Inspection on 07/02/06 for Forest Brow Care Home

This inspection was carried out on 7th 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.

Other inspections for this house

Forest Brow Care Home 12/06/06

Forest Brow Care Home 22/08/05

Forest Brow Care Home 10/02/05

Forest Brow Care Home 08/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Forest Brow Care Home 63 Forest Road Liss Hampshire GU33 7BL Lead Inspector Pat Griffiths Unannounced Inspection 7th February 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 Forest Brow Care Home DS0000057070.V281184.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. Forest Brow Care Home DS0000057070.V281184.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Forest Brow Care Home Address 63 Forest Road Liss Hampshire GU33 7BL 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) 01730 893342 BRIJ Care Ltd Mrs Susan Makhzangi Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (30), of places Physical disability over 65 years of age (4) Forest Brow Care Home DS0000057070.V281184.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 4 service users may be accommodated in the category PD(E) Date of last inspection 22nd August 2005 Brief Description of the Service: Forest Brow is a service that provides accommodation for up to 30 service users, or residents as they prefer to be called, within the category of old age. The home also provides a service for older people with dementia. The home is a large house that has been extended to provide accommodation over three floors, which are accessed by passenger lift. There are twenty-four bedrooms, single and double, and some have en-suite facilities. There are two sitting rooms, which are light and airy. The home has a one and a half acre garden, which is accessible to the residents. The home is located in a semi rural area in the small village of Liss, between Petersfield and Liphook, and is within access of local shops and larger towns in the area. Forest Brow Care Home DS0000057070.V281184.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two unannounced inspections for the inspection year 2005/06. The focus of the inspection was to talk to residents about their life in the home and how their needs are met. Eight residents, two visitors and four members of staff spoke to the inspector. A tour of the premises was undertaken and assessments, care plans, policies and other documents were looked at. What the service does well: What has improved since the last inspection? What they could do better: The paintwork in the hallways, especially skirting boards and doorframes, looks very battered and tatty. Apparently this will be attended to later in the summer. The registered person must ensure that there is an accessible complaints procedure, which includes the stages and time-scales for the process and details of external agencies to which complaints may be made. Forest Brow Care Home DS0000057070.V281184.R01.S.doc Version 5.1 Page 6 The registered manager must obtain a new CRB disclosure for every new member of staff before employment commences. CRB disclosures are not transferable. (Criminal Records Bureau) 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. Forest Brow Care Home DS0000057070.V281184.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 Forest Brow Care Home DS0000057070.V281184.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): These standards were not examined during this visit EVIDENCE: Forest Brow Care Home DS0000057070.V281184.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): 7 and 9 The arrangements for care planning ensure that the resident’s needs are met. Arrangements for medication administration protect the residents. EVIDENCE: The inspector looked at four care plans. She was able to see that preadmission assessments had been completed and were very informative. Care plans have been drawn up for each resident and they identified the aims of the care to be provided and how the care should be provided. The plans are reviewed monthly be the residents key-worker and checked by the senior carer, the residents are involved in this review if they wish to be. Part of the review is to assess the ‘matrix assessment criteria’, a tick-box document that allows any changes in the resident to be noted and the care plans adjusted accordingly. Information contained in the care plans includes a record of visiting healthcare professionals, results of blood tests, mobility assessments and details of their next of kin. Residents and their families have also discussed their wishes in the event of their death or deterioration in health and this information is also kept in their care plans. Forest Brow Care Home DS0000057070.V281184.R01.S.doc Version 5.1 Page 10 The home has policies and procedures in place to enable residents to look after their own medication; but they all prefer that the home is responsible for their medication. The residents MAR sheets (Medication Administration Record) record the drugs that are received into the home and administered to each resident. The home also record all other drugs that enter the home into another book to ensure there is a complete record of all drugs delivered to the home. The manager said that all staff who administer medication have received training and had their skills assessed. Forest Brow Care Home DS0000057070.V281184.R01.S.doc Version 5.1 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 the following standard(s): 13 and 14 The home has an open visiting policy and arrangements ensure that residents exercise choice and control over their lives. EVIDENCE: The visitor’s book showed that visitors are received in the home with no restrictions on visiting times. Residents can entertain their visitors in their bedroom or in any of the communal areas in the home. A lay preacher from a local church visits regularly to provide pastoral care for those who wish to receive it. The bedrooms seen on the day of inspection had been personalised with resident’s own furniture and ornaments. The manager said that she would organise inventories of all the resident’s possessions as currently no records are kept. Residents are encouraged to handle their own finances and leaflets are available about advocacy services should they need help or advise about their personal or financial affairs. Residents are encouraged to choose when they will get up or go to bed and which clothes to wear each day. Forest Brow Care Home DS0000057070.V281184.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 Arrangements do not always ensure that complaints are listened to and acted upon EVIDENCE: The home has a complaints policy and procedure in place. There has been one complaint since the last inspection, which was resolved. The complaints policy was seen by the inspector and did not contain sufficient information. Details of agencies that someone may complain to outside the home, such as the commission and social services, were not available. This was discussed with the manager who must review the document and make it available within the home. Forest Brow Care Home DS0000057070.V281184.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): These standards were not examined during this visit EVIDENCE: Forest Brow Care Home DS0000057070.V281184.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): 27, 28 and 29 Staffing numbers and skill mix ensure that resident’s needs are met. Arrangements for staff recruitment do not always ensure the safety of the residents and staff. EVIDENCE: The home employs twenty-six staff, this includes care staff, cooks and cleaning staff. Nine of the care staff have completed an NVQ in care and eleven are currently doing a course at level 2 or upgrading to level 3. (National Vocational Qualification) One member of staff is currently doing the NVQ assessors course, which will enable more of the NVQ assessments to be done in-house. The home has a recruitment policy and following the last inspection the manager checked all staff files to ensure compliance with the standards, the files ones were seen to be up to date. The recruitment process is thorough, there is an interview checklist of questions to be asked and references are taken. The file of a recent applicant was seen by the inspector and the recruitment process had been followed but a CRB disclosure (Criminal Record Bureau) from another home had been accepted and a new one had not been applied for. The inspector discussed the need for CRB disclosures and POVA checks (Protection of Vulnerable Adults) and the use of POVAfirst. CRB disclosures are not Forest Brow Care Home DS0000057070.V281184.R01.S.doc Version 5.1 Page 15 portable, a new one must be obtained for every new member of staff. The manager said that a new CRB disclosure would be applied for. Forest Brow Care Home DS0000057070.V281184.R01.S.doc Version 5.1 Page 16 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 and 38 Arrangements ensure the home is run by a fit person and in the best interests of the residents. Arrangements ensure that resident’s financial interests are safeguarded. The health, safety and welfare of the residents and staff are promoted and protected. EVIDENCE: The manager is a trained nurse and has many years experience working in care homes for the elderly. She is currently undertaking her Registered Managers Award, which should be completed this summer. The residents have recently completed a service user survey and the results are being collated. The manager said that the results would be available for any interested parties and a copy sent to the commission. The manager and Forest Brow Care Home DS0000057070.V281184.R01.S.doc Version 5.1 Page 17 inspector discussed the need to gain the views of relatives and visiting professionals and of the benefits of making the survey anonymous. The procedures and polices in the home are dated 2004, some have been reviewed and updated. The owners of the home have recently employed the services of a new external company to review the resident’s contracts and to advise on employment matters and health and safety issues. The manager said that the home does not look after money for any of the residents. Those that wish to keep their money in locked boxes that have been secured in their wardrobes. Families or nominated representatives look after the financial affairs of the other residents. An environmental health officer inspected the home in January 2006 and the ‘Food Standard Award’ was presented for ‘premises which attain and maintain high standards of cleanliness and food hygiene practice’ the award is current for one year. Records were seen which confirm that regular testing and servicing of fire equipment is carried out and that staff receive regular fire training. The report for the five- year hard- wire electrical inspection was also available. A risk assessment of the building was carried out in June 2005. The landlords certificate for the service of the gas boiler must be made available for inspection. The manager has undertaken a ‘train the trainers’ course in manual handling and now does in-house training for all staff annually and as part of the induction training for new staff. All staff have completed fire safety and first aid training. The manager said that most have done training in infection control and more food hygiene training was due to be done soon. Forest Brow Care Home DS0000057070.V281184.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Forest Brow Care Home DS0000057070.V281184.R01.S.doc Version 5.1 Page 19 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 OP16 Regulation 22 Requirement The registered person must ensure that there is an accessible complaints procedure, which includes the stages and time-scales for the process and details of agencies to complain to outside the home. The registered manager must obtain a new CRB disclosure for every new member of staff before employment commences. Timescale for action 30/04/06 2 OP29 19(1)(b) 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Forest Brow Care Home DS0000057070.V281184.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Forest Brow Care Home DS0000057070.V281184.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!