Inspection on 06/06/07 for Forest Home

This inspection was carried out on 6th June 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Forest Home 13/10/06

Forest Home 27/01/06

Forest Home 24/08/05

Forest Home 09/02/05

Forest Home 15/09/04

Forest Home 22/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Forest Home 58 Swan Street Sible Hedingham Halstead Essex CO9 3HT Lead Inspector Brian Bailey Key Unannounced Inspection 6th June 2007 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 Home DS0000017820.V342571.R01.S.doc Version 5.2 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 Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Forest Home Address 58 Swan Street Sible Hedingham Halstead Essex CO9 3HT 01787 460361 01787 463870 foresthome58@btinternet.com 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) St Giles Homes Limited Mrs Tanya Jelley Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 34 persons) 13th October 2006 Date of last inspection Brief Description of the Service: Forest Home is a privately owned home situated in the village of Sible Hedingham. It is registered under the Care Standards Act 2000 as a Care Home to accommodate 34 older people. The registered manager is Tanya Jelley. The building is a detached listed property, with a more recently built fourteenbed extension to the rear of the building. There is a driveway to the front of the property with car parking facilities and a large garden and patio area to the rear of the property. The local amenities include a post office, church, newsagents and a supermarket. Accommodation consists of 20 single bedrooms and 7 shared rooms, which are located on the ground and first floor. There is a passenger lift between the two floors. There are a number lounges and a large dining room with access to a patio area and the gardens. Fees for the home range between £434.00 and £524.00 per week. The cost of hairdressing, chiropody, newspapers and toiletries is not included in the fees. Inspection reports are available from the home and from the CSCI website www.csci.org.uk Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection looking at the core standards for the care of older people. This report is based on a range of information that has been accumulated from our inspection records, a site visit to the home that took place on 6th June 2007 at 10.00am, a tour of the property, discussions with the manager, staff, people that live at the home, records kept at the home and questionnaires issued and returned to CSCI. The home is registered to provide accommodation and care to thirty-four older people. At the time of the site visit, there were twenty-eight people in residence and seven vacancies, although two shared rooms were being used by choice as single rooms. People living at the home spoke of being cared for by kind and attentive staff. Staff spoken with were happy working at the home and considered people were well cared for. Since the last inspection visit in October 2006, the manager has worked hard towards achieving the requirements made at the last inspection visit and has made further improvements to enhance the facilities available. The manager has advised that the matters raised in this report in relation to medication have been addressed. This would indicate that the home is providing a good service to people living at the home. What the service does well: What has improved since the last inspection? • • • Redecoration of six bedrooms; Provided three new WC en-suite facilities; Provided new carpets in six bedrooms and a hallway; DS0000017820.V342571.R01.S.doc Version 5.2 Page 6 Forest Home • • • • Improved call bell system installed; Replacement of some kitchen equipment; Improved computer facilities; Keypad entry facilities on doors to staff room, laundry and kitchen. 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. The summary of this inspection report can be made available in other formats on request. Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 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 Home DS0000017820.V342571.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 2. Quality in this outcome area is good. People who use this service can expect to have sufficient information to make an informed choice and have their needs assessed prior to moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s statement of purpose was available. This contained all the relevant information about the home’s aim and objectives, facilities and services that are available. This document meets the requirements of the national minimum standards. In the admission section it refers to a pre-admission assessment of need, which is required to enable the home to determine whether a persons needs could be met. Three care records were inspected and each one contained a detailed assessment dated prior to the date of admission to the home. The assessments covered past medical history and the present medication regime, in addition areas of care such as mobility, continence, personal hygiene, Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 9 communication, pain, orientation and sleep pattern were assessed. There was also information recorded about interests and family contacts. Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is adequate. People who use this service can expect to have a plan of care to help meet their needs and be treated with respect, but they can not be certain that all medication is being stored appropriately and that staff have been formally assessed as competent to carryout those duties. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans and daily records were inspected of people that had been admitted to the home over the past few months. Care plans continued to be detailed and well written. Each care plan had interventions related to the assessed needs of the person. Areas of care that needed support such as mobility, personal hygiene, continence and night needs had details of how the person wanted support to manage these care needs. There was evidence that care plans were regularly reviewed. Each file also contained some life history work, details of the next of kin and contacts for any health professional involved in the resident’s care. There were risk assessments for falls and moving and handling, Waterlow tissue Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 11 viability scores and a record of health care appointments. In addition social needs were recorded. Other information recorded included known allergies, any religious persuasion and in some cases the person’s final wishes. Each file had a recent photograph of the person. The home has adopted a monitored dosage system for the administration of medication. All medication is kept in a locked trolley. The Medicine Administration Record sheets (MAR) were checked and no signature gaps were noted. Only staff that have been assessed to administer medication are permitted to carry out these duties. However, the manager needs to ensure that the system used to assess the competency of staff is thorough and meets the requirements of the Skills for Care Knowledge Sets. Medicines that require temperatures lower than room temperature are stored in a refrigerator in the staff room. There is keypad entry to the staff room and although the medication is now kept in a locked container within the domestic refrigerator, the temperature was not being checked or recorded. Seven people that live at the home spoke of the staff as being patient and considerate; they felt staff respected their dignity and their right to privacy. Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. People who use this service can expect to be encouraged to maintain contact with family and friends, to be offered meaningful activities and have a balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the files seen of people living at the home had appropriate contact details for the next of kin and the life history work had details of family and relationships. The home was in the process of having repairs carried out to the heating system and therefore the manager has suggested that people might prefer to remain in the dining room where it was warmer. A few people had by choice stayed in the lounges or their bedrooms. Activity was high with plenty of visitors, plumbers on site and a hairdresser attending to people between meals. Seven relatives were spoken with about the care provided at the home. All felt confident that their relatives were being well cared and they had no concerns. They said they were always made welcome and could visit at anytime. Questionnaires returned to us by relatives and people at the home stated that a range of activities are provided although one person felt that more external entertainers should be brought in. The Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 13 home employs an activities coordinator who provides a range of activities on four days each week. People spoken with said they were happy with the meals they received. They said they were of a good standard and they were given choice. The lunch seen on the day of inspection looked appetising. The menus seen showed that there was a cooked breakfast available if residents chose and a choice of two main dishes and at least two desserts each day. Fresh cakes are made daily. The kitchen was visited and the freezer, refrigerator and dry food stores were checked. Good food stocks were available. The temperatures of refrigerators and freezers were logged daily and showed that they were within safe limits for food storage. Food left over in the refrigerator was covered, labelled and dated. After lunch people decided where they wanted to spend the afternoon but many remained in the dining room because of the heating problem. A questionnaire returned to us by a relative stated “”The food is of a good standard and variety”. Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. People who use this service can expect to have their complaints taken seriously and be protected from abuse by staff who are knowledgeable about the procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an appropriate complaints procedure and people at the home and visitors were all clear about who to approach if they had any concerns or complaints about the service. Records seen showed that staff are provided with the Protection of Vulnerable Adults (POVA) training and that staff spoken with were clear about their duty of care. Further training on POVA is planned. The home has a whistle blowing policy. The POVA policy was seen and the guidance issued by Essex protection of vulnerable adults committee. Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. People who use this service can expect to live in a clean, comfortable environment and that improvements will continue to be made to benefit them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home, which is ideally situated close to local amenities, has been adapted and extended to meet the needs of older people. A tour of the building included a check of some of the bedrooms, bathroom, toilets, laundry, kitchen, dining room and lounges. All areas were clean and tidy. Many bedrooms had been personalised and all were comfortable and homely in appearance. They were in general suitably furnished and decorated. There were no odour control problems. The call bell system had been improved with some new equipment. Corridors in the extension were wide and had rails to assist any resident who was unsteady in walking. Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 16 The communal lounges were furnished with comfortable chairs and the décor was attractive. All rooms seen had pleasant outlooks and were light and airy. Since the last inspection visit, three bedrooms have had new WC en-suites provided. Six bedrooms and the hallway have been re carpeted. The laundry, which had a keypad entry restriction for safety reasons, was seen and was clean. The washing machines had a sluice programme and high temperature wash for soiled linen. The home has an infection control policy that requires the use of protective gloves and aprons for performing tasks that could spread infection. A questionnaire returned to us by a relative stated “Forest Home is always very clean and tidy”. As already indicated, work was in progress to replace some of the heating system and the home had taken steps to ensure people at the home were not unduly affected by the work. There had been a leak from a first floor room, which had caused some damage to a wall in a corridor. People spoken with said they liked their rooms and had no complaints. Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing rotas were seen and showed that a senior carer was rostered for each early and late shift. Four carers on the early shift and three carers on the late shift supported them. Three carers covered nights. In addition the manager worked some supernumerary shifts and three days a week the home had an administrator covering the office. Ancillary staff consisted of two domestics daily, a cook and kitchen assistant and a kitchen assistant for the evening to manage the teatime meal. The files of four members of staff were inspected. These are kept in a locked cabinet to ensure confidentiality is maintained. They each contained two references, a contract with terms and conditions of employment and a criminal record bureau (CRB) check. All four files had evidence that checks had been made on the identity of the staff member and contained a photograph. There was evidence of first day induction that covered fire awareness, the environment, confidentiality and the aims and objectives of Forest Home. The manager was in the process of using the Skills for Care induction Package. Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 18 The home employs twenty-seven care staff, five of who have achieved an NVQ level 2 or above. There are two staff currently working towards gaining this qualification. This gives a percentage of 28 , which does not meet the recommended level of 50 . Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38. Quality in this outcome area is good. People who use this service can expect to be consulted about the service and have their personal monies protected but be assured that all fire prevention recommendations will be enforced. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has many years experience of caring for older people and since the last inspection has commenced the Registered Managers Award (RMA) at a local college. The system for managing personal monies for residents had not changed since the last inspection when it was found to be safe and efficient. The home’s administrator is responsible for the administering of the system. The records of two people were checked and were again seen to be accurate and the type Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 20 of expenditure was in accordance with the items considered to be extra to the fees such toiletries and hairdressing. The home undertakes annual surveys of residents and visitors’ opinions on the level of care being offered. The most recent one was done in May 2007. The questionnaires covered a good range of topics. Responses were still arriving and therefore a summary of the findings was not yet available. Eleven questionnaires were returned to CSCI at the time of the inspection visit. These were positive about the service and the care provided. Health & Safety records were seen for routine checks on equipment. These showed that contractors service systems and equipment at the appropriate intervals. It was pointed out at the last inspection that a number of fire doors to residents’ rooms were wedged open during the day. Equipment has since been purchased to ensure these doors are now adequately properly. Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 21 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23 (j) Requirement The manager must consider how the hairdressing facilities can be improved to enable people to have their washed in improved surroundings with an appropriate type of washbasin. The manager must continue to work towards ensuring that at least 50 of care staff obtain a NVQ 2 to ensure that people at the home are supported by qualified staff. (Previous timescale not met). A refrigerator used to store medicines must have the temperature-monitored daily to ensure it functions at the correct level for the storage of medication. (Previous timescale of 31/10/06 not met) Staff that administer medication must be formally assessed to ensure they are competent to carryout these duties so that people at the home are safeguarded from errors being made. Timescale for action 01/11/07 2 OP28 18 01/11/07 3 OP9 13 (2) 01/07/07 4 OP9 13 (2) 01/09/07 Forest Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 23 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 Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Home DS0000017820.V342571.R01.S.doc Version 5.2 Page 25 - 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!