CARE HOME ADULTS 18-65
Forest House Church Square Newnham Road Blakeney Glos GL15 4AA Lead Inspector
Mr Richard Leech Key Unannounced Inspection 10:00 – 1400 11 & 12th April 2007 & 10:30 –
th Forest House DS0000016440.V335567.R01.S.doc Version 5.2 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 House DS0000016440.V335567.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 Adults 18-65. 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 House DS0000016440.V335567.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Forest House Address Church Square Newnham Road Blakeney Glos GL15 4AA 01594 516825 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) www.craegmoor.co.uk Parkcare Homes Limited Mr Jonathan Harker Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 19th September 2006 Brief Description of the Service: Forest House is registered to provide care for up to eight adults with a learning disability. The service is operated by Parkcare Homes, which is a subsidiary of the Craegmoor Healthcare group. The home is in the small village of Blakeney in the Forest of Dean. The building is a renovated and refurbished stone cottage. Whilst this gives the home character, it also means that there are some low ceilings and doorways, fairly steep staircases and steps to many of the rooms on the ground floor. The home provides 24-hour staffing. All service users have single rooms, some with en-suite facilities. There is a communal lounge, smoking area and dining room. Outside there is a patio, outbuildings and stepped access to the garden. People who may move to the home and those involved in their care are offered information about the service including copies of the Statement of Purpose and Service Users Guide. Fee levels were reported to range between approximately £600 to £1200 per week, with a base fee of £1026 at the time of the inspection. Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection began on a Wednesday morning, lasting until early afternoon. A longer visit was made on the following day from mid-morning through to early evening. All of the people living in the home were met, along with several members of the staff team. The manager was also present throughout the visit. Some discussion took place with the people using the service, with staff and with the manager. There was also some general observation of life in the home at different times of day. Some surveys were sent out around the time of the visit and any significant findings will be included in the report. Surveys were sent to staff, relatives and health & social care professionals. In addition some survey forms were received from the people living in the home, in some cases completed with assistance. Various records and documents were looked at. These included selected care plans, risk assessments, medication charts, training and staffing files and policies & procedures. What the service does well:
Admissions to the home are well handled. People who move in can feel confident that their needs have been assessed and that the home will be able to meet these. There are good systems in place for care planning and for managing risks, though some comments are made about ways this could improve. People who live in the home are offered choices and control over their lives. They feel listened to and respected. They also feel safe and able to say if they are unhappy about something. Support is given to enable people to take part in activities of their choice. People are also helped to stay in contact with family and friends. People living in the home are happy with the food that they have. The way that medication is looked after is good. People’s health and personal care needs are met in ways which help people to stay well and which respect their wishes. Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 6 The home is bright, clean and comfortable. People’s rooms are personalised according to their tastes. There are good systems in place for checking on health and safety. The people living in the home like the staff. Appropriate training is provided so that people have the skills that they need for the job. Good recruitment procedures help to protect the people using the service. The home is well run. There are systems in place to check the quality of the service and to make improvements. This includes asking the people living in the home what they think. 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. The summary of this inspection report can be made available in other formats on request. Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A thorough approach to admissions means that people moving into the home can be confident that their needs will be appropriately assessed and met. EVIDENCE: One person had moved into the home since the previous inspection. The way that this had been handled was checked. The manager said that he had turned down some referrals as inappropriate for the service, providing evidence that due consideration was being given to whether people’s needs could be met in the home. For reasons described it had been agreed that the usual staged admissions process was not appropriate in this case, although the manager, staff and service users confirmed that the person had made one visit to the home before moving in. The manager said that a specialist had assessed the suitability of the physical environment before the person came to live at Forest House, resulting in some adaptations being made. This is good practice. The manager reported that he visited the home where the person was living in order to conduct assessments and to meet staff and others involved with the person’s care. Their file included discharge information from the previous
Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 9 placement. The information included was minimal, though it was agreed that this was not the fault of the team at Forest House. The assessment completed by the manager was seen to be thorough and covered appropriate areas. Some additional background and assessment material had also been obtained. Discussion, observation and checking care notes indicated that the person was settling in well and that the home was in a position to meet their needs, although there was significant work to be done in areas such as care planning and daily routines/structure. Staff spoken with confirmed that they had read the person’s care plans, and indicated that they felt equipped to provide appropriate support. There was a discussion with the manager about the categories of registration and whether there may be a need for the service to apply for some changes to these. This will be looked into and communicated to the manager. Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A reasonable framework exists for care planning and risk assessment, although there is some potential for improvement in order to make the approaches more person-centred and robust. People using the service are enabled to make meaningful choices, helping them to feel in control of their lives. EVIDENCE: Care plans for two people living the home were looked at. These covered a range of appropriate areas and provided reasonable guidance for staff. In one case the person had only recently moved in. The manager confirmed that further care planning would follow around areas such as activities, independent living skills and the management of finances. Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 11 Most care plans were hand written. In some cases they were difficult to read. Ideally care plans should be typed. The manager agreed, though pointed out that some people lacked the necessary IT skills. For all care plans seen there was written evidence of reviews at least once a month. More detailed reviews were also seen to be undertaken periodically. Some plans seen needed some revision, such as to update the name of the home’s manager. There was little documented evidence of service users having input into the care planning process, although some people confirmed that their care plans had been talked over with them and others had signed some of the review notes. Some person-centred care planning formats had been started, although these were incomplete and in the example seen there was no evidence of areas such as goals having been reviewed. The manager showed some new person-centred planning formats which were going to be implemented in the near future. It was agreed that keyworkers using the formats would need support to ensure that they had understood the principles of person-centred planning, and that in some cases aspects of the templates may benefit from being amended (for example, to give more space). The manager said that people using the service would be given copies if they wanted, and that the new care plans would have greater evidence of their input. He said that keyworkers had been asked to ensure that people living in the home would be directly involved in care plan reviews every three months. People living in the home were observed to be offered choices or making their own decisions over the course of the visit. This included what they ate and when, where they had their meal and how they spent their time. People spoken with confirmed that they were in control of different areas of their lives such as times for getting up/going to bed, their activities, diet and how they spent their money. Some people were spoken with about limitations which were in place and confirmed that these were with their agreement. Restrictions were seen to be documented on file and to accord with best-interest principles. Discussion with staff and checking care notes also provided evidence of the service seeking and respecting people’s choices and wishes. There was discussion with the manager about the dilemmas which can arise around respecting expressions of choice and also motivating people to develop new interests and skills and to move forwards. The discussion provided evidence of a supportive rather than prescriptive approach being adopted. Service users confirmed that they had been offered access to advocacy services, in some cases deciding to take this up. Risk assessments for two service users were looked at. These considered significant identified risks and generally provided clear guidance for staff.
Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 12 There was some discussion with the manager about improvements that could be made. These included considering capacity, consent and best-interests issues more explicitly where relevant and adding further guidance in some cases so that it was clear to staff what they should do in particular scenarios. There was documentary evidence of risk assessments being regularly reviewed. There was some more general discussion about the Mental Capacity Act and some possible implications around areas such as consent and best interests. Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are supported to take part in a variety of activities in the home and community and to maintain contact with family and friends, promoting their quality of life. The rights and responsibilities of people using the service are respected, helping them to feel valued and included in the running of the home. Menus are varied and respect people’s choices, enhancing service users’ wellbeing and enjoyment of their food. EVIDENCE: Some people living in the home were asked about their activities and expressed satisfaction with how they spent their time. People described spending time pursuing hobbies and interests in the home, going for walks and trips out, visiting cafes, pubs and restaurants, going to bingo, working on a
Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 14 farm and taking part in college courses. Some people had recently been to a local church service. Records were sampled for a period of 10-days for two people. These provided further evidence of people taking part in a variety of different activities in the home and community. During the visit to the home people were seen going out to different activities and also pursuing their interests in the home such as watching television, knitting or helping around the home. One person described having a job and was clearly very proud to be working in the local community. The manager and staff said that since the closure of a day centre there had been some difficulty finding alternative activities. Other factors were also seen to be impacting on individual activity programmes. However, discussion and records provided evidence of the team working towards overcoming these complex issues. The manager said that, as with any area of the home’s operation, there was scope for improvement in activity provision and described the measures being taken towards this. Contact sheets and other records, discussion with service users and general observation provided evidence of people being supported to maintain contact with family and friends in accordance with their wishes. During the visit one person went out with a family member and then brought them back to the home. Throughout the inspection people living in the home were seen to be spending time in ways of their choosing. This included assisting with domestic chores in a very natural and inclusive way and also helping themselves to drinks and food of their choice. Some restrictions were in place due to identified health and safety issues. People were seen accessing locked areas of the home such as the laundry when they wished to with appropriate support. The front door of the home was locked along with the garden gates. The manager and staff described the reasons for this but were also clear about people’s right to leave the home if they wished to. The manager was aware of proposed changes to legislation which may introduce new measures around people’s liberty and the ways in which this might lawfully be restricted under certain circumstances. One person living in the home has a front door key. Discussion and records provided evidence of people being offered keys to their bedrooms and of this being kept under review. Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 15 All of the people living in the home who were asked about the food said that they were very happy with it. One person said that it was ‘beautiful’. Another said that it was ‘very nice’. People were seen choosing and preparing their lunch on their own or with help. The menu for the week of the inspection was looked at, providing evidence of a varied range of foods being served. The manager and staff said that people living in the home sometimes went food shopping with them. Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s personal and healthcare needs are met, promoting their dignity and wellbeing, although there is scope for some development in line with best practice. Satisfactory arrangements are in place for the handling of medication, promoting service users’ wellbeing and, where appropriate, their independence. EVIDENCE: Care plans covered issues around personal and health care where relevant. Staff described how they provided personal care with regard for people’s privacy and dignity as well as their preferences. Staff were seen responding to people’s requests for support, providing this in a way which reflected the person’s wishes. People living in the home were dressed individually. One person confirmed that they used local hairdressing services. The same person said that their washing Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 17 always came out clean and that people’s clothes did not get mixed up in the laundry system. The manager said that staff were expected to ring the doorbell when they arrived for work, as part of respecting that it was the service users’ home. Records and discussion with staff provided evidence that people’s routine and specialist healthcare needs were being met. Some health action planning work had been started, although the process was incomplete and the documentation was also in need of review and update. It is recommended that there be a renewed focus on health action planning as this system can promote a more comprehensive and proactive approach to healthcare. It is also an expectation of government from the ‘Valuing People’ paper of 2001. The service has a new policy covering medication from September 2006 based on a range of documents including the National Minimum Standards and national guidance about medication in care homes. Staff are expected to read and sign this. Training records showed that staff who administer medication had received appropriate training, in most cases consisting of both a package about monitored dosage systems and a more in-depth distance-learning course. People’s care planning files included reference to medication issues including consent forms and whether they wanted to self-medicate. There was some self-administration in the home, based around a framework of risk assessment. Medication administration records viewed were satisfactory. Storage appeared to be in order. Some protocols for ‘as required’ medication had been signed by the GP. These would benefit from review in cases where they were signed some time ago (e.g. 2005). Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate arrangements are in place to enable people using the service to raise concerns and complaints, helping them to feel valued and listened to. There are also arrangements which help to protect service users from the risk of harm and abuse. EVIDENCE: A complaints procedure was on display in a corridor in the home, although the version was not very accessible. Alternative formats also operate in the home, although the example seen would benefit from updating as some of the contact names had changed since it had been written. A new framework for handling complaints dated November 2006 was seen in the home’s policies and procedures file. Service users spoken with felt able to raise issues and concerns and indicated that staff would listen to them. The manager and staff gave examples of people freely raising issues on a day-to-day basis or in residents’ meetings. Service user surveys provided evidence that people knew who to speak to if they weren’t happy about something. During the visit one person was supported to make a complaint about an issue that had been concerning them for some time. It was suggested that staff
Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 19 could be more proactive about offering people the option of going down the more formal route of making a complaint at an earlier stage if they wish. A new policy about the protection of vulnerable adults dated December 2006 was seen. This was detailed and provided clear guidance for staff. The manager described the arrangements for handling service users’ money. The money is held in a central interest-bearing account (with one exception). Day to day money is given to people from petty cash and the sums then deducted from the total of the money held centrally. Some people were asked if they felt safe living in the home and confirmed that they did. Discussion with staff provided evidence of awareness of adult protection issues. Training records also confirmed that most staff had received training about adult protection in July 2006. Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 20 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Forest House is clean and homely and is also well decorated and furnished, enhancing service users’ comfort and quality of life. EVIDENCE: Some people living in the home showed their rooms and said that they were happy with them. Bedrooms were seen to be personalised. Some had been redecorated since the last inspection. A toilet has been added to the en-suite facility in one room. All of the communal areas were checked. Décor was generally pleasant and fresh. Furniture seen was comfortable and in good condition. The atmosphere was homely. There were plans to redecorate the dining room and lounge, including fitting a fish tank above a fireplace. There is a designated smoking area. However, this was open to the rest of the home, resulting in a smoky atmosphere throughout communal areas. Staff
Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 21 now smoke outside, helping to reduce this to some extent. There was a discussion with the manager about the implementation of new smoking legislation and the changes this implies. A new fridge-freezer and separate freezer have been purchased. The kitchen was in reasonable condition though staff felt that the distance between the hob and sink was quite large, posing some risks when carrying hot pans. It was agreed with the manager that a risk assessment should be done about this issue in the first instance. People living in the home were seen using the courtyard at the back of the house. From here there is access to a garden from some steps. The garden would benefit from weeding/a general tidy up. During the inspection the manager received the go-ahead for having TV aerial points fitted in each bedroom to improve the reception. A maintenance book was seen, with jobs being regularly recorded and ticked as done. This provided evidence of an efficient system for reporting and addressing maintenance issues. The home was seen to be clean throughout. Service user surveys also provided evidence that the home was kept clean and fresh. One person commented that the home was ‘always clean’. Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 22 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care is provided by a skilled and competent staff team, promoting service users’ safety and wellbeing. However, there is potential for professional development within the team to further enhance the quality of care. A good recruitment and selection framework helps to safeguard the people living in the home. EVIDENCE: Staff spoken with and observed demonstrated awareness of the needs and conditions of people living in the home. Care planning files included guidance about the conditions experienced by some of the service users. People living in the home were positive about the staff team. Comments included that they were ‘nice and caring’, ‘very friendly’ and ‘helpful’. People described being able to talk to staff openly. Service user surveys also provided positive feedback about staff. Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 23 The manager gave information about the number of people who had achieved relevant NVQ qualifications. Four of the staff team had either completed or were undertaking NVQs in health and social care out of a total of nine full-time and two part-time staff. The manager had requested that three more staff be offered the opportunity to take an NVQ but this had not yet been agreed. He felt that the NVQ courses would improve staff members’ understanding of their roles and responsibilities and improve the overall quality of care. A new recruitment and selection policy from November 2006 was seen. The manager said that staff turnover had been very low. Only one person had been taken on since the last inspection. Their staffing file was checked and found to contain all necessary documentation and information. Training records indicated that staff were generally up to date with basic training such as food hygiene and first aid. The system was seen to be well organised, with certificates kept on files as evidence of training. The manager was aware of when certain training was due and had already made provision for this. Records provided evidence that staff were accessing other relevant training such as about health and safety issues, medication, equal opportunities and the management of challenging behaviour. Staff had also had training about learning disability and mental health. There was discussion with the manager about whether training on acquired brain injury would benefit staff. The manager felt that this was unnecessary as staff developed the knowledge and skill they needed through reading files/care plans and through direct work in the home. Discussion with staff provided evidence of knowledge about the condition and its impacts. Nonetheless the team could consider sourcing training and/or relevant literature and other material in order to further enhance knowledge and understanding. Some training is completed in-house by working though material produced by the company and taking an assessment. The manager said that staff need to attain 80 to pass, and said that he was satisfied with the quality of the training. Some training which used to be in-house had now reverted to being externally provided. At the time of the inspection training in fire safety, first aid and moving & handling were among those externally provided. Staff spoken with expressed satisfaction with the training they received. A certificate was seen confirming that in July 2006 the home was re-awarded Investor in People status. Staffing surveys returned indicated that team members were satisfied with the support that they received. Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good management of the service promotes the safety and wellbeing of the people living in the home. Various systems are in place which help to monitor and improve the quality of the service. There are a range of measures in operation which help to protect service users’ health and safety. EVIDENCE: Service users and staff spoken with were positive about the manager. Comments included that he was ‘approachable’, ‘brilliant’ and ‘really great’. Staff felt that the home was well run and had significantly improved since the new manager joined the team.
Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 25 The manager has completed the Registered Manager’s Award. He also has a degree in psychology and a diploma in the management of care services. There was evidence that the home was being well run as indicated throughout the different sections of this report. The service has a number of audit tools, both internal and external, covering different areas of operation such as finances, health & safety and medication. There is also a more wide-ranging overview audit tool. Examples of completed audits were viewed. These were seen to be detailed and the home was generally scoring well in each area. Some recommendations from these audits were seen to be documented and acted upon. Minutes were seen for some recent residents’ meetings. The organisation also has a wider-ranging forum for people using the services, with representatives from different homes. One person from Forest House was involved in this, though it was reported that some recent meetings had been postponed or cancelled. Reports of visits made under Regulation 26 are being forwarded to CSCI. New policies were seen to be in place about different aspects of health and safety such as use of equipment, safer handling and violence/aggression. There was also a new general health and safety policy dating from August 2006. As noted, there is a regular health and safety audit of the home. One was due in the weeks following the inspection. A new fire safety file was seen. This included a fire risk assessment and action plan from early 2007 as well as satisfactory records of tests and drills. Portable appliance testing took place in August 2006. The manager said that there had been a wiring check three years ago. Staff spoken with said that they had no health and safety concerns other than about carrying hot objects across the kitchen (see ‘environment’ section). A requirement had been made in the last report to either repair or keep closed the fire door between the kitchen and the hall, rather than prop it open. The manager said that there had been a delay in getting this work done but provided documentary evidence that it was scheduled for May 2007. The requirement is therefore not repeated on the understanding that the work will be undertaken then. Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 27 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. 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 YA6 Good Practice Recommendations Aim to type care plans as far as possible (including the new person-centred formats being implemented). Staff could be offered support and training with computer literacy if necessary. There should be a renewed focus on health action planning for the people living in the home. Review PRN protocols signed by the GP in cases where these have been signed some time ago. Review and update complaints procedures in use in the home. Undertake a risk assessment about the issues around carrying hot pans and other items from the hob to the sink in the kitchen as discussed in text. Act on findings. More staff should be offered the opportunity of taking NVQ qualifications in health and social care. Consider sourcing training and/or relevant literature and other material about acquired brain injury in order to further enhance staff members’ knowledge and understanding of the condition. 2 3 4 5 6 7 YA19 YA20 YA22 YA24 YA32 YA35 Forest House DS0000016440.V335567.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 House DS0000016440.V335567.R01.S.doc Version 5.2 Page 29 - 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!