Inspection on 24/10/07 for Fircroft Care Home

This inspection was carried out on 24th October 2007.

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

Fircroft Care Home 20/02/07

Fircroft Care Home 15/11/05

Fircroft Care Home 10/05/05

Fircroft Care Home 29/09/04

Fircroft Care Home 25/05/04

Fircroft Care Home 12/12/02

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

CARE HOMES FOR OLDER PEOPLE Fircroft Care Home 114 Ladbroke Road Redhill Surrey RH1 1LB Lead Inspector Christine Lawrence Unannounced Inspection 24 October 2007 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 Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 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. Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fircroft Care Home Address 114 Ladbroke Road Redhill Surrey RH1 1LB 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) 01737 773424 marcel@fircroftservices.co.uk Fircroft Services Limited Mrs Samantha Richards Care Home 18 Category(ies) of Learning disability (0), Learning disability over registration, with number 65 years of age (0) of places Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability - LD Learning Disability over the age of 65 years LD(E) 2. The maximum number of service users to be accommodated is 18. Date of last inspection 20 February 2007 Brief Description of the Service: Fircroft Care Home is a residential care home providing care and support to eighteen people with learning disabilities, most of who are also elderly. The owners also own another care home. The home is situated in a residential part of Redhill with access to the town centre not far away. Most of the rooms are single but there are two shared rooms. There is a large lounge area and separate dining room. There is a large rear garden which is satisfactorily maintained. Car parking spaces are available at the front of the house. The home’s current range of fees is from £400.00 to £875.00. Fees vary according to the individual needs of residents. Information about the home, including the inspection report from the Commission for Social Care Inspection, would be made available on request. Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit started at 10.30 and finished at 15.20. I looked at various records in the home and also used information sent to the commission by the registered manager, Sam Richards before the visit. This was in the form of the Annual Quality Assurance Assessment (AQAA). Information from the previous inspection was also referred to. I spoke with several of the residents and observed a mealtime, an activity and a medication round. A tour of the parts of the building was undertaken. I made observations of staff interacting with and supporting residents. Staff chatted informally with me and I had discussions with one of the directors of the owning company who visited the home while I was there. I also spoke to the registered manager, Sam Richards. Comment cards and surveys were sent out to GPs, relatives and others, and also to the residents. The information contained in those returned is also used for this inspection. What the service does well: What has improved since the last inspection? What they could do better: In the AQAA, Samantha Richards has identified the following plans for improvement in the next 12 months:- To continue to develop person centred Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 Page 6 plans for all residents and make them more user friendly using pictures and symbols. To develop the complaints procedure to incorporate pictures and symbols to make it more user friendly. To implement the Department of Health guide ‘Essential Steps’ to assess current infection control management. To enable another four members of staff to complete their national vocational qualifications (NVQs). For Ms Richards herself to complete the NVQ Level 4 and the Registered Manager’s Award. There are no formal requirements from this inspection. 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. The summary of this inspection report can be made available in other formats on request. Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 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 Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the home judges that it can meet their needs. EVIDENCE: One new person had moved into the home in recent months and the records relating to their admission were looked at for this standard. The home uses an assessment form which covers an extensive range of subjects to help identify any needs and also allows for particular wishes of the individual to be recorded. There was also information from the placing authority and from the place the resident used to live in. The assessment was carried out by Sam Richards the registered manager. This information is then used to compile a care plan (see also Standard 7). Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from having an individual plan of care which identifies how their health and care needs are to be met. They are protected by the home’s procedures for dealing with medication and they can be confident that they will be treated with respect. EVIDENCE: The comprehensive assessment noted under Standard 3, is used to create a care plan. Five of these were looked at for this inspection. They were detailed and had clear guidelines for staff to ensure that all aspects of individuals’ needs are met. These plans are reviewed monthly and the manager was clear about the home’s responsibility to ensure that any changing needs were responded to immediately eg when a resident has been in hospital or has been seen by their GP. Staff complete daily records and those seen for this inspection were informative and relevant. Some of the records seen showed that residents are involved in their care planning as much as possible and the home is building on its good practice by including a person centre approach for Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 Page 10 some of the objectives and wishes identified with individuals. Sam Richards demonstrated her knowledge of the Mental Capacity Act and has included some information about individual’s ability to make judgements within their individual record. She gave an example of involving an Independent Mental Capacity Advocate regarding a decision about a resident’s best interest when the person was not able to make their own decision and there were no relatives. The individual records gave clear information about residents’ health care needs and healthcare professionals are involved on a regular or when required basis. Six general practitioners completed comment cards for this inspection and they were all positive in their responses. The following comments were noted:- “…very good level of care…” “…very satisfied…” “…I am very happy with the care provided to my patients at Fircroft…”. One resident said, “…whenever I need to see my doctor the staff are there to help me…”. Nutrition is included within the assessment and care planning process and residents are weighed monthly or more if a problem has been identified. Records are kept of past visits to and from healthcare professionals to enable the home to plan for future appointments. I observed medications being given to residents and this was done appropriately. The records of administration were completed properly and the storage of all medications is appropriate. The manager has a copy of the new guidelines from the Royal Pharmaceutical Society of Great Britain (The Handling of Medicines in Social Care) and she will use this to ensure all of the home’s policies and procedures are compliant. The staff are clear about how individuals prefer to be addressed and this is noted in individual records. The staff room can double up as a hairdressing salon and any visits by community nurses or GPs take place in privacy. The person who provides an aromatherapy service to residents confirmed that this was always in their own rooms. Staff will knock on residents’ doors to seek permission to enter bedrooms and Sam Richards ensures that privacy, dignity and respect are emphasised through the induction training. Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their preferences will be responded to as far as possible and that they will be enabled to maintain contact with friends and family. Residents are given opportunities to make choices, therefore allowing for some level of control over their lives. The meals in this home offer both choice and variety and catering for special needs. EVIDENCE: The home provides a range of activities within the home. These are provided by staff and there are three sessions during each day. Keyworkers discuss these with the residents to ensure that preferences and wishes are taken into account. It is clear from watching an activity during the inspection, as well as comments from the residents’ surveys, that people make choices about whether to join in or to enjoy watching others or choose to pursue a personal interest. A four week programme of activities is on display and each day’s sessions are also on display. The home also has external activities providers and entertainers. There are also shopping trips, outings to the pub for lunch, outings to the cinema, ten pin bowling and theatres. Residents can choose to go on an annual holiday and there are occasional days out also. The home Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 Page 12 provides a stimulating atmosphere but it is equally clear that people are seen as individuals and are involved and supported as such. Lots of examples were noted of residents being supported to attend church and there is also a monthly in-house service provided at Fircroft. Residents are supported to maintain contact with family and friends and there were examples noted of letter writing, receiving phone calls, invitations to join in social events and of residents’ visitors being made welcome and offered refreshments or to join residents for a meal. As previously noted, the manager is very aware of the new Mental Capacity Act and she intends to use this to underpin the already good practice in the home relating to enabling and supporting people to make choices and decisions for themselves. The keyworker system also supports people to maintain as much autonomy as possible. This is also reflected in the way residents are involved in making choices about what is included in the menu. Residents’ comments about the food were positive. I observed a meal and it looked and smelt appetizing. Staff are responsive to individuals’ preferences and needs regarding when and where they wish to eat and staff were discreet and sensitive when offering support. Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents/their representatives can be confident that any concerns will be taken seriously and responded to. Staff are very clear about their responsibilities relating to protecting residents. There are policies and procedures in place which include whistle blowing and systems relating to protecting residents’ finances. EVIDENCE: The home has a clear complaints procedure which is on display in the entranceway, as well as included in the statement of purpose, service user guide and staff policies and procedures. There is also a facility to encourage people, including visitors, to make suggestions. There are appropriate policies and procedures relating to safeguarding vulnerable adults and staff have received training about this. Sam Richards, the manager has a copy of the local multi agency procedures. Staff are also given training in ‘effective communication’ to emphasise the importance of listening to residents and encouraging them to be confidant about speaking up. Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a well-maintained and clean environment. EVIDENCE: The building and grounds are well maintained and the décor within the home is kept looking fresh. There is a large, well-maintained garden which can be used by all residents. There is a business plan in place for the home and this incorporates planned redecoration and refurbishment. Any maintenance jobs are noted in a log and the maintenance person indicates when they have been completed. The clothes washing machine provides appropriate washing cycles for foul or infected items. There is an appropriately secured cupboard for storage in keeping with the Control of Substances Hazardous to Health Regulations and there are hand-washing facilities. There are appropriate policies and Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 Page 15 procedures in place. Sam Richards has received a copy of the Department of Health’s new infection control information (Essential Steps) and will use it to review her current infection control systems. Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by sufficient staff who are competent and trained. Residents are supported and protected by the home’s recruitment procedures. EVIDENCE: The rota indicated that there are sufficient staff on duty and Sam Richards confirmed that extra staff would be put on shift in the event of a particular need such as an outing. There is a management structure of manager, deputy and seniors. There are domestic staff members and a maintenance man. Staff are encouraged to gain their national vocational qualifications and this is ongoing. Sam Richards, the manager, provided information which showed that the recruitment procedures include two written references, criminal records bureau checks, and terms and conditions of employment. The home gives copies of the Codes of Conduct published by the General Social Care Council. There is a training programme in place and the detailed induction training programme which has been compiled by the manager, is in keeping with Skills for Care guidance. Some training is provided by external trainers and some in house. Each member of staff has an individual personal development plan. Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from the home being managed by someone who is competent, experienced and knowledgeable. Residents’ financial interests are safeguarded and their views are sought. Staff and residents have their health and safety promoted and protected. EVIDENCE: Sam Richards has eighteen years experience in the care sector which includes five years at senior management experience. She is currently undertaking her NVQ Level 4 and the Registered Manager’s Award and she confirmed that her job description gives her clear guidelines about her duties and responsibilities. She keeps up to date with current practice and undertakes training courses within the home. She has recently completed a distance learning course with Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 Page 18 Croydon College regarding equality and diversity to keep up to date with current legislation. It is clear from talking to her that she values the work that staff do to promote good outcomes for the people living in the home and she therefore works hard to support this through supervisions, appraisals, staff meetings, post training evaluations and talking and listening to staff on a day to day basis. The directors of the owning company carry out visits to the home and provide reports under Regulation 26 of The Care Homes Regulations. The owners visit much more often than required and the manager confirmed that they work together well to agree on any necessary improvements. The home has its own quality monitoring systems and they are proud to have achieved Investors in People accreditation. Sam Richards confirmed that where the home has any involvement with any residents’ money, there are clear records maintained. The training programme covers a range of aspects of health and safety such as first aid, food hygiene, manual handling and fire safety. The fire safety checks are appropriately carried out. The home has relevant and appropriate policies and procedures and maintenance and service contracts were satisfactory and up to date. Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Fircroft Care Home DS0000013641.V345933.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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