CARE HOMES FOR OLDER PEOPLE
Forest Hill House Nursing Home Rushall Lane Corfe Mullen Wimborne Dorset BH21 3RT Lead Inspector
Debra Jones Unannounced Inspection 22nd November 2005 10:30 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 Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 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 Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Forest Hill House Nursing Home Address Rushall Lane Corfe Mullen Wimborne Dorset BH21 3RT 01202 631741 01202 632742 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) Royal Bay Care Homes Ltd Miss Julie Louise Wilson Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. One named person (as known to CSCI) over the age of 65 may be accommodated to receive nursing care in the category MD. One named person (as known to CSCI) in the age range 40-64 may be accommodated to receive nursing care. 21st July 2005 Date of last inspection Brief Description of the Service: Forest Hill House is set in a rural area with spacious wooded grounds and a large gravelled parking area. Forest Hill House is registered as a care home with nursing for people over the age of 65. It offers accommodation on three floors for 36 elderly people with 18 single rooms and 9 double rooms. Many of the rooms have en-suite facilities and there are sufficient communal W.Cs and bathrooms. There is a passenger lift to all three floors and a stair lift to the first floor. There are a variety of aids and adaptations around the building to allow residents to move about more independently. There is a large sitting room, a dining room and a conservatory, which leads out on to a small patio area with a pond and raised flowerbeds. There is a bird table and a variety of outdoor seating arrangements. Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over two and a half hours and was the second of the two anticipated inspections of the year. The 4 requirements and 2 recommendations made at the last inspection were followed up to see if there had been any progress made towards meeting them. All requirements had been addressed. No requirements were made at this inspection. During the inspection a number of records were looked at. The Inspector walked around some of the building and met with residents and a visitor who spoke positively about the home ‘It’s very good’ “the girls are great.” The manager – Jules Wilson - and her staff assisted the Inspector in her work. Prior to the inspection the Commission asked the home to send out / make available comment cards to get people’s views of the home. 4 were returned, all from General Practitioners. They were very positive about the staff and service provided at the home. Comments made were “staff maintain friendly informal atmosphere- matron very much on the ball.” “No concerns at all about this residential nursing home.” “This is an excellent nursing home. The care is exemplary.” What the service does well:
Forest Hill House provides a service for the older people living there in a house decorated and furnished in a homely way and has a comfortable relaxed atmosphere. There is a robust system for medication administration at the home. Staff were observed throughout the inspection to be treating residents with courtesy, patience and kindness and residents and visitors confirmed that their privacy and dignity were respected at all times. There is a good programme of activities on offer at the home. Some activities are structured and well organised, others are 1-1. Activities are at times responsive to what residents want to do that day. Residents are able to do as they wish at the home and join in or not with the activities on offer. Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 Page 6 Visitors are always welcome at the home and residents are encouraged to maintain and develop relationships with people in the home, with their families and friends and the local community. Meals are varied and planned around the likes and dislikes of residents. Meal needs and preferences are always taken into account and mealtime arrangements are flexible enough to accommodate individual preferences. A quality assurance system is in place. This is due to be completed in the New Year. Where residents want the home to look after small amounts of money for them a good system is in place to do this. What has improved since the last inspection? 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. Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 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 Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 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): 4 (Standards 3 and 5 were met at the last inspection) 6 is not Prospective residents get the necessary assurance that their needs can be met at the home. EVIDENCE: The home now confirms in writing that having assessed residents prior to admission that they can meet their needs. Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 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 (Standards 7,8 and 11 were met at the last inspection with 7 & 11 exceeded) The medication at this home is well managed promoting the good health and well being of residents. Residents confirmed that they were treated with dignity and that their privacy was respected. EVIDENCE: A robust system for the ordering, administering and recording of medication is in place at the home. Medication at Forest Hill House is only administered by the qualified staff who are all considered competent to carry out this task. Medication records sampled were up to date and properly completed. Where it is recommended that 2 staff sign to confirm balances of certain medicines this was seen to be happening. Staff are aware that they should record the date, and where appropriate the time, that medicines are opened/ brought into use and that where handwritten entries are made on the Medication Administration Records
Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 Page 10 that these should be checked by another competent person, who should also sing the record. Medicines and dressings were tidily stored in appropriate places e.g. medication cupboards, trolleys and in the fridge. The maximum and minimum temperature of the fridge used to store medication is not currently monitored as the home is still waiting for the delivery of the thermometer they have ordered to do this. The home has made appropriate arrangements for the disposal of medicines that have not been used through a licensed waste disposal company. Records were seen of medicines that had been disposed of. The medication policy has been updated accordingly. Residents spoken to said that they felt well cared for, that staff were very good and that their privacy and dignity were respected. A visitor talked of how this happened in practice. Staff are introduced to the principles of promoting privacy and dignity in their induction. It is also referred to in the home’s policies that support care practice in the home. Staff were seen to be treating residents in a respectful and dignified way during the course of the inspection. Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 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): 12,13,14 and 15 Residents’ lives are enriched by the social opportunities afforded by their visitors and the stimulating social activities available in the home. Visitors are made welcome at the home and can come whenever it suits the residents. Residents are helped and encouraged to exercise choice in their daily lives at the home. The meals in this home are very good offering both choice and variety and are served in a pleasant environment. EVIDENCE: Forest Hill House has a dedicated activities organiser. Residents and visitors praised her for her hard work and for the range of interesting and enjoyable activities that were on offer at the home. Activities are arranged for groups and are also 1-1. Outings to places of local interest are also arranged. Adverts were up in the main hall for the Christmas pantomime, party and carol service. Families and friends are invited too. Photos of recent social events were also on display.
Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 Page 12 Hobbies and interests are explored with residents when they first move to the home, along with finding out about people’s happy memories and achievements. Information is given to residents and their relatives / friends about staying in contact and visiting the home. Residents and visitors spoken to said that visitors were always made welcome and of how they always got a cup of tea. The visitors’ book confirmed the number and range of visitors to the home. People are encouraged to make choices about how they live their lives at the home. Residents said that they were able to get up and go to be when they wanted, choose to eat what they liked and join in with activities as they wished. Menus are based around the known likes and dislikes of the residents. The home has summer and winter menus on a six week rotation. Residents are offered meal choices on the day and alternatives can be provided. The meal served on the day of inspection was meat loaf with a range of vegetables. Dessert was bread and butter pudding. Residents praised the food ‘sometimes it’s very, very good!’ The chef on the day confirmed that in respect of food / ingredients the home ‘never scrimps on quality.’ Special diets are catered for e.g. diabetic, high protein, low fat. Residents said they could have meals where it suited them. The home has a pleasant dining area that residents can eat in if they wish. Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 Page 13 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): Standards 16,17 and 18 were met at the last inspection. EVIDENCE: None of these standards were inspected on this occasion. Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 Page 14 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): All standards were met at the last inspection. EVIDENCE: None of these standards were inspected on this occasion. Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 Page 15 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 (Standards 27 and 30 were met at the last inspection.) Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. EVIDENCE: At the last inspection a few gaps were found in the documentation that must be obtained for staff employed at the home. This was in respect of evidence being held of CRB disclosures and POVA 1st checks prior to starting work there. This has been addressed. Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 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): 33, 35 and 38 (Standards 31,32 and 37 were met at the last Whilst there is nothing to demonstrate that the home is not run in the best interests of residents the quality assurance system has not been fully implemented yet this year. Residents can have confidence that the home will look after their pocket money proprerly should they wish for this to happen. Staff fire training records now demonstrate that residents would be as safe as they could be in the event of a fire breaking out. EVIDENCE: The home sent out and made available comment cards for the Commission as requested prior to this inspection. Those that came back were full of praise for the home. Policies and procedures are regularly reviewed and updated as appropriate at the home. The home responds to Commission inspection
Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 Page 17 reports and maintains a high quality service for residents. The home’s own quality assurance system is not due to be completed until early in the new year. The home keeps a little money belonging to residents and a solid system is in place to look after it. Clear records are kept of expenditure and balances. A number were sampled and found to accord with the details in the records. Fire training records for staff are easy to follow and it could be seen at a glance when individual staff last had fire training and when it is next due. Night staff are now fully up to date with their fire training. Data product sheets were not being kept with the cleaning equipment and so were not readily accessible to the staff using the products. Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 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 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 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 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 x x 2 Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 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 OP9 Good Practice Recommendations The registered person should obtain a thermometer that records the maximum and minimum temperature of the fridge used to store medication and the temperatures should be recorded daily. The registered person should ensure that a set of data product sheets e.g. for cleaning products, be kept near to where the products are in use / stored. 2. OP38 Forest Hill House Nursing Home DS0000064305.V268107.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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