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Inspection on 18/10/05 for Florence House

Also see our care home review for Florence House for more information

This inspection was carried out on 18th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Florence House continues to offer service users a high standard of care in a comfortable and homely environment. Service users individual bedrooms are personalised to meet the person`s tastes, which can include their own furniture and possessions. There is great emphasis placed upon the spiritual well being of service users. A short informal daily act of worship is provided for those who wish to attend. There is also regular contact with local churches. Continuing contact with relatives and friends is clearly promoted which was evident during the inspection.

What has improved since the last inspection?

Requirements from the previous inspection have been met including improved supervision recording and photographs have been added to staff files. A number of chairs have also been recovered in the main lounge.

What the care home could do better:

Care plans need to be reviewed on a more regular basis to ensure that any changes in care and supported is monitored. Refurbishments need to be implemented to a number of doors and hallways. The dining room carpet is becoming stained and needs to be cleaned appropriately.

CARE HOMES FOR OLDER PEOPLE Florence House 220 Park Road Peterborough PE1 2UJ Lead Inspector Andy Green Unannounced Inspection 10:45 18 October 2005 th 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 Florence House DS0000015170.V250771.R01.S.doc Version 5.0 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. Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Florence House Address 220 Park Road Peterborough PE1 2UJ 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) 01733 315900 01733 702272 Park Road Baptist Housing Association Mrs Christine Lightfoot Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th May 2005 Brief Description of the Service: Florence House is a Christian Retirement Home situated in a residential area of Peterborough, close to the Central Park. The original house was a detached domestic property, which was extended to provide a home for older people. Accommodation for 21 elderly people is offered on two floors in 17 single rooms and 2 double rooms, all with ensuite facilities. The home has a large lounge and dining room with a lounge area. There are attractive gardens to the front and rear of the property. The home is near to the city centre of Peterborough has a wide range of shopping and leisure facilities. There are good road and rail links from Peterborough to London and other major cities. Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Regulation Inspector, Andy Green undertook this announced inspection on 18th October 2005. The inspector met with the manager, care staff and service users to gather views regarding the care and services that are provided in the home. A number of records were inspected including care plans, training records, fire records and medication. A tour of the building and grounds was also undertaken. What the service does well: What has improved since the last inspection? 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. Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 6 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 Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 7 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): 1,3,5, The home produces a variety of information so that prospective service users can decide if they wish to live in the home. EVIDENCE: There have been no changes to the Statement of Purpose or Service User Guide since the last inspection. The manager stated that these documents would be reviewed during the year to ensure that they remain effective and provide up to date information. Prospective service users and their family/relatives continue to be encouraged to visit Florence House as part of the assessment process, prior to admission. This ensures that the prospective service users need’s can be fully assessed and also gives the person a chance to experience life in the home. There are two vacancies in the home and prospective service users from the home’s waiting list will be assessed in the forthcoming weeks. Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 8 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): 7,8,9,10 The home has care plans, which are clear and informative but need to be reviewed more regularly to ensure that the assessed needs of service users are being met. The health of service users is monitored and ranges of healthcare professionals visit the home on a regular basis. EVIDENCE: Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 9 Four care plans were inspected and a variety of information is in place. It was noted however that reviews of care have been intermittent with gaps of six months. The manager acknowledges that this is an area that needs to be improved and she stated that she will action this in conjunction with her senior care staff. Service users continue to receive visits from a variety of healthcare professionals including district nurses, GPs, chiropodist and a dentist as required. The care staff in the home assist service users with personal care where necessary. The manager and staff team in the home are committed to maintaining service users privacy and dignity at all times. This was confirmed by service users on the day of inspection and was observed by the inspector. Improvements in medication recording have been made since the last inspection and are accurately maintained. Service users spoken to were complimentary regarding the care and support they received from the management and staff team Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 10 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, 15 Staff provide support to ensure that service users have access to activities in the home and access to the community appropriate to their needs and abilities. EVIDENCE: A range of activities, entertainments, outings and access to community events are offered to service users. Individual preferences and interests are recorded in the service users plan. Summer fetes held in the garden area and plans are being made for a number of events at Christmas. The registered manager stated that a variety of entertainers provide musical events throughout the year. There is a programme of light exercise for service users. A short informal daily act of worship is provided for those who wish to attend and ministers from local churches regularly visit service users. Relatives of service users are welcome to the home at all times and there is a lively and friendly atmosphere in the home. Varied and nutritious meals are available to service users. Service users, spoken to on the day of inspection, were complimentary about the meals they received. Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 11 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): 16,18 The home has a satisfactory complaints process to make sure that service users and their representatives have their complaints or concerns listened to and actioned properly within agreed timescales. EVIDENCE: The home has a full complaints procedure in place .The manager has provided a detailed complaints procedure that includes the CSCI contact details. This policy has been explained to service users and relatives and is also included In the Statement of Purpose and Service User Guide. Staff receive training in the protection of vulnerable adults to ensure that service users are protected from abuse. There have been no complaints regarding the home and its care and services since the last inspection Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 12 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): 19,20,21,24,26 The environment of the home provides service users with a safe and comfortable place in which to live but some areas are in need of refurbishment. EVIDENCE: Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 13 The home is kept in a clean and tidy way and is free from odours. All bedrooms are en-suite and there are three bathrooms with WCs, two with shower facilities and one separate WC, which are all located close to the service users rooms and near to the lounges and dining area. Bedrooms seen on the day of inspection were presented in a homely and comfortable manner in accordance with service user’s preferences. The manager stated that bedrooms are redecorated as required. There is a maintenance programme in place to ensure the ongoing renewal, refurbishment and decoration of the premises. Maintenance issues are actioned via the regular management committee meetings. The attractive gardens are accessible and continue to be well maintained. Service users often enjoy spending time in the garden with their visitors during the summer months. A number of armchairs have been reupholstered in the main lounge since the last inspection. It was noted that some of the doors and walls are becoming marked or damaged due to wheelchairs and that protective guards might be purchased to protect vulnerable areas. The dining room carpet needs to be cleaned, as there is evidence of staining around some of the dining tables and near the entrance to the kitchen. Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 14 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): 28,29,30 The home’s recruitment policy and processes make sure that service users are protected from potential harm. Training is provided to make sure that care staff are competent to deliver personal care to the service users they support. EVIDENCE: The manager stated that there were vacancies for one full time care and one catering assistant. She also reported that due to staff sickness the senior care management team had been more involved in assisting service users with personal care. She stated that the home was processing applications and were awaiting adequate employment checks to be completed. The home’s training files was seen with evidence to show that staff members receive a variety of training including catheter care, infection control and POVA. Training is well monitored with refreshers/updates to ensure safe practice throughout the year. This was confirmed through conversations with staff. Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 15 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): 31,32,33,36,38 The home is well managed and the manager provides supportive leadership and guidance to staff to ensure that service users receive good quality care EVIDENCE: The registered manager continues to provide a clear and inclusive style of management supported by members of the Management Committee’s regular input. A new deputy manager has been appointed and will commence employment when all recruitment checks have been completed. A supervision form has been developed to give greater space for recording issues that are discussed. The manager stated that these forms would be used in all forthcoming staff supervision meetings. There is an annual appraisal meeting with all staff in the home. Fire records are kept and recorded regularly. Service contracts are in place for equipment in the home and hard wiring and portable appliance testing has recently been carried out. Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 16 Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 17 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 3 X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 X X 3 X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 X 3 Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 18 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. 1 2 Standard OP7 OP19 Regulation 15 (2) (b) 23 (2) (b) Requirement Service user care plans must be reviewed regularly. The premises need to be kept in a good state of repair. Timescale for action 18/12/05 18/12/05 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 Florence House DS0000015170.V250771.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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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