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Inspection on 10/03/06 for Forest Place Nursing Home

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

This inspection was carried out on 10th 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

Forest place provides open and friendly care services. Service users` health needs are well met and monitored and there are good connections with other local health care providers. Medication is well organised and delivered. Residents praised the staff and then care that they receive. "They`re (the staff) all very good.. and at night." "Rooms are nice" "I know can ring at any time to speak to her (relative) they take the phone to her." "I don`t eat much but the food is very nice."

What has improved since the last inspection?

Care planning for respite care residents are detailed and are reviewed. The laundry floor has been repaired. Residents personal money accounts are up-to date. Cleaning materials were appropriately put away.

What the care home could do better:

There needs to be an annual development plan based on the feedback that is received from residents, relatives and other stakeholders. Activities need to be provided that take account of the individual residents needs and be provided throughout the home on a regular and planned basis.

CARE HOMES FOR OLDER PEOPLE Forest Place Nursing Home Roebuck Lane Buckhurst Hill Essex IG9 5QN Lead Inspector Clare Walker Unannounced Inspection 10th March 2006 09:30 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 Place Nursing Home DS0000015391.V283075.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 Place Nursing Home DS0000015391.V283075.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Forest Place Nursing Home Address Roebuck Lane Buckhurst Hill Essex IG9 5QN 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) 0208 5052063 0208 559 0193 Martlane Limited Mrs Kanagathevi Obeyesekere Care Home 72 Category(ies) of Dementia - over 65 years of age (30), Learning registration, with number disability (1), Physical disability over 65 years of of places age (41) Forest Place Nursing Home DS0000015391.V283075.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. One named person, under the age of 65 years, who requires care by reason of a learning disability Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 41 persons) Persons of either sex, aged 65 years and over, who require nursing care by reason of dementia (not to exceed 30 persons) The total number of service users accommodated must not exceed 72 persons 9th November 2005 Date of last inspection Brief Description of the Service: Forest place is registered to provide nursing care and does so to older people who need nursing care due to physical illness or dementia. This home is a two-storey building with a large extension at the rear of the property. A second floor to this extension has just been completed increasing the potential number of beds for residents to 90. All rooms are single some with en-suite facilities. The home has it’s own gardens to the side and rear and car parking for visitors. The local shops are a mile away as is the railway and London transport underground services. . Forest Place Nursing Home DS0000015391.V283075.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspector took 6 hours and was carried out in one day. During the course of the inspection the inspector spoke to 5 residents, 3 relatives, 2 activities organisers, a support manager, a nurse, the registered manger and the proprietor. A tour of the building was undertaken which included looking at the new facilities and rooms on the second floor that as yet have not been occupied. Care files were reviewed as were health and safety requirements. Overall all the standard of care was found to be good. Both residents and relatives that they were satisfied with the level and quality of the care and said that food was good. What the service does well: What has improved since the last inspection? Care planning for respite care residents are detailed and are reviewed. The laundry floor has been repaired. Residents personal money accounts are up-to date. Cleaning materials were appropriately put away. Forest Place Nursing Home DS0000015391.V283075.R01.S.doc Version 5.1 Page 6 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 Place Nursing Home DS0000015391.V283075.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 Place Nursing Home DS0000015391.V283075.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): 1,2,3,4,5,6 There is comprehensive information given to enable prospective residents to make an informed choice. Clear assessments of need are made prior to residents moving into the home. EVIDENCE: The statements of purpose and service users’ guide are comprehensive and up to date. Each person has a statement of terms and conditions were they take a place at the home. All files reviewed demonstrated that an assessment of need is carried out prior to a person moving into the home. The manager usually undertakes this. People are given the opportunity to view the home before moving in. Intermediate care is not offered. Forest Place Nursing Home DS0000015391.V283075.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): 7,9,11 All plans examined showed that health and personal care needs are catered for. EVIDENCE: The care plans tracked showed that personal; social and health needs are documented in the care plans and are regularly reviewed. There are robust medication procedures that the senior spoken to was ably able to outline and explained why the system was as it was. All those dealing with medication are nursing trained. Files showed that questions about how an individual would like their death managed are asked when a person joins the home. Staff are training to offer palliative care and the unit is currently part of a community palliative care programme, which is part of a national initiative. Forest Place Nursing Home DS0000015391.V283075.R01.S.doc Version 5.1 Page 10 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 Activities in the home need to be move planned and be informed by care plans. Service users can exercise control over their lives. EVIDENCE: There were 2 activities co-ordinators in the home on the day of inspection. There were some activities in progress on a 1-1 basis and group activities. However the plan for the week was not accurate. In discussion with the workers it was clear that changes had been made to the way activities were to be provided but these were not clear to the workers themselves, the manager or the service users. The activities organisers spoken with did not base the activities they provide on the needs and preferences of individuals as recorded in the care plans. Neither co-ordinator had any training in providing activities to people with dementia. There was evidence of family and friends visiting within the home both through observation, discussion and from the visitor’s book. Residents said that they had choice over rising and bedtimes, whether to take part in activities and the fact that there were always choices in relation to food. “We get to choose when we go to bed.” Forest Place Nursing Home DS0000015391.V283075.R01.S.doc Version 5.1 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Complaints are recorded and demonstrate a commitment to improving the service to residents. EVIDENCE: Complaints are recorded. The manager showed her commitment to ensuring all complaints are handled within the time frame of the complaints procedure. There is one current complaint being investigated by the proprietor. Service users have their civil rights protected through being on the electoral register. Staff are aware of the issues with regard to the abuse of vulnerable adults. The manager ensures this training is carried out. Forest Place Nursing Home DS0000015391.V283075.R01.S.doc Version 5.1 Page 12 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): 19,26 The environment for the residents is generally good. The home is clean. EVIDENCE: The service users have a safe and well-maintained environment. All concerned say the disruption caused to residents by the new extension has been minimal. The new rooms are ready for new residents and look to be of a high standard of furnishings. The home was clean and hygienic. Forest Place Nursing Home DS0000015391.V283075.R01.S.doc Version 5.1 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,30 Staff numbers, skill mix and training are appropriate to maintain service user safety. EVIDENCE: The rota’s show that there are always 3 qualified staff on duty and 13 care assistance during the day and at night 3 qualified persons and 5 care assistants. The numbers of staff available during the inspection was appropriate to the level of residents needs. No agency staff are used to cover vacancies, shifts are always covered from within the staff group. Several staff are employed as care assistants who have trained as nurses in their home country and are undertaking adaptation courses to enable them to register as nurses in the United Kingdom. Statutory training is provided on an annual basis. All staff when they join the unit have an orientation and induction course. Over 90 of care staff hold a National Vocational Training award level 2. Alongside statutory training there are in-house trainings, which include care of individuals with dementia. Forest Place Nursing Home DS0000015391.V283075.R01.S.doc Version 5.1 Page 14 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): 31,32,33,34 Management and administration procedures within the home protect residents and ensure the efficient running of the business. EVIDENCE: There has been no change in management at the home. There is clear leadership and the manager has an open and clear management style. There was observed to be good rapport between staff and residents and between staff and managers. The personal monies handled have a clear accounting system and overall the systems discussed with and shown to the inspector were clear and that levels of responsibility/accountability were clear. There is a quality assurance questionnaire, which has been sent out to service users and relatives however there was no evidence of how feedback is used to form an annual development plan for the unit. In fact there appears to be no current development plan and the analysis of questionnaires was not available. Forest Place Nursing Home DS0000015391.V283075.R01.S.doc Version 5.1 Page 15 Forest Place Nursing Home DS0000015391.V283075.R01.S.doc Version 5.1 Page 16 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 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 4 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 X X X X Forest Place Nursing Home DS0000015391.V283075.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP12 Regulation 16(2)(m) Requirement Timescale for action 31/05/06 2 OP33 24(1a-b) The registered manager must ensure that 1) a planned and co-ordinated programme of activities takes place within the home 2) the programme of activities is widely advertised within the home 3) activities that are provided include individual preferences as outlined in the care plans The registered manager must 31/05/06 ensure that an annual development plan is produced that is based on the feedback from the quality assurance questionnaires. 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 Good Practice Recommendations DS0000015391.V283075.R01.S.doc Version 5.1 Page 18 Forest Place Nursing Home 1 Standard OP12 The register manager should consider obtaining a training course on dementia for the activity co-ordinators. Forest Place Nursing Home DS0000015391.V283075.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Place Nursing Home DS0000015391.V283075.R01.S.doc Version 5.1 Page 20 - 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. 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