Inspection on 21/09/05 for Firwood House

This inspection was carried out on 21st September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Firwood House 20/06/07

Firwood House 16/03/07

Firwood House 03/02/06

Firwood House 03/11/04

Firwood House 04/06/04

Firwood House 11/02/04

Similar services:

Chirnside House

Emmaus House

East Croft Grange

Craignair

Croston Park Nursing Home

Conifers Nursing Home

Cloisters

Elmsdene Care Home

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

CARE HOMES FOR OLDER PEOPLE Firwood House Crompton Way Bolton BL2 2PE Lead Inspector Stuart Horrocks Unannounced 21 September 2005 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. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Firwood House Address Crompton Way Bolton BL2 2PE 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) 01204 337770 01204 337772 Bolton Metropolitan Borough Council CRH Care Home 27 Category(ies) of OP Old Age : 27 Places registration, with number of places Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for a maximum of 27 service users to include: Up to 27 service users in the category of OP (Older People); The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. Date of last inspection 03 November 2004 Brief Description of the Service: Firwood House is owned by Bolton Council and is run by the Social Services Department. At this time the home accommodates a small number of long stay older persons with social care needs. The home is now, and will in the future only be admitting people with dementia care problems for short stay and respite periods of time with some “emergency beds” also being available..The home also provides a day care service from Monday to Friday of each week. Firwood House is in a residential area of Bolton just off Crompton Way and it is close to bus services with shops and pubs close by. The building is on two floors with a passenger lift and there are 27 single bedrooms. The home has five small lounge/dining rooms and there is also a large central dining area. The building is surrounded by gardens and there is parking to the rear. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was started at 9.30am.It took place on one day and it lasted for just under 7 hours. About half of this time was spent in talking to the manager and in looking at records. The rest of the day was spent in looking around the home, watching what was happening and in talking to residents, visitors and staff. Five residents, two visitors and six staff were spoken to. What the service does well: What has improved since the last inspection? Although the home has not had a regular manager for some time the staff have continued to maintain services for the residents who have been provided with a good standard of care. The home to endeavours to continue to improve the services and the facilities enjoyed by the residents and their visitors at the home. The presently appointed temporary manager appears to have gained the staffs confidence with the staff saying that they felt more settled to have this person running the home. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 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. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 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 Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 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. The admission procedure is good which makes sure that residents needs and expectations can be met by the home. The home does not provide intermediate (rehabilitative) care so this Standard (6) does not apply. EVIDENCE: The home is no longer admitting residents for long term care. Therefore preadmission assessments are aimed at assessing potential residents suitability for admission to the home’s Dementia Care Respite Service. This admission procedure is thorough and checking the provided pre-admission assessment information showed that a full assessment of potential residents care needs had been completed prior to their admission to this service. From this information the home is then able to decide whether these people’s needs could be met and a care plan is then put together. Those staff spoken with said that they used the above assessment and care plan information to guide them in giving care to the residents. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 9 Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 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 standard(s) 7, 8, and 9. Proper arrangements are in place that ensures the residents health care needs are monitored and met. Individual care plans are also in place, which were up to date, regularly reviewed and provided the staff with the information needed to give a good standard of care. The home’s medication systems are generally satisfactory in ensuring that residents received medication as prescribed. EVIDENCE: The care plans of three long stay and two respite care residents were looked at. Each plan contained details of health, personal and social care needs for the resident. All of them had been reviewed and up dated at the required monthly interval. The staff said that they knew the residents needs by reading the care plans, which are readily available to them. Talking to residents, the manager and the staff and looking at records showed that the resident’s health care needs are taken care of. When necessary health workers such as doctors, nurses and opticians are called. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 11 A number of risk assessments are in place; all of these had been reviewed with the information being up to date. The checking of the above records showed that some residents had been weighed regularly whilst some had not. All of the residents must be weighed regularly as this is an easy method of monitoring their wellbeing. Two systems of giving medicines to the residents were used at the home. The system used for the permanent residents is one where the medicines are kept in individual packs whilst those for the residents receiving respite care are provided on an individual basis. All medicines were safely stored and the medicine administration records were properly filled in and were up to date. The prescription sheets for the giving of medicines are currently filled in handwritten by the home’s senior staff. The safety of this method relies on the staff making sure that the right name and amount of the medicine is written on the prescription sheet, in order to ensure that right details are entered the staff must ensure that two people witness the prescription, which they both must sign. Those staff who give out medicines have been given the necessary training for this task. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 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 standard(s) 12, 13 and 15. The home offers a range of leisure activities, which help to keep the residents interested and stimulated. The visiting arrangements are flexible thus enabling residents to have good contact with family and friends as they please. The meals at this home are good, offering choice and variety, and catering for individual dietary needs EVIDENCE: Residents have choice about their daily routines (e.g. getting up and going to bed times, when to eat) thus they are able to spend their time as they wish. The home provides a number of recreational and stimulating activities (e.g. quizzes, exercises, crafts, reminiscence sessions, entertainers) that the residents are encouraged to join in with. Discussion with residents and staff confirmed that the visiting arrangements are flexible with these being described in the resident’s information guide. Residents said that “they can see their visitors in their rooms” if they so wish. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 13 Visitors were seen to be coming and going from the home throughout the inspection. These people were made welcome and they said “that they could visit whenever they wanted to”, and that no restrictions were imposed. The menu offers a variety of good nourishing food. This menu provides a single choice but alternatives were seen to be readily available and to be regularly provided. This is a relatively small home where individual preferences and choices are easily catered for. This was confirmed by the residents who said, “there is a choice of food” and they also said that the food was “OK”, “good” and “very good” and “it is properly cooked”. No complaints were made regarding the food provided by the home. The inspector saw that the midday meal was well presented and looked appetising. The home has five small dining rooms that are nicely furnished and they provide a comfortable and homely setting for the residents to eat in. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 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 standard(s) 16 and 18. The home has a clear complaints system ensuring that concerns are speedily dealt with. A protection of vulnerable adults procedure is in place that ensures a proper and prompt response to any suspicion or allegation of abuse. EVIDENCE: The home has a Bolton Metro Boro Complaints/Comments/Compliments leaflet that advises on the steps to be taken when someone wishes to make a complaint. Complaints notices are also displayed around the home and these are placed in resident’s bedrooms. A complaints book is kept which records the details of any complaints made, of any action needed to deal with the complaint and of the final outcome. No complaints have been made to the CSCI since the last inspection (November 2004) but two complaints have been made to the home. One of these has been resolved whilst the other, which was made recently is still being dealt with. The residents spoken with said that they would feel comfortable about raising concerns and that they would “talk to the staff” if they had any worries. Talking with staff showed that they would know what to do if a resident made a complaint. A number of staff said that if “they couldn’t sort things out at the time” then they would inform the manager about the problem. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 15 There are written procedures for whistle blowing and responding to allegations of abuse. Staff members had received instruction in these topics during induction and vocational training with this being confirmed in discussion with them. Discussion with the manager showed that when incidents arise they are dealt with quickly and properly. Those staff interviewed were aware of the different sorts of abuse and they also understood what they should do if they suspected that someone was being abused. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 16 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 and 26. Firwood House provides safe, clean, comfortable, homely and friendly surroundings for the people living there. EVIDENCE: Firwood House is well maintained both to the inside and to the outside. Decoration, furnishings and lighting is generally to a good standard with a lot redecoration and refurbishment having been done in most parts of the home fairly recently There is a well-kept, peaceful and secure garden area that is easily accessible to the residents which is provided with seating. Firwood House has a properly equipped laundry and guidance about the control of infection is available. Those residents spoken with had no complaints about the laundry service provided by the home. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 17 The home was clean and tidy throughout and was free from any offensive odours therefore providing a pleasant place to live in. . Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 and 30. Staffing levels are satisfactory therefore ensuring that the residents are properly cared for. Staff training is good thus making sure that the residents are provided with a good standard of care. EVIDENCE: A lot of the staff team have worked at the home for a considerable time. This helps provide continuity and a good standard of care for the residents. The residents said that the staff were “easy to get along with” and that they were helpful and considerate. Staff morale was good with staff saying that “there is a good team spirit” and that “we work together well as a team”. On the day of this inspection enough staff were on duty to meet residents care needs. Rotas showed that staff were regularly available in sufficient numbers to ensure that care was properly provided. The staff and the manager said that in their opinion there was enough staff to meet the needs and dependency levels of the residents living at the home. Although the staff were busy they had time to talk to the residents and they had a comfortable and friendly understanding with them. Discussion with the staff and the manager showed that there is a strong commitment to staff training within Bolton Local Authority. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 19 The staff gave examples of the wide range of training that they had done. This included induction to the job training, the care of people with dementia, dealing with challenging behaviour, safe moving and handling, fire safety, food hygiene and first aid. The provision of this training was confirmed when looking at staff training records. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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 and 38. An agency-employed manager is presently supervising the home. This Standard has therefore not been able to be assessed (please see text below). Safety checks of equipment and staff training generally promotes the health and welfare of the people living and working at the home. EVIDENCE: The manager’s post at Firwood House has been vacant since January 2004 with the position having been covered during this time by two short-term managers on a temporary basis. The inspector understands that recruitment to this post is ongoing. The position is at this time is filled by a manager who has been employed from a staff recruitment agency. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 21 This person has considerable management experience in looking after people with dementia care needs and he was previously registered with the National Care Standards Commission. The CSCI will however have to verify this person’s suitability for the post. This verification will be dealt with as a separate issue to this inspection. The sort of service provided by the home has now largely changed from that of providing long-term care for older people to that of providing short-term care for older people with dementia care needs. As such the home’s current registration status does not accurately show the service provided; the registered person will therefore have to make an application to the CSCI to have the home’s registration changed. The checking of records and maintenance certificates showed that these were up to date apart from that for the servicing of the fire extinguishers, which had expired. The checking of records and conversations with staff also showed that the necessary training had been provided so that they can work safely. The home’s fire alarm system is checked and tested at weekly intervals and a staff fire drill was held on the 9th August this year. Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 2 Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 23 No 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 9 Regulation 17 Requirement The handwritten medicine prescription records must be checked and signed by two members of the staff at all times thus ensuring their accuracy. The residents must be weighed regularly thus ensuring their wellbeing. The registered person must make an application to the CSCI to vary the homes registration categories to include that of DE (E) for the care of older people with dementia. The certificate veryfying the servicing of the homes fire extinguishers must be renewed thus ensuring safety. Timescale for action 17th October 2005 17th October 2005 31st October 2005 2. 3. 8 31 12 39 4. 38 23 31st October 2005 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 None. Good Practice Recommendations Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich Bolton BL6 6HG 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 Firwood House F56 F06 S30981 Firwood House V232313 210905 Stage 4.doc Version 1.40 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!