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Inspection on 01/09/05 for Foresters

Also see our care home review for Foresters for more information

This inspection was carried out on 1st September 2005.

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

Foresters has an established and stable staff team many of whom have worked at the home for several years. The Registered Providers, Dorset Residential Homes with the support of the staff maintain a relaxed and homely atmosphere whilst ensuring the National Minimum Standards are achieved. Staff demonstrated skills of comfortably working side by side with residents in making and supporting daily decisions. This group of residents have varying abilities, needs, likes and dislikes and all these details were reflected in their Individual Profiles, Assessments and daily notes. These records clearly demonstrated good multidisciplinary work was taking place on a regular basis. Residents are encouraged to be as independent and active as possible participating in a range of social and leisure activities. Foresters provides a genuine "needs-led service" ensuring each resident has individual one to one time with their designated key worker.

What has improved since the last inspection?

Since the last inspection an informative reference file has been compiled which is available for all current residents and prospective residents and their representatives. The OK Health Assessment is being re-formatted which will improve some of the language used i.e. reference "to the client". New furniture and flooring has been provided for the communal lounge improving and brightening this room.

What the care home could do better:

The Plans to refurbish the bathrooms need to come to fruition as soon as possible and the floor covering in Oakwood side on the landing, stairway and hallway needs to be considered for upgrading. From observations and discussions with staff it is clear that residents are actively consulted in daily decision making however the records do not do justice to this positive work. Consideration needs to be given to the presentation of information which is specific for the residents i.e. the newly compiled information file for prospective residents would not give a person a real feel of the life at Foresters.

CARE HOME ADULTS 18-65 Foresters 18-20 Alexandra Road Weymouth Dorset DT4 7QQ Lead Inspector Marion Hurley Unannounced 01 September 2005 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 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 Stationary 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. Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Foresters Address 18-20 Alexandra Road Weymouth Dorset DT4 7QQ 01305 777189 01305 777189 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Dorset Residential Homes Ms Sara Ann Harpley CRH N - Care Home with Nursing 15 Category(ies) of LD Learning disability (15) registration, with number of places Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user within the category LD(E) [Learning Disability over 65] may be accommodated. Date of last inspection 10 March 2005 Brief Description of the Service: Foresters is a care home registered with the Commission for Social Care Inspection to provide personal care, nursing care and accommodation to 15 learning disabled adults who may also have emotional and behavioural needs. The home is operated by Dorset Residential Homes, a registered charitable trust that operates a number of care homes in Dorset. Foresters is located in a residential area of Weymouth within walking distance of the town centre. The property is made up of 2 large semi-detached Victorian houses that have been altered internally to form one house. The home provides 15 places for service users. The home is staffed by a team of registered learning disability nurses and care staff who provide 24-hour care and support. Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection has been undertaken as part of the statutory inspection process in accordance with the Care Standards Act, 2000. Foresters was assessed according to the Care Homes for Adults (18-65), National Minimum Standards. The overall time spent to complete the inspection process was a total of seven hours, three of which were spent at Foresters. Six residents and four staff were present during this inspection. The residents chose not to specifically participate however all were observed side by side with staff throughout the visit. The Deputy Manager was available and provided information and access to all records requested. A tour of the premises and grounds was conducted with the Deputy Manager. Foresters offers a homely domestic style residence for up to 15 people with varying abilities and needs. The premises and grounds are suitable for the current group of people and the facilities and services meet their individual and collective needs. From observations both staff and residents appear to enjoy a positive level of satisfaction with their lives and work and are comfortable and relaxed in each other’s company. The inspector was grateful for the time and support provided by residents, staff and the deputy manager throughout this inspection visit. One Requirement (YA1) has been carried forward as this standard was not assessed at this inspection and a further Requirement (YA24) remains but it should be noted that work is in progress to meet this standard. What the service does well: Foresters has an established and stable staff team many of whom have worked at the home for several years. The Registered Providers, Dorset Residential Homes with the support of the staff maintain a relaxed and homely atmosphere whilst ensuring the National Minimum Standards are achieved. Staff demonstrated skills of comfortably working side by side with residents in making and supporting daily decisions. This group of residents have varying abilities, needs, likes and dislikes and all these details were reflected in their Individual Profiles, Assessments and daily notes. These records clearly demonstrated good multidisciplinary work was taking place on a regular basis. Residents are encouraged to be as independent and active as possible participating in a range of social and leisure activities. Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 6 Foresters provides a genuine “needs-led service” ensuring each resident has individual one to one time with their designated key worker. 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. Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 • Prospective residents and or their representatives are provided with sufficient information to make informed decisions about whether or not the home is somewhere they may chose to live. EVIDENCE: Dorset Residential Homes have produced a new practical publication entitled DRH Foresters, A Guide for Residents. This manageable booklet contains essential information for both prospective residents and those already residing at Foresters. The publication is written in plain English and includes several graphics/symbols however, for many residents this format and the concept of a Residents Guide would still prove difficult to comprehend. In addition a comprehensive file has been complied containing more detailed information for prospective and existing residents and their representatives. Staff confirmed this information is offered to anyone interested in finding out more about the services and facilities available at Foresters. Both publications were readily available and read on the day of the inspection. There have been no new residents moving to Foresters since the last inspection. Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 & 9 • • Each resident has a Personal Profile, containing information, which reflects the support they require to manage their daily and personal needs. Residents are encouraged and supported to make decisions affecting their daily lives which enable them to retain as much independence as possible. Whilst this was evident in practice, there were not sufficient records confirming this good practice. Each resident has a completed Risk assessment checklist • EVIDENCE: Two sets of resident’s records were read and discussed with staff. Both contained comprehensive information and specific assessments i.e. Relationships and Sexuality Assessment and Health & Safety/Well Being Assessment/Plan. Both the RAS Assessment/Plan and the Personal Support Plan (Environment) included specific reference to individual communication styles. The Personal Profile provided an excellent picture of the resident describing in the first person their practical daily living needs, their interests, and likes and dislikes. The resident’s representatives had signed consent forms i.e. opening post. Each resident has a diary for appointments/ activities and daily notes are kept in addition. Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 10 The style of these plans is not presented in a way, which makes them understandable for the majority of the residents living at Foresters and whilst written in the “ first person” there is no record to indicate the process or the communication methods used to consult with each resident in developing their Plan. Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13 &14 • • • The home provides a high level of flexible personal support to residents, which provides many opportunities for personal development. Residents pursue a variety of daytime occupations, which include attendance at Social and Educational Centres. This provides further opportunities to pursue activities and socialise with their peers. Residents have a choice of holidays and outings, which reflect their interests identified in their Personal Profiles. EVIDENCE: On the day of this inspection a group of residents and staff were visiting Thorpe Park. Throughout the summer various outings have been organised with the residents and have included several local trips plus longer ones to London and Jersey. All the residents have individual weekly programmes which link to their likes and dislikes identified in their Personal Profiles. Participation in regular activities are then checked off on their individual Activity Checklist. In discussion with staff and through observations made during the inspection, it was evident that flexible personal support is provided to residents and Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 12 wherever possible residents are encouraged to make everyday decisions. One resident explained their plans for their forth-coming birthday celebrations. Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 & 19 • • The home offers a good standard of personal support with individual preferences being taken into account. Resident’s healthcare needs are provided for including those with more complex physical and emotional needs with evidence of positive multidisciplinary work regularly recorded. EVIDENCE: Resident’s personal care needs are identified in their Personal Profiles, the Well Being Plan and in the Health OK assessment. Medication details are also listed. Staff spoken with demonstrated a good understanding of the personal and healthcare needs of residents living at the home and confirmed that residents receive personal support in a way that suits their preferences and needs. There was further evidence of liaison with healthcare professionals and other members of the Community Multi-Disciplinary Teams and a record of appointments were all noted. A GP routinely visits Foresters and regularly reviews both the medication and general health needs of each resident. Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed at this inspection and will assessed at the next inspection. EVIDENCE: Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 • • • Foresters is a comfortable and homely property, which provides suitable accommodation for the current group of residents living there. The home offers a good complement of communal space that is freely accessed by all residents. The home was found to be clean and hygienic on the day of the inspection. EVIDENCE: Resident’s live in a homely environment with sufficient private and communal space comprising, a good size lounge, separate dining area, kitchen, specially equipped sensory room, and a further room which residents may use as they wish for a quiet time or specific activities. The home is attractively decorated and each bedroom has been personalised. There are 11 single bedrooms and two shared rooms. There is a large rear garden, with a range of garden equipment and furniture. The garden is fully accessible for all the residents. At the time of this inspection Arjo representatives were on site to discuss plans to refurbish two of the bathrooms. All residents have the opportunity to retain a bedroom key and have a lockable facility however, only one person has chosen to do so. The lounge has been Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 16 decorated and new furniture purchased. The carpet in the communal areas on “Oakwood side” should be considered for replacement. A tour of Foresters found the premises clean and hygienic throughout Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed at this inspection and key standards will e assessed at the next inspection. EVIDENCE: Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 • Health and safety records examined demonstrated safe working practises were in place and implemented thereby protecting residents and promoting their well being. EVIDENCE: The health and safety records examined indicated that the health, safety and welfare of the residents is safeguarded as far as practical through the regular monitoring and safety checks of equipment/services and ensuring the mandatory training of all the staff. Fire prevention records were clear and risk assessments had been completed both for aspects of the environment and specifically for individual residents. On the day of this inspection the staff fire training records were not fully located, though staff stated all training was up to date. Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x x x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Foresters Score 3 2 x x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 20 NO Are there any outstanding requirements from the last inspection? 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 2 Regulation 18 Requirement All staff must be aware of the homes aims and objectives and philosophy of care as outlined in the Homes Statement of Purpose. This standard was not assessed at this inspection and therefore the requirement has been carried forward with a new timescale. Floor covering in the first floor shower room & Malibu bathroom must be replaced. PLEASE NOTE WORK IS IN PROGRESS TO MEET THIS REQUIREMENT. Timescale for action 30:11:05 2. 24 13(4) 31:12:05 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 1 & 22. Good Practice Recommendations Dorset Residential Homes should continue to develop the Service User Guide and other documents i.e Complaints procedure in formats that residents may more easily understand Care & Personal Profiles and Support Plans should detail the consultion which takes place with the residents. D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 21 2. 6&7 Foresters Commission for Social Care Inspection Unit 4 New Fields Business Park Stinsford Road Poole Dorset BH17 0NF 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 Foresters D55 S20466 Foresters V246618 010905 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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