Inspection on 25/09/06 for Forder Lane House

This inspection was carried out on 25th 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

Forder Lane House 03/02/06

Forder Lane House 30/06/05

Forder Lane House 26/10/04

Forder Lane House 20/04/04

Forder Lane House 28/10/03

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Forder Lane House Forder Lane Dartington Totnes Devon TQ9 6HT Lead Inspector Margaret Crowley Unannounced Inspection 25th September 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Forder Lane House DS0000003703.V302523.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. Forder Lane House DS0000003703.V302523.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Forder Lane House Address Forder Lane Dartington Totnes Devon TQ9 6HT 01803 863532 01803 863685 careoffice@dartingtonha.co.uk 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) Dartington Housing Assoc Limited Mrs Elizabeth Jean Shinner Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Forder Lane House DS0000003703.V302523.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd February 2006 Brief Description of the Service: Forder Lane House is a purpose built care home owned by Dartington Housing Association. It is set within a complex of sheltered bungalows, also owned by the housing association. All bedrooms, communal rooms and facilities are situated on the ground floor. Residents are accommodated in pleasant single rooms, which have en-suite facilities or a designated toilet nearby. The bedrooms all have an external door that opens out onto level gardens. There is an attractive central combined lounge/dining area. A new enlarged conservatory has been built, which is used by the small number of service users who receive day care. The home provides aids and adaptations to meet service users needs including grab rails, a mobile hoist and an adapted bath. The Registered Manager’s office is situated on the first floor, next to Dartington Housing Association’s administration and the Chief Executive’s office. Outside there are attractive level gardens, which surround the care home. A new patio area with seating has been provided at the front of the building. There is an external laundry that is also shared with the bungalows. Forder Lane House is located on the outskirts of the village of Dartington, near Totnes. The village has a shop, a church, public house and the Dartington Hall and craft centre nearby. Fees currently range from £375 per week. Written information regarding the home and the services provided is available for prospective residents. Forder Lane House DS0000003703.V302523.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place took place over eight hours on 25th September 2006. The registered manager Liz Skinner was on duty and present throughout the inspection. Mr Stephen Prime, the responsible individual and chief executive of Dartington Housing Association was also available for discussion. A tour of the premises was made. All of the 11 residents in the home on that day were spoken to, including 4 in more depth, regarding the lifestyle in the home and the care services they receive. Two service users who visit Forder Lane House for day care were also spoken to. In addition, 2 relatives, a visiting general practitioner, a community nurse and a management committee member were spoken to. Five staff on duty were observed and spoken to in the course of their daily duties. Records were inspected including care, medication and staff records. Comment cards were received from the community nursing service and the social services review officer and from 4 of the 5 relatives who were written to. Feedback questionnaires were left for staff and 4 were received. What the service does well: What has improved since the last inspection? Liz Skinner, the registered manager, has obtained the Registered Manager’s Award. A quality assurance system has been introduced since the last inspection and quality surveys take place twice a year to seek the views of residents, relatives and visiting professionals. Forder Lane House DS0000003703.V302523.R01.S.doc Version 5.2 Page 6 There are clear systems for the storage and administration of medicines. Medication records were in order. Staff have received training in the protection of vulnerable adults since the last inspection There is an ongoing programme of maintenance and renewal to ensure that residents’ rooms are kept at a good standard. Three rooms have been recarpeted and redecorated. A new patio and seating area has been provided at the front of the building where residents like to sit. A large conservatory has been installed which is used for social events. It also used by the small number of service users who receive day care and those attending the luncheon club, who previously shared the residents’ dining room. 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. Forder Lane House DS0000003703.V302523.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 Forder Lane House DS0000003703.V302523.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): 1,3, The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Prospective residents and their families receive appropriate information from the home to assist in making a decision to live at Forder Lane House. The assessments of prospective residents needs prior to admission ensure that their needs can be met. EVIDENCE: A Statement of Purpose and Service User Guide are provided for prospective service users. Information is also available in the reception area. A resident who had been admitted since the last inspection described a clear admission process. She had visited the home prior to admission and was pleased that she had made the decision to move to Forder Lane House. Staff had been welcoming and “nothing was too much trouble”. She felt she has the level of assistance that she needs. Evidence in the records was seen of assessments and risk assessments undertaken with new service users. The manager is clear regarding the needs that they are able to meet. This is also included in the statement of purpose and service user guide. A visiting general practitioner said that the Forder Lane House DS0000003703.V302523.R01.S.doc Version 5.2 Page 9 management had a good awareness of their strengths and limitations, which enabled them to achieve a good balance when admitting new residents. Forder Lane House does not provide intermediate care. Forder Lane House DS0000003703.V302523.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): 7,8,9,10 The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Resident’s health and personal care needs are met with respect and privacy. There are safe practices for the administration of medication that ensure service users are not placed at risk. EVIDENCE: Residents said that they were being well cared for and that the staff were very kind. This was echoed by relatives. Feedback from the community nursing service, and social services review officer was positive regarding the health and social care provided. Health professionals said that their assistance was sought appropriately, and that staff were always quickly available when they visited. The general practitioner described the service provided as excellent. The inspector observed all staff treating residents in a friendly manner and respecting their privacy when entering rooms. An inspection of the records showed that although service users have care plans that are reviewed, this is not on a monthly basis. Discussions took place with the manager and deputy manager regarding ways improving the assessment and care plan tools to make them more comprehensive, by for example, including more information regarding residents’ interests and Forder Lane House DS0000003703.V302523.R01.S.doc Version 5.2 Page 11 choices. There is a daily record book, and the entries are typed, held on computer and transferred periodically to the resident’s records. The inspector recommended that entries are recorded separately for each service user and transferred more frequently to the service users records, so that an up to date record is readily available at all times for those providing care. There are clear systems for the storage and administration of medicines. Medication records were in order. A drugs fridge has been purchased and is now in use. No residents currently administer their own medication, but the registered manager said that they are offered this facility subject to risk assessment. Staff who administer medication receive appropriate training. Forder Lane House DS0000003703.V302523.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): 12,13,14,15 The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Residents are enabled to live a flexible lifestyle with activities available to provide interest for them. Residents are provided with a nutritious and well-balanced diet. EVIDENCE: Routines within the home are flexible to ensure that residents can choose how they spend their time. Residents said that they like to spend time in their own pleasant rooms. However, in comparison with a previous inspection, it was observed that they now also choose to make more active use of the lounge, spending more time talking to each other and participating more in activities provided. Residents said that they also enjoy watching “soaps” together and talking with staff in the evenings. The management and staff have made efforts to create a more positive environment in the lounge/dining room. A concern regarding service users not being encouraged to use the lounge in the evenings has been raised by a relative and been addressed. Activities are provided such as whist, bingo and an exercise class, to which to residents of the neighbouring sheltered bungalows are invited. One relative said that more occupational therapy could be provided. Forder Lane House DS0000003703.V302523.R01.S.doc Version 5.2 Page 13 Forder Lane House has good links with the local community. A small luncheon club is held in the new conservatory for people living in the Dartington/Totnes area. The home has begun to provide day care in the conservatory for a small number of service users. There is a member of staff specifically employed for this purpose. There is an open visiting policy. Residents said that their visitors are always made welcome, and feedback from all relatives confirmed this. Residents praised the quality and variety of the meals. The meals seen during the inspection were of a very good standard. A balanced and varied diet is provided that meets residents tastes and dietary needs. Every effort is made to use fresh produce. Forder Lane House DS0000003703.V302523.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Residents can be confident that they are listened to and their concerns acted upon. EVIDENCE: There have been no complaints received by The Commission for Social Care Inspection since the last inspection. The Commission received a concern from a relative regarding a staffing matter in the feedback from the inspection, which has been referred to the management. Part of this had already been addressed, as referred to in the previous section of the report. The management recognises the importance of having robust procedures in place to address complaints in a timely manner and to protect residents. The home’s record of complaints was examined and no complaints had been received by the home since the last inspection. The complaints procedure is displayed in the home and is also contained in the service users guide. Residents spoken with said they would address their concerns to care staff, or any member of management. Staff have received training in the protection of vulnerable adults since the last inspection. Forder Lane House DS0000003703.V302523.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to the service Residents are provided with accommodation that is safe, attractive, comfortable and well maintained. EVIDENCE: Forder Lane House is very well maintained and furnished to a good standard. There is an ongoing programme of redecoration and renewal that ensures that the environment remains clean and attractive. A tour of the premises took place. Residents said how much they like their rooms. All bedrooms are situated on the ground floor and have individual access to level gardens and have an attractive outlook. Since the last inspection three residents rooms have been redecorated and new carpets have been fitted. All residents have en suite facilities or a designated toilet. Residents now have sole use of their dining room/lounge. A large, new conservatory has been built that has its own entrance, but it is also accessible from the lounge. It is used for activities and social events, but will primarily used as a day care centre for up to 6 service users, and is currently also used Forder Lane House DS0000003703.V302523.R01.S.doc Version 5.2 Page 16 by the luncheon club. Previously this was held in the residents’ dining room. The chief executive said that the day centre does not provide a bathing service and the only facility used within the home is the visitors’ toilet. The day care service is being introduced gradually, and currently has 2 service users. It will be monitored and reviewed. Residents and their relatives were consulted prior to the service commencing. The premises were clean, hygienic and free from unpleasant odours throughout. There are adapted bathing facilities and ramps and environmental adaptations to meet service users needs. There are two bathrooms and a staff member commented that one bathroom is rather small for use with wheelchairs. The inspector advised the registered manager that residents’ orientation within the building may be assisted by improved signage; for example, residents rooms are numbered, but do not show the residents name, or other symbols to aid identification. Forder Lane House DS0000003703.V302523.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Staff are employed in sufficient numbers to meet the current service users needs. Staff are provided with training opportunities to enable them to develop their knowledge and skills in caring for service users. The procedures for the recruitment of staff are robust, offering protection to people living at the home. EVIDENCE: On the day of the inspection there were 11 service users present in the home and 2 in hospital. The staff roster was available for inspection. It showed that in addition to the registered manager and the deputy manager, there were 2 care staff on duty, a cook and a domestic, plus a care assistant for the service users receiving day care. The registered manager said this was sufficient to cater for the needs and numbers of service users currently living in the home. At nighttimes there is one night staff who is awake for part of the shift, but then allowed to sleep on call and one night staff who sleeps in. There was discussion regarding the nighttime staffing arrangements and the inspector recommended that this should be reviewed in view of the frailty of service users. Residents spoken to said that staff were always accessible and available without undue delays if they needed to call for assistance. There are 14 care staff currently employed, 7 of who have the National Vocational Qualification in Care at Level 2 or above. There have been some Forder Lane House DS0000003703.V302523.R01.S.doc Version 5.2 Page 18 staff changes since the last inspection and several new staff have been appointed some of who are qualified and experienced. The registered manager said that she has authority to employ bank/agency staff to ensure sufficient numbers are on duty at all times. Feedback from staff spoken to and via questionnaires showed that staff felt very positive about working at Forder Lane House. They valued the training opportunities available and felt supported by the management who listen to their views. Staff felt that the residents’ welfare was prioritised and concerns followed through. Attention is given to staff training needs, including mandatory training. Since the last inspection staff have received training in fire safety, the protection of vulnerable adults, stoma care, first aid and manual handling. Additional training is planned in food hygiene and health and safety. There are comprehensive recruitment policies and procedures, and staff records inspected showed that the necessary references are obtained. Information regarding Criminal Record Bureau checks was sent to the inspector following the inspection. Files are well organised and stored securely protecting confidentiality. Forder Lane House DS0000003703.V302523.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service Forder Lane House is well managed with clear systems in place to ensure the safety and well being of residents. Quality assurance systems ensure that the views of residents, relatives and staff are sought and acted upon. EVIDENCE: The registered manager has been in post for several years and has now gained the Registered Managers Award. She provides continuity and consistency to both residents and staff. Residents described her as the “guiding spirit of the home” and “a bundle of energy”. She receives support from the chief executive, and they work together in the best interest of the service users and the home. The chief executive has now established quality assurance and monitoring systems. Quality surveys are carried out twice a year. A member of Forder Lane House DS0000003703.V302523.R01.S.doc Version 5.2 Page 20 the Management Committee conducts monthly Regulation 26 visits and produces a report. The management do not manage residents financial affairs. These are handled by the resident themselves or their representative. Any payments made on behalf of the residents are recorded and invoiced. An inventory of residents’ possessions is now completed and a copy kept in their records. Routine health and safety issues are managed satisfactorily and records are maintained up to date and accurate. Fire and accident records were in order. A fire audit has been arranged from a specialist company in response to the new regulations. A door wedge used by the cleaner was removed by the management and during the inspection the chief executive issued guidance to staff and arranged for a suitable hold open device to be fitted in the office. The door to the staff toilet was unlocked. As it contains hazardous materials it must be kept locked at all times. Forder Lane House DS0000003703.V302523.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 3 x 3 x x N/A 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 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 3 x 3 4 x x 3 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 4 x 3 x 3 x x 2 Forder Lane House DS0000003703.V302523.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. Standard OP7 Regulation 15(2) b, c Requirement The registered person shall keep the service user’s plan under review…After consultation with the service user or a representative revise the service users plan. Re Care plans must be reviewed a minimum of monthly and updated when service users’ needs change. Unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. Re The door to the staff toilet must be kept locked at all times. Timescale for action 25/12/06 2 OP38 13(4)c 25/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations Improvements should be made in the co-ordination of service users records DS0000003703.V302523.R01.S.doc Version 5.2 Page 23 Forder Lane House 2 3. OP22 OP27 Signage within the building should be improved to aid the orientation of new service uses and those with memory loss The management should review staffing arrangements during the night time Forder Lane House DS0000003703.V302523.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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