Inspection on 27/02/06 for Fleming House

This inspection was carried out on 27th 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 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

Fleming House 08/11/07

Fleming House 10/10/06

Fleming House 10/10/05

Fleming House 01/02/05

Fleming House 09/08/04

Fleming House 10/12/03

Fleming House 22/07/03

Fleming House 16/01/03

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

CARE HOMES FOR OLDER PEOPLE Fleming House Heron Square Eastleigh Hampshire SO50 9JD Lead Inspector Kathryn Kirk Unannounced Inspection 27th February 2006 10:00 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 Fleming House DS0000039582.V280611.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. Fleming House DS0000039582.V280611.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Fleming House Address Heron Square Eastleigh Hampshire SO50 9JD 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) 023 8061 2538 Hampshire County Council Mrs Deborah Ann Harrington Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (25) of places Fleming House DS0000039582.V280611.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Agreement has been given for one named service user in the LD(E) category to be accommodated at the home. 10th October 2005 Date of last inspection Brief Description of the Service: Fleming House is a large purpose built unit, situated in the residential area of Eastleigh. It is run by Hampshire County Council and is currently registered to accommodate up to 25 service users who have support needs associated with old age or dementia. Building works are in progress to completely refurbish the original residential unit. Service users have moved into the new wing whilst work is being carried out. It is the intention that once this is complete, residents will move back and Hampshire County Council will apply for the new wing to be registered as a 30 bedded nursing unit. Fleming House DS0000039582.V280611.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection to take place in the year April 2005arch 2006. Only key standards that were not assessed at the last inspection were considered on this occasion, along with the requirement made. As such, to gain a more detailed overview of this service, this report should be read in conjunction with the one dated 10/10/05 This inspection lasted for four hours. The manager, five staff and twelve service users spoke of their experience of living and working at the home. Some communal areas were toured and some documentation was reviewed. The inspection found that the overall quality of service remains good. No requirements or recommendations have been made as a result of this visit. What the service does well: What has improved since the last inspection? What they could do better: Fleming House DS0000039582.V280611.R01.S.doc Version 5.1 Page 6 Some elements regarding the management of medications could be refined to further improve this system. This is being addressed as the policy is currently being reviewed. The home should continue to review the effect that current and future changes to the environment could have on the workload of the domestic staff. 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. Fleming House DS0000039582.V280611.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 Fleming House DS0000039582.V280611.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): No standards were assessed on this occasion. EVIDENCE: Fleming House DS0000039582.V280611.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): 7 8 and 9 Although lengthy, the care planning system appears to address appropriately the needs of current service users. Health care and medication needs are appropriately managed. EVIDENCE: The care planning system was reviewed at this inspection. Staff said that they find care plans longwinded to complete and service users asked said that staff asked them a lot of questions. Service users asked said that they know what is in their care plan, know who their keyworker is and said that staff are providing the right amount of help to them. Service users said that they feel that their health needs are monitored effectively by staff and say that staff have a good understanding of how they are feeling. Health care professionals were observed to be shown to service users bedrooms so that consultations could take place in private. Service users confirmed that staff liaise appropriately on their behalf with health care professionals. One service user said that they continued to consult the same chiropodist that treated them before they moved to the home. Fleming House DS0000039582.V280611.R01.S.doc Version 5.1 Page 10 Staff said that no service users currently self-administer medication. Medicines were observed to be securely and appropriately stored. The home currently uses the nomad system for medicines but staff said that it is the intention to revert to administering medicines from bottles in the future. Medication administration sheets and record of medicines returned was seen to have been correctly completed. The senior care staff on duty currently administers medicines. Staff said that this process could take up to an hour to an hour and a half to complete. Staff spoken with said that they had received training regarding the management of medication. Through discussion it was unclear as to how often staff responsible for administration of medicines were having training updates. The manager said that a new medication policy is currently being developed which should address this issue. Fleming House DS0000039582.V280611.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): 12, 13, 14 and 15 There is a willingness to incorporate individual preferences regarding daily life and social activities into the running of the home. The quality of food provided is good. EVIDENCE: Information regarding social and recreational interests is recorded as part of the care planning process. There is information on display in the home regarding activities provided. Staff said that some outside activities arranged, for example going out for a meal had not been very well attended. Service users said that they are encouraged to give their ideas about what sort of activities they would like to be offered in the home. One service user said that they would like to have more quizzes, but said that it was difficult for staff to arrange suitable activities to suit everyone. Others said that they enjoyed art and singing sessions. One service user spoken with said that they continue to go to a weekly social club that they have attended for years. The home organises residents meetings. One service user spoken with said that they enjoyed attending these. Fleming House DS0000039582.V280611.R01.S.doc Version 5.1 Page 12 Visiting is open, within reasonable times. Information about visiting is displayed on a poster in the home and is included in the pre admission pack Service users said that they could entertain visitors in private, if they wish. The manager said that where service users are unable to manage themselves, families assist with their financial affairs. Staff said that any person requiring advocacy services would be referred to social services for advice and support. Service users asked said that they were able to bring some personal possessions with them, and all bedrooms seen had been personalised to the residents taste and choice. Service users asked said that the food was very good and that there was plenty of it. One said the food was” better than in a hotel” There are four set mealtimes a day. The lunchtime meal at 12.30 is the main meal of the day and provides a choice of two hot meals, followed by a pudding. Fresh fruit was observed to be available on the day of inspection. Menus were seen to be displayed on tables and residents spoken with said that they were not hurried during mealtimes. Fleming House DS0000039582.V280611.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): No standards were assessed on this occasion. EVIDENCE: Fleming House DS0000039582.V280611.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): 26 Suitable systems are in place to ensure that the home is hygienic. EVIDENCE: On the day of inspection all areas toured were clean and free from offensive odours. Laundry facilities are sited temporarily in the new wing until the refurbishment of the residential block has been completed. Washing machines have a sluicing facility. There are appropriate hand washing facilities for staff and plastic aprons and gloves were seen to be in plentiful supply. There is information regarding infection control and information about the control of substances hazardous to health (COSHH) on display for staff. Fleming House DS0000039582.V280611.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 Service users needs continue to be met by the number and the skills of staff employed, although environmental changes have put some strain on domestic services. EVIDENCE: Staffing levels were discussed during the previous inspection and were found to be appropriate for care staff. This continues to be the case although discussion with domestic staff indicated that they are struggling to complete their tasks within the hours allocated. As all of the bedrooms have en suite facilities in the new wing, which has increased the amount of cleaning required. The manager was aware of the situation and said that additional hours have been agreed to recruit another kitchen assistant. The recruitment process continues to be slow however and she said that there is sometimes a lack of suitable applicants. The manager said that senior staff are currently studying for their NVQ level 4 in care. Of the twenty-one other care staff employed, seven have successfully completed an NVQ in care at least to a level two and six care staff are currently studying for at least this level of qualification. The manager said that she has had some difficulty in retrieving recruitment records for some staff that have been employed for a considerable period of time. She said however she would ensure that copies of all relevant records would be held at the home regarding all new and future staff. Fleming House DS0000039582.V280611.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 35 and 38 The home is well managed and quality is monitored effectively. Service users health and safety is appropriately protected. EVIDENCE: The registered manager is Ms Deborah Harrington. She is a registered nurse and has completed an NVQ level 4. She has had considerable experience in working with older people, including those with dementia. Staff and residents said that the management team were good and that they were approachable. In terms of quality assurance, the manager said that care plans and notes are audited by an external person. Similarly records regarding money kept on behalf of service users have also recently been audited. As discussed earlier, residents meetings are held to ensure that service users can voice their opinion about all aspects of the quality of care provided. Fleming House DS0000039582.V280611.R01.S.doc Version 5.1 Page 17 A visit, by an external person, takes place every month to review the conduct of the home and a report is compiled regarding the findings of this visit. A copy of the report is forwarded to CSCI for information. Through discussion with service users it was clear that they have been kept fully informed about the progress of the refurbishment of the residential home. Staff said that it is the policy of the home to keep small amounts of money on behalf of service users. This was seen to be securely and individually stored and one record kept that was checked balanced with monies held. It was noted that there were no signatures on records from recipients of money to confirm that the amount recorded had been received. Staff said that this had been highlighted also during the audit process and that procedures would change accordingly. Health and safety matters in the building have been assessed as satisfactory as part of the recent registration process. Fire safety training records for staff were seen. These showed that all staff have completed their most recent fire training in January or February 2006. The accident book was also seen and this had been completed appropriately. Fleming House DS0000039582.V280611.R01.S.doc Version 5.1 Page 18 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Fleming House DS0000039582.V280611.R01.S.doc Version 5.1 Page 19 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 Fleming House DS0000039582.V280611.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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