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Inspection on 23/09/05 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 23rd September 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.

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

All potential residents are fully assessed before they are admitted to make sure that the staff can meet their needs. The care plans are detailed and contain the residents` needs, wishes and preferences, they guide staff well. The residents are full of praise for the home and said they feel happy and settled there. The residents said the staff are caring although they wish they had more time to sit and chat with them. Records are very well kept and provide evidence of good monitoring and management. Residents` views are sought regularly and any shortfall in the service provided is acted upon.

What has improved since the last inspection?

The records of controlled drugs have improved. The lock on the ground floor toilet has been repaired and can now provide privacy. The residents are offered several items of furniture for their bedrooms, the manager records if they choose not to and the residents sign to confirm that this is the case. The manager now has a job description which makes clear her role and responsibilities. Meetings with the residents now take place more often, every six weeks and minutes are kept of these. Staff have been given guidance about treating residents with dignity and respect.

What the care home could do better:

Staff files do not have all of the documents they should have to prove the identity of staff and this could place residents at risk of harm or abuse. Further investigation and action is recommended to try and reduce the number of falls resulting in fractures. The arrangements for staff should be reviewed to provide more opportunities for staff and the residents to chat together.

CARE HOMES FOR OLDER PEOPLE Falcon House Care Home 2 Middle Street Beeston Nottingham NG9 1FX Lead Inspector Linda Hirst Unannounced Inspection 23rd September 2005 09:30 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.V251729.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. 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.V251729.R01.S.doc Version 5.0 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.V251729.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5/1/05 Brief Description of the Service: Falcon house is a purpose-built establishment, providing accommodation for up to 40 older people. The accommodation is sited over two floors with a shaft lift providing independent access, there are two main lounge and dining areas, one on each floor, there is also a separate quiet lounge on the ground floor. The accommodation is provided in single and twin-bedded rooms all of which have ensuite facilities, are well decorated and comfortably furnished. The home is situated close to the centre of Beeston with a good variety of shops, facilities and excellent access to public transport. Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit involved one inspector who was at the home for half a day. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through checking their records and discussion with them. Records of incidents, complaints, staffing, training, residents’ feedback and health and safety servicing and checks were inspected during this visit to make sure they are completed properly. Staff were seen undertaking their duties. What the service does well: What has improved since the last inspection? The records of controlled drugs have improved. The lock on the ground floor toilet has been repaired and can now provide privacy. The residents are offered several items of furniture for their bedrooms, the manager records if they choose not to and the residents sign to confirm that this is the case. Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 6 The manager now has a job description which makes clear her role and responsibilities. Meetings with the residents now take place more often, every six weeks and minutes are kept of these. Staff have been given guidance about treating residents with dignity and respect. 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. Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 7 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.V251729.R01.S.doc Version 5.0 Page 8 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): 3, 6 Residents are properly assessed before admission to make sure that the staff at the home can meet their needs. EVIDENCE: The last resident to be admitted to the home was selected for “case tracking” to make sure she had been properly assessed before admission. There was a completed pre admission assessment on the file and a good care plan was held on file (she had been in the home for 10 days). This detailed her background, interests, and preferences for rising and retiring and identified risks, which included falling out of bed. There was an authorisation in place for the use of bed rails which had been signed by the resident herself. The residents who were interviewed said they had either been assessed in their own setting before admission or had visited the home to be assessed. There was clear evidence that the resident had been properly assessed before admission to prevent any unnecessary moves. Intermediate care is not provided at the home and this standard is not applicable. Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 9 Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 10 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, 10 Care plans are person centred and detailed and give staff clear guidance about how to meet the residents’ needs. Health care needs are properly assessed and provided for to maximise residents’ wellbeing. The residents are treated with dignity and respect and their privacy is protected. EVIDENCE: The care plans for the “case tracked” residents were inspected to make sure that these detailed all of their areas of need and offered proper guidance to staff about how to help them. There was clear evidence in the plans seen of residents being fully involved in developing their care plans and they confirmed that staff talk to them about how they will help them. The care plans are comprehensive and detail needs, wishes and preferences. The background histories are done with the residents and give staff good insights into residents’ previous lives and the key people Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 11 within them. The care plans make reference to issues of independence, dignity and privacy. Health care is well managed, the residents’ mobility, skin care, nutrition and continence are assessed as part of their plan and there is evidence that the staff contact the GP and District Nurse appropriately for advice and to access treatment for the residents. One of the residents who was case tracked has a pressure relieving mattress and cushion and is about to get an electric wheelchair to further his independence. One resident had recently had an operation and said that it was the staff who noticed a change to her skin in the first instance and involved the GP who referred her to Hospital. She was full of praise for the actions of staff and the health care support and treatment she had received. The residents who were interviewed said they feel happy and settled at the home. They said that the staff offer help discreetly and make sure that residents’ privacy and dignity is maintained. Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 12 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): 12, 13, 14 Appropriate activities are provided at the home, and residents have the choice as to whether to join in. Routines are flexible and preferences recorded and residents access the community with the staff or their family and friends. EVIDENCE: The residents who were interviewed said they choose not to take part in the activities which the home arranges, preferring their own company and enjoying watching the television and reading. They confirmed that they go out into the community, both with staff and family/friends. One resident is about to get an electric wheelchair which he anticipates will enable him to get out and about independently. Residents said that they could have visitors whenever they wish and there are no restrictions. They confirmed that visitors are made welcome and those interviewed usually see people in their own bedrooms. The care plans indicate residents’ needs, wishes and preferences and offer clear evidence that the routines are flexible. This was confirmed by the people interviewed who said they have a choice about how they live their lives. Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 13 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, 19 Complaints are well organised and any concerns raised are properly investigated, responded to and acted upon. The residents are protected from harm and abuse by trained staff who are aware of their responsibilities to keep the residents safe. EVIDENCE: There is an appropriate complaints procedure in place and this is displayed in reception. The records indicate that both minor grumbles and major complaints are recorded. These indicate that all issues raised are properly investigated, action is taken to address any shortfalls in the service and the complainant is properly responded to. None of the residents interviewed had complained but they said they knew how to do this and feel the manager would deal with any issues raised properly. There is a copy of the Adult Protection Procedures in the office which staff can refer to. Issues regarding abuse are dealt with during the formal induction for new staff; they are also discussed in staff meetings. There have been no allegations of abuse in the past year, no major disciplinary issues, no incidents of restraint and no issues of concern have been raised following Criminal Records Bureau checks. The residents said they feel well cared for at the home and have never been treated inappropriately by the staff. They feel safe and secure at the home. Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 14 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): EVIDENCE: Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 15 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, 29, 30 The staffing arrangements meet the care needs of residents but do not allow enough time to make sure that staff have time to chat to the residents in their care. The staff files do not have all of the documents required by Law in order to properly protect the residents from harm or abuse. The staff have good access to training and this enables them to be competent in undertaking their role. EVIDENCE: The staff rota was inspected to check that there are enough staff on duty to meet the dependency needs of the residents. This provides evidence that there are 5 staff on each day shift and three waking staff on each night shift. The staffing hours in all areas are above minimum requirements, though it should be noted that the building is large and several residents choose to spend their day in their own bedroom so staff have to work hard to monitor appropriately. The residents said that the staff are “really good,” but very busy, one resident said that she wished staff had more time to chat. It is recommended that the staffing arrangements be reviewed to try and give staff and residents more time to chat. Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 16 Staff files were inspected and these contained all of the required documents for new staff but two key documents were missing on the files of existing staff and this matter must be addressed to make sure that the Law is complied with. The training records were seen and with the exception of Infection Control (pending) and Basic Food Hygiene (2 staff have still to do this) all staff are up to date with statutory training which protects the Health and Safety of staff and residents. The records indicate that staff are progressing well with their NVQs and in addition training has been provided to staff on Equality and Diversity, Adult Abuse, Safe Handling of Medication, Dementia and the manager is undertaking training to become an NVQ assessor. The evidence indicates a high level of commitment to provide training to staff to enable them to become competent. Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 17 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): 33, 38, The residents are regularly consulted about the quality of the service provided and are encouraged to give their views which are acted upon. The arrangements for the health and safety of staff and residents are generally good, but a full risk assessment is needed to minimise the number of falls resulting in injury to residents. EVIDENCE: There is evidence in the office of regular monitoring of different aspects of the service (bar charts indicated the number of medication errors, returned residents’ questionnaires, staff retention and accidents.) The quality assurance file was inspected and provides good evidence of regular, thorough auditing of the service provided. The last resident and GP feedback questionnaires were seen and these were generally very good, with the resident feedback being very positive. Any issues of concern are actioned. The residents said that Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 18 residents’ meetings are held “regularly” and said that they feel able to express their views. The records of incidents indicate a higher that normal number of falls are occurring which result in fractures. This was explored with the manager who has established a pattern in terms of when the falls occur. The records in place indicate she has taken action to try and address these falls but it is important that a specific risk assessment is done to specify exactly what steps are being taken to minimise this risk. The records of Health and Safety tests were inspected to check these are up to date. The servicing of vertical lifts and lifting equipment is up to date, a new gas boiler has been fitted, the electrical testing (including the hardwire testing) was being done during the inspection along with Portable Appliance testing. The Fire Safety checks and tests are undertaken at the required intervals and all servicing is up to date to make sure the residents are safe in the event of an emergency. There is a file about products subject to Control of Substances Hazardous to Health Regulations and a file containing risk assessments for all safe working practices. The evidence suggests good levels of management and oversight are maintained in order to ensure that staff and the residents at the home are safe. Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 19 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 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 2 28 X 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 2 Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 20 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 OP29 Regulation 17, Schedule 4 Requirement Staff files must contain the information and documentation specified in Schedule 4 of the Regulations Timescale for action 21/10/05 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 2 Refer to Standard OP27 OP38 Good Practice Recommendations The staffing arrangements should be reviewed to enable more time for residents and staff to chat. A detailed risk assessment should be undertaken to indicate the steps being taken to minimise the risk of injury from falls. Falcon House Care Home DS0000008673.V251729.R01.S.doc Version 5.0 Page 21 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.V251729.R01.S.doc Version 5.0 Page 22 - 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. 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