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Inspection on 08/10/08 for Falstone Manor Nursing Home

Also see our care home review for Falstone Manor Nursing Home for more information

This inspection was carried out on 8th October 2008.

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

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

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

What the care home does well

There are good examples of residents needs being identified and appropriate support being provided. These include identifying peoples religious and dietary needs. The staff have devised a communication system to enable them to communicate with a resident for whom English is not his first language. Relatives also commented positively on the communication between them and the staff. The catering staff provide meals which are nutritious, nicely presented and in sufficient quantities. The residents and relatives commented that the food is always good. The staff are very enthusiastic in ensuring that the residents engage in meaningful social and recreational activities. There are several indoor and outdoor fund raising activities organised by the staff to raise money towards the residents funds. There are regular bus trips along the coast and to other local places of interest. The home has a good admissions procedure and residents and relatives confirmed that they were given the opportunity to visit the home and to see it for themselves before they decided on coming to live there. The residents and relatives made very positive comments about the home and the staff. Staff were described as very caring, very good at their jobs and also very professional in the way they conduct themselves. Some of their comments include "The girls are very good with us". "We have a lot of activities here". "My mum is well looked after, and that is what is important". "I can not fault the staff here, they are alright".

What has improved since the last inspection?

In the last inspection report, one requirement for improvement was placed on the home involving light cords in the toilets and bathrooms. This has been resolved. Also since the last inspection, the manager has made further improvements to the care plans and the care plan review system.

What the care home could do better:

The care plans relating to psychological needs should be more specific so that the staff would know exactly how to provide that support. For example, there were a number of instances where the care plans simply said that reassurance to be given. The plan did not state what constitutes reassurance for the individual. Another care plan asked the staff to observe for DVT but it did not tell the staff what signs they are to look for. One resident commented that staff are always busy and they do not have time to sit and talk to you. Another resident said the staff are good but there is one or two who can be impatient at times.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Falstone Manor Nursing Home Cliffe Park Whitburn Road Roker Sunderland SR6 9NQ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sam Doku     Date: 0 9 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Falstone Manor Nursing Home Cliffe Park Whitburn Road Roker Sunderland SR6 9NQ 01915496699 01915497799 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Apta Healthcare (UK) Ltd Type of registration: Number of places registered: care home 53 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 53 The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 36 Physical disability - Code PD, maximum number of places: 17 Date of last inspection Brief description of the care home Falstone Manor provides nursing care for up to thirty-six older persons on the first and second floor of the building and a unit on the ground floor for up to seventeen younger adults with a physical disability. Falstone Manor Care Home is a purpose built threestorey building situated near to the sea front at Roker, enjoying panoramic views Care Homes for Older People Page 4 of 27 Over 65 36 0 0 17 Brief description of the care home across the coastline. It is part of a complex, which also includes Falstone Court, another care home, which is separately registered for personal care for people with dementia, with the Commission for Social Care Inspection. The two services share car parking space to the front and rear of the building, kitchen and laundry facilities. The home is within short walking distance of the sea front, local seaside amusements and shops. It is accessible by local transport services and is within easy reach of Sunderland City centre. Information about the home is included in the Statement of Purpose and Service User Guide. Fee rates 422.80 pounds for EMI residential, 525 for EMI Nursing, 402 pounds for general residential, 505.80 for general nursing, 442 for YPD non nursing and 545.80 pounds for YPD nursing. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating of this service is 3 Star. This means the people who use the service experience excellent quality outcomes. The inspection was unannounced and commenced on 8 October 2008 and completed on the 9 October 2008. Before the visit the inspector looked at: Information we have received since the last inspection visit on 17 October 2006. How we dealt with any complaints and concerns since the last inspection. Any changes to how the home is run. The providers view of how well they care for people, as highlighted in the details provided in the Annual Quality Assurance Assessment (AQAA). The views of the people who use the service. Care Homes for Older People Page 6 of 27 During the visit the inspector did the following. Talked to the people who use the service, the manager and the care staff. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff have the knowledge, skills and training to meet the needs of the people they care for. Looked around the home to make sure it is safe and secure. Checked what improvements have been made since the last inspection. The inspector told the manager what he found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 27 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides good information about the service, including invitation to visit the home, which enable prospective residents to make decisions about the home. All residents are assessed before admission and on admission, to make sure that the home has the necessary skills and facilities to look after them, thus promoting their welfare and wellbeing. Evidence: The home provides good information to prospective residents in the form of service user guide and other supporting brochures about the home and the company. The information is readily available in the foyer and residents confirmed that they have received copies of the service user guide. It is the policy of the home to invite people who are wishing to go into care to visit the Care Homes for Older People Page 11 of 27 Evidence: home and to see the place and assess it for themselves before making decisions about coming to live at Falstone Manor. Two recently admitted residents confirmed that they were supported by the home to visit and to spend sometime in the home when they were making enquiries about care homes. One relative also described how she visited the home on behalf of her mother and how helpful the staff were in giving her all the necessary information that she needed in order to make a decision about the home for her mother. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents receive care that is consistent with their personal and healthcare needs. Furthermore, the home has good procedures in place for administration and safe handling of medication so that residents welfare is safeguarded and promoted. Evidence: Detailed care plans are available and these set out the care needs of each resident. The plans provide details of how nursing and care staff are to support each residents in meeting their personal and healthcare needs. However, some of the plans are not detailed enough to guide staff on providing specific care needs. For example, in one case staff are advised to give plenty of reassurance to a resident. The plans did not state what is reassuring to that particular person. In another case, staff were advised to provide watch out for signs of DVT but the care plans did not tell the staff what those signs were. The residents and their relatives have been involved in reviewing and updating the care plans. This is particularly the case on the younger adults unit. Where relatives are Care Homes for Older People Page 13 of 27 Evidence: unable to attend review meetings, their views are sought by telephone and they are updated on their next visit to the home on any changes to the care plans. The care plans are reviewed on six monthly basis but the residents who have extensive care needs have their care plans reviewed on a three monthly basis. The residents who were spoken with confirmed that they have access to healthcare facilities including GP support and other healthcare professionals including psychiatrist, speech therapist, tissue viability specialist nurse, optician, chiropodist, dentist, occupational therapist and dietician. The views of the residents about the good care they recieve are confirmed by the details in the daily report records. The records provide details of the visits from healthcare professionals and the treatment they receive from them. The home has details policies on the storage and administration of medicines. These are followed by the nursing staff who have overall responsibility for the administration of medicines in the home. A random check of the medicines administration system was undertaken by the inspector. There were no discrepancies noted. All the drugs administration records were appropriately maintained. At the time of the inspection the staff were noted to relate very well with the residents and there was obvious respect between staff and the residents. The residents confirmed that the staff treat them with respect and dignity. The staff were friendly and professional in the way they interacted with the residents. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides meaningful and fulfilling activities which enhance the wellbeing of the residents. It home supports and encourages residents to maintain close relationship with their friends and relatives. Furthermore, the home provides individuals with the opportunity to make decisions about their care thus promoting their independence. The residents are also provided good variety of wholesome and nutritious meals, which promotes their health and wellbeing. Evidence: The care plans that were viewed contained information about the social and recreational care needs through the social history section of the plans. However, in one case the religious needs of the resident could have been highlighted a bit more. The role of the activities coordinator has been commended by residents and relatives. There are regular bus trips for the residents and in-house social and recreational activities are evident in the home. The notice boards on the various floors inform residents of the activities for the day. On the day of the inspection, a trip had been Care Homes for Older People Page 15 of 27 Evidence: organised for some of the residents to visit Newcastle to see the QE2 luxury liner, which had docked on the Tyne. The activities for both the younger adults and the older people are purposeful and are enjoyed by those who get involved in them. Some of the activities include flower making, indoor bowling, chair exercises, film shows and painting. The workshop offers residents, particularly the younger adults, the opportunity to develop interests and to be creative. There are some residents who go out and are supported to maintain their outside interests. At the time of the inspection arrangements were being made for the forthcoming Halloween night. Residents were being involved in the arrangements for the occasion. Coffee mornings are regularly organised for residents and relatives. The home has organised various fundraising activities to boost the residents amenities fund. The residents are able to make choices and make independent decisions about their care and the way they wish to be looked after. Residents described how they are able to do the things they like to do with the support of the staff. One staff member indicated that advocacy service would be sourced if this is necessary. She said that this had happened in recent months. The dining areas on each of the floors are pleasantly decorated and furnished. Dining table were appropriately set and residents had their meals in a pleasant and comfortable environment. Examination of past menus show that the home provides a choice of menu for the residents. Those residents with special dietary needs are catered for. For example, one resident requires special meals for religious reasons and the home has made suitable arrangements to ensure that they get the right food. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and relatives have information about how to make a complaint and are confident that any concerns raised would be acted on by the home, thus promoting their right to express their views about the service. Staff are aware of safeguarding adults procedures and have received suitable training which safeguards the safety and welfare of the residents. Evidence: The complaints procedure is posted in the reception area and a summary of the procedure is in the service user guide. Details in the complains book shows that the home takes complaints seriously. A number of residents and relatives were spoken with about the homes complaints procedure. Residents said they are aware of the procedure and feel confident about raising any concerns with the manager if they were unhappy about something. One relative commented that she had on one or two occasions raised concerns about her mothers care but the manager and the staff dealt with her concerns immediately and satisfactorily. Staff have had training in safeguarding adults. The training record shows that 90 of the staff have received training in safeguarding. Staff who were spoken with were Care Homes for Older People Page 17 of 27 Evidence: familiar with the homes policy on safeguarding vulnerable people. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides safe, secure, clean, warm and pleasant environment for the residents to live in. Evidence: The home is clean and maintained to good standard. The bedrooms that were seen were clean and personalised, reflecting individual tastes and preferences. People have been encouraged to furnish their rooms with personal items which enhanced the homeliness of their rooms. There are good arrangements in place for regular maintenance work in the building. The maintenance book shows that the handyman has kept on top of any safety work that is needed to maintain a safe environment. These include fire safety checks and drills. The home has suitable infection control policies in place. Staff have had training in infection control and records show that the home has adhered to infection control procedures. The kitchen was noted to be clean and maintained to good standard. There is a cleaning rota showing how the domestic staff keep up with the cleaning activities in the kitchen. Records relating to food temperatures and other food hygiene measures are maintained and effective. The laundry was found to be well ordered, and Care Homes for Older People Page 19 of 27 Evidence: appropriate COSSH notices are in place. The laundry machines are suitable for cleaning foul linen. The defects in the laundry flooring that were identified in the last inspection report have been remedied. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing numbers are satisfactory and promote the safety and welfare of the residents. Furthermore, the company adheres to good recruitment practices, which safeguards the welfare of the residents from unsuitable carers. Evidence: The home employs sufficient numbers of staff to meet the needs of the residents. The inspector had discussions with staff and the residents about the staffing levels and there is a general view that there are always sufficient staff on duty to meet their needs. The staff have had appropriate training to equip them for their roles. The manager confirmed that the staff have received training in moving and handling, first aid, protection of vulnerable adults, fire safety, food hygiene and health and safety training. This was confirmed by the staff training log that was available in the home which shows the percentage of staff with relevant training. Four staff files were examined to check on the recruitment process by the manager. The files show that the home has been following the companys policy on recruitment. All the files contain completed job applications, copy of job description, appropriate references, evidence of CRB checks and record of training. Care Homes for Older People Page 21 of 27 Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a qualified and experienced person, and runs the home for the benefit of the residents, ensuring the safety and welfare of the residents through stingent quality assurance systems that are in place. The manager has in place an excellent supervision arrangements. This promotes the quality of the service that the residents receive. The safety and welfare of residents is protected fully by the regular equipments servicing and safety arrangements that are in place. Evidence: The registered manager has long experience of managing a residential care home. She is the registered manager for the two services and manages both from the Manor. Her management ability was commented on positively by the staff. Staff feel that she is approachable and supportive of them. Staff said she is supportive of the residents. Care Homes for Older People Page 23 of 27 Evidence: There is a quality assurance system in place for seeking the views of the residents and visitors to the home. The manager described the procedure for ensuring that the service is under constant review taking into consideration the views from area manager, residents and relatives. The monthly quality assurance checks include catering, medication system, accidents, complaints and servicing and maintenance. Remedial action is formulated to address any faults in the system. Examination of the personal allowance records and receipts of transaction show that there is a good system in place and that the residents monies are safe and properly accounted for. There are suitable arrangements for staff to receive one-to-one supervision from the manager. Staff records show that the manager has provided individual supervision to staff on regular basis. Staff commented that they find the supervision sessions useful. The company Health and Safety policies remain in place. These cover policy areas such as fire prevention and Care of Substances Hazardous to Health (COSHH). Staff adhere to the policies as set by the company. Servicing records confirm that all portable appliances have been tested. A record is maintained of regular water temperature tests are maintained in the home. Regular servicing of fire equipment, passenger lift, bath lifts and hoists, gas and electrical appliances have been carried out by the contracted companies. All the servicing records that were examined were up to date. These included servicing of passenger lift, hoists, water treatment, electrical installation and gas servicing. Records examined indicate that fire precautions relating to weekly fire alarm testing and record of inspection takes place. There are records in the home indicating fire drills and fire instructions with staff. Residents and relatives commented that the manager runs the home for the benefit of the residents. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Care plans should contain sufficient details to provide staff with the proper instructions on how to meet specific needs. For example care plan should state clearly what signs to look for if staff are ask to look for sings of DVT. Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!