Inspection on 01/03/07 for Forest View

This inspection was carried out on 1st March 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Forest View 29/10/07

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Forest View Southway Burgess Hill West Sussex RH15 9SU Lead Inspector Mrs K Allen Unannounced Inspection 1st March 2007 09:45 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 View DS0000068372.V330562.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 View DS0000068372.V330562.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Forest View Address Southway Burgess Hill West Sussex RH15 9SU 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) 02920 364411 Shaw Healthcare Ltd Mrs Paula Patricia Devonport Care Home 60 Category(ies) of Dementia - over 65 years of age (60), Old age, registration, with number not falling within any other category (60) of places Forest View DS0000068372.V330562.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That from time to time the service may admit up to maximum 5 persons from the age of 60 years. Date of last inspection Brief Description of the Service: Forest View is a care home registered to provide care and accommodation for up to sixty older people over the age of 60. The majority will need care due to their dementia. It is a new purpose built property in its own grounds located in a residential area of Burgess Hill, West Sussex. It is near to local shops and a short distance to the town centre. The home is divided into six units each of which has its own open plan kitchen, dining room and lounge. All residents have their own room with en-suite facilities either on the ground or first floor. Both floors are serviced by two passenger lifts. In addition, there is a separate day care unit which is used by some of the residents for activities. There are grounds to the rear and side of the property which are yet to be landscaped but are secure so that residents can use the area safely. Forest View DS0000068372.V330562.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the site visit a review was made of the contact between the home and the Commission for Social Care Inspection (CSCI) since its registration. This included an analysis of incident reports and those of other statutory bodies such as the fire service as well as any complaints. The manager completed a pre-inspection questionnaire prior to the visit which gave up to date information about the home. The visit took place over eight hours during which time fifteen residents were spoken to individually, either in communal areas or in the privacy of their own room. A discussion was held with five visitors and three staff were interviewed. Day to day interaction was observed in two units and an interview was held with the manager. In addition a number of records were seen. Residents said “I am treated like a queen”, “It’s brilliant here”, “there’s always someone to help” and “I can do more or less what I like”. Three requirements have been made and these are given under ‘What they could do better’ below. What the service does well: What has improved since the last inspection? What they could do better: All medication given must be recorded accurately. Opportunities must be made to provide for residents social interests so that they lead fulfilled lives. Staffing levels must be improved to ensure the safety and well being of residents. Forest View DS0000068372.V330562.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Forest View DS0000068372.V330562.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 View DS0000068372.V330562.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): 3 & 6. Quality in this outcome area is good. No resident moves into the home without having their needs assessed first. Intermediate care is not provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A written assessment was available for all residents whose files were sampled. They contained information on physical and mental wellbeing as well as daily living skills. The manager confirmed that whilst the home has three respite care beds it does not provided intermediate care. Forest View DS0000068372.V330562.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. Residents’ health, personal and social care needs are set out in an individual plan of care and their health needs are met. They are not always protected by the homes medication procedure. Residents feel they are treated with respect and their privacy is upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A written care plan was available for all residents whose file was sampled. This included a ‘night care plan’ which ensured that, amongst other things the sleeping environment was geared to the individual eg open/closed window. Staff stated that they used the care plan to familiarise themselves with residents needs and that they recorded how these were met on a daily basis. Care plans were regularly reviewed and changes made accordingly. Care staff support residents in maintaining good personal hygiene. An individual assessment is made with regard to the risk of pressure areas and this is regularly reviewed. Staff were able to describe the steps they need to take in order to prevent pressure areas, particularly for those who spend long periods in bed. Equipment is provided such as ripple mattresses and special Forest View DS0000068372.V330562.R01.S.doc Version 5.2 Page 10 cushions. However, whilst most residents are mobile there were no arrangements in place to ensure that they got regular exercise. (see requirement 2) Residents are assessed with regard to their continence and steps taken to manage any problems. Everyone is registered with a doctor and specialist help is obtained as necessary eg psychiatrist, chiropodist as well as access to the optician and dentist. Residents are assessed with regard to looking after their own medication, however staff manage this in the majority of cases. Good storage facilities are provided and only senior staff who are trained, administer medication. Records were poorly kept however and showed that whilst medication had been given it had not always been recorded as such. In one instance, morning medication was given at lunchtime as the person had been asleep, but this was signed as being given in the morning. These matter were brought to the attention of the manager who confirmed that she would address the issues urgently to ensure that accurate records are kept. Staff approached residents in a respectful manner which was considerate and caring. Residents described staff as “kind”, “marvellous” and “helpful”. Residents preferred form of address is recorded and used by staff. Staff knocking on their doors, the provision of locks on all bathrooms and toilets and having use of their own room and en-suite facilities residents’ privacy. Forest View DS0000068372.V330562.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. Residents do not always find the lifestyle they experience at the home matches their expectations. They maintain contact with family and friends and can exercise some choice and control over their lives. Satisfactory meals are provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Daily living routines are flexible with one person stating that he can do ‘more or less what I want’. Although the home is divided into six units residents can access all parts of the home at any time. They also have opportunities to attend the day centre on an ad hoc basis. A church service is held at the home each month. However, there is no programme of planned activity available at the home and therefore opportunities to pursue leisure interests are very limited. One person said he used to enjoy exercise classes before moving in and would appreciate the chance to continue these. Staff said they take residents out if they have an appointment but rarely for pleasure. Staffing levels mean that providing uninterrupted time with individual residents is limited to essential tasks such as personal care. This was discussed with the manager who confirmed that an activities co-ordinator had been appointed and was due to start work at the Forest View DS0000068372.V330562.R01.S.doc Version 5.2 Page 12 home on March 5th. However, this will be a part–time position and other staff will be needed to ensure a reasonable programme is implemented. The inspector spoke to five people including relatives and friends of residents. They all said that they found the home to be satisfactory and that they were welcome at the home at any time. One person was slightly concerned that they often had to wait at the door for sometime before being let in but said that he could approach the manager about this if he wanted to. Resident’s money is managed by relatives or other representatives such as solicitors, however small amounts are received at the home on residents behalf. This is safely stored and accounted for. A full-time cook is employed as well as kitchen assistants all of whom have a food hygiene certificate. Residents receive three meals and drinks throughout the day. A menu is available offering residents a choice which they make prior to each meal. However, the menu on the tables was out of date and this could have been confusing for residents. Special diets are catered for. Meals are cooked in a central kitchen and delivered to each unit in a hot trolley with care staff then serving the meal up in each unit. The arrangements for serving the meal were disorganised and meant that one person got the wrong meal (which was subsequently changed) and staff were seen to directly handle the food on three occasions. This was drawn to the attention of the manager who agreed to follow it up with the staff team concerned. Forest View DS0000068372.V330562.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. Residents and relatives are confident that their complaints will be listened to. Residents are potentially at risk of harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a written complaints procedure which is made available to residents and relatives. Arrangements are in place to record any complaints and the details include the steps the home has taken to resolve them. The manager holds a quarterly meeting with residents and their relatives and this ensures that any concerns can be raised and resolved directly with them. Minutes are kept of these meetings and they show that it is a very useful forum. There is a written policy and procedure for dealing with any adult protection matters. Staff were able to describe what action they would take should they suspect that someone was being poorly treated. This included reporting any incidents to the manager or her line manager should this be appropriate. Guidelines are drawn up for staff to follow should any resident present difficult or challenging behaviour. There have been two incidents when residents have left the building unescorted putting themselves at risk. In the most recent incident staff had not missed the person concerned for some time. The manager stated that all exterior doors are alarmed and was therefore unclear how residents were able to leave the premises undetected. She has reviewed the safety arrangements and briefed staff on being more vigilant. However, the staffing levels do not provide for supervision of residents at all times. Forest View DS0000068372.V330562.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is excellent. Service users live in a safe and well-maintained environment which is clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The premises are new and provide spacious accommodation. One visitor described it as resembling a hotel and another said how much bigger individual rooms were than her relatives’ previous residential home. It meets with the requirements of the fire service and environmental health department. There have been some difficulties with the premises being new but the manager confirmed that she has good links with the builders who remain responsible for the premises during it’s first year of its operation. The home is clean and hygienic throughout with no offensive odours present. There is a well-equipped laundry which is located away from food preparation areas. It has washing machines that can deal with soiled or infected linen. Forest View DS0000068372.V330562.R01.S.doc Version 5.2 Page 15 There is a sluice room on each floor both of which are equipped with a macerator. Wash hand basins are sited in the laundry and sluice rooms and soap and towels are provided. Forest View DS0000068372.V330562.R01.S.doc Version 5.2 Page 16 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 adequate. The number and skill mix of the staff does not always meet service users needs. Staff are trained to do their jobs. Residents are protected by the homes recruitment procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a written rota showing which staff are on duty at any time. There are a maximum of eight care staff on duty and this drops to six for significant parts of the day. The care staffing ratio is a maximum of one staff to ten residents and this is dictated by the allowance given to the home rather than the assessed needs of residents. It was evident that this level of staffing was insufficient as staff were seen hurrying to complete their work and residents left on their own. Staff said that they had little time to spend with them except when attending to their physical needs. There was no programme of planned activity and no opportunity for residents to go out unless taken by a relative or to attend medical appointments. As previously stated, there was one reported incident of a resident leaving the premises unescorted which went unnoticed for some time. It is still not known how this person got out of the building, particularly as the external doors are alarmed. Care staff also attend to some domestic duties including changing sheets when soiled and washing up tea and coffee cups. Forest View DS0000068372.V330562.R01.S.doc Version 5.2 Page 17 More than 50 of staff have obtained an NVQ level 2 or above and there is an on-going training programme. This includes areas such as food hygiene, infection control, medication, adult protection and first aid. A thorough recruitment procedure is followed for new staff including taking up references and a Criminal Records Bureau (CRB) check. The identity of people is verified as well as their qualifications. Forest View DS0000068372.V330562.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. The home is managed by a person fit to do so and in resident’s best interests. Their financial interests are safeguarded. Residents’ health and safety is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is qualified and has over two years experience in managing a residential care home. Residents, staff and visitors all confirmed that she was efficient, helpful and approachable. It was evident that she knew all of the residents and that they knew her. She understood who she was accountable to and was in regular contact with her senior. A quality audit has been carried out and the outcome showed that the service was being satisfactorily managed. Action to be taken following this audit is recorded in a report and an action plan devised to monitor progress. Forest View DS0000068372.V330562.R01.S.doc Version 5.2 Page 19 Regular meetings with residents and staff are held and these showed that a good dialogue had been established between the management of the home and those who use its service. Plans are in hand to develop a quarterly newsletter. The home looks after money for a number of residents and all transactions are documented. The system has recently changed so that residents’ money is now pooled into a general bank account. This is not seen as good practice although it is accepted that holding small sums of money for individuals is cumbersome and requires a lot of secure space for the number of people involved. This practice should however, be agreed with residents or their relatives and reviewed regularly. Staff receive training in health and safety covering moving and handling, fire safety, first aid, food hygiene and infection control. Hazardous chemicals are safely stored, water temperature regulated and radiators covered. Risk assessment are carried out for example regarding falls, the use of hoists, personal safety and difficult behaviour. Accidents and incidents are recorded. Action has been taken to meet the recommendations of the fire service and environmental health officer. Forest View DS0000068372.V330562.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 2 28 3 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 View DS0000068372.V330562.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? N/A 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 2 3 Standard OP9 OP12 Regulation 13 16 18 Requirement All medication given must be recorded accurately Opportunities must be created to provided for residents social and leisure interests Staffing levels must be increased to meet the needs of residents Timescale for action 09/03/07 01/05/07 01/05/07 OP27 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 OP35 Good Practice Recommendations The practice of pooling residents money should be regularly reviewed. Forest View DS0000068372.V330562.R01.S.doc Version 5.2 Page 22 Forest View DS0000068372.V330562.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 View DS0000068372.V330562.R01.S.doc Version 5.2 Page 24 - 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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