CARE HOME ADULTS 18-65
Falmouth House Residential Care Home 24 Edwards Road Whitley Bay Tyne & Wear NE26 2BJ Lead Inspector
Jim Lamb Key Unannounced Inspection 20th August 2007 09:30 Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 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 Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 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 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. Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Falmouth House Residential Care Home Address 24 Edwards Road Whitley Bay Tyne & Wear NE26 2BJ 0191 2513729 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) falmouth24@yahoo.co.uk Mrs Anne Elkin Mrs Anne Elkin Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10) of places Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Three named service users are known to be category LD and four named service users are over pensionable age, category MD(E). Should any of these named service users leave the home, the Commission for Social Care Inspection should be informed immediately, at which time these places will revert to category MD. 2nd October 2006 Date of last inspection Brief Description of the Service: The home is located close to the town centre and sea front of Whitley Bay. The home provides personal care and accommodation for up to 10 younger adults with a mental disorder or a learning disability. The home is a large converted terrace house. The accommodation is on three floors; there is no passenger lift. The laundry and office are located in the basement of the home; service users do not have access to these areas. The home has a large lounge and a separate dining area; there is an additional lounge where service users can see visitors in private. The service users have access to a rear yard with seating. Fees for the home range from £300 to £400. Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Summary:
How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 20.8.07. During the visit we: Talked with people who use the service, staff, and the manger. Looked at information about the people who use the service, (case tracking) this is a method used to tell us how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, • Looked around the building/parts of the building to make sure it was clean, safe & comfortable, • Checked what improvements had been made since the last visit. We told the manager/provider what we found. • What the service does well: The service is aware of equality and diversity and encourages staff to explore issues relating gender, ethnic origin, culture, religion, education and social histories.
Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 6 Service users, where able, described good relationships with the staff and said they were all polite and helpful. Staff were observed to be friendly and relaxed and showed a good understanding of their needs. Arrangements for service users to maintain contact with their family and friends are good. Meals are varied, well balanced, offering good choice and nutritious food at all meals. All spoken to were pleased with the quality and choice available. Meals were seen as a relaxed and social occasion. Service users are involved in menu planning and weekly food shopping. Hygiene practices were good protecting the health of service users and staff. The home is staffed with a skilled, consistent and trained staff team giving security to service users. The staff vetting process helps protect service users. The staff have a good understanding of each individual needs. More than ninety percent of staff is qualified to National Vocational Qualification in Care level 2 (NVQ) or above providing service users with a trained, skilled staff team. The service users were very complimentary about the staff. Comments included: “I’m very happy with the support I receive, I am encouraged to remain independent”. “I am always well cared for here, and I can come and go as I please”. “I am very happy living here, the staff are great, and so are Mr & Mrs Elkin”. What has improved since the last inspection?
Since the last inspection visit, there has been significant improvement to the environment, a new kitchen has been fitted, hall, landing, lounge and dining rooms decorated, and new flooring laid. Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 7 There have been no changes to the staff team during the last twelve months, and the service users have confidence in the staff that cares for them. 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. The summary of this inspection report can be made available in other formats on request. Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are provided with enough information about the service to enable them to make a choice about where they want to live. All service users are appropriately assessed prior to admission into the home. All are provided with a written contract explaining their terms and conditions with the home. EVIDENCE: Details of the extra charges and what these are for, are in the contract given to service users and are agreed prior to their admission. The homes Statement of Purpose and the Service Users Guide both contained the full range of information required. Two service users’ files were checked and each included a full needs assessment. Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 10 They contained a range of appropriate information. The service users are involved in drawing up both these initial assessments and the home’s subsequent service user plans. The 2 service user plans checked by the inspector were comprehensive, and listed details of service user’s needs and actions taken by the staff to meet these needs. The service users feedback cards all showed their needs were met and they were happy with the care offered to them. Two care plans were checked and two staff interviewed, which confirmed that a range of specialist services was provided to service users. Staff interviewed had had a range of relevant training and experience. Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and safe environment for those living there. The standard and decoration within the home is generally quite good. Some areas still need to be improved. Communal areas and bedrooms are large, and meet the service users needs. Most areas within the home are well maintained, clean, tidy and free from offensive odours. EVIDENCE: There are comprehensive assessments in the service users’ care plans. There is also a comprehensive risk assessment of service users. These have been agreed and signed by service users.
Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 12 There are advocacy arrangements, as well as family input, to represent service users. Each service user has an allocated key worker. Care plans are drawn up with service users. Plans continue to be amended and reviewed on a regular basis. There are systems in place that will ensure that the placement and the service users plans are reviewed annually. These involve the care managers and the service users representatives. Service users can use a range of external agencies that promote independence. Any rights that are restricted are linked to risk assessments. Service users’ feedback cards all showed that they are able to make decisions for themselves, and that they are happy with all aspects of the care that they receive. Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 15 16 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The meals in the home are good, offering both choice and variety. The service users have opportunities for personal development and leisure activities. They are supported to maintain very good links with the community and their relatives and friends. EVIDENCE: Each service user has a daily living life skills assessment carried out. This is reviewed and updated on a regular basis. All service users participate in this process. Service users are supported to live a normal life in the community. They are supported and encouraged to be in control of their own lives, to enjoy their
Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 14 own interests and to continue their education, or even take up paid employment if they wish. The staff team continue to liaise closely with external agencies in order to monitor each service user’s progress. All service users are supported to maintain very close links with their families. They can choose who they want to see and when. Daily routines promote independence, choice and freedom of movement. Service users are involved in housekeeping tasks. The Home’s menus are based on the known likes and dislikes of the service users. At least two hot meals are provided each day. The service users confirmed that they are always offered a choice, and that the meals are always good. Service users have access to the kitchen and can prepare snacks for themselves if they wish. Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health care of the service users is met and there is good multi disciplinary working taking place. The promotion of health care needs is taken seriously. Medication systems are well managed. Personal support is always provided in the way that service users prefer. EVIDENCE: Service users do not have any moving and handling needs. Service users need minimal help and prompting only with their personal care. Privacy and dignity are respected at all times.
Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 16 Service users do not need any technical aids or equipment. Service users care records showed that they have access to external health care services. G.Ps visit when necessary. Service users are referred for specialist health care if appropriate. All service users receive regular health care checks. The medication systems were examined for ordering, receiving, administering and disposal. These are well managed. All staff has had accredited medication training. Controlled drugs are not currently prescribed. Should this change; appropriate systems and procedures will be put in place. The dispensing pharmacist offers good support and advice. Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good, clear, user-friendly complaints system and service user’s views are listened to and acted upon. Procedures are in place to protect service users from harm, and these are followed. EVIDENCE: There is a complaints procedure. It contains details of how to contact the CSCI to make a complaint, if complainants are not happy with the homes investigation and response. The procedure is written in a way that ensures service users fully understand its contents. Three service users confirmed that they had been given copies of the procedure and that staff listened to their concerns and dealt with them fairly. The home keeps a record of complaints. Since the last inspection visit, there has been one safeguarding adults investigation, this incident was appropriately investigated and resolved. Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 18 The home has a Whistle Blowing policy and the Local Authorities Vulnerable Adults procedures. The home also has a copy of the Department of Health’s document, “NO SECRETS”. The Home keeps detailed financial records on behalf of the service users. Each has an individual bank account. Receipts of personal spending are kept. Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 19 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 25 26 27 28 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and safe environment for those living there. The standard and decoration within the home is generally good. Some areas still need to be improved. Communal areas and bedrooms are large, and meet the service users needs. All areas within the home are well maintained, clean, tidy and free from offensive odours. EVIDENCE: The home was clean, well decorated and well maintained. The home is in a residential location, near to all the amenities of the town. The grounds were tidy, safe, and accessible.
Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 20 The fire service and the environmental health department had made visits to the home. Previous requirements made by these organisations had been met. The home has an appropriate amount of sitting, recreational and dining space. Service users can see visitors in private in their own rooms. There is a designated smoking area with good ventilation. Furnishings and fittings were domestic in design and in quite condition. Lighting was bright and domestic in design. Doors have privacy locks. Service users’ bedrooms have opening windows. The rooms were centrally heated and the heating level could be controlled within each bedroom. Radiators and pipes were guarded. All bedrooms are personalised. There was emergency lighting throughout the home. Water is stored at over 60°C. Valves at water outlets ensure water is provided close to 43°C to prevent scalding. The home was clean and free from offensive odours. The laundry facilities are located in the basement, and are well organised. Service users do not have access to the basement area. The washing machine has the specified programme to meet disinfection standards. Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 21 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good match of well-qualified staff offering consistency of care within the home. There are robust procedures in place for the recruitment and selection of new staff, which helps to protect service users. The staff receives supervision and this provides them with a good understanding of the service users support needs. EVIDENCE: Staff levels on the day of the inspection met the agreed level. Samples of 4 weeks’ rotas showed the required numbers of staff were on duty: 2 staff between 8am and 5pm, 1 between 5pm and 9pm with one sleep-in between 9pm and 8am. Staff said that staffing levels were appropriate. Mr&Mrs Elkin and another member of staff are on standby after 5pm and at
Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 22 weekends. All the staff were over 18 years of age and those left in charge were at least 21. Training needs of staff are identified in supervision and appraisal sessions. The training programme has been reviewed to ensure it meets The National Training Organisation requirements for the first six months. The service has a rigorous staff recruitment and selection process to ensure that all appropriate checks and references are in place prior to employment. Since the last inspection visit, there have been no changes to the staff team. Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager provides clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The systems for service users’ consultation are good, and service user’s views are both sought and acted upon. The health and safety of the service users is promoted. The service is aware of equality and diversity and its implications. EVIDENCE: Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 24 The manager is also the proprietor, she has many years experience in senior management, she is a qualified social worker, and has the necessary qualifications to manage the home well. Staff were clear about their responsibilities. Service users are told when inspections take place and they are shown inspection reports. These are also summarised and discussed in service user meetings. Copies are available for relatives and others to see. The service continues to operate a good quality assurance system, service users views are sought and acted upon, and there is an annual development plan in place. The service has developed a range of new policies and procedures which have been linked to the National Minimum Standards, including equality and diversity procedures. The records inspected were found to be appropriately completed. These included the fire log book, accident records, personal allowance records and Health and Safey manual. There are appropriate maintenance contracts for the home. Service users can deposit cash for safe keeping in the home’s safe and records are kept of accounts. A sample of personal finances records was examined. Transactions were appropriately recorded and had two signatures for each entry. There was plenty of evidence of personal spending. Receipts are obtained for purchases and numbered to cross-reference to the transaction. Weekly checks of balances and cash are carried out. There is a health and safety policy and range of associated procedures. Staff receives training in health and safety and safe working practices (fire safety, moving and handling, first aid, food hygiene, and infection control). The home has an internal Health and Safety representative, and there are regular meetings to discuss issues. Servicing and maintenance agreements are in place for facilities and equipment. Risks in the environment and tasks, including safe working practices are assessed and reviewed. All fire safety checks; tests and instructions to staff are conducted at the required frequency and recorded. Accident reporting was suitably recorded. Water storage tanks, gas and electrics are checked annually. Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 2 26 3 27 3 28 3 29 N/A 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 26 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 YA25 Regulation 16 Requirement Two service users bedrooms must have new carpets to be fitted. Timescale for action 01/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Falmouth House Residential Care Home DS0000000312.V343992.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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