CARE HOMES FOR OLDER PEOPLE
Forde Park Residential Home 18 Keyberry Park Newton Abbot TQ12 1BZ
Lead Inspector Mark Sharman Announced 05/04/05 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. Forde Park Residential Home Version 1.10 Page 3 SERVICE INFORMATION
Name of service Forde Park Residential Home Address 18 Keyberry Park, Newton Abbot, Devon, TQ12 1BZ 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) 01626 352904 01626 356847 The Wilson Crawford Partnership Mrs Barbara Elsie Underhill Care Home 15 Category(ies) of Dementia (15), Old age, not falling within any registration, with number other category (15), Physical disability over 65 of places years of age (15) Forde Park Residential Home Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: None. Date of last inspection 27/10/04 Brief Description of the Service: Forde Park residential home is a large detached house in a quiet and attractive residential area about a mile from the centre of Newton Abbot. There is a public park nearby. The home offers care for up to fifteen people aged 65 or over, who may also have a dementia. There are three ground floor bedrooms, and there are stair lifts on the main staircase. It is necessary to use a short flight of steps to reach a few of the first floor bedrooms. There are seven single rooms and four double rooms. There is an attractive lounge, separate dining room and small sun lounge. The home is on a level site and has a large decked area and garden, although there are a few steps at the front door. There are ample car parking areas. The organisation which owns this home providing personal care also operates a care home providing nursing care (two doors away). Forde Park Residential Home Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Twelve service users were interviewed, although some were quite confused and unable to express their opinions. Those who were able all said that they felt well cared for and that the staff are kind. Four comment cards were received from relatives, none of which contained any negative comment. One of them commented that “the staff are always very friendly, helpful and interested in my mother’s overall wellbeing”. One service user’s daughter was seen in person, and said that she was satisfied with her father’s care in the home. Four of the care staff were interviewed. Most of the rooms in the building were inspected. It was found that most of the National Minimum Standards which were assessed were met. What the service does well:
Service user’s health care needs are monitored and met. A visiting district nurse said that she is currently attending one of them every day to provide nursing treatment. She has known the home for about eleven years and she said that the staff look after service users’ health well. This includes administering prescribed medication to all of them. Several are quite confused, and the home requests the help of the specialist mental health team when behaviour causes concern. Meals served are nourishing and varied, and several service users were complimentary about the food. Staff training is given a high priority. The Forde Park organisation has a training co-ordinator, and the staff confirmed that they are encouraged to obtain appropriate qualifications. Most of the staff are appropriately experienced and have worked at this home for a number of years. There has been very little staff turnover, which contributes to the continuity of care. The home’s manager is well aware of health and safety issues, especially in view of the fact that several of the service users are confused. Forde Park Residential Home Version 1.10 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or
Forde Park Residential Home Version 1.10 Page 7 by contacting your local CSCI office. Forde Park Residential Home Version 1.10 Page 8 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 Forde Park Residential Home Version 1.10 Page 9 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) 3 and 5. New service users have an assessment of their needs carried out prior to being admitted to the home, and the home receives a copy of this. Prospective service users and/or their relatives are invited to visit the home beforehand. EVIDENCE: In fact there have been only two new admissions in the last year. In both these cases the files contained a prior Care Management assessment done by social services staff (plus an assessment by hospital staff in one case), and there was a social services care plan in both files. In addition the home manager had completed the home’s own assessment form for both of these service users. Forde Park Residential Home Version 1.10 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 and 9. There were satisfactory care plans in place for service users, and there were satisfactory arrangements for meeting their health care needs. In general they are protected by the home’s medication procedures, although one shortcoming was identified. EVIDENCE: A sample of three service users’ files was inspected. In each there was a completed care plan containing information on health and social care needs, and including goals for that particular service user. A social history form had been completed with the help of a relative in all cases, and moving and handling assessments had been completed in all cases. Two of the care plans had been reviewed monthly, but one had not been reviewed in the last two months. With regard to health care there was good evidence of service users receiving attention from health care professionals, including general practitioners, district nurses and chiropodist. A visiting district nurse was interviewed and said that the staff do a good job of meeting service users’ health needs. She said she has known the home for about eleven years.
Forde Park Residential Home Version 1.10 Page 11 Medication handling was generally sound, and most of the staff are currently doing external training in the safe handling of medicines. However the one controlled drug in use was not stored in strict accordance with the Standard, and there were a few gaps in the signing by a staff member of the medication administration recording sheets for the previous day. This would necessitate checking whether that medication was actually given to those service users. Forde Park Residential Home Version 1.10 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 and 14. Provision of activities has been improved, and a range of appropriate activities is available. These are suitable for service users with limited mobility and with problems of confusion. EVIDENCE: Activities available to service users have been expanded, as evidenced by the written record of activities. Recent activities have included chair exercises, crafts work, bingo, games and quizzes, videos. In addition professional musical entertainment is now provided monthly, which is particularly suitable for service users who are confused. It is recommended that the manager should have a regular budget for activities, which will enable her to plan future activities with confidence. Some service users have regular visitors, and one visiting relative said that she is always welcome and is always offered refreshments. There was plenty of evidence of personal possessions in the bedrooms which were inspected. Forde Park Residential Home Version 1.10 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 standard(s) 16 and 18. The home has a satisfactory complaints procedure, with some evidence that service users feel that their views are listened to. EVIDENCE: The home has a clear complaints procedure, which includes the stages and time-scale for the process. This was displayed in the hall, where the last Commission for Social Care Inspection report was also available. The Commission has not received a complaint about the home in the last year. The home has an abuse policy, including a whistleblowing policy, and also policies/procedures on physical restraint and dealing with physical aggression. The staff were aware of the home’s policy. The manager attended a training day on adult abuse very recently run by Devon County Council (the certificate was seen), and all care staff will attend this training this year. Forde Park Residential Home Version 1.10 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 standard(s) 19, 22 and 25. Initial impressions are good, and the home appears bright and attractive. However closer examination shows that some of the décor is tired and in need of improvement. EVIDENCE: The home was warm and the communal rooms were welcoming and attractively furnished. However some parts of the home are now looking a little shabby and in need of redecoration, such as some of the bedrooms (especially wallpaper). The kitchen is in particular need of refurbishment. Requirements made by an environmental health officer in June last year in respect of the kitchen have yet to be complied with, although the manager said the work is to be done soon. This related to broken wall tiles. Access into/out of the building remains problematic for people with poor mobility. Although the manager said that an occupational therapist employed by the organisation has assessed the disability equipment in the home, an independent assessment and report is needed to satisfy Standard 22.
Forde Park Residential Home Version 1.10 Page 15 With regard to Standard 25 the radiators in communal rooms and bedrooms have now been covered or replaced with a low temperature type, thus making the environment safer. Forde Park Residential Home Version 1.10 Page 16 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, 29 and 30. Staffing levels were adequate and there is a stable staff group, which contributes to continuity of care. EVIDENCE: Most of the staff are appropriately experienced and have worked at this home for a number of years. Staffing levels were adequate for the service users accommodated (14). There are normally four carers in the morning until 1400, and then three until 2100. At night there is one awake carer and one sleepingin. A designated domestic assistant and a part-time maintenance person are employed. Only two staff have left in the last year, one due to ill-health, so there has been little staff turnover. Only one new staff member has started work in the last year. Recruitment practice was found to be satisfactory. Her file contained evidence of her induction training. The staff present confirmed that there are good training opportunities. All staff except two have now attained NVQ level 2 and one has attained level 3. Forde Park Residential Home Version 1.10 Page 17 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) 33, 35 and 38. The manager provides clear leadership, and other staff are aware of their roles and responsibilities. Substantial administrative support to the home is provided by the Forde Park organisation. EVIDENCE: A quality management system is in use, and the organisation has achieved the ISO 9002 award. It has also had the Investors in People award for several years. Recent Commission for Social Care Inspection reports were available in the hall. With regard to Standard 35 a sample of service users’ personal financial records was inspected, and expenditure was backed up by receipts. The manager is aware of health and safety issues. The fire risk assessment book was inspected, and the fire log showed that tests and checks of
Forde Park Residential Home Version 1.10 Page 18 equipment had been done as recommended (including fire drills). The recent completed accident sheets were inspected. Forde Park Residential Home Version 1.10 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x
COMPLAINTS AND PROTECTION 2 x x 2 x x 3 x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Forde Park Residential Home Version 1.10 Page 20 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 9 Regulation 13 Timescale for action Controlled drugs administered by With staff must be stored in a metal immediate cupboard which complies with effect. the Misuse of Drugs (Safe Custody) Regulations 1973. The medication recording sheets With must by signed at the time the immediate medication is given to service effect. users. Requirement 2. 9 13 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 19 19 Good Practice Recommendations The kitchen should be refurbished and redecorated. A ramp should be provided at the front door to improve access for people with poor mobility. Forde Park Residential Home Version 1.10 Page 21 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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