Inspection on 08/09/06 for Floron Rest Home

This inspection was carried out on 8th September 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 21/02/06

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 8th September 2006 09:45 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.V310313.R01.S.doc Version 5.2 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.V310313.R01.S.doc Version 5.2 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.V310313.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2006 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 en-suite 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.V310313.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the inspection was to inspect the key standards for care homes for older people. The inspection was unannounced and took place over one short day. The inspector spoke to three residents and two carers and interviewed the owner/manager. The inspector observed the administration of medication and balanced three medications held against the records. She viewed three residents files, and three carers files in addition to other documentation. She made a partial tour of the premises including the gardens. The inspector would like to thank the residents, staff and owner/managers of the home for their co-operation and assistance with the inspection. What the service does well: The home has a number of reliable staff who have worked there for some time and know the residents well. Health care needs are well understood and met. The owner managers take a personal pride in the appearance of the home. The feedback from residents was very positive, one resident said she liked the home and was well looked after everyone is so nice and kind and the food is exceptionally nice. Another said you could not wish for a better place. The inspector was told I like all the staff and they all talk to you nicely this is a good place, there is always someone you can ask. Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 6 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. Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 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.V310313.R01.S.doc Version 5.2 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): 3 and 6. Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The home is skilled at assessing new residents against its admission criteria. EVIDENCE: As previously stated the inspector viewed three cardex files for service users. These are in daily use and they evidenced short and long term care assessments. The long term care assessment was focussed and covered personal and social needs. In addition residents also have a personal file where this assessment information is recorded in a different format. The home has an admission criteria and they liaise with social workers or families to gather information about prospective residents. The inspector was satisfied that residents needs are assessed before they move into the home. The home does not offer intermediate care. Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 9 Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 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): 7,8,9 and 10. Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The health and personal care needs of residents are well met. EVIDENCE: As described above service users have a care assessment and service plan combined. The inspector viewed three, on the files of residents and felt that they were sufficiently detailed to inform care. There was evidence in the daily recordings of wellness of individuals. Their medical conditions were documented and staff appear to understand them. Deaths do occur from time to time and two new residents have been admitted since the last inspection. The owner/manager was able to speak knowledgably about both new residents and their needs, including complex health care. One Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 11 resident had, during the few weeks she has been at the home had a cataract operation. The inspector took this opportunity to remind the owner/manager of her responsibilities to under regulation 37 of The Care Homes Regulations 2001 to make notifications to the Commission for Social Care Inspection (CSCI). The manager is directed to the list in that regulation which includes: (a) the death of any service user, including the circumstances of his death. (d) the serious illness of a service user at a care home at which nursing is not provided. The inspector observed staff administering the morning medications. Medications are kept in a locked dresser. The Boots bubble pack system is used for most medications. Those which are not bubble packed are kept in their boxes with the residents name written on. The senior carer dispensed the medication whilst another handed it to the resident with a drink. When the medicine was taken the record sheet was initialled. The inspector balanced three medications from three different residents. One resident was one tablet short on a number of medications. The carer advised that this is a new resident who came in short of these tablets. The inspector was shown a letter which had been written to the general practitioner of the resident, asking for the missing tablets to be prescribed. The inspector observed that staff spoke respectfully to residents. One resident was joking with the cleaner and obviously enjoys an ongoing repartee with him. The inspector felt that the atmosphere in the home was relaxed and informal. The inspector noted some small stools in the sitting room which allow carers to sit next to the residents for one to one interaction with them There is a little reception room where residents can entertain their visitors or they can use their bedrooms if they prefer. Rooms are shared at the home but screens are provided for privacy. Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 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): 12,13,14 and 15. Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The lifestyle experienced in the home affords residents choice and dignity. Meals are enjoyed. EVIDENCE: The home had a party recently for a resident who has reached a great age. Among other guests the mayor came and the resident advised him to put your name down for the home so that he could be sure of a future place. The resident also had a party at a relatives house. The home arranges one or two summertime outings. They have recently been to South End and a trip to Bluewater is planned. The owner/manager stated that residents have also been taken to the nearby park. The inspector noticed a small library of large print books in the sitting room. Residents daily recordings evidence them taking part in activities provided in house, like singing. Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 13 Family are encouraged to visit residents and the inspector has often observed visitors when she has been at the home. She noted in the records of some residents that they had been visited by clergy. The owner/manager stated that service users are encouraged to exercise choice whenever possible. The inspector understands that all service users are up and dressed by 8a.m.when the day shift come on duty. She asked the owner/manager if residents can choose when they get up in the mornings. The owner/manager said that no-one has to get up before they are ready and all are have a first cup of tea in their rooms. A number of residents tend to wake quite early anyway, as they retire early. The owner/manager said that if someone feels unwell or just wants to stay in bed a bit longer then their breakfast is brought to them and they dont get up until they feel ready. The inspector asked if some residents like to go back to their rooms during the day. The owner/manager said that this is fully supported and there are currently three residents who do this. One resident told the inspector you go to bed when you want. The inspector noted that the residents zimmer frames are all stored in the laundry room. The owner/manager stated that they are produced as needed and pointed out that a resident sitting in the garden had her frame right next to her, which she did. The owner/manager stated that all residents have their zimmer frames in their rooms overnight. The inspector noted a resident came out to the garden to smoke a cigarette and felt that this was an example of exercising personal autonomy. The inspector observed that a senior staff who has been at the home for a number of years chatted very comfortably with residents without any need to raise her voice or overarticulate. This conveyed to the inspector that residents are used to chatting with this carer and are tuned in to her voice, which is a positive communication indicator. The homes cook showed the inspector a Food Standards Agency manual of food hygiene, safety, contamination etc. This provides a diary so that all information regarding food can be recorded there. The cook has undertaken a training course to use this system and finds it very helpful. The inspector noted records of food eaten with temperature recordings of the food. Also temperatures of fridges and freezers. The cook said she is very particular what she gives the residents to eat, and that the residents when asked, do not want to change the menu. She said she Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 14 finds the residents like the food they have always been used to, which is home cooked English food. Two resident do not like fish and as it was fish on the menu on the day of the inspection, they were both offered alternatives. Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 15 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 and 18 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The home protects the residents and takes complaints seriously. EVIDENCE: The owner/manager stated that there have been no complaints since the last inspection. The inspector did not view the adult protection policy on this occasion as she has seen it previously. The owner/manager stated that NVQ training includes adult protection and the level of staff at the home with NVQs is high. Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The home is clean and hygienic and provides a good environment. EVIDENCE: The inspector made a partial tour of the premises, which present a safe, hazard free environment. She saw bedrooms on the first floor which looked very pleasant, particularly those with en-suite facilities. The home employs two cleaners and as usual it looked clean and bright. It is currently being painted. The exterior has been done and looks very smart, interior work is now being carried out. The inspector viewed the gardens front and rear. The rear garden looks really colourful and two huge umbrellas have been purchased this year for shade. Three residents came out to sit in the garden Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 17 while the inspector was there. The inspector noted that staff also slip outside for breaks, so the garden is appreciated by all. The home has a separate utility room where the washing machine is housed. The owner/manager stated that there is no foul laundry to be washed but in any case they have a top of the range machine which has the programming to meet disinfection standards. Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 29 and 30. Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The home has recruited a competent staff and supports the development of their skills. EVIDENCE: The owner/manager stated that there are about 19 members of staff counting part-timers. The ratio of care is two carers to the sixteen residents. In addition to this the home has trainees and students who visit They are allowed to help the carers under supervision. There are two waking night staff. The owner/manager stated that the home supports carers to undertake NVQS and by the end of the month there will only be two carers who do not have NVQ level 2. Carers personnel files evidenced a robust staff recruitment system, which incorporates equal opportunities, and is consistently followed. The staff group is culturally diverse. The inspector noted on a carers file a good induction process. The owner manager stated that there has been a recent series of training with carers undertaking courses on Food Hygiene, Health and Safety and First Aid. Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 19 She said that the majority of carers had just done manaual handling and one carer has done a course on writing care plans. The inspector advised the owner/manager that the carers training history is not always clear on their files. In some cases the courses are listed but without dates or certificates to support. A clear training programme available for inspection and evidence in carers files of the training they have undertaken and when, would provide better evidence of training. Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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. Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The home is well run and managed. EVIDENCE: The home is run by the two owner/managers. They have been running it for thirty years. The registered manager is a qualified nurse. The owner/managers come to the home every day and are on hand to advise and guide staff. The owner/manager stated that a lot of verbal feedback is collected by chatting to relatives. In addition surveys are used and the inspector saw two completed surveys which had been signed by residents. Both were positive. Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 21 The home does not deal with service users monies. This is done by their relatives. If there are no relatives available to help, social workers act as appointees. The manager stated that they do not have any difficulties collecting monies when this is the case, even for larger items, like clothing. Before the inspection the inspector received, a copy of a letter to the home from the London Fire and Emergency Planning Authority advising that following a recent inspection of the premises they were found to be satisfactory as far as fire safety matters were concerned. The inspector asked to see the arrangements for Control of Substances Hazardous to Health (COSHH). The owner/manager showed the inspector a manual with up to date assessments for products used. The inspector checked the store of COSHH products and noted that they corresponded to the products assessed in the manual. The COSHH items in the house were securely locked away. Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 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 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 23 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 Standard OP8 Regulation 37 Requirement Timescale for action 18/09/06 2 OP30 18 3 OP30 18 The manager must ensure that she makes notifications to CSCI as directed under regulation 37 of The Care Homes Regulations 2001. The manager must ensure that 01/11/06 training profiles bear the dates of training so that training needs including the updating of core training are obvious. The manager must make 01/11/06 available for inspection the training programme for carers. 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 Floron Rest Home DS0000022836.V310313.R01.S.doc Version 5.2 Page 24 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.V310313.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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