Inspection on 21/02/06 for Floron Rest Home

This inspection was carried out on 21st 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

Floron Rest Home 08/09/06

Floron Rest Home 12/07/05

Floron Rest Home 14/03/05

Floron Rest Home 21/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Floron Rest Home Floron Rest Home 236 Upton Lane London E7 9NP Lead Inspector Anne Chamberlain Unannounced Inspection 21st 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 Floron Rest Home DS0000022836.V281157.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. Floron Rest Home DS0000022836.V281157.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Floron Rest Home Address Floron Rest Home 236 Upton Lane London E7 9NP 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) 020 8472 5250 020 8655 7228 Mrs C Quarshie Collison Mrs C Quarshie Collison Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Floron Rest Home DS0000022836.V281157.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th July 2005 Brief Description of the Service: Floron Rest Home is a residential home for 16 service users over the age of 65 years. It has been established since 1972. The home does not offer nursing care. There are 4 single bedrooms and 6 double bedrooms. 3 of the single rooms are ensuite and all the rooms have basins. There are two bathrooms with toilets and 1 shower room and toilet on the ground floor. Floron is situated in Upton Lane in Forest Gate and backs on to West Ham Park. It is on a main bus route and a short distance from both underground and rail stations. Floron has off street parking in front of the house, for several vehicles. There is a pleasant garden with patio area at the rear. The registered manager is also the registered provider. Floron Rest Home DS0000022836.V281157.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The aim of the inspection was to monitor progress on requirements which had been made at the previous inspection, and to inspect standards which had not been inspected so far this year. The inspection took place over one day. The inspector spoke with service users, the owner/managers, the deputy manager and one member of staff. She also talked with visiting relatives. The inspector viewed parts of the premises, service user and staff files, and key documentation. A service user was having an annual review of care on the day of the inspection and the inspector attended it. What the service does well: What has improved since the last inspection? The home has responded well to the requirements made at the last inspection. Care planning and staff supervision have improved. The difficult topic of death arrangements has been raised, and wishes and views sought. The deputy manager has returned to work from extended sick leave and the service is benefiting from her input into documentation and record keeping. Floron Rest Home DS0000022836.V281157.R01.S.doc Version 5.1 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. Floron Rest Home DS0000022836.V281157.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 Floron Rest Home DS0000022836.V281157.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): 2 and 4. Service users have written contracts and these are generally signed by both parties. Collectively the staff have substantial skills and experience in caring for older people. EVIDENCE: The inspector viewed on the files of service users, contracts of terms and conditions, singed by both parties and dated. One contract had not been signed. The deputy manager said this was because the service user was not able to understand and the next of kin was reluctant. The inspector advised that in all instances where parties are not prepared to sign paperwork, a slip recording this fact is attached, signed and dated by staff. This is a recommendation. Floron Rest Home DS0000022836.V281157.R01.S.doc Version 5.1 Page 9 The deputy manager said that staff are very attentive to the health of service users and will call the general practitioner out to see them whenever necessary. The inspector saw a copy of a fax which had been sent to a surgery. The deputy manager stated that if there is no response to telephone calls and faxes staff will physically go to the surgery to request a visit. The doctor called at the house on the day of the inspection. The deputy manager said that the district nurse calls weeks for one particular service user who has specialised needs. She said the staff have all done pressure sore training and the tissue viability nurse has visited the home. The home has a number of special mattresses to support tissue viability. The deputy manager stated that the service users have all just had their eyes examined by a visiting ophthalmologist. Floron Rest Home DS0000022836.V281157.R01.S.doc Version 5.1 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 the following standard(s): 7 and 11. Health, personal and social needs are set out in individual service user plans. Death is treated with sensitivity and respect. EVIDENCE: The previous inspection made a requirement relating to the regular review of service users care plans. Also that care plans be signed and dated. The home keeps two care plans for each resident, one in their service user file and one with the standex system which they use. The inspector saw evidence of assessment, care planning, risk assessment and daily recording of care. The deputy manager said that service users are usually reviewed by their care manager after six weeks in the home, after six months and then annually. A service user had her annual care plan review on the day of the inspection and the inspector, with the permission of the service user, attended it. The deputy manager explained that minutes are the responsibility of the social work care manager but are sometimes slow to appear. For this reason the home keeps their own notes of review meetings. The inspector saw the book where this recording is made. Floron Rest Home DS0000022836.V281157.R01.S.doc Version 5.1 Page 11 The previous inspection required the manager to record information regarding service users wishes for time of death. The manager and deputy manager explained that service users and their families are often very reluctant to engage with this subject of death. The deputy manager said that when people go to hospital their progress is reported to the other service users. However if they deteriorate and die in hospital this is not reported. She said that as most of the residents are rather confused and forgetful this seems to work best for them. The deputy manager said that local clergy visit to meet spiritual needs and should anyone express preferences they would be recorded. She said that she had written to families requesting preferences and inspector noted that in some cases a specific wishes box had been completed with preferences regarding funeral arrangements. The inspector is satisfied that the home had done their best to comply with the requirement and that they are responding sensitively to the preferences of service users. Floron Rest Home DS0000022836.V281157.R01.S.doc Version 5.1 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 the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: Floron Rest Home DS0000022836.V281157.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): 17. The legal rights of service users are protected. EVIDENCE: The deputy manager advised that some service users who have no next of kin are represented by a solicitor. Relatives act as advocates for others. She advised that voting in elections is facilitated. Some service users have been taken to cast their vote, others have used postal votes. Floron Rest Home DS0000022836.V281157.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): None of these standards were inspected on this occasion. EVIDENCE: Floron Rest Home DS0000022836.V281157.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): 30. Staff are well trained but the recording of training needs could be improved. EVIDENCE: The deputy manager said that training is provided for the staff in corroboration with other homes in the area. Trainers are arranged and training is delivered at two local centres. The staff files had training profiles but no dates for the training. It is therefore difficult for the manager to tell at a glance when refresher training of core subjects is due. The manager should ensure that the training profiles bear the dates of training so that it is obvious when refresher training of core subjects is due. This is a recommendation. The deputy manager stated that most staff have NVQ level 2 and some are doing levels 3 and 4. She and the manager have also successfully completed level 4. She finds the management are very supportive of NVQ training. Floron Rest Home DS0000022836.V281157.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): 31,32,33,34,36 and 37. The home is run by fit, responsible people. The ethos of the home benefits the service users and it is run in their best interests. The financial and accounting procedures of the home are effective. Staff are properly supervised and record keeping is generally satisfactory. EVIDENCE: The owners who manage the home both have substantial experience having run the home for thirty years. One is a registered nurse and as noted elsewhere in this report has NVQ 4. The deputy manager described the ethos of the home as safe, warm, loving and homely. She said that workers use their caring skills to preserve personal independence whilst providing the assistance needed. She spoke of the need for clear communication and explained how this is achieved. The deputy Floron Rest Home DS0000022836.V281157.R01.S.doc Version 5.1 Page 17 manager felt that the home is committed to continuous development and uses criticism constructively. The manager stated that the home is undertakes annual self audit with performance indicators for every aspect of the work. This year they are focussing on practical performance. She inspector saw a copy of a questionnaire which is being used with service users, relatives and staff. The inspector asked how the inspection report would be circulated. She was told that it would be shared with staff at a meeting and that a copy would be placed in reception for people to read. As previously stated this home has been open for thirty years. The home looked well maintained and in good decorative order. The gardens are nicely kept. There is nothing to suggest that this home is other than financially viable, effectively and efficiently managed. The previous inspection required the manager to ensure that staff are supervised regularly not less than six times per year. The inspector was shown four supervision records which were to be filed on individual staff files. They were adequately completed, signed by both parties and dated. The inspector also saw records of group supervision sessions held in December 2005 and February 2006. She was satisfied that the home have addressed the need for regular supervision of staff. The previous inspection required that service user files be kept up to date and in good order. The inspector viewed various records including service user and staff files, the shift handover book, record of house meetings and the accident book. She felt that the home keeps adequate records. The service user files have been improved by the addition of a paper wallet which gives basic information with a photograph of the service user attached. However other paperwork is still rather inaccessible being in punched plastic pockets and rather mixed up. The manager should ensure that the files are tidy and papers properly divided. This is a recommendation. Floron Rest Home DS0000022836.V281157.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 3 x 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 x x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 x 3 3 x Floron Rest Home DS0000022836.V281157.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. 1. Refer to Standard OP2 Good Practice Recommendations The inspector advised that in all instances where parties are not prepared to sign paperwork a slip recording this fact is attached, signed and dated by staff. The manager should ensure that the training profiles bear the dates of training so that it is obvious when refresher training of core subjects is due. The manager should ensure that the files are tidy and papers properly divided. 2 OP30 3 OP37 Floron Rest Home DS0000022836.V281157.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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 Floron Rest Home DS0000022836.V281157.R01.S.doc Version 5.1 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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