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Inspection on 19/12/05 for Fir Close Residential Home

Also see our care home review for Fir Close Residential Home for more information

This inspection was carried out on 19th December 2005.

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.

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 provides a comfortable and homely environment for people to take short breaks, and long-term care. Care plans identify residents` needs in detail and this helps staff to provide consistent care. People who use the service are happy with the care they receive. The staff group know the people who use the service well.

What has improved since the last inspection?

The registered manager has reviewed the care plans for all residents since the last inspection. They now meet the National Minimum Standards. Supervision was not being provided in June 2005 at the frequencies set out in the National Minimum Standards. A supervision programme is now in place to ensure this requirement is met. There was no evidence found at this inspection of staff not considering the dignity and privacy of residents. This was not the case in June 2005.

What the care home could do better:

Staff have not been recruited in accordance with the Prime Life Limited recruitment policy. The records for the administration of controlled drugs have not been completed correctly. The registered manager has not monitored these records. There is a need for an ongoing maintenance program, which should include consideration for the redecoration of some areas of the home.

Residents Visiting CARE HOMES FOR OLDER PEOPLE Fir Close Residential Home 2 Westgate Louth Lincs LN11 9YH Lead Inspector Mr Ken Hague Unannounced Inspection 19th December 2005 09:00 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 Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 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. Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fir Close Residential Home Address 2 Westgate Louth Lincs LN11 9YH 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) 01507 603882 Prime Life Limited Mrs S Capes Care Home 36 Category(ies) of Dementia (22), Old age, not falling within any registration, with number other category (14) of places Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23/06/05 Brief Description of the Service: Fir Close Care centre is owned by Prime Life Limited who have 50 care homes throughout the country. The home is made up of two detached buildings, which are named Riverview and Fieldview, both set in the same grounds. The home offers residential care for 36 older people over the age of 65, this includes 22 service users suffering with dementia. Fir Close offers both short-term and long-term care, nursing care is not provided. Fir Close Care Home has large extended private gardens and a large car park at the side of the care home. The home itself is set in the centre of Louth and, therefore, can be reached easily by local transport services. The service users staying in the home are provided with a minibus for transport to hospital appointments and for local shopping. Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 8am and 12.30pm. The main method of inspection used is called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. A tour of the premises was conducted and care records were inspected. Two members of staff and four service users were interviewed. What the service does well: 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. Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 6 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 Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 7 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): 1,2,3 The home undertakes comprehensive assessments before people are admitted to the home to ensure that the home can meet their needs. Potential residents visit the home prior to admission to make sure that the home is suitable for them. The home does not provide dedicated intermediate care beds. EVIDENCE: The home provides potential residents with a copy of the statement of purpose and service users guide which sets out the resources of the care home. The sampled files provided evidence to support the registers manager’s statement that “residents are given a copy of their terms and conditions for their stay at the care home.” The registered manager stated that any new residents receive a full assessment including a risk assessment before being admitted. The files of the three residents being case tracked contained initial assessments, risk assessments, and a copy of a terms and conditions. The home does provide short-term care but has no dedicated intermediate care unit. Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 8 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 contain sufficient information to ensure that the care needs of service users are met. Risk assessments detail the management of any identified risk. Staff ensure that they always consider the resident’s dignity and privacy when providing care. The home has failed to follow the correct procedure for the recording of the administration and storage of controlled drugs. This could have placed a resident at risk. EVIDENCE: The care records for the three residents being case tracked contained a detailed care plan, which included a risk assessment written at the time of their admission. Where a risk was identified the management of that risk was included with the care plan. There was evidence of input from local community Healthcare services, one resident being case tracked had received weekly visits from the district nurse to check on tissue viability. All three residents had received visits from chiropodists and had received dental and eye care. There were details of visits, comments and instructions on care records made by consultants and community psychiatric nurses. Observations and formal discussions with staff provided evidence that the home has addressed the issue of ensuring that resident’s dignity and privacy is respected. This was a requirement at the last inspection. There are references in care records Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 9 reminding staff to ensure privacy and dignity are considered when providing personal care. One resident stated “staff are kind they help me with some of my personal care but allow me to wash certain parts of my own body”. Staff were observed to knock on doors before entering bedrooms. Conversations heard during this inspection provided evidence that staff listen to the views of residents and were heard to speak to them in a polite and calm manner. Staff provided evidence in their responses to questions that they understood the importance of respecting the wishes and choices of residence. Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 10 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 A range of activities is available to residents at the care home. The home consults residents to obtain their comments on the services and resources being offered. Relatives and friends are encouraged to visit the home. EVIDENCE: The registered manager stated that there is an activity programme in place for residents, which includes entertainers visiting the home. The register manager showed the Inspector photographs of the last residents outing to a local garden centre. She stated regular outings are organised. The home’s visiting policy meets the National Minimum Standards. Visitors were seen to be entering and leaving the home throughout the inspection. Two residents confirmed to the Inspector that they had regular visits from their friends and family. They said “they are made very welcome by staff ”. The care records provided evidence that choices are being offered in the provision of menu and activities. Resident stated that they choose what time they get up, what time they go to bed and where they have their breakfast. Staff and the register manager confirmed that residents meetings are held at the home. Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 11 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 There are robust procedures for the handling of complaints and any allegation of adult abuse. Staff are clear on the actions to take in the event of this occurring, ensuring that residents are safe. Staff have received training in the identification and prevention of abuse. EVIDENCE: The registered manager stated that staff have been provided with training in the identification and prevention of abuse. Staff confirm this statement to be correct. There is a complaint policy and an abuse policy in the homes procedure manuals, which meets the National Minimum Standards. Staff were able to discuss these policies in their formal interviews. Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 12 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 Residents live in a clean, comfortable and homely environment. There is however no rolling maintenance program for the care home. EVIDENCE: The registered manager stated that there is no planned ongoing maintenance being carried out at the care home. There has been some repairs carried out but some areas of the home are beginning to look tired and worn. The home however was found to be clean and smelt fresh. Residents stated they were satisfied with their own individual bedrooms. One resident did express some concern regarding the noise caused by a resident who has now moved into nursing care. He stated that it is difficult to have private conversations with visitors unless you returned to your bedroom. The comments was made “if you have poor mobility having to go back to your room to talk to visitors can be difficult”. Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 13 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): 29 The home has failed to follow the recruitment policy of Prime Life Ltd, as a result residents could have been placed at risk. EVIDENCE: The recruitment records for three new members of staff were seen. One file contained no Criminal Records Bureau Check. A second file contained only one reference. The Care Home Regulations state that a Criminal Record Bureau check or a protection of vulnerable adults (POVA first check) must be obtained before the member of staff is employed. In addition two written references must be on their personal file before they work in the care home. Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 14 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 There is leadership and guidance for staff, ensuring that service users receive consistent quality care. The environment is generally safe, but some issues were identified, relating to ongoing maintenance. The home consults with people to make sure that they are happy with the service provided. EVIDENCE: The home has a registered manager who has worked in the field of providing community care for many years. Staff stated that she is very supportive and generally there is good morale in the home. A member of staff interviewed said she believed “teamwork has improved recently”. The registered manager stated that quality assurance checks are made regularly by the company. She stated resident’s meetings are held to obtain the views, choices and wishes of residents. Prime Life Ltd have policies and procedures in place to ensure that residents finances are protected. A Regional Manager who supervises the home’s registered manager monitors these systems. The health and safety of Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 15 residents could have been placed at risk by the failure to monitor the controlled drug register. (See standards 9 comments) Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 16 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 3 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 17 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 Standard OP9 OP29 Regulation 13-2 19-1 Requirement The registered person must ensure that controlled drugs register is completed correctly The home’s recruitment policy must be followed. Timescale for action 19/12/05 01/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP19 Good Practice Recommendations The registered person should review the maintenance program for the home to ensure planned maintenance is being carried out. Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Fir Close Residential Home DS0000002358.V272382.R01.S.doc Version 5.0 Page 19 - 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. 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