Inspection on 08/05/06 for Fir Close Residential Home

This inspection was carried out on 8th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fir Close Residential Home 19/12/05

Fir Close Residential Home 23/06/05

Fir Close Residential Home 07/02/05

Fir Close Residential Home 02/09/04

Fir Close Residential Home 05/12/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Fir Close Residential Home 2 Westgate Louth Lincs LN11 9YH Lead Inspector Mr Ken Hague Unannounced Inspection 8th May 2006 07:40 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.V292378.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. Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 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.V292378.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th December 2005 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.V292378.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6.5 hours, which included a site visit of 3.5 hours. A partial tour of the premises was undertaken with the assistance of the registered manager and discussion and feedback was given at the end of the inspection. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents. A sample of care records was inspected. The Lincolnshire county council social services department were contacted to obtain feedback regarding the services being provided to residents funded by the county council. All residents were provided with comments feedback cards to be completed and returned to the Commission for Social Care Inspection these views are reflected within the inspection report What the service does well: What has improved since the last inspection? Evidence was found or and increased maintenance programme since the last inspection. All staff are following the policy on the Administration and storage of medication. This includes the management of controlled drugs. Recruitment procedure the care home has, has been followed. Care assessments, care plans, and individual staff recruitment records have increased in quality and now exceed the National Minimum Standards. Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 Page 6 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.V292378.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 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 the following standard(s): 3&6 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to this service. A detailed assessment, which includes a risk assessment, is carried out before any new resident is admitted to the care home. The home does not provide intermediate care services. EVIDENCE: Three residents were case tracked as part of this inspection. The individual personal files were studied and discussed with staff and the registered manager. All three files contained a detailed assessment which set out the care needs and social needs for all individual residents. This information had then been transferred onto a care plan, which included a risk assessment where any needs had been identified. Initial assessment were signed and dated by the assessor and by the resident. Assessments were found to be of high quality. The registered manager stated that the home does not offer an Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 Page 9 intermediate care service. This statement was found to be included within the home’s statement of purpose. Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9,&10 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to this service. Care plans contain comprehensive information, which identify the care needs and personal preferences of the residents. Risk assessments are of a good quality, providing management strategies that enable residents to be as independent as possible. All staff respect Resident’s dignity and privacy. EVIDENCE: Residents health, personal social care needs are set out in their individual care plan. This includes the involvement of community health care services. There are records on each resident’s file of GP visits, consultants, appointments and district nurse visits. All files contain details of dental care, eye care and foot care. One resident’s file stated resident refused to allow staff to cut toenails and provide foot care. Staff stated this resident prefers to carry out her own foot care and cut her own fingernails. Staff stated “this is her choice and she should be allowed to carry out this task herself. She can do this without Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 Page 11 assistance”. A resident spoken to during the site visit confirmed that her medical needs are being met by care home. The inspection of care records, the pharmacy report, and discussions with staff and the registered manager produced evidence that the medication policy of the home is being followed. The Pharmacy report confirmed satisfaction with the care practice of the home. Staff confirmed that they had received appropriate training. Spot checks made by the registered manager confirmed that the storage and administration of medication is being carried out in accordance with the National Minimum Standards and the home’s procedures manual. Residents confirmed that in their opinion staff respect their privacy and dignity. One resident stated “staff are very good here they always come and help you.” Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 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 the following standard(s): 12.13.14. & 15 Quality in this outcome area is Good. This judgement has been made using the available evidence including a visit to this service. Residents are encouraged to keep in contact with their family and friends. All visitors are made welcome by staff at the care home. Catering arrangements for the home reflects the service users choices, preferences and personal dietary needs. Residents with a special diet are provided with a menu which takes their personal needs into account. EVIDENCE: The home provides a range of activity and a copy of the activity programme was given to the Inspector. On the day of the site visit five residents went out for the day to Skegness. One resident commented “I would like more bingo”. Another resident stated I choose not to take part in activities I prefer to carry out my hobbies and interests within my own room. Other residents stated we are very satisfied with the activities being provided. Visitors were seen coming to the home throughout the site visit. Residents confirmed their family and friends are made welcome. Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 Page 13 There is a detailed document on residents individual files which states the likes and dislikes of each individual resident this includes their dietary needs. All residents interviewed stated their satisfaction with the home’s menu. The registered manager supplied a copy of the menu for a four-week period which providing evidence that choice is offered. The cook confirmed that residents are given the choice of a hot or cold breakfast. She was able to state the names to the residents who requested a hot breakfast on the day of the site visit. She confirmed that the menu takes into account any special dietary needs of residents. The resident’s comment cards asked, the question “do you always like your meals?” The responses from 3 residents who completed the cards was we always like our meals. Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 Page 14 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 the available evidence including a visit to this service. Residents are protected and are able to voice opinions by procedures in place for handling complaints and any allegations of adult abuse. The staff are clear on what action to take in event of this occurring ensuring that the Residents are safe. Residents are confident in being able to raise any concerns with members of staff or through residents meetings. EVIDENCE: Residents stated that they felt confident to raise any concerns with any member of staff or the registered manager. The home holds residents meetings where residents views are sought by staff. Residents spoken to as part of this inspection confirmed that they were aware of the formal complaints procedure. Staff stated that they had received training in the recognition and prevention of abuse. They were able to describe the action appropriate to take in respect of two scenarios given to them by the Inspector. All residents spoken to as part of this inspection stated that they felt the home is a safe place in which to stay. There have been no complaints made to the home since the last inspection. The Commission for Social Care Inspection has not carried out any investigation or received any complaint in respect of this home since the last inspection. Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 Page 15 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 in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Maintenance is being carried out within the care home. Residents feel the decoration standard of the care home is good. The infection control policy the home has is being followed. EVIDENCE: A number of bedrooms have been decorated since last inspection. A number of items of furniture have been replaced and new carpets have been ordered for a number of corridors within the home. The home was clean and tidy on the day the inspection there were no health and safety issues identified. Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 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 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 Excellent. This judgement has been made using the available evidence including a visit to this service. The home provides training for all care staff and encourages NVQ training. There are always sufficient staff on duty to provide essential care for service users. Staff are recruited in accordance with the company’s recruitment policy. EVIDENCE: Staff stated that the staffing Rota is given two month in advance. Staffing hours are never allowed to fall below the number of care hours recorded on the staffing rota. Staff who were formerly interviewed stated they believed there was always sufficient staff on duty to meet the needs of the residents. They confirmed that in their opinion theyve been trained to be competent in meeting the needs of all residents in the care home. Staff stated in our opinion we worked well as a team. We feel there is support by our registered manager. Staff training records confirmed that staff are being given a range of training including specialist training to ensure they can meet the needs of residents. The registered manager produce evidence of staff taking NVQ training. Residents stated they felt safe in the home, staff were very kind and are always sufficient staff on duty to meet their needs. These statements were Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 Page 17 confirmed by residents comments cards received by the Commission for Social Care Inspection. The recruitment records for staff exceeded the National Minimum Standard. The individual files were very well-organised indexed and easy to follow the contain detail recordings which contained all information required by the care home regulations. There was evidence of the registered manager monitoring to ensure that there were no gaps on application forms or missing details of past employment. Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 Page 18 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 the available evidence including a visit to this service. The home is well run, with good leadership and guidance from the registered manager who has worked for many years in the provision of community care. The health and safety and welfare of service users is promoted. EVIDENCE: Staff stated that the registered manager is very supportive and consistent in the guidance she gives to all staff. She obtained her registered manager award in the summer of 2005 and in addition was awarded an NVQ 4 in care. Staff stated that she encourages them to be involved in NVQ training and to take advantage of appropriate training courses. Residents stated that the registered manager is very approachable and listens to their comments regarding the services provided at the home. They stated Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 Page 19 that the home holds regular residents meetings. Residents confirmed that staff treat them as individuals and they feel that there personal needs are being met. There were no health and safety issues identified at this inspection. The Lincolnshire county council social services department who purchase beds for residents have not admitted any new resident since last inspection. They are satisfied with the services being provided to residents placed by the social services department. The inspection of record and discussions with staff confirmed that supervision and appraisals are being provided in accordance with the National Minimum Standards. The home has policies and procedures in place to ensure that the financial interests of the residents are safeguarded. Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 Page 20 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 4 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 x 3 x x 3 Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? yes 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 OP38 Good Practice Recommendations it is recommended that a steam cleaner be purchased the use in the kitchen. Fir Close Residential Home DS0000002358.V292378.R01.S.doc Version 5.1 Page 22 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. 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