent. What the service does well: The home environment enables people with disabilities to be as independent as possible. There is level access in most areas, wide corridors and doorways. All main corridors have handrails and there are suitable toilets that allow access for wheelchair users. There is a loop system in operation for those with hearing difficulties. A small room off the main lounge has materials for those with visual impairment. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 6 The management of the home ensures that a well-trained staff team treats residents respectfully. Residents’ individuality, rights and choices are respected. Residents are enabled to take risks and lead fulfilling lives within a risk management framework. There is a commitment among staff to ensure that the views of those that use the service are heard and acted upon. What has improved since the last inspection? What they could do better: The manager must ensure that where residents are at risk from hot water that all hot water outlets are checked and records of the temperature held, this will ensure that should the temperature control valves fail that staff would be alerted and able to rectify the problem. All radiator guards should be fixed and held to the wall safely to prevent residents who may be at risk from removing them. The provision of photographs on each medicine administration record sheet along with the signature of the person writing up the medicine instructions and being witnessed would provide a safer system of medicine management and reduce the risk of error. Please contact the provider for advice of actions taken in response to this Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-3 Quality in this outcome area is excellent. This Judgement is made using available evidence including a visit to this service. The homes admission procedure ensures that residents receive an appropriate assessment of their needs and are assured that these needs can be met. Intermediate care is not provided. EVIDENCE: The home has recently had a change of ownership and the Statement of Purpose and Service User Guide have been reviewed to include this information. The home has a sustained record of meeting the standards around admission of residents. This inspection looked at the records of recently admitted residents and confirmed that the admission procedure ensures that all prospective residents receive a full assessment of their needs and a care plan is then prepared with Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 10 the resident and their relative ensuring that all parties agree to the care provided. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7-8-9-10 Quality in this outcome area is good. This Judgement is made using available evidence including a visit to this service. The residents at the home are involved with how their care is to be managed. Health, personal and social care needs are planed fro and managed safely. Staff are trained to administer medicines safely. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: The home has a sustained track record in meeting these standards. The care plans of four residents were examined and demonstrated a thorough assessment of each persons needs had been undertaken. Each plan had wherever possible been drawn up with the resident or their representative. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 12 The plans contained risk assessments with particular attention to the risk of falling. Plans contained good detail on how staff were to meet the persons needs. The operations manager said that a new care planning format was to be introduced and it was agreed that this would be trialled in the first instance to ensure that it was suitable. The health care needs of the residents are appropriately managed. Residents receive the support of external specialists when required. There was good assessment and provision of equipment to ensure residents were protected from developing pressure sores. Each resident is weighed monthly and is assessed for their nutritional requirements. Records indicated that residents receive chiropody and ophthalmology as required. Medicines in the home are stored safely. There are policies in place that ensure staff know their responsibilities when administering medicines. The supplying pharmacist provides an audit of the homes medicine management and records of these were seen. Staff receive training from external providers and from the pharmacist in safe medicine administration and ensures that only staff that are trained to administer medicine undertake this procedure. The safe recording of medicines could be improved if staff signed any hand written prescriptions and had these checked by a second person. Six residents spoken with all said they were treated well by the staff at the home. They were provided with privacy when they were being attended to and staff respected their individual wishes and preferences. Staff interaction was seen to be respectful and residents were confident to speak to them. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This Judgement is made using available evidence including a visit to this service. Residents are enabled to have a lifestyle that matches their expectations and capacities. The home encourages visitors and links with the local community. Residents are able to exercise choice over their own lives. EVIDENCE: The home has a sustained track record of meeting these standards. The care plans of four residents had a clear history of the persons social and recreational interests. Residents are informed of the homes activities and outings within the service user guide and each week a list of the daily events is displayed on the homes notice board. Residents meetings are held and issues affecting their daily lives are discussed and inform any necessary changes. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 14 There are church services held at the home and residents can see their own minister in private. One resident said that he was aware that staff would take him to visit his church if he so wished. Residents are able to have visitors, receive mail unopened and access a telephone. Residents can also have their own telephone installed. There is an audio loop system in one area of the main lounge for those with hearing difficulties. A small “snug” room provides materials for people with visual impairment. Differing expectations are met at the home, there are residents that have their own tea making facilities, microwaves and fridges to enable them to take reasonable and assessed risks and promote their independence. For others less able there are opportunities to join group activities and receive the support they require to participate. One resident felt that she was living her life as she wished, in private but with the assistance of staff if she required it. There are dining areas on both the ground and first floor. The dining rooms provided good space for those people with mobility problems. The tables were set for lunch and the setting was quiet and organised. Each resident spoken with was very happy with the food provided and confirmed that they were offered a choice of meals. There was no evidence of a cultural diet being provided for one resident but she was able to tell me that she was very happy with the diet she did receive. The person’s care plan did contain information on her diet. Residents are encouraged to continue to manage their own financial affairs and there is a range of information available to residents and relatives on advocacy and legal services should this be required. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16-18 Quality in this outcome area is excellent. This Judgement is made using available evidence including a visit to this service. Residents are listended to and complaints are handled seriously and acted upon. The procedures and training in place ensure that staff are aware of how to protect residents from abuse. EVIDENCE: The home has a sustained track record of meeting these standards. Records of recent complaints show that 2 complaints have been appropriately addressed at the home in the last 6 months. There is a complaints procedure in place and residents are aware of how to complain. The policies and procedurs at the home ensure that vulnerable residents are safeguarded from abuse. All new staff are trained in adult protection and how to deal with difficult behaviours ensuring that any physical or verbal aggression is dealt with safely and appropriately. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19-26 Quality in this outcome area is excellent. This Judgement is made using available evidence including a visit to this service. The home is accessible and well maintained and able to meet the needs of the residents. There are arrangements in place that ensure residents are protected from cross infection. EVIDENCE: The home has a sustained track record of meeting these standards. The home is well maintained throughout and provides suitable access and facilities for people with mobility problems. The home is compliant with Fire and Environmental Health requirements. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 17 For the residents case tracked the home were providing suitable private and communal accommodation. The home was well maintained with well kept grounds and level access for wheelchair users. There is a regular programme of routine maintenance in place and a handyman is employed. The home was free from any offensive odours and cleaning schedules were in place. There are good arrangements around control of infection which provide good safeguards to prevent cross infection occurring. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27-28-29-30 Quality in this outcome area is excellent. This Judgement is made using available evidence including a visit to this service. The recruitment of staff, and the provision of training ensures that the numbers of staff are sufficient and the workforce is skilled in the care of older people. EVIDENCE: The home has a sustained track record in meeting these standards. Duty records viewed showed that there were suitable numbers of staff employed which is calculated daily to ensure that any changes in the needs of the residents is considered and planned for within the levels of staff on duty. All new care staff complete an induction that is Nationally recognised and leads to the commencement of NVQ level 2 training following the probationary period. The recruitment practice and staff records provide evidence that staff are suitably checked prior to commencement of employment, which ensures that anyone unsuitable to work with vulnerable adults is identified. Domestic and catering staff also complete NVQ training. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 19 Records indicated that staff receive appropriate ongoing training annually to ensure their practice is up to date and appropriate. Residents spoken with felt that staff were very helpful and knew them well. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31-33-35-38 Quality in this outcome area is good. This Judgement is made using available evidence including a visit to this service. Residents live in a home that is run and managed by a suitably trained person. The home is run in the best interests of the residents and they are safeguarded from financial abuse. The management of the health, safety and welfare of the residents is promoted and protected. EVIDENCE: The home has a sustained track record in meeting these standards. There is a registered manager in post who is presently completing her registered managers award. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 21 There is an operations manager closely involved with the home who is now providing monthly visit reports for the home as required within the National Minimum Standards. There is a clear sense of direction and leadership, the manager, deputy manager and operations manager all work closely and provide a creative team that are keen to develop the service the home provides. There were excellent examples of the procedural files for meeting the National Minimum Standards, ensuring that staff have a clear understanding and are able to meet the homes objectives and to exceed what is required as a minimum. There is extensive work on assuring quality within the home and seeking the views of residents, relatives and professionals involved in the service. The home does not manage the personal finances of residents but is able to provide safe storage of valuables or small cash floats if necessary. Records and receipts are held of any money or valuables held. There is a health and safety policy in place and there is good recording of activities that monitor the safety of the home with regard to fire, accidents, electricity safety. All accidents are recorded and action taken to address any emergency as a result. The manager audits all accidents and ensures that suitable safeguards are put in place if shorfalls or risks are identified. One individual room and 1 bathroom had hot water exceeding a safe temperature, regulators were in place but were not functioning safely. A resident had removed a safety guard to her radiator which the manager replaced during this inspection. Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 2 Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? NO 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 OP9 Regulation 13 Requirement The registered person must make suitable arrangements for the management of medicines; 1. The record sheet should have a photograph of the resident attached. 2. Any hand written prescriptions should be signed and witnessed. 3. Personal medical equipment such as a nebuliser must have a cleaning and maintenance schedule that reflects the manufacturers guidance. Timescale for action 30/06/06 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 OP38 Good Practice Recommendations The registered person should ensure that all hot water outlets are monitored to ensure that water temperature DS0000008673.V294276.R01.S.doc Version 5.1 Page 24 Falcon House Care Home 2 OP38 regulators are functioning correctly and at safe temperatures. The registered person should ensure that radiator guards are securely fitted to prevent residents from accidental harm Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Falcon House Care Home DS0000008673.V294276.R01.S.doc Version 5.1 Page 26 - 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!