Inspection on 18/07/05 for Firbank Private Nursing Home

This inspection was carried out on 18th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Firbank Private Nursing Home 09/08/07

Firbank Private Nursing Home 19/09/06

Firbank Private Nursing Home 16/02/06

Firbank Private Nursing Home 22/02/05

Firbank Private Nursing Home 27/07/04

Firbank Private Nursing Home 23/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Firbank Private Nursing Home 81 Fir Road Bramhall Stockport SK7 2JF Lead Inspector Tracey Rasmussen Announced 18 July 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Firbank Private Nursing Home Address 81 Fir Road Bramhall Stockport Cheshire SK7 2JF 0161 440 8725 0161 440 8224 smallwoodhomes@btopenworld. Smallwood Homes Ltd Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Sarah Catherine Regester Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21), Physical disability (21), Terminally ill (2) of places Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. No service user may be received in the home who is less than 50 years old, male/female. Date of last inspection 22 February 2005 Brief Description of the Service: Firbank Nursing Home is a care home that provides 24 hour nursing care and accommodation to 21 adult service users. Many of the residents accommodated at the home have high physical dependency needs. The home is privately owned by Smallwood Homes Ltd. Firbank Nursing Home is situated on a quiet leafy residential road in Bramhall. Bramhall village, local shops, churches, and Bramhall Park are close by. Local bus services are also available. A small driveway leads to a car park and the main entrance to the home. Outside, to the front and rear of the home, there are pleasant garden areas which are accessible to service users. The home is a two storey building converted some years ago to a care home. Sixteen bedrooms are single rooms and two are shared rooms. Two single bedrooms and one shared room have en-suite facilities. Assisted bathing facilities are available on both floors. There is one large lounge which also provides a small dining table. Service users have a choice of spending time in their rooms or in the lounge. Well maintained enclosed gardens at the rear of the home are accessible from doors off the lounge. A wide variety of adaptations and aids are provided to assist in the nursing of the service users and this includes a passenger lift and hoists. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over six hours on the 18th July 2005 by one inspector. A tour of the home took place and care and staff training records were seen. Three of the 21 residents, two visitors (close relatives) and three staff were spoken to. Two relative comment cards, six resident comment cards and four GP comment cards have been returned to the CSCI and all contain positive responses. Verbal feedback of the findings from the inspection was given to the manager and the operations manager of the home at the end of the visit. What the service does well: What has improved since the last inspection? The home has improved its medication systems and these are now safer. Building remedial work to create a secure dedicated medication rooms is planned for later this year. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 6 The home had fitted a new central heating boiler, which has improved the flow of hot water to the majority of resident’s bedroom wash hand basins. 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. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4 Residents needs are assessed before they move into the home. The home can confirm they can meet the needs of the resident on admission. EVIDENCE: A sample of care files were examined and all had some form of community care assessment or nursing assessments and these were supported by the home’s own assessment of the new resident’s needs. The operations manager did state that at times the home was struggling to obtain community assessments and on occasion was dependent on Age Concern providing relevant information. The care needs of the new resident had appropriate care plans recorded so all staff had the necessary information to provide a care service. Relatives and residents spoken to said they were satisfied with the level of care and support they received to meet their physical needs. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10,11 The care planning documentation was not always sufficient to meet the health, personal and social care needs of residents. Residents stated they were treated with respect and dignity. Medication practices were safe. End of life care was good. EVIDENCE: The manager and nurse on duty interviewed during this visit both stated that written documentation was not one of their strengths. Both nurses worked ‘hands on’ providing care to residents and support to families. Both residents and relatives confirmed this. Some of the care plan documentation was untidy, however assessments were available with corresponding care plans which had signatures of agreement from residents or relatives. One relative said she had discussed and agreed her love ones care plans and she was very satisfied with the care in the home. Residents were very positive and complimentary about the home, the care they received and the staff and they confirmed their privacy and dignity was maintained. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 10 Documentation and care plans for pressure wound management do need further development. Wound assessment and care plans did not show any evaluation of the wound care management provided. However the tissue viability and ulcer nurse’s support had been sought and their written comments indicated that the wound care being provided was effective and good healing progress had been achieved. Care plans did not detail the type and setting of the specialist mattress used for each resident and this could result in the equipment being used inappropriately by new or inexperienced staff. Medications were checked briefly. There was no overstocking of medications. Controlled drugs were maintained appropriately and records of the medications in the home maintained. The storage area for medication does need moving away from the kitchen and a timescale was agreed at the last inspection for the home to implement this change. The timescale agreed expires in October 2005. Firbank nursing home is part of a pilot project set up in the north west to improve end of life care to people in the community including people who live in care homes. The focus of the pilot is to ensure that a consistent quality standard of care is provided across both health and social care services. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 Not all resident’s social needs are met. Life style choices are available and resident’s family and friends are welcome in the home at any time. The quality of food provided to residents is good. EVIDENCE: The home employs one member of staff to undertake activities for two afternoons per week. It was reported that all staff do get involved in providing activities. Two of the returned resident comment cards indicate that suitable activities are not provided at all times. An activity programme was available and evidence that trips out and entertainers brought into the home was available. Discussion with staff identified that they spent time on a one to one basis with residents when time permitted Staff did have a good awareness of residents individual preferences but records to support this support were not available. Work and play care plans for residents also lacked specific person centred detail. Two residents did detail areas where they felt their social needs were not met. One resident said she went to bed early in evening because other residents had gone to bed and she had no one to talk to. The resident did acknowledge Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 12 her care needs were not the same as most of the other residents. Another resident stated that she wanted someone to read to her or write letters for her but this was not available in the home. The manager did state that they did have a volunteer who did spend time with the resident but was not available because he was on leave. Visitors said they were welcome in the home at any time. Residents and relatives were complimentary about the meals provided in the home. The home’s chef prided himself on ensuring the meals provided to residents were enjoyed. The chef chatted with residents to find out their likes and dislikes and sometimes change the days menu in accordance with the weather and from discussion with residents. Residents confirmed choices were available. The kitchen was spotlessly clean. Stocks of fresh fruit and vegetables were available. All pies, cakes and pastries were home made. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Residents can be confident that complaints will be treated seriously. EVIDENCE: Residents, relatives and staff were clear that they could complain either to the manager or the operations manager or the proprietor of the home if the need arose. The manager reported that the home had not received any complaints. A copy of the complaints procedure was displayed clearly in the home. Records were available to indicate that staff had received training in abuse but this standard was not fully assessed at this inspection visit. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 22, 24, 25 Residents live in a clean, safe, well-maintained and comfortable home, which has aids and adaptations to meet their needs. EVIDENCE: The home offers compact accommodation and with limited storage of equipment. This, however did not seem to be an issue for the residents and the manager did state that extra storage solutions were being planned. A full tour of the home was not undertaken however the home was very clean and maintained to a good standard. Records of routine and contracted maintenance were available. Work place risk assessments were available. Residents and relatives said they were comfortable in the home. Suitable aids and adaptations are available in the home. Bedrooms were personalised according to the resident’s preference. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 15 The home recently had a new central heating boiler installed, however problems with the provision of hot water to some of the resident’s bedrooms had still not been resolved. The operations manager did state that the home was waiting for a part to be delivered so this could be fully addressed. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Staffing levels were sufficient to meet resident’s needs. Staff are trained to do their job. Staff vetting procedures are not totally safe. EVIDENCE: The home’s rotas identify that staffing levels are maintained in the home at a appropriate level meet the needs of the residents. Staff at interview said that there was good team work and if the home was short staffed then they pick up extra shifts to help cover the rota. Two residents, one relative and one resident comment card did state that they thought the home was short staffed at times . They also said that it was normally the same staff on duty who knew them and knew what their care needs were. One relative wrote, “The staff are always courteous and sensitive to the needs of relatives and residents alike” Induction training is in accordance with a National Training Organisation and booklets of induction training were available. Staff files contained various certificates for different training courses they had attended and this included statutory training in health and safety issues. The files of 3 three new members of staff were inspected. Criminal Records Bureau checks and 2 written references had been obtained before employment commenced. These were in place on the files. However two long term employees still had not provided the manager with completed CRB applications. The operations manager stated that they were proceeding down the disciplinary route with these staff members. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32, 34, 36, 38 The management of the home promotes the health, safety and wellbeing of the residents. Residents have some say in how the home is run. Accounting and financial procedures are safe. EVIDENCE: Residents, relatives and staff were positive about the contribution the manager makes to the home. All said the manager was accessible and very willing to listen and act on concerns. The manager has almost completed her NVQ 4 in management. Residents and relatives meetings – ‘The Resident’s Forum’ are held regularly and minutes indicate that families and staff discuss future activities and events in the home. Relatives were positive about these meetings. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 18 Business and financial plans were available for the home and these evidenced ongoing development and investment. Records were available of staff supervision. Fire safety records, maintenance records and health and safety training records were seen. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x 3 x 3 2 x STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 x 3 x 3 x 3 Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 8 Regulation 12 13 Requirement The registered person must ensure that wound assessemnt and care plans are evaluated regularly and this includes reference to the size, depth and tissue appearance. The registered person must ensure that the type and settings of all pressure relieving equipment used for each resident is recorded in their plan of care. The registered person must ensure that a treatment room is provided which has a separate access to the main kitchen and kitchen stores. The registered person must ensure that all residents wash hand basins have hot water (43 deg C). The registered person must ensure all care staff employees have a enhanced CRB disclosures. Timescale for action 31/08/05 2. 8 12 13 16 15/08/05 3. 9 13 01/10/05 4. 25 16 23 19 31/08/05 5. 29 15/08/05 Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 21 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 12 Good Practice Recommendations The registered person should ensure that work and play care plans reflect residents actual social preferences. Firbank Private Nursing Home F54-F04 Firbank NH S17294 V224922 180705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 2nd Floor Heritage Wharf Portland Place Ashton under Lyne OL7 0QD 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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