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Inspection on 19/04/06 for Far Fillimore Rest Home

Also see our care home review for Far Fillimore Rest Home for more information

This inspection was carried out on 19th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

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

What the care home does well

The home`s staff consulted regularly with residents about what they wish to do on a daily basis, how they like to spend their time, and residents` views are generally acted upon. For instance, at the previous inspection residents were talking about how they enjoyed watching the wildlife in this very rural setting. On this visit they were able to talk about a visit they had from a wildlife expert who bought owls to the home and there were many pictures of the residents with them. Communication between the home and health care professionals has improved in the last 18 months; this was confirmed by surveys and talking to health care professionals. This has resulted in good positive relationships between the home and outside agencies, thus ensuring residents` care needs are being met by staff who are trained and informed in the care of older people.

What has improved since the last inspection?

The redecoration/refurbishment programme at the home has continued. A number of bedrooms have been redecorated and new carpets fitted, enhancing the environment for residents. All unguarded hot water pipes and radiators have now been boxed in and guarded to meet the requirement of the previous report. The general redecoration of the home has improved. The environment overall is bright and clean; this programme should continue on a rolling basis to maintain standards.

What the care home could do better:

Ground floor bathroom should be updated; the bath is very low for residents to get into and staff to assist. The care manager told the inspector that a new bath has been purchased and is waiting to be fitted. The fitting of this bath will improve access for residents.Care plans when agreed with residents need to be signed by the resident or their relative; some are, some are not. Copies of Regulation 26 visits carried out should be sent to the Commission for Social Care Inspection, as well as being retained at the home.

CARE HOMES FOR OLDER PEOPLE Far Fillimore Rest Home Wood Lane Hanbury Burton On Trent Staffordshire DE13 8TG Lead Inspector Mrs Kathryn Marks Key Unannounced Inspection 19 April 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Far Fillimore Rest Home Address Wood Lane Hanbury Burton On Trent Staffordshire DE13 8TG 01283 812180 01283 813666 Ffchltd@aol.com 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) Mr Chander Goel Mrs Nisha Goel Nicola Jayne Yeomans Care Home 26 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (26) of places Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th December 2005 Brief Description of the Service: Far Fillimore Rest Home is situated in the hamlet of Hanbury, mid-way between Uttoxeter and Burton-on-Trent, in a country setting. Road links are via Broads and lanes, with no appreciable bus service. The three-storey house was converted from a private dwelling to provide residential accommodation and care for twenty-six persons with elderly care needs, three of whom may have dementia-type conditions. Far Fillimore has a bungalow within the grounds of the home, which provides accommodation for four overseas staff. Far Fillimore consisted of twenty-two single occupancy bedrooms, two of which were equipped with en-suite facilities; there were also two shared bedrooms that were provided with dividing screens to afford service users with additional privacy one of these rooms are currently being used as single. The home also provided two lounge areas and a separate dining room. Toilets were provided throughout the property and were in close proximity to bedrooms and communal areas. Ramp access and grab rails were provided at the external entrances, enabling service users to access the large attractive well maintained gardens where there is seating for residents and visitors. On entering the home, there are notice boards in the reception hall displaying information about the home and the services provided. The home’s last report from the Commission for Social Care Inspection is also displayed here. Information gained from the Pre-Inspection Questionnaire (PIQ) received on 10/04/06 identified that the current fees charged are: Shared Room £335, Single Room £355, En-Suite Room £365 per week. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key Inspection was carried out over half a day on the 14th April 2006. During the course of the inspection the inspector spoke to residents, staff on duty, the visiting district nurse and student nurse. Two residents were case tracked; both were spoken with, all records relating to them were seen and accommodation was visited. Comments received from residents verbally and via written surveys about staff and life at the home, and the manner in which they are cared for, were of a positive nature. Surveys were also received from relatives, general practitioners and health care professionals, a sample of whom were contacted and made positive comments about the home. Information was provided by management and via observations of the Inspector regarding staffing, staff training, menu and dietary provision. There is a cook or kitchen assistant (or both) on duty for all mealtimes and individual preferences are discussed with residents. Resident accommodation is located on all floors and as at previous visit, observations of the inspector were that the home was clean. Resident bedrooms were individualised with favourite items they had brought into the home with them. Far Fillimore has in place a Statement of Purpose and Service User’s Guide to inform residents of the services and facilities provided. Pre-inspection planning identified that this needed to be updated to include new fees, hairdressing charges and changes in management. The Care Manager had updated the documents on arrival at the home and they are being forwarded to the Commission for Social Care Inspection. Regular social opportunities are available for individuals who wish to take part. The home has in place a complaints procedure; this is given and explained to residents on admission to the home. Arrangements are in place for meeting health and personal care needs of residents and details are recorded in care records. Staff on duty at the home was observed to be experienced and competent to care for older people and were able to discuss diseases associated with old age. The Inspection Record identified that at previous visit, appropriate recruitment procedures were in place and all staff prior to employment have Criminal Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 6 Records Bureau and Pova checks carried out. This was confirmed at the time of this inspection. What the service does well: What has improved since the last inspection? What they could do better: Ground floor bathroom should be updated; the bath is very low for residents to get into and staff to assist. The care manager told the inspector that a new bath has been purchased and is waiting to be fitted. The fitting of this bath will improve access for residents. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 7 Care plans when agreed with residents need to be signed by the resident or their relative; some are, some are not. Copies of Regulation 26 visits carried out should be sent to the Commission for Social Care Inspection, as well as being retained at the home. 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 Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3, 6. Quality in this outcome area is good. This means that information available to residents and their relatives is clear and detailed. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose and Service User’s Guide provides prospective residents with up-to-date details of the services the home has to offer, enabling an informed decision about admission to Far Fillimore to be made. EVIDENCE: Minor adjustments have been made to the Statement of Purpose to bring it upto-date. A copy is to be forwarded to Commission for Social Care Inspection. Observations by the inspector of residents’ assessments confirmed that a full assessment of individual needs is carried out prior to admission to Far Fillimore, including district nurse assessment to ensure that the needs of residents can be met. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 10 The prospective resident or their relative would visit the home where possible and staff would visit the individual in their own home or current surroundings. The outcome of the assessment is confirmed to individuals in writing. Standard 6 is not applicable to this home, Intermediate care is not offered. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs of residents is well met. The systems for the administration of medication were observed by the inspector to be good, with clear arrangements being in place to ensure residents’ medication needs are met. EVIDENCE: As at previous inspection, detailed care plans are in place and contain profiles of life history and information relating to the individual’s diagnosis, care needs, any specialist intervention and support and assistance required to enable service users to live an independent lifestyle. All care plans need to be signed by the resident or their relative when agreed; some are, some are not - the care manager is dealing with this. All special needs are identified on the care plan which is reviewed monthly on a dependency profile. Healthcare needs are met by two visiting GP practices; there are visiting optician, chiropodist and district nurses. The Inspector spoke to visiting district nurse today who made positive comments about the home and the way residents are cared for. She had also Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 12 responded to the health professionals’ survey. Nurse said that staffs refer appropriately, and that overall there has been a general improvement at the home. Dementia Care and Management of Medication training has been carried out since the last inspection. Infection Control Training is arranged for the 2nd May 2006. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using evidence available, including a visit to this service. The home has systems in place that indicates that residents’ views are sought and acted upon. There was a relaxed and friendly atmosphere with residents moving freely around the home. Contact with the small local community is good - a lot of residents are from the local area. The cook at the home provides excellent food with a choice at all meals. EVIDENCE: Residents confirmed through conversation with them and positive responses to eight resident’s questionnaires that they are consulted about events in the home. Regular residents meetings are held where discussions take place regarding issues at the home, social activities and any areas residents themselves wish to discuss. These meetings are minuted. All residents sign to say they have attended the meeting and all, with support in some cases, are able to put forward their views. Very relaxed and friendly atmosphere, with individuals and visitors moving freely around the home. There are no restrictions on visiting times. Good family contacts all have relatives visiting them and taking them out. Noticeboard in the hallway to inform residents and families of events taking place in the home. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 14 Individuals are encouraged to make choices about their daily lives, how they wish to spend their time, lots of resident interaction in both lounge areas. Comments made by residents include “very good rest home in every respect, more than happy with everything” “I am happy living here, they do everything they can for you, the staff are kind and I feel safe”. There is a monthly newsletter that contains resident views, up and coming events, activities, proposed inspections. There is also monthly news and action plan for staff includes areas of development and matters for action. All staff involved and there is a new aim identified each month for staff to achieve. The homes menu offered a balanced nutritious diet with a choice at all meals, home baking and fresh produce delivered weekly residents said they always enjoy their food. A cook covers all mealtimes or a kitchen assistant all have food hygiene training. Inspector took lunch at the home today cheese pie with fresh vegetables, sponge and custard alternative choice for lunch and dessert was available. Lunch was nicely presented and portions were generous. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good this judgement has been made using evidence available including a visit to this service. The home has a satisfactory complaints system with some evidence that service users feel their views are listened to. Regular staff awareness training takes place to protect residents from abuse. EVIDENCE: The home has in place a complaints procedure that has been discussed with residents and their relatives. All have a copy in their bedroom and it is displayed on the homes notice board and in the statement of purpose. There have been no complaints made in the last twelve months. The procedure includes information on how to contact the Commission for Social Care Inspection. Residents the inspector talked to said they were aware of the complaints procedure and that they would talk to staff or relatives if they had any concerns. There is a comments box in the hall for residents and visitors. Resident’s legal rights are protected by the involvement of relatives, advocates, and solicitors as appropriate. Residents are protected from abuse by staff awareness via discussions at staff meetings and during formal supervision and training, and the policies and procedures in place at the home. All staff prior to employment has Criminal Records Bureau and Pova checks carried out. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 16 Residents relatives are involved in the management of finances, those finances managed by the home were sampled by the inspector cash balanced with records maintained. No Secrets and Whistle Blowing policies are in place; any allegations of abuse would be followed up and recorded. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Quality outcome in this area is good this judgement has been made using available evidence including a visit to this service. Far Fillimore is an old period house that requires constant maintenance. Work continues on a planned programme of maintenance by the permanently employed maintenance persons to keep the house in good order. Internally the home is well maintained and has an ongoing programme of general maintenance and refurbishment. EVIDENCE: The location and layout of the home are suitable for the stated purpose. Secondary glazing has been fitted to two windows residents said they find this much warmer and draught free. New window ledges have been fitted at the front of the home and externally all windows have been painted. A recent Fire Risk Assessment has been completed at the home copy on the homes file and provided for Commission for Social Care Inspection. A new bath has been purchased for the ground floor bathroom the maintenance person is to fit this and bathroom will then be redecorated. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 18 New emergency lights have been fitted and a new fly screen and blinds ordered for the kitchen. The office has been redecorated and laminate floor fitted. Quotes are being obtained for new carpets first floor landing and corridors, staircase, hallway and corridors ground floor. The home was clean and free from offensive odour. Infection control policies are in place and Infection Control Training is arranged for the 2nd May 2006. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good this judgement has been made using available evidence including a visit to this service. As at previous inspections staff on duty at Far Fillimore was observed to be competent and satisfactory in number to meet the needs of individuals in their care. Staff morale was observed to be high with the staff team working well together assisting individuals where needed to make choices to improve their quality of life. Appropriate procedures are in place for the recruitment of staff. EVIDENCE: The staff at this home are very welcoming and friendly creating an atmosphere of openness and trust at Far Filliemore. At the time of this unannounced key inspection the inspector identified that staff on duty were as stated on the rota and were sufficient in number to meet the observed needs of residents in their care. The one staff change was the cook off sick but the deputy had stepped in and this was identified to the inspector. Eleven out of seventeen staffs are trained to NVQ Level 2 or above the Care Manager and Deputy Manager both doing the registered managers award. All mandatory staff training is carried out. Residents are supported by the homes recruitment policy with staff being recruited locally via advertisements, job seekers direct, word of mouth recommendations. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 20 Prior to commencing employment all staff complete application forms two written references are obtained, Criminal Records Bureau checks and Pova checks are carried out. Regular programme of staff training is in place with records being maintained. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. Quality in this outcome area is good this judgement has been made using available evidence including a visit to this service. The Care Manager is supported by the proprietors in providing clear leadership throughout the home with all staff on duty demonstrating an awareness of their roles and responsibilities and continuing to work as a team. EVIDENCE: Discussions with the Care Manager identified that she is experienced and competent to manage the home and care for older people. The Care Manager is currently working towards obtaining her Registered Managers Award. Resident’s financial interests are safeguarded by the involvement of individuals themselves their relatives/solicitors and staff at the home. As at previous visit finances sampled by the Inspector identified that cash balanced with receipts and records maintained. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 22 The Registered Proprietors and Care Manager ensures so far as is reasonably practicable the health safety and welfare of service users and staff. Health and Safety awareness training is covered and daily health and safety checks are carried out. Safe working practices are in place and staff had received training in moving and handling, fire safety, first aid, and food hygiene and infection control. Hazardous substances are stored safely. Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 23 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 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 24 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. Standard Regulation Requirement 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 Op1 Good Practice Recommendations The completed updated Statement of Purpose be forwarded to Commission for Social Care Inspection Far Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Fillimore Rest Home DS0000034076.V289781.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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