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Inspection on 23/03/06 for Forest Court Nursing Home

Also see our care home review for Forest Court Nursing Home for more information

This inspection was carried out on 23rd March 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.

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

This home has a non-judgemental way in its approach to residents who may exhibit challenging behaviour. Each resident is treated as an individual and is supported to make decisions however small these maybe. The use of medication is kept to a minimum and the use of other methods allows staff to care effectively for the resident. It is noticeable that the staff working at the home genuinely enjoy working with individuals with dementia.

What has improved since the last inspection?

Apart from additional work carried out to ensure the home meets with the new fire regulations, a good standard of care has been maintained since the last inspection with no real changes.

What the care home could do better:

Staff need to improve their knowledge base relating to pressure relief equipment.

CARE HOMES FOR OLDER PEOPLE Forest Court Nursing Home Bradley Court Road Mitcheldean Glos GL17 0DR Lead Inspector Mrs Janice Patrick Unannounced Inspection 23rd March 2006 10:20 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 Court Nursing Home DS0000016438.V278285.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 Court Nursing Home DS0000016438.V278285.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Forest Court Nursing Home Address Bradley Court Road Mitcheldean Glos GL17 0DR 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) 01989 750775 01989 750348 www.bupa.co.uk BUPA Care Homes (CFCHomes) Limited Mr Christopher James Rowlands Care Home 49 Category(ies) of Dementia (49) registration, with number of places Forest Court Nursing Home DS0000016438.V278285.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th October 2005 Brief Description of the Service: Forest Court is a large imposing building situated outside the town of Mitchledean in the Forest Of Dean. It commands extensive views over the surrounding countryside and has large gardens and plenty of level parking. An area of the garden leading from one of the communal lounges has been enclosed to provide a safe and sheltered garden for residents and their relatives to enjoy. This care home specialises in the care of the older person who has dementia and who requires nursing care. All staff are qualified or have been trained within this specialist area of care. The main philosophy of the home is for those suffering from this form of illness to retain the right to a dignified life in which they can still make choices for themselves. There is minimal use of medication and residents are free to walk and explore as they wish, but with potential risks carefully monitored. The home offers daily recreation and activities and family and visitors are welcomed as part of a large extended family. There is a lot of support and guidance offered to relatives and friends in coping with a loved one who has this form of illness. External health care professionals have established relationships with the home and work with the home staff to ensure all health care needs are met. Forest Court Nursing Home DS0000016438.V278285.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out between the hours of 10:20am and 12:45pm. The Registered Manager was on holiday but the Deputy Manager was on duty, as were other members of the home’s team. This was a short inspection where 6 of the core national minimum standards were inspected. These included: • The home’s admission process • Staff training • Management of the Home • Communication between teams within the home and other interested party’s • Quality Assurance and auditing processes. Throughout the inspection the atmosphere was calm and friendly and residents who were spoken with or who were just observed, appeared well cared for and content. What the service does well: What has improved since the last inspection? What they could do better: Staff need to improve their knowledge base relating to pressure relief equipment. Forest Court Nursing Home DS0000016438.V278285.R01.S.doc Version 5.1 Page 6 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 Court Nursing Home DS0000016438.V278285.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 Court Nursing Home DS0000016438.V278285.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): 3 A thorough and appropriate assessment process ensures that the needs of an individual are well known before admission. EVIDENCE: The Registered Manager and Deputy Manager had carried out an assessment on a prospective resident the day before this inspection. All documentation pertaining to this was seen. The assessment process was able to show that the home would be able to meet this person’s needs; therefore admission was booked for 4 days time. The pre assessment documentation was also read for another resident who had been admitted earlier in January, this showed that the same process had taken place. In this case a Joint Assessment of Needs, carried out by other health care professionals, added to the information that the home took into consideration. Forest Court Nursing Home DS0000016438.V278285.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 Effective care planning allows for all care and health needs to be reviewed and addressed and gives clear guidance to staff in how this is to be carried out. EVIDENCE: This standard was not inspected in detail with full case tracking carried out, as this has been completed in the previous inspections. However, the care documentation of two residents was read. This showed that key needs were being planned for and reviewed as and when changes occurred. The qualified nurses on duty confirmed that care staff were not involved in the actual documenting but are consulted when care plans are devised and reviewed. Any changes are then subsequently passed onto the care team. In the case of one resident the Inspector cross-referenced the written care plan with what was actually being used for pressure relief. This very frail resident was seen resting in a profiling bed on a dynamic air mattress and looked extremely comfortable. Although the care documentation indicated that pressure relief equipment had been introduced, the documenting was not specific as to the level of equipment used and the staffs’ knowledge in this area was limited. Consideration should be given to further training in pressure relief equipment and the ‘step up’ and ‘step down’ concept. Forest Court Nursing Home DS0000016438.V278285.R01.S.doc Version 5.1 Page 10 Forest Court Nursing Home DS0000016438.V278285.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): None of the above standards were inspected. N/A EVIDENCE: N/A Forest Court Nursing Home DS0000016438.V278285.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): None of the above standards were inspected. N/A EVIDENCE: N/A Forest Court Nursing Home DS0000016438.V278285.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): None of the above standards were inspected. N/A EVIDENCE: N/A Forest Court Nursing Home DS0000016438.V278285.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): 28 & 30 Arrangements are in place to ensure appropriate training is given to staff in order for them to give a high standard of care to the elderly person with dementia. EVIDENCE: All care staff that work for BUPA are expected to undertake a National Vocational Qualification (NVQ) in Care. The majority of staff at Forest Court have achieved this at varying levels. Funding is currently being awaited for two further candidates to commence training. In addition to NVQ training, all staff participate in a structured induction programme. Other mandatory training is also provided on subjects such as fire awareness, moving and handling, first aid and food hygiene. BUPA’s one day and three day training in the care of the person with dementia has been attended by many staff at Forest Court and is supplemented by ‘in house’ training on this subject. The Deputy Manager and one other Registered Nurse who trained in mental health (RMN) have recently attended a weeks training in ‘breakaway’ techniques. This teaches the professional how to deal with challenging situations such as being held forcibly without having to use restraint or force and how to use diversional tactics in order to diffuse potentially aggressive situations. Their new updated knowledge will be cascaded down through the staff team. The activities co-ordinator and 2 members of the care staff have Forest Court Nursing Home DS0000016438.V278285.R01.S.doc Version 5.1 Page 15 completed the ‘Active Life in Aging’ course. This helps staff to identify ways of helping the older person to remain active through activities that can be fun. It also links into the national ‘falls’ prevention forum. Forest Court Nursing Home DS0000016438.V278285.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, 32 & 33 The Home is managed by a person competent to do so whose main aim is to ensure the home is run for the benefit of the residents and that this is achieved with strong sense of teamwork. A well established process of auditing and evaluation ensures that a good standard of care and service is maintained and improved upon for the benefit of the resident. EVIDENCE: The Registered Manager has managed the home for 3 years. He is dedicated to the care and well being of those with dementia and has many years of practical experience and updated knowledge in this field of care. He holds the Registered Manager’s Award (RMA) and is updated in mandatory trainings. The Deputy Manager who is also a qualified nurse is due to commence the Registered Manager’s Award in May of this year. Forest Court Nursing Home DS0000016438.V278285.R01.S.doc Version 5.1 Page 17 Meetings are held regularly within the staff team to ensure communication. A recent trained staff meeting was held and was attended by the night nurses. One nurse on duty confirmed that this had been a constructive meeting where care planning had been discussed. The home complies with BUPA’s requirements by following the company’s structured quality assurance system, of which some records were seen. This involves regular auditing of the care delivered and services provided and is monitored by senior Managers. Another BUPA Care Home Manager was fulfilling one of the Care Home Regulations on the day of this inspection. This was an unannounced visit to the Home, which will result in a report being submitted to the CSCI on how the Home was functioning on the day of their visit and aims to seek views from residents/relatives on the services and care being offered. Forest Court Nursing Home DS0000016438.V278285.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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X X X Forest Court Nursing Home DS0000016438.V278285.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. Standard Regulation Requirement Timescale for action 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 Staff should know if a piece of pressure relieving equipment is appropriate to the residents needs and have an understanding of when to alter this. Forest Court Nursing Home DS0000016438.V278285.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Court Nursing Home DS0000016438.V278285.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. 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