Inspection on 28/02/06 for Favordale

This inspection was carried out on 28th February 2006.

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

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

Other inspections for this house

Favordale 21/01/09

Favordale 07/02/08

Favordale 31/07/07

Favordale 31/07/06

Favordale 04/05/05

Favordale 27/10/04

Favordale 07/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Sunny Bank (P.R.S.) Ltd

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Favordale Favordale Byrom Road Colne Lancashire BB8 0BH Lead Inspector Mrs Marie Dickinson Unannounced Inspection 28th February 2005 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Favordale DS0000035216.V275232.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. Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Favordale Address Favordale Byrom Road Colne Lancashire BB8 0BH 01772 563002 01772 562304 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) Lancashire County Care Services Miss Deborah Margaret Watson Care Home 31 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (5), Old age, not falling within any other category (31) Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should, at all times, employ a suitably qualified manager who is registered with the CSCI. Within the overall registration of 31, no more than 5 service users of 55 years of age and above who fall into the categories of either MD or MD(E) shall be resident at any one time. A maximum of 31 service users who fall into the category of OP may be accommodated. 3. Date of last inspection Brief Description of the Service: Favordale is registered with the Commission for Social Care Inspection to provide personal care and accommodation for thirty one people. The home is owned by Lancashire County Council and managed by Lancashire County Care Services. The property is set back off a main road and on a bus route to Colne. There are gardens to the side and rear, accessible to the residents. Accommodation offered is in single bedrooms. There are sufficient bathrooms and toilets, and various aids provided for residents throughout the home. The home is staffed twenty-four hours a day, with a member of the management team on duty and on call at all times. Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 28th February 2006. It is the second required statutory inspection carried out this year. The inspection involved getting information from staff records, care records and policies and procedures. It also involved talking to residents, staff on duty and the registered manager. Areas that needed to improve from the previous inspection were looked at for progress made. The home was assessed against the National Minimum Standards for Older People. Not all standards were assessed and this report should be read with the inspection report dated 4th May 2005 for the reader to have a complete overview of the home. What the service does well: Before people are admitted to the home information needed to give the right care for them is recorded. Staff knew the needs of residents and worked as key workers to a number of residents. This helped to personalise care. All the residents had the benefit of an additional care plan written specifically for personalised care needs during the night. Healthcare was monitored. Residents were generally happy with the carers and felt more secure with the number of long serving staff who they ‘trusted’. This opinion was shared with visiting relatives. Visitors were made welcome and the staff made themselves available to speak to them. Catering arrangements were good with choices and alternatives offered at every meal. Residents thought the meals were ‘tasty’, ‘good’ and ‘more than enough’. Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 6 Training was provided for staff and included topics such first aid, medication and infection control. The standard of training and commitment of the Lancashire County Care Services was very good. Staff were described by residents as ‘professional when caring’. They were trained in basic care and had other specialist training. Training provided for staff included topics such as care for people with dementia. Staff showed they had a good knowledge in understanding the needs of older people. They were supervised in their work and teamwork was evident. Staff said they enjoyed their work and chosen career. A good standard of hygiene was maintained and observed during inspection. Resident’s health, safety and welfare were considered, and staff worked with safe working practices. There was a member of the management team on duty at all times, and staff said they benefited from being able to discuss their work with the area manager who visited the home every month. What has improved since the last inspection? What they could do better: When people are admitted to the home they must be given a contract that outlines the terms and conditions of residence. Staff responsible for medication must make sure this is done properly. The storage of medication could improve. Activities for residents must improve and take into account their wishes. Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 7 To make sure the complaints procedure is effective the outcome of any investigation or response should be given in writing to the person making the complaint. To make sure gaps in employment are explained properly, applicants for jobs should be asked to write this on their application form. This can be verified at interview. Sufficient staff must be employed to meet the needs of residents properly. Residents should be given more opportunities to have meetings and the results of any quality assurance audits must be made available to interested people, with a copy sent to the Commission. To protect the financial interests of residents two signatures must be recorded when handling resident’s temporary savings and regular auditing of their money carried out. To protect confidentiality for staff, supervision records must not be taken from the home and proper storage facilities provided for this purpose. Supervision must be kept up to date. 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. Favordale DS0000035216.V275232.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 Favordale DS0000035216.V275232.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): 2,3,4,5 Two residents admitted had not been issued with a contract from Lancashire County Care Services. Proper assessments were carried out and visits and short stays offered. Assessments contained sufficient information to help make sure the home had the right facilities and staff to meet needs. Staff were trained to care for people with special needs such as dementia. Advice was taken from other professionals to make sure all care needs were met properly. EVIDENCE: A number of residents had been admitted to the home since the last inspection. Records showed that residents had been assessed before they came to live at the home. The assessments were clearly written, showing what support was needed. It was also noted that where possible family and residents had also been involved in the process. Each person had a plan of care for daily living It was the homes practice that before anyone is admitted they are given an opportunity to visit and look at the home and meet the staff. Sometimes this is Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 10 not possible and a representative of the resident is invited to look around on their behalf. Residents placed in the home by the local authority were given a contract for financial arrangements for payment. Not all residents had been given a contract of residence by the home. The range of needs for residents had been considered. All staff had instruction in basic principles of care and staff working in the home said they had continuing training in other relevant topics such as moving and handling residents safely. Daily records showed staff acted upon changing needs of residents and where necessary other professionals had been consulted for advice. This included amongst others, contact with visiting district nurses who was present during inspection. Senior management were present in the home at all times which meant staff were able to seek advise at any time regarding residents needs. Favordale DS0000035216.V275232.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 Care plans were used to help staff to provide appropriate personal care for residents. The plans were basic but information recorded showed care needs were identified. They had been reviewed regularly and residents had been included in these. Residents were satisfied that their care needs were met and they considered staff were respectful to them. Privacy for healthcare procedures should be observed. Medication management needed improvement. EVIDENCE: Residents had care plans. Care plans referred to residents assessed need. They were used to help staff personalise care for each person. Although brief they included health, personal and social care needs. A brief record was made of residents past history, helped staff to understand people as individuals, their likes and dislikes. The plan also showed what help was required such as when getting up, or if help was needed for walking and bathing. In addition to the daily care plan each resident had a night care plan that showed how care was to be provided during the night. These were good. Residents said they sometimes ‘talked about their care with staff.’ Residents said they liked most Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 12 of the staff and were generally happy with how they were helped. Reviews of care were done regularly and care plans changed when resident’s needs changed. Staff were familiar with the content of the residents care plans. They worked to a key worker system. This is when a carer takes extra responsibility for named residents to make sure their needs are met. Entries in daily records showed residents received personal care and additional specialist support where needed. This included the resident’s healthcare and mental health care needs. Visits from a chiropodist, district nurse and their doctor were evident. Residents also confirmed this. Pressure care was promoted and pressure-relieving aids were used where needed. A district nurse visited during inspection. Clinical procedures such as dressings however, should not be carried out in communal areas with other residents present Residents confirmed staff in the home were mindful of their privacy, for instance they kept the bathroom and toilet doors locked when they were helping them. They also confirmed staff would knock on bedroom doors and wait to be invited in. This was also observed during inspection. When asked, relatives visiting confirmed they were kept informed of matters that involved their relative. One visitor said ‘she had no problems at all with the care her father received at the home’. She thought staff ‘understood his needs’. Good practice was observed in confidentiality of information. Records were kept secure in the office. Medication was stored in a locked room. This room needed organising however as district nurse’s supplies were also stored in the room and space was limited. Medication not being used and dating back to last year must be returned to the supplying pharmacist. In addition to this, medication that must not be used after a specified time limit once opened, should indicate the date when opened for reference. All staff responsible for administering medication had been trained. Information to keep residents safe had been completed. This meant staff had guidance to follow when seeing to residents needs. Favordale DS0000035216.V275232.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 Resident’s lifestyle was to near to their expectations and they felt generally satisfied with their care in the home. Activities were limited. Visitors to the home were made welcome. Catering arrangements were satisfactory. EVIDENCE: Residents talked about their life in the home. They said there were no rules imposed on them such as when they went to bed or got up in the morning. One resident said she had lived at the home for several years and loved every minute of her stay’ and described the staff as ‘’great and so kind’. She also said she did what she wanted to do ‘nobody questioned this’. Several residents talked about their family visiting. Staff were thoughtful offering drinks and were friendly. When birthdays were celebrated family were invited and sometimes a buffet was provided as part of the celebrations. Visitors at the home said they ‘never had any problem when calling in the home and were kept up to date with changes’. Residents gave mixed views about activities. There was an overall opinion that these were not very good. Comments included ‘I get fed up just sitting about’ and ‘before I came here I enjoyed gardening and going out, I don’t do this Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 14 anymore’. The residents considered staff gave them as much time as they could but said they were ‘run off their feet’. Staff said they had bingo sessions and quizzes and tried to spend time with the residents. Clergy visited the home. One visiting priest said he came in regular to two residents and gave them communion. Comments from residents indicated the food was up to their expectations. They said it ‘tastes good’ and ‘I can have my meals in my room if I want’. The cook discussed menus with them. They were given choices at meals and some said if they did not like the choices offered the cook would provide an alternative. Staff were observed offering support to those people who could not manage to eat their meal without assistance. Fresh fruit was included in the menus. Favordale DS0000035216.V275232.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 The complaints procedure was clear and available for residents and visitors to the home such as relatives. It was evident that any concern or suggestion was acted upon and taken seriously. There were policies and procedures in place to ensure a proper response to any suspicion or allegation of abuse, and support offered to staff from higher management in doing so. EVIDENCE: Residents said they knew who to speak to if they had any concerns. There was a complaints procedure for residents to use. This was given to residents when they came to live at the home. Residents said they had no complaints against the staff. Anything they wanted to discuss was taken seriously and dealt with. One resident said ‘you have to stick up for yourself, staff have my welfare at heart’. One relative visiting said she was able to tell the manager if she was unhappy about anything. There had been no complaints received at the Commission. The manager dealt with one complaint received at the home. To show complaints are taken serious, the action taken by the manager to resolve issues must be followed through to a satisfactory conclusion. This should include a written record and confirmation in writing to the complainant with the outcomes of the homes investigation Staff working at the home said they were aware of the abuse policies and procedures, which included a whistle blowing policy. Staff said they had regular contact with the area manager of Lancashire County Care Services and could Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 16 approach her with any problem. Staff contracts precluded them from financial reward or assisting in or benefiting from the service users’ wills. Favordale DS0000035216.V275232.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): 26 The home was clean. EVIDENCE: The home is near completion of major refurbishment and alterations. The home was very clean. Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 18 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 The level of staffing did not meet with residents needs. Recruitment and selection procedures were mostly satisfactory. Residents had confidence in the staff working at the home. Training provided and attended by staff was very good and offered a wide range of topics. EVIDENCE: The home was fully staffed during the inspection. The current level of staffing however needs to be reviewed. This is because the home has been altered in lay out and is now operating on two floors in addition to residents being more dependent on staff support. Observations showed staff were left working alone during staff meal and break times. Some residents said staff did not have enough time for them. The rota showed staff worked alone between 8am and 8.30am. The residents were very happy with most of the staff in the home. They thought the pressure of their work was too much at times. In the morning they had to wait until staff had time to see to them and this meant they sometimes had breakfast later on. One resident said ‘like everybody else they get jaded, they have to do the cleaning washing and ironing.’ Another resident said her key worker was ‘very efficient’ when she cleaned her bedroom. Staff files showed how recruitment procedures had been carried out. The application form completed by new employees had no declaration signed by Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 19 them regarding their mental and physical health. The manager said medical questionnaires were held at head office. References had been applied for and Criminal Record Bureaux (CRB) and Protection of Vulnerable Adults (POVA) check had been obtained prior to staff working in the home. Information disclosed on CRB checks is not made available for the manager. In addition candidates completing application forms should record information regarding gaps in employment. This can then be verified during interview. One member of staff had not been given a proper induction. All staff had attended basic training. The percentage of staff having completed NVQ level 4 was 68 . Staff enjoyed their work and said the content of training sessions was good. Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 20 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): 31,32,33,35,36,37,38 Good professional relationships existed between the manager, staff, residents and relatives. Guidance and support was given to staff by the management team in the home and from the area manager of Lancashire County Care Services. To help improve services for residents, regular residents meetings should be organised. The management team benefited additional support for record keeping. Financial procedures to protect resident’s personal money required improving for auditing purposes. Good practice was observed in safe working procedures. EVIDENCE: Since the last inspection a new manager has been appointed and registered with the Commission. Lancashire County Care Services as Registered Provider have the overall responsibility in the management of the home. Senior management visit the home unannounced every month and send a report of Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 21 this visit to the Commission. The role definition of the manager outlines the responsibilities and expectations of this position. The means of seeking residents and staff views about the home was both formal and informal with resident’s, staff and management meetings. The number of residents meetings need to increase as the last recorded one was June 2005. A quality assurance audit had been carried out. Staff confirmed they received routine formal supervision, although these were not carried out regularly. Personal supervision records belonging to staff must not leave the home. Proper arrangements should be made to keep them confidential and safe. . Residents and relatives expressed general satisfaction about the care and facilities in the home. Staff were praised for their efforts in making the home ‘so friendly’ and for the commitment to improve standards. Staff teamwork was evident. Small amounts of money held for resident’s use balanced correctly against records, however it is advisable two signatures are always shown for auditing purposes. A member of staff has been appointed to support the management team with record keeping. The health, safety and welfare of residents and staff had been considered. Staff were instructed in safe working practices such as moving and handling residents, first aid and fire procedures. In addition to this regular monitoring of water temperatures and fire safety checks and drills were regularly carried out. Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 22 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 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 X X X X X X X X 3 STAFFING Standard No Score 27 1 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 2 2 3 3 Favordale DS0000035216.V275232.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4 5 6 Standard OP2 OP9 OP10 OP12 OP27 OP29 Regulation 5(1)(b)(c) Sch4 13(2) 12(4)(a) 16(2)(m) (n) 18(1)(a) Schedule 2 Schedule 4 Requirement All residents must be given a contract. Medication must be managed properly. Healthcare procedures must be carried out in private. Improvement in activities is required for residents individually and as a group. Lancashire County Care Services must employ sufficient staff to meet the needs of the residents. Application forms must include a statement from the employee as to their physical and mental health. Supervision records must be kept in the home. Timescale for action 14/03/06 07/03/06 01/03/06 31/03/06 30/04/06 14/03/06 7 OP36 01/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Favordale Refer to Good Practice Recommendations DS0000035216.V275232.R01.S.doc Version 5.1 Page 24 1. 2. 3. 4 4. 5 6 7 Standard OP9 OP16 OP29 OP30 OP33 OP33 OP35 OP36 It is recommended that the storage of medication be better organised. It is recommended that a written record be made of the outcome of complaints and notification of this given to complainants in writing. It is recommended that job application forms request the applicant explain gaps in employment. It is recommended all staff complete initial induction training. It is recommended residents meetings be held regularly. It is recommended the results of the quality assurance audits are sent to the Commission and made available to residents and other interested people. It is recommended two signatures be obtained when handling residents personal money. It is recommended supervision of staff is kept up to date. 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