Inspection on 11/09/08 for Ford Place Nursing Home

This inspection was carried out on 11th September 2008.

CSCI found this care home to be providing an Adequate service.

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

Ford Place Nursing Home 06/12/07

Ford Place Nursing Home 29/09/06

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 13/11/2008.

CARE HOMES FOR OLDER PEOPLE Ford Place Nursing Home Ford Street Thetford Norfolk IP24 2EP Lead Inspector Kim Patience Unannounced Inspection 11th September 2008 10:15 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 Ford Place Nursing Home DS0000067712.V371835.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. Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ford Place Nursing Home Address Ford Street Thetford Norfolk IP24 2EP 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) 01842 755002 01842 750964 www.barchester.com/oulton Barchester Healthcare Homes Ltd Mrs Denise Hubbard Care Home 49 Category(ies) of Old age, not falling within any other category registration, with number (49), Physical disability (49) of places Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th December 2007 Brief Description of the Service: Ford Place is a 49 bedded nursing home caring for older people. The home, originally a family mansion, was refurbished in 1997 and an extension was added in 1999 with a further extension in 2005 It is situated in the market town of Thetford and is a short walk from shops and other local amenities. The gardens are a positive feature of this home, with landscaped views over the lawns and river, (which runs along the rear boundary of the property). There is a car park at the front of the home with easy access from the road. The older part of the building is on two floors and is accessed by a small shaft lift. The fees charged for the service range from £477 to £810. Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection consists of information gathered since the last inspection and a site visit to the home. During the site visit we took a tour of the premises, looked at records relating to residents and staff and we spoke with residents, relatives and staff. In addition we made observations of daily life in the home. The site visit took approximately 9 hours to complete. We surveyed residents, relatives and staff. At the time of writing this report we received 3 completed resident surveys, 2 relative surveys and 2 staff surveys. Comments from the surveys have been incorporated in the report. What the service does well: What has improved since the last inspection? Since the last inspection the home has made improvements to care plans and a checklist has been introduced to ensure that all care plans and health assessments are completed where necessary. The training needs of staff have been reviewed and where needed staff have undertaken refresher training. Staff have now been trained in safeguarding. Staffing has been reviewed and the home has taken on a bank of staff to cover absences and avoid the use of agency staff. Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 Page 6 The complaints procedure is now more widely publicised and people feel confident that complaints will be listened to and acted upon. 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. The summary of this inspection report can be made available in other formats on request. Ford Place Nursing Home DS0000067712.V371835.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 Ford Place Nursing Home DS0000067712.V371835.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. People can be assured that their needs will be assessed prior to moving into the home and informed that they can be met. People are given good information about the service so they can make a decision about its suitability. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has policies and procedures for the admission of people to the home. The manager completes pre admission assessments before people come to live at the home and confirms in writing that their needs can be met. The home has a brochure that sets out the facilities and services that are available and this is given to prospective residents. Pre admission assessments relating to two recently admitted residents were examined and found to be in good order. Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 Page 9 We surveyed people who live in the home and received two completed surveys. Both surveys indicated that people were provided with the information they needed prior to moving into the home and that they had received a contract setting out the terms and conditions of residence. People also confirmed that the home had assessed their needs prior to moving in. Ford Place Nursing Home DS0000067712.V371835.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. People can be assured that the home has systems in place to ensure their needs are assessed and met. However, some improvements are needed in care planning, risk assessments and medication practices before the outcomes can be good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at care plans and associated records relating to people living in the home. We found that care plans were well organised and contained good information about people’s needs and how they should be met. There was good practice in relation to risk assessments of people’s health needs followed up with a care plan setting out how they should be met. However, some areas are in need of improvement. For instance nutritional needs assessments, where in two cases it was not clear how the home was responding to the individual’s needs when weight loss and low body mass index scores were evident. In Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 Page 11 addition the home needs to make further progress in making assessments more person centred. People spoken with during the inspection and those surveyed said that they were happy with the care provided. One relative wrote ‘ since mum moved to Ford place, she has become much happier and relaxed, loves the setup. Her welfare is very well looked after, as well as her medical needs. We are impressed with the house and its staff. People also stated that they were well looked after and that care staff treated them kindly and with respect. Medication arrangements were inspected. The home has recently changed its system to intecare, which supplies storage facilities, medicines and medication administration charts. We found that the home has good storage facilities for all medicines and each resident has a lockable medicine cabinet in their own room. Nurses administer medicines and hold a master key for each cabinet. We observed the nurse administering medicines during the inspection and good practice was seen. Controlled drugs are stored in a secure locked cabinet and a controlled drugs register is maintained. The controlled drugs and register were checked and found to be in good order. Medication records were examined and crosschecked with medicines remaining in stock. Medication charts were well organised and contained an identifying photograph of the resident and any relevant information, such as allergies. However, we found that there were some gaps in the records and use of codes that were not defined on the charts along with crosses and ticks. On these occasions we could not determine if medicines had been given or not. In addition, we were unable to complete a full audit as the manager said that the home has experienced some problems during the change over from one supplier to another and this had resulted in some medicines not being available for administration. They were planning to meet with the new supplier to resolve the problem. Following the meeting we asked the manager to complete a full audit of medicines and to ensure that all medicines were available for administration. We asked for regular updates on the current situation until the matter has been fully resolved. The manager has provided us with the information requested and taken immediate action to ensure that medicines are available. Ford Place Nursing Home DS0000067712.V371835.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. People can be assured that they will be supported to maintain a lifestyle that meets their expectations whilst maintaining choice and control. People are provided with a diet of their choosing that is nutritious and supports them to maintain good health. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at records relating to social care needs and spoke with several residents about how their needs are met in this respect. We noted that work is being done to gather more information about people’s interests and activities they would like to see taking place in the home. Relatives are being asked to provide life history information so that more person centred plans of activity can be arranged for those people who are not able to communicate their needs directly. Two activities coordinators are employed to work 40 hrs per week, one works 24 hrs and the other 16 hrs. We spoke to one of the coordinators who was able to give an account of the activities provided. A programme of activities is Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 Page 13 designed around the needs and wishes of people living in the home and advertised in the entrance hall. There are group activities such as bingo, quiz games, puzzles and reminiscence. There are also themed activities such as wedding themes and the harvest festival. People who do not wish to take part in the group activities or are unable to are provided with one to one time. The activities coordinators have done some excellent work on miniature gardens, which they take to show people who are unable to leave their rooms. People who were spoken with said they were satisfied with life in the home and took part in activities as they wished. Two if the three surveys returned by people living in the home indicated that there were usually activities they could take part in and one said always. One person also wrote ‘the activities ladies are very good’. One relative survey returned stated that the service could be improved by providing more activities or games. We observed the meals served in the home. The dining room was nicely laid out and is a pleasant place to take meals. Some people chose to eat in their rooms and some preferred to eat in other areas of the home. There was a wide variety and choice of meals on the menu. The food appeared to be appetising and prepared and presented in an appealing manner. Each day staff tell people what is on the menu for the following day and ask them what they would like to eat. People spoken with said that the food is good and they are always offered choice. The home employs two cooks and a kitchen assistant who cover all meals in the day. The cook on duty during the inspection said she is told of any special dietary requirements that people have and of individual likes and dislikes. The menus are based on what people like to eat and meetings are held so that people can contribute to the meal planning process. Records of resident’s dietary intake are maintained so that the home can monitor diets and nutritional intake. On the day of inspection we saw visitors coming into the home without restriction. One resident said that he often goes out with his family who take him shopping and for other excursions out of the home. Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. People know how to make complaints and can be assured they will be taken seriously. There are systems in place for the protection of vulnerable people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy and procedure, which is now publicised around the home. It is also included in the service users guide and in the welcome book. Relatives and residents who completed surveys all indicated that they knew who to contact if they wished to make a complaint and they felt it would be taken seriously. People spoken to in the home also said they would know who to talk to if they had any concerns. There have been no safeguarding concerns since the last inspection. Staff are trained in safeguarding and this is included in the homes rolling programme of training. Two completed staff surveys were returned to the commission and both indicated that staff had knowledge of safeguarding and would support people if they needed to raise any concerns. Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is excellent. People live in a home, which provides a high standard of accommodation and facilities and is maintained to a high standard in all respects. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We completed a tour of the premises and entered some people’s private accommodation. The premises were found to be clean and tidy throughout. The standard of furnishings, fittings and décor is of a high standard. People’s private accommodation is personal and homely and there was evidence that people had brought personal effects into the home with them. The bathrooms are equipped to a high standard and it was noted that the home had a range of new hoists and other equipment for assisting people with mobilising. Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 Page 16 The laundry facilities were well organised and there was a good system for keeping soiled laundry separate from clean laundry. The home has dedicated laundry staff. The home employs a maintenance man who deals with all repairs and maintaining the home to a high standard in terms of health and safety and appearance. Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. People have their needs met by a well-trained and supported team of staff with a range of skills and expertise. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs a good skill mix of staff. There are trained nurse, care assistants and a range of ancillary staff. Staff have clearly defined roles and are dedicated to their work. During the inspection there appeared to be sufficient staff to meet people’s needs and no residents expressed concern about the number of staff available. However, one of the surveys returned to the Commission indicated that at times people had to wait a long time for assistance when they used the call bell. We spoke with the homes training officer. All staff have individual training plans in addition to the homes mandatory training programme. Barchester offers staff good training using a range of resources. Ford Place also offers staff other training that is either provided in house by staff with the necessary expertise or it is sourced externally through networks the home has established with other agencies. The training officer was able to provide a print out of all the training that has taken place since the last inspection and the names of the staff who attended. It showed that all the mandatory training Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 Page 18 such as moving and handling, fire safety and safeguarding is underway and additional training such as palliative care, person centred approaches and wound care have been provided. The home now operates an IT system that stores information relating to individual training needs that informs the management when each member of staff is due for up dates to their mandatory training. This is also monitored by Barchester to ensure that training needs are being addressed. We looked at recruitment practice and checked the files relating to new staff employed. There were no issues with recruitment and files were found to contain all the information required. Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. People live in a home that is well managed with systems in place to assure quality and continuous improvement. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This home has an experienced manager supported by a good organisation. The management structure ensures the smooth running of the home even when the manager is not present. Barchester has a good quality assurance system in place and consults with people who use the service on a regular basis. Feedback from consultation processes and quality assurance is published and action plans state how any issues will be taken forward to achieve better outcomes. Regulation 26 visits are conducted in accordance with the Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 Page 20 regulations and the home has completed a Annual Quality Assurance Assessment (AQAA) as requested by the Commission. The AQAA sets out how the home has improved since the last inspection, what it could do better and how they hope to achieve this. The manager said the home does not hold any money for residents and does not get involved with people’s finances. There were no issues in relation to health and safety. We were provided with records relating to health and safety risk assessments and fire safety that showed systems to ensure people’s safety and protection were being well maintained. Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 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 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 2 8 2 9 2 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 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 Page 22 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 OP8 OP9 Regulation Requirement Timescale for action 13/10/08 13/10/08 12.1(a)(b) People must have their nutritional needs assessed and met. 13.2 Medication arrangements must be safe and promote the health and well being of people living in the home. 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 OP7 OP12 Good Practice Recommendations The home should continue to make improvements to care plans so that people’s holistic needs are assessed and met in a person centred manner. The home should continue to develop a programme of activities that is individualised based on people’s interests and hobbies. Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Ford Place Nursing Home DS0000067712.V371835.R01.S.doc Version 5.2 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. 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