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Inspection on 03/02/06 for Forder Lane House

Also see our care home review for Forder Lane House for more information

This inspection was carried out on 3rd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Forder Lane House provides a warm and homely environment. Many of the residents previously lived locally and there is a strong emphasis on maintaining friendships with family, friends and the local community. Residents spoken to say they feel very happy at the home. One said "its like being looked after in your own home" and "you always get what you ask for". Another said "this is as good as it gets". Positive respectful interactions were observed between staff and residents. Meals are freshly prepared with the use of fresh ingredients to ensure a balanced and wholesome diet. Alternatives and individual tastes are routinely offered . Meals are highly praised by residents.

What has improved since the last inspection?

A drugs fridge has been purchased. Improved awareness and understanding from management regarding the importance of robust procedures in addressing the complaints and concerns of residents.

What the care home could do better:

Attention is needed to ensure that all records are accurately and consistently maintained.Establish a formal system of quality assurance that reviews, reflects and monitors the views of residents, families and other stakeholders involved with the home.

CARE HOMES FOR OLDER PEOPLE Forder Lane House Forder Lane Dartington Totnes Devon TQ9 6HT Lead Inspector Annie Foot Unannounced Inspection 3rd February 2006 9:40 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.V282028.R01.S.doc Version 5.1 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.V282028.R01.S.doc Version 5.1 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.V282028.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30 June 2005 Brief Description of the Service: Forder Lane House is a single storey building built in the 1980s, and set within a complex of sheltered bungalows, also owned by Dartington Housing Association. It provides care for up to 14 older persons in the category of old age only. The accommodation is in single rooms, mainly en-suite, all with exterior doors to the gardens. There are adapted bathing facilities.A central area provides dining space and a small lounge area, with a conservatory leading off. There are level gardens surrounding the premises. There is a large external laundry, shared by the bungalows. The office is situated on the first floor, with the organisations administration. Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over four hours during the morning of 3 February 2006. This was the second inspection of the year. The main purpose being to follow up on requirements and recommendations made at the previous inspection. The manager Liz Skinner was on duty and present throughout the inspection. Two members of the care staff were also on duty and were spoken to. The cook is currently on sick leave and at the time of the inspection the manager was undertaking the cooking. Most of the residents were met during the inspection and three were talked to in more depth. A partial tour of the premises was made. Care, medication records, and staff files were inspected. Requirements and recommendations from the previous inspection were followed up and progress discussed. 12 residents are currently living at the home, and 1 person in hospital. There has been one new admission since the last inspection. What the service does well: What has improved since the last inspection? What they could do better: Attention is needed to ensure that all records are accurately and consistently maintained. Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 6 Establish a formal system of quality assurance that reviews, reflects and monitors the views of residents, families and other stakeholders involved with the home. 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.V282028.R01.S.doc Version 5.1 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.V282028.R01.S.doc Version 5.1 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): 1and 4 Prospective residents and their families receive appropriate information from the home to assist in making a decision to live at Forder Lane House. EVIDENCE: These standards were assessed and fully met at the last inspection. There has been no change to the statement of purpose, which is displayed in the entrance hall. Several residents said they were familiar with the home prior to admission. One resident said they made a positive choice to move from another home to Forder Lane House as soon as vacancy became available. Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 9 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): 9, 10 The recording systems for administration of medication are inconsistent and potentially could present a risk to residents. Resident’s health and personal care needs are met with respect and privacy. EVIDENCE: Medication records were examined. Gaps in a staff signature were missing on three consecutive days. None of the residents are able to self medicate. The controlled drugs cabinet has been secured to a wall but at this time, no controlled drugs are in use. A drugs fridge has been purchased but has not yet been set up. Eye drops are currently stored in a locked box in the fridge. Residents said that they felt staff treated them with respect and that they are afforded privacy at all times. Staff were observed to be respectful in their interactions with residents. Residents are able to have a telephone installed in their own rooms. Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 10 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): 14, 15 Support for daily living is well managed giving residents choice and control over their lives. The meals in the home are balanced and offer a good choice and variety of foods, which cater for individual tastes, and special dietary needs. EVIDENCE: Residents said that they are always given a choice of meals, activities and how they wished to spend their time. The atmosphere within the home is relaxed supporting the homes desire to create a home from home. Two of the residents said they particularly enjoyed the trips out organised by staff, another said they enjoyed keep fit sessions. Residents are encouraged to bring personal possessions and belongings into the home and this was seen in individual rooms. Residents handle their own financial affairs with the support of their families. Residents praised the food and meals. The menu are planned weekly and freshly prepared using fresh ingredients. Although the menu is currently restricted during the cook’s absence, residents said meals continue to be “excellent”. Menus with alternatives are distributed each week to residents who make their choices on this basis. However, it was also confirmed that wherever a resident prefers something different to the Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 11 menu options another dish would be provided. Lunch on the day of the inspection looked appetising and well balanced. The kitchen facilities and equipment are of a very high standard. Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 12 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 Residents can be confident that they are listened to and their concerns acted upon. EVIDENCE: There has been 1 complaint since the last inspection. A full and thorough investigation has taken place and appropriate action taken. As a result improvements to one of the homes procedures is being taken by; ensuring that any used incontinence pad is removed from a residents rooms promptly; reviewing reporting and recording systems; reviewing staffing rotas and a move toward more meetings with families. The home recognises the importance of having robust procedures in place to protect residents. Records of the complaint were examined. The complaints procedure is displayed in the home and also contained in the residents terms and conditions document. Staff training in the protection of vulnerable adults is taking place. The Chief Executive confirmed that additional monies had been identified to ensure that all staff have appropriate training in this area. Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 13 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): 26 Residents are provided with accommodation that is safe, warm and comfortable. EVIDENCE: These standards were assessed and fully met at the previous inspection. The home was being cleaned during the course of this inspection. The premises, all residents rooms and communal areas were clean hygienic and odour free. Residents expressed their appreciation of the cleanliness of their rooms. Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 14 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): 29 The procedures for the recruitment of staff are robust, offering protection to people living at the home. EVIDENCE: Comprehensive recruitment policies and procedures are implemented at the home. Policies last reviewed June 2005. Six staff files were inspected. All contained the required documentation, although in some cases they were no photos of the staff member. Files are well organised and stored securely protecting confidentiality. All of the staff on duty were spoken to. The two care staff confirmed they were undertaking NVQ training and were well supported. The manager confirmed that as necessary she has authority to employ bank/agency staff to ensure sufficient numbers on duty at all times. There are 8 care staff employed. The home does not use a key working system in place and this was discussed with the manager. Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 15 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): 32, 33 Clear leadership and guidance from management ensures that residents receive a high standard of care. Formal systems for quality assurance and monitoring systems to ensure the homes success are not evident. EVIDENCE: The manager of the home has been in post for several years. She provides continuity and consistency to both residents and staff. Residents spoke of their confidence in the manager. The manager is proactively supported by her manager, who has an office on the premises. There are well-organised systems, underpinned by policy and procedures in place to ensure the home is run and managed smoothly. A member of the Boards management Committee conducts regulation 26 visits. A short report is produced monthly. Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 16 The last residents survey took place in 2002 and there have been no residents meetings in the last six months. The manager acknowledges that the quality system needs to be reviewed, although informal systems do exist for consultation with residents on an individual basis. Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 17 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 x 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 x x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 1 x 2 x x x Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 18 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 OP9 Regulation 13 (2) Requirement All staff to be advised that medication records must be signed at the time of administration. A monitoring system should be established to ensure medication records are checked regularly for inconsistency. To establish a system of quality assurance that reviews and monitors the views of residents and other stakeholders involved with the home on a regular basis. Timescale for action 04/02/06 2 OP33 24 30/06/06 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 OP9 Good Practice Recommendations To obtain a copy of the Royal Pharmaceutical Society Guidelines for the Administration and control of medicines in care homes. www.rpsgb.org.uk Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 19 2. 3 4 5 6 OP9 OP16 OP18 OP29 OP35 To set up the drugs fridge in working order. To ensure that all measures identified following the complaint are implemented. To ensure that all staff attend training in the protection of vulnerable adults. To ensure that all staff files contain a photograph of the person concerned. An inventory should be kept of service users furniture and possessions (repeated from previous inspection30/6/05) Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 20 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. Extracts may not be used or reproduced without the express permission of CSCI Forder Lane House DS0000003703.V282028.R01.S.doc Version 5.1 Page 21 - 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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