CARE HOMES FOR OLDER PEOPLE
Far Croft North Road Wellington Telford, Shropshire TF1 3EU Lead Inspector
Patricia Scott Unannounced 22 June 2005 09:30
nd 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 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. Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Far Croft Address North Road Wellington Telford Shropshire TF1 3EU 01952 223447 01952 245558 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Coverage Care Shropshire Limited Mrs Alison Louise Gough Care Home (PC) 41 Category(ies) of 6 x Dementia (DE) registration, with number 35 x Old age, not falling within any other of places category (OP) Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home may accommodate a maximum of 41 service users. 2. The home may accommodate 41 Elderly Persons of whom up to 6 may be suffering from Dementia. Date of last inspection 29th March 2005 Brief Description of the Service: Far Croft is registered as a Care Home to provide care for a maximum of 41 older people, within which up to 6 Residents may have care needs associated with a dementia. The Home provides long term care and respite care within a designated respite unit and all bedrooms are single. The Registered Manager is Alison Gough and the Proprietors – Coverage Care (Shropshire) Ltd – a ‘nonprofit’ organisation registered with the Registrar of Industrial & Provident Societies as a charitable status. The gardens and grounds surrounding Far Croft are well maintained and provide a safe and pleasant outside environment for Residents and their Visitors. Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 22rd June 2005 commencing at 09.30. The National Minimum Standards for Care Homes for Older People focus on achievable outcomes for service users – that is the impact on the individual of the facilities and services of the home. Evidence was looked for that the standards were being met and a good quality of life enjoyed by service users through: • Discussions with service users, families and friends, staff and managers. • Observation of daily life in the home • Scrutiny of written records (including care plans for 4 service users). The statement of purpose was used to assess how far the home’s objectives to be able to meet service user requirements and expectations were being met. Reports regarding an overview of the conduct of the home are sent to CSCI on a monthly basis by the Head of Operations for Coverage Care. These, as well as the risk assessment from the last inspection were taken into account to determine the core standards focused on and depth of inspection. The Commission does not currently have any concerns regarding this home. What the service does well:
The home provides for the needs of elderly people including those with dementia through small group living. Service users were seen to be treated in a respectful and dignified way. After appropriate risk assessment, service users are not discouraged or unduly restrained from undertaking activities solely for fear that for example, they may hurt themselves. Coverage Care provides training to a level that creates a trained and experienced staff team that is well managed. Service users living in care are often vulnerable both physical and emotionally and the manager ensures that staff are recruited with the ability to carry out personal services for people sensitively and tactfully. The recruitment of good staff is critical to the running of care homes and the manager at Farcroft undertakes this carefully. Through discussions with the manager, the principles that should govern life as stated in the statement of purpose, focus on the importance of promoting service users’ independence through enabling them to make their own
Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 Page 6 decisions and fostering their individuality. The manager has been reviewing the respite care service so that an enhanced level of provision is provided from the pre admission assessment, the 48hr review and a review after discharge home. From surveying their views the home can gage whether it got the service right for these people according to their wishes, needs and aspirations of their brief stay at Farcroft. From this recognition flows a style of management which enables service users to make decisions for themselves, choose the way in which they spend their time, build friendships with whom they wish, and find satisfaction in living in the home environment. A good leader can have a major impact on the way care is delivered and the National Minimum Standards that are achieved or exceeded. Mrs Gough has demonstrated this quality through implementing a person centred ethos within the home. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 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 standard(s) 1,3 The homes statement of purpose and service user guide is good providing service users and prospective users with details of the services the home provides enabling an informed decision about admission to the home. Pre-admission needs assessments are thorough ensuring that service users who move into the home are assured that their needs will be met. EVIDENCE: The statement of purpose and service users guide have been updated for 2005. The information provides details of needs assessment to be conducted prior to admission and examination of care plans on the units confirmed that this process had been carried out. The home provides respite care and a service user who was receiving such a break in the home stated that the transitions between the home and their own home were well planned and that she had benefited from her stay. This service user’s husband had previously lived at the home and through visiting him had been able to experience the advantages and disadvantages of spending time in
Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 Page 9 a care home and had received great support from the staff in coming to terms with this. The manager intends to make the respite service more tailored to the needs of service users in that they enjoy the same routine as they would at home, with more emphasis on quality assurance and service user satisfaction. In carrying out pre admission assessments on planned respite care the margin for error in meeting needs will be less than just relying on the care management referral process. For this the home has scored a 4. Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 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 standard(s) 7,8,10 There is a clear, consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. Personal support in this home is offered in such a way as to promote and protect service users’ dignity and privacy in their daily life. EVIDENCE: 4 care plans were case tracked on the dementia unit. The care worker on this unit spoke about the care these people receive which mirrored the content of the plans. The staff member was very knowledgeable about the client group she was caring for on this shift and approached them respectfully and spoke to them in a dignified manner. She was kindly persuasive with a service user to affect a change in behaviour for his benefit. Service users in this unit showed signs of well being by their relaxed manner, being allowed by the staff member to show their emotions and being able to assert their own wishes e.g. they chose where to sit, whether they wanted music on and at what time they got up (one service user was still in bed late morning) but had been discreetly checked upon. Care plans looked at were consistently completed and had all the useful information in them that is necessary to enable a care worker to provide the
Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 Page 11 right care for that individual in a way that meets their wishes and preferences. Ascertaining such information can be difficult when an individual has dementia or mental health problems and records provide evidence of consultation with families and other supporters. The information that was read showed that individuals receive the level of care which their own situation requires. Regular monitoring and review of a service user’s condition takes place to ensure that the correct treatment and care is being given. Service users spoken to on the elderly care units stated that they were happy with their care. One particularly said that although she was going home she would not mind when the time came to stay at Farcroft permanently. Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 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 standard(s) These standards were not assessed at this inspection EVIDENCE: Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 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 standard(s) These standards were not assessed at this inspection EVIDENCE: Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 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 standard(s) 19 The standard of the environment within this home is very good providing service users with an attractive and homely place to live. EVIDENCE: A general tour of some bedrooms and communal spaces demonstrated that the home is purposely designed into small group units each with its own lounge/kitchenette and dining area. These were all in a good state of repair and comfortably furnished. It is easy for service users, elderly frail or those with dementia to find their way around their unit. Due to the layout of the home there are some ‘dead ends’ particularly on the ground floor dementia unit. Staff manage this appropriately and were seen to interact well with service users that would ‘wander’ about. The monthly report on the overview of the home details routine decoration and maintenance of the building due to be carried out. Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 Page 15 Two communal bathrooms have carpet flooring. There is a potential here to harbour bacteria from accidental soiling of urine and faeces. The garden areas are safe and accessible to all. Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 The arrangements for the induction and training of staff are good with the staff demonstrating a clear understanding of their roles. There is a good match of well-qualified staff offering consistency of care within the home. EVIDENCE: A file of a care worker was seen who has transferred from another coverage care home. All checks had been put in place. This staff member said that she had received induction, fire, manual handling and dementia training. This was on the homes records but had not been entered onto the individual’s staff training profile. The levels of staff on duty today were such as to ensure that service users needs could be met. Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,38 The manager has a clear development plan and vision for the home that will enhance the facilities even further. EVIDENCE: The manager possesses all the relevant qualifications required within the standards. Discussions demonstrated that she continues to strive for excellence and to provide person centred care. She seeks out relevant training to enhance the care provided e.g. activities training for staff who care for those with dementia. Service users spoken with said they would have no hesitation about talking to staff or the management about any concerns. The manager is introducing an additional quality assurance and monitoring system that seeks the views of service users using the respite care service. This will enhance the ability to measure success in meeting the aims and
Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 Page 18 objectives of the home for the provision of respite care services to the community. Her aim is to extend this into the long term care provision. Risk assessments were seen on files re falls and behaviour management of people with dementia. On a tour of the premises with the manager there was no doubt that the service users knew who she was. Monthly visits to the home are conducted by the Head of Operations for Coverage Care. Reports for these visits are received that give an overview of the conduct of the home and are taken into account before an inspection takes place. The report for 24th May 2005 detailed that health and safety checks had been carried out and no defects noted. Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 N/A 4 N/A N/A N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 N/A 10 4 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 N/A 13 N/A 14 N/A 15 N/A
COMPLAINTS AND PROTECTION 3 N/A N/A N/A N/A N/A N/A N/A STAFFING Standard No Score 27 3 28 N/A 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score N/A N/A N/A 3 4 4 N/A N/A N/A N/A 3 Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 Page 20 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 Regulation Requirement None were made Timescale for action 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 26 Good Practice Recommendations Replace floor covering in the two carpeted bathrooms as soon as possible. Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 1st Floor, Chapter House South Abbey Lawn SHREWSBURY SY2 5DE 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 Far Croft E56 S20547 Far Croft V235753 UI 220605 Stage 4.doc Version 1.30 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. 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!
