CARE HOMES FOR OLDER PEOPLE
Fordlands Road (1) Residential Elderly Persons Home, City of York Council 1 Fordlands Road Fulford, York North Yorkshire YO19 4QT Lead Inspector
David Martin Unannounced 21 July 2005 9:30 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. Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Fordlands Road (1) Residential Elderly Persons Home, City of York Council 1 Fordlands Road Fulford York North Yorkshire YO19 4QT 01904 630048 01904 613892 N/A City of York Council Address 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) Mrs Maureen Carr Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 03/02/05 Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: 1 Fordlands Road is a care home run by City of York Council and registered to provide a service for 31 older people of either gender aged over 65 years who do not have any specialist requirements. The home is situated in Fulford within easy access of the local village amenities. There is a large parking area to the front of the home with garden areas to three sides. The accommodation is provided on two floors. The upper floor is accessible via vertical passenger lift. Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was carried out on 21 July 2005. It was unannounced and took 6 hours to complete. The majority of time was spent within with the service users in the home at the time of the inspection and with the staff on duty. There were opportunities to observe staff interaction with the service users. A sample of service user files was examined and a check was made as to whether the home had complied with recommendations from the last inspection. Feedback was given at the end of the inspection to the registered manager. What the service does well: What has improved since the last inspection? What they could do better:
To determine whether staff have been properly vetted and are suitable to work with older people, staff records need to be kept by the manager in the home. The manager is yet to complete the NVQ4 qualification but is enrolled on a course. This training will assist her in ensuring care practices within the home are up-to-date.
Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 Page 7 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. Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 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 Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 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 & 6 Prospective service users’ can be confident that their care needs will be met by staff. EVIDENCE: The case file of the service user most recently admitted to the home was inspected. This provided evidence that an assessment and personal information about the service user had been provided to the home by the care manager. One of the home’s management team will visit a prospective service user in his/her own home or hospital. All prospective service users are encouraged to spend a day in the home prior to admission as part of the assessment process. It also enables the service user to make a choice about moving to the home. Intermediate care is not provided. Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 -10 Service users health and social care needs are met. EVIDENCE: The care needs of each service user are set out in individual service user plans. A sample of service user plans was inspected and they were fully completed providing background information and a clear description of the day-to-day task that service users can accomplish and those where some assistance is required. The service user plans are well-maintained ensuring that staff members have up-to-date information as to what is expected of them in helping service users to stay safe and comfortable. Observation of the interaction between staff and service users provided evidence that care is delivered in a respectful and sensitive way. In response to concerns raised in the last inspection about the safe-handling of medications, the home has switched to a monitored dosage system. This has improved the record-keeping and safety. Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 Page 11 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 -15 Service users are able to follow a lifestyle that suits their individual needs and they are able to maintain social contacts. EVIDENCE: Service users said they were pleased with the services offered at Fordlands and that the standard of care met their expectations. They said that they are able to see their relatives and friends and can choose whether or not to be involved in any organised activities. There is a monthly activity programme which includes coffee mornings, contact with local schools and residents’ meetings. The service users said that the food was good and during the inspection were making their choices for the following day. Observation of the lunchtime meal provided evidence that all service users were able to manage without assistance. The meal was well-presented and was unhurried. A visiting hairdresser and meals-on-wheels worker both spoke very positively about the way in service users are looked after. Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 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 standard(s) 16 - 18 Service users are protected from abuse and their right to complain is upheld. EVIDENCE: Service users have been provided with the home’s complaints leaflet and a copy is pinned to the main notice board. The complaints record shows that one minor complaint has been made since the last inspection. It was resolved appropriately. In discussion, service users said they had no complaints to make about the quality of service in the home. The home has a copy of the latest version of the multi-agency procedures for the protection of vulnerable adults. Staff have received training in safeguarding older people as part of NVQ courses. They were clear about how they would report any concerns. Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 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 standard(s) 19 - 26 Service users live in a home which is well-maintained and safe. EVIDENCE: Service users’ bedrooms are comfortably furnished and have been decorated with personal items such as photographs and ornaments. There are numerous communal rooms and pleasant sitting areas which are in good decorative order and well furnished. There are well-maintained gardens. There were no safety matters requiring action identified during this inspection. Safety certificates for equipment, power supplies and fire were available for inspection. Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 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 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 - 30 Service users’ needs are met by a competent, well-trained staff group but records relating to the vetting of staff are inadequate. EVIDENCE: Staffing levels in the home are adequate and staff who spoke with the inspector confirmed that there are always sufficient staff on duty. More than 50 of the care staff have obtained NVQ2 qualifications and there is a range of ongoing training available. The staff records are not maintained by the manager in the home. She is, therefore, unable to demonstrate that the staff working in the home have been properly vetted. This is a longstanding issue which has yet to be sorted out by the City of York Council. Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35 & 38 Service users benefit from living in a well-managed home and can be confident that the environment is safe. EVIDENCE: The manager is experienced and has managed the home for 10 years. She is enrolled on a course leading to the award of NVQ level 4 in care. The staff spoke positively about the home’s management team and said that they are approachable. Records kept in connection with service users’ finances were accurate, tallying with monies held in the safe. Staff have completed health and safety training, first aid and fire safety training. Health and safety records were inspected are up-to-date and well-maintained. Service users confirmed that they have recently completed a survey asking for their views about the way in which the home is run. Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 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 3
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 x 3 x 3 x x 3 Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 Page 17 Yes 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 29 Regulation 19 Requirement Records relating to the recruitment of staff must be maintained by the Registered Manager in the home. (Previous timescales set since 2002 have not been met). Timescale for action 15/09/05 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 None Good Practice Recommendations Fordlands Road (1) Residential Elderly Persons Home, City of York Council J53_ JO4_ S34942 _Fordlands Road_ V236455_ 120705 _Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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