Inspection on 03/02/06 for Firwood House

This inspection was carried out on 3rd February 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

Firwood House 20/06/07

Firwood House 16/03/07

Firwood House 21/09/05

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 Inspection 3rd February 2006 09:30 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 Firwood House DS0000030981.V281501.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. Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Firwood House Address Crompton Way Bolton BL2 2PE 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) 01204 337770 01204 337772 Bolton Metropolitan Borough Council Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Home is registered for a maximum of 27 service-users to include: Up to 27 service-users in the category OP (Older People not falling in to any other category). The service should at all times employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 21st September 2005 Date of last inspection 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 DS0000030981.V281501.R01.S.doc Version 5.1 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 about five and a half hours. The time was split between talking to the Manager and checking records, and looking around the home, watching what was happening and talking to residents and other staff. Five residents and eight staff were spoken with. What the service does well: What has improved since the last inspection? What they could do better: The Responsible Individual needs to make sure that the presently employed agency manager is approved and registered by the CSCI and progress must be made about clarifying the home’s registration position. Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 Page 6 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 DS0000030981.V281501.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 Firwood House DS0000030981.V281501.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): The above key Standard 3 was not examined at this inspection. It should however be noted that this standard was checked and met at the time of the previous inspection (September 2005). The home does not provide intermediate (rehabilitative) care so this Standard (6) does not apply. EVIDENCE: Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 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 the following standard(s): 10. The staff work hard to make sure that the residents are treated with dignity and that their privacy is respected. EVIDENCE: Key standards 7,8 and 9 were examined at the time of the last inspection and they were largely met. These standards were therefore not checked in full at the time of this visit, but the requirements made previously regarding Standards 8 and 9 were followed up and a number of care plans (Standard 7) were briefly looked at. The care files of the three long stay residents were looked at. These were found to contain up to date care plans that had been properly reviewed at the required monthly intervals. The care files of three respite care residents were also checked. These files also contained the required information. The inspector was told that the care needs of these residents is reviewed by the social worker who makes the arrangements for their short term stay at the home (usually two weeks). A requirement made at the time of the previous inspection (Standard 8) was that “The residents must be weighed regularly thus ensuring their wellbeing”. Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 Page 10 Looking at paperwork showed that the residents are now being weighed on a regular basis. A further requirement made at the time of the previous inspection (Standard 9) was that “The homes handwritten medicine prescription records must be checked and signed by two members of the staff at all times thus ensuring their accuracy”.Examination of the homes medication administration documents showed that this requirement has also been complied with. Records looked at emphasised the need for the residents privacy and dignity to be respected at all times, and the staff gave examples of how the residents privacy and dignity were promoted in the home, such as when giving personal care. Residents said that the staff treat them with respect and that their dignity is valued, for example they said that the staff knocked on their bedroom doors before entering. Those residents spoken with said that the staff were “helpful” and that “they (the staff) talk to us properly”. The staff were seen to have a good relationship with the residents, speaking to them in a natural, caring and friendly manner. Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 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 the following standard(s): 14 and 15. The meals at the home are good, offering choice and variety, and catering for individual dietary needs. Residents have choice about their daily routines, spending their time doing whatever they prefer. Where residents are unable to make choices the staff offer support in such a way that promotes the residents dignity and independence. The above key Standards 12 and 13 were not examined at this inspection. It should however be noted that these Standards were met at the time of the previous inspection. EVIDENCE: The home uses a four weekly menu that offers a choice of good attractive nourishing food. Warm food is always offered at midday and a warm choice is usually also available at teatime The inspector saw that the midday meal was well presented and looked appetising. The residents were heard to say that the food was “good and warm” and they told the inspector that “there is a choice” and that they had “enjoyed the meal”. Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 Page 12 The home has a large central dining area and there are also five small dining rooms that are nicely furnished that provide a comfortable and homely setting for the residents to eat in. The residents said that drinks and snacks are available at most times of the day and night. The issue of residents being able to make choices is described in the home’s Charter of Rights that forms a part of the Service User Guide. Due to their condition some of the residents have a limited ability to make decisions and choices about their day-to-day living arrangements. In discussion the staff said that they try to assist the residents with this by offering them choices about such things as what clothing to wear, when to rise and retire and helping to choose from the menu. The inspector saw this at lunchtime when he spent some time in a lounge near to the dining room when the staff were seen to offer the residents assistance with choosing a meal and with what they wanted to drink. Those residents that the inspector spoke with said that they made choices about what they wanted to do during the day, what time they got up or went to bed, and whether they spent time alone or with others. They said that were comfortable living at the home and that the home was “relaxed” and that “you can do what you like”. The residents are able to, and do bring personal items in to the home such as televisions, radios, photographs, pictures and mobile ‘phones. Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 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 the following standard(s): The above key Standards 16 and 18 were not examined at this inspection. It should however be noted that these Standards were met at the time of the previous inspection. EVIDENCE: Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 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 the following standard(s): The above key Standards 19 and 26 were not examined at this inspection. It should be noted that these Standards were assessed as being satisfactory at the time of the last inspection. However the inspector did spend some time walking around the building whilst talking to residents and staff. The home is decorated and furnished to a good standard and it was seen to be well maintained to both the inside and the outside. EVIDENCE: Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 Page 15 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 and 29. Staffing levels were satisfactory thus ensuring both consistency of care and that the assessed need of the residents were met. Staff morale was good with the staff saying that they enjoyed their work at the home. The home has met the requirement to have at least 50 of the care staff trained to NVQ Level 2 or above by 2005 so making sure a good standard of care is provided. Staff recruitment could not be checked as the Bolton Council does this work centrally therefore no staff recruitment records are kept at the home. The outcome for this Standard was therefore not assessed. However the CSCI undertook a random sample of staff personnel files in the Spring of 2005 to check on the vetting arrangements for care staff working in regulated services. The findings of this sample were that Bolton Local Authority operates a sound employment procedure and that care staff are properly recruited. The above key Standard 30 was not examined at this inspection. It should however be noted that this standard was checked and met at the time of the previous inspection. EVIDENCE: Looking at staff rotas showed that as well as employing care staff, the home also employs domestic and catering staff Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 Page 16 Many of the staff team have worked at the home for a considerable time, which ensures that residents are cared for by people they know and are familiar with. Staff morale was good with staff saying that “there is a good atmosphere” and that “we work together well as a group”. The residents said that the staff are “kind”, “happy to help” and that they were “patient and considerate”. 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. The staff were seen to have a natural and comfortable understanding with the residents and they had time to sit and talk with them. Of the 30 care staff employed at the home 15 have got a National Vocational Qualification at Level 2 and two at Level 3. Two staff are presently undertaking NVQ assessment at Level 2 with a further six undertaking Level 3. A number of other staff are waiting to start such assessment at Levels 2,3 and 4. Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33 and35. An agency-employed manager is presently running the home. This Standard has therefore not been able to be assessed (please see text below). The home has recently started to consults the residents about the way that the service is run so that both improvements can be made and problems can be dealt with. A satisfactory accounting method is used which protects the resident’s interests. The above key Standard 38 was not examined at this inspection. It should however be noted that this standard was checked and met at the time of the previous inspection. EVIDENCE: Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 Page 18 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 position is at this time is filled by a manager who has been employed from a staff recruitment agency. 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 home’s conditions of registration require that the service should at all times employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. The Responsible Individual must therefore make an application to have the above-described agency employed manager approved and registered by the CSCI to ensure that 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. 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. A requirement of the previous inspection was that the Responsible Individual must make an application to the CSCI to change the home’s registration status to include the registration categories of DE (E) for the care of older people with dementia. This requirement has not been addressed; therefore the requirement is made again. The home holds money for a number of residents for safekeeping. This system was checked with the details found to be properly written down and with the correct amounts of money kept. Secure storage is available for the safekeeping of money and of any valuable items. A requirement of Standard 33 is that care homes must use quality assurance systems that are largely based on seeking the views of residents to measure their success in meeting the home’s aims and objectives. The manager told the inspector that such a system has recently been started which uses a survey document that asks 15 questions about how well the home is meeting the residents’ needs. Three of these had been returned at the time of this inspection with all of them scoring positively for each of the questions. Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 Page 19 The manager intends to use these surveys with the long stay and the respite care residents and also with relatives. Respite care residents will be given a survey to complete at the time when they leave the home with a stamped and addressed envelope provided for the return of the document. The manager is reminded that when these questionnaires are returned the answers must be brought together in the form of a report so that both good and not so good comments are highlighted and steps can then be taken to deal with any issues. Firwood House DS0000030981.V281501.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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? YES Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 Page 22 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 OP31 Regulation 9 Timescale for action The Responsible Individual must 31/03/06 make an application to have the presently employed agency manager approved and registered by the CSCI to ensure that 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 The Responsible Individual must 31/03/06 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. (Previous timescale of 31/10/05 not met) Requirement 2 OP31 39 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 Firwood House DS0000030981.V281501.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office 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 DS0000030981.V281501.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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