Inspection on 20/04/05 for Fontenay Nursing Home

This inspection was carried out on 20th April 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.

Other inspections for this house

Fontenay Nursing Home 11/12/06

Fontenay Nursing Home 01/11/05

Fontenay Nursing Home 30/03/05

Fontenay Nursing Home 13/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Fontenay Nursing Home 39 Watts Avenue Rochester Kent ME1 1R Lead Inspector Lucy Ansell Unannounced 20 April 2005 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 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. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Fontenay Nursing Home Address 39 Watts Avenue Rochester Kent ME1 1R 01634-843753 01634-830173 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr. Thomas Michael Kelly Mrs. Florence Mary Hussin Care Home 28 Category(ies) of Older People 27 registration, with number Dementia 1 of places Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: To accommodate one person with dementia whose date of birth is 19.09.1919. Date of last inspection 30 March 2005 Brief Description of the Service: Fontenay Nursing Home is a detached Victorian home providing accommodation on two floors, and a further third floor with the communal areas. There is a passenger lift to all floors. Fontenay is a 28-bedded unit providing nursing care to older people. There are a variety of aids and adaptations around the home, which enable more independence for the residents. All areas of the home used by the residents are wheel chair accessible. The home has 18 bedrooms, 9 singles and 9 doubles, 2 of which have ensuite toilets. Over the three floors there are many communal toilets and three bathrooms with assisted electric baths. The home is situated in a residential area less than a mile from Rochester town centre. The home is located on a main bus route and within walking distance of shops and a Post Office. The home has attractive front and side gardens with seating. The Kelly Family has owned the home for over thirty years, the registered manager has also been in post for many years and the home has an experienced staff team. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection under the terms of the Care Standards Act 2000 carried out by one inspector who was in the home from 09.30 to 15.30 on the 20th April 2005. During the inspection the owner and Manager arrived having cancelled previous plans to attend. Their openness, dedication and enthusiasm about their home was recognised. Documentation and records were read, including care plans. A tour of the premises was undertaken. The inspectors spent time talking with 6 service users and 1 relative. What the service does well: What has improved since the last inspection? The manager has a good understanding of the areas in which the home needs to improve. These are only minor changes to improve practice. Planning was in place and evidence was seen that improvements and change needed from any requirements are implemented immediately by the home. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 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. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 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 standard(s) 1,3 and 4 The home’s Statement of Purpose and Service User guide contains the required information for residents and families to make an informed decision about moving into the home. There is a system of pre assessment at the home that enables staff to assess the needs of residents satisfactorily and assure that these will be met at the home. EVIDENCE: The home has completely revised its statement of purpose and service users guide. It is now clear and concise with all relevant information included. Residents are provided with a statement of terms and conditions when moving into the home. Evidence was seen of the homes contracts, which were very detailed. Residents are admitted following a full assessment by the homes manager or one of the registered nurses. The information gathered forms part of the overall care plan. The home uses a mini mental test within the preassessment paperwork this is not qualified with what the actual scores mean and when it is repeated in the home after admission it is still not satisfactorily explained. The home does not offer intermediate care. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 9 Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 10 and 11 Residents benefit from a high standard of care planning which encompasses all of their health, personal and social care needs. Residents are treated with respect and dignity and their independence is promoted. Resident’s wishes in the event of death have been established in care plans and are respected. EVIDENCE: Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 11 Four residents care plans were looked at. These were detailed records, which contained good personal and health care recording. The health needs of residents are well met with evidence of good multi-disciplinary working taking place on a regular basis. The risk assessments were clear and concise, and a family member and one of the staff team signed assessment forms around mobility or restraint. The home has in the file a checklist for questions to ask when a resident will be sharing a room to ensure complete agreement is gained from both residents. Evidence was seen that reviews are taking place regularly. The manager has in place a system to monitor all care plans after the staff have completed their reviews. The home operates a key worker system where residents have an identified staff member. The home promotes and maintains residents health through supporting and facilitating medical appointments as required. At this time the home has three pressure sores, one that was acquired in hospital and two that are skin tears but are now greatly reduced. All residents have electric beds and pressure reliving mattresses, either airbeds or flotex. The home has good links with other professionals and the homes visiting medical officer who is frequently there stated, “he had recommended the home to Rapid Response as it provides good nursing care”. The staffs on duty were observed indirectly throughout the inspection, they were seen to interact in a positive and respectful manner with residents. Residents gave positive feedback during the inspection about the approach of the staff team, comments included “nothing is too much trouble for the girls” and “they are very kind and you can have a laugh with them”. In the residents shared rooms it was noted that new privacy curtains were in place that ensured privacy and dignity for the occupier. Residents are consulted regarding their wishes concerning terminal care and arrangements after death. The home has collected this information in a sensitive and professional manner, and care and support is provided for relatives after bereavement. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 The residents have access to a range of appropriate social activities which enhances their quality of life. Residents are encouraged to exercise their right to choice which ensures they have some control over their lives. The residents’ dietary needs are well catered for with a balanced and varied selection of food that meets resident’s tastes and choices. EVIDENCE: An activity co-ordinator works at the home four days a week for 16 hours, they also have an activity lady once a week for singing and games. During the inspection a communion was taking place and after this finished the vicar saw individual residents in their rooms for prayers. Evidence was also seen of a painting group and another group were socialising watching a video and chatting. The home does have entertainers coming in monthly. Residents stated they’re happy with the level of activities offered. The home has just bought new seating for outside. One resident stated, “ She loves to go outside and cannot wait for the warmer weather”. The home has started booking trips for the summer and a bus is booked for July to go to the seaside for Ice creams, fish and chips and a Pub visit paid for by the home. Evidence was seen of a daily log of activities with all clients being seen daily, for a one to one chat or a hand massage if not able/wanting to partake of the activity. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 13 One lady who does not speak any English is given more time by the activity co-ordinator in one to ones and she has found out basic words and aids in her native language. A number of residents spoken to in the home who commented on the food said how well received it was and that they welcomed the daily choices offered. Evidence was seen of the four-week rota, of stocked larders and fresh food orders. Residents were observed during meal- time and choice and variety were seen to be offered. One resident stated “ the food was excellent and they always have something on the menu which I like”. The cook was aware of only one specialist diet, which is a Hindu vegetarian and she will make this specifically for this resident. The home has two liquidised meals and vitamin drinks are offered as required. Visitors are made welcome at any time and a private visitors room is made available with refreshments as required. This was evidenced during the inspection and on speaking to a relative. They stated, “They were free to visit when ever they wished and were very happy with the home”. The home also provides meals at no cost to relatives who wish to stay for this. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 14 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 standard(s) 16 The residents and their relatives benefit from having access to the home’s clear complaints procedure. Residents and relatives are aware of how to complain and feel that their views are listened to and acted upon. EVIDENCE: The home has a clear step-by-step procedure that meets the requirement of the regulations. The complaints procedure was displayed within the home and evidence was seen of it included in the statement of purpose and service user guide. The home has received no complaints since the last inspection; evidence was seen of a copy of the complaints form. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19,20,21,23 and 25 Residents benefit from living in a safe, well-maintained and clean environment which is decorated, furnished and fitted out to a high standard. EVIDENCE: The home location and layout is suitable for its stated purpose; it has been visited recently by the fire officer and environmental health and had met all their requirements. The home has one communal lounges spread across the top floor of the building, split into three sections one of which is a quiet room, another for viewing the television and a arts and craft area. The home has a small dining area, also at the top of the home but most residents eat in their rooms. On the day of the inspection five residents had chosen to eat up there after they had finished their activities. Several residents spoken to commented “On the welcoming feeling of the home”. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 16 Two of rooms have ensuite toilet facilities and rooms where these are not included a suitable bathroom/toilet is located nearby. The home has sufficient toilet and bathroom facilities for the number of service users. Bedrooms seen had all been personalised by the service users. The rooms were all clean and well decorated. Bedrooms have sufficient space to accommodate the required furniture. The home has very high standards of cleanliness and no odours were detected anywhere in the house. The home has a separate laundry room, which met infection control requirements. The kitchen was viewed and this was well maintained. The home has two sluice rooms and a large basement which doubles as a storage space and a staff room. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 Residents benefit from having a highly motivated and enthusiastic staff team. Through a detailed staff training programme service users can be confident that their needs will be met by a competent staff team. Residents could be potentially put at risk owing to the home not implementing fully changes in employment legislation. EVIDENCE: Staff rotas were seen and evidenced that staffing was suitable to provide appropriate shift cover. On the day of inspection one carer was off sick so the second registered nurse became a carer for the shift. The home does not use agency staff and has its own bank of care staff to call on. All the staff working in the home have an NVQ, from domestic to care staff ranging from NVQ 2 to some staff taking an NVQ4. 2 qualified nurses and 4 carers staff the home on the morning shift, then in the afternoons 1 qualified nurse and 4 carers and in the evenings 3 waking staff 1 qualified. The home also employs a cook, Handyman, activity co-ordinator and several domestic staff for cleaning and laundry room. The home uses unsuitable recruitment paperwork as seen from staff files inspected. The inspector sampled a number of staff files, which included all types of staff, who had been at the home for varying lengths of time. All files seen did not contain the correct information. The inspector did not see the employment history on the application form, interview notes or offer letter. All staff had completed CRB disclosures. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 18 The homes only requirement was to look into new employment laws and update application forms to show full record of employment history. The home was advised to also keep any interview notes made and have copies of interview questions on file. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35,36,and 37 The residents benefit from a staff team that is well managed and has a clear understanding of its roles and responsibilities. The owner has a clear plan and vision for the home, which is effectively communicated to the residents, staff and relatives. Residents enjoy effective consultation which ensures their views are both sought and acted on. EVIDENCE: The manager was seen to communicate a clear sense of leadership and direction to her staff. The process of management appeared to be open and transparent. Staff indicated that they felt part of a good team and this was due to the way the home was managed. The home holds bi-monthly residents meetings and regular staff meetings are taking place with productive agenda’s and full involvement of all staff to improve the service provided. All the staff and residents are proud of the home and this is conveyed in the atmosphere of Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 20 the home. The owner is also very involved in the management side of the home and regularly visits the home three to four times a week. The home completes quality assurance questionnaires with all residents and relatives 6 monthly. The owner also speaks to the residents on a fairly frequent basis to ascertain they are well with no complaints. These are seen recorded on the monthly provider reports. The home does not deal with resident’s money and the home pays for all extras for the residents E.G papers, hairdressing, and chiropody. There was evidence seen that formal staff supervision took place this was confirmed in discussion with staff and also by the manager who manages supervision as often as possible. The home holds a large organisational policy and procedural file, which is accessible by management and staff have a copy in their staff room. It is noted that the home has revised and updated all the policies as required and staff sign to say they have seen these. During the course of the inspection a number of records, policies, procedures and other documents were examined. Records are stored securely and safely. The homes policies are reviewed under the Data Protection Act 1968. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 4 3 x 3 3 3 3 Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 22 No Are there any outstanding requirements from the last inspection? 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 OP 29 Regulation 19 S4.6 Requirement to ensure staff files hold all relevant information. Timescale for action 31-5-2005 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. 2. Refer to Standard OP 7 OP 7 Good Practice Recommendations To ensure assessments of residents are valid and qualified. To ensure the location and date of a pre-assessment is completed. Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent, ME16 9NT 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 Fontenay Nursing Home H56-H06 S26167 Fontenay V222863 200405 Stage 4.doc Version 1.30 Page 24 - 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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