Inspection on 06/09/06 for Foresters

This inspection was carried out on 6th September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Foresters 21/04/08

Foresters 15/02/06

Foresters 01/09/05

Foresters 10/03/05

Foresters 16/12/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Foresters 18-20 Alexandra Road Weymouth Dorset DT4 7QQ Lead Inspector Marion Hurley Key Announced Inspection 6th September 2006 10:00 DS0000020466.V305435.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 DS0000020466.V305435.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. DS0000020466.V305435.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Foresters Address 18-20 Alexandra Road Weymouth Dorset DT4 7QQ 01305 777189 F/P01202 777189 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) Dorset Residential Homes Ms Sara Ann Harpley Care Home 15 Category(ies) of Learning disability (15) registration, with number of places DS0000020466.V305435.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three named service users (as known to CSCI) in the category of LD(E) may be accommodated to receive nursing and personal care. 15th February 2006 Date of last inspection 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. DS0000020466.V305435.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key announced inspection that took place at the home over a period of five hours. Additionally, time was spent in preparation for the visit, looking at previous inspection reports and Regulation 37 and 26 reports and other relevant documents. This inspection looked at the designated core national minimum standards. The inspection methods used included observation of residents and staff, record checks, case tracking and discussions with the manager and staff. Five residents were at home during the inspection though two went out during the course of the morning. Staff demonstrated throughout the inspection process their excellent understanding of the residents’ personal needs and abilities and there was clearly a good rapport between staff and residents and visiting relatives and professionals. Professionals, relatives and residents returned twelve comment cards. All indicated a high level of satisfaction with regard to the services, facilities and staffing provided at Foresters. One raised personal issues, which are being addressed directly with the manager of the home. Records relating to staff training and recruitment, care planning and daily recording, medication, health and safety were examined and were accurately maintained. A tour of the home was completed and all areas were clean and hygienic. The bedrooms were personalised and reflected the different interests of the residents. A copy of the last inspection report is available directly from Foresters or from Dorset Residential Homes head office in Dorchester. Current fees are £987:00 but may vary according to the individual’s support needs. DS0000020466.V305435.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Staff continue to maintain a very positive and caring relationship with all the residents. Safe working practices are evident and have been well maintained since the last inspection, with evidence of training and testing of equipment being regularly completed. The key-worker system continues to work well ensuring residents benefit from regularly one to one time with their designated worker. The alterations to the bathrooms on the ground and first floor have successfully been completed. New staff have successfully been recruited who have settled well into the established staff team. DS0000020466.V305435.R01.S.doc Version 5.2 Page 7 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. DS0000020466.V305435.R01.S.doc Version 5.2 Page 8 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 DS0000020466.V305435.R01.S.doc Version 5.2 Page 9 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 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. The home/organisation (DRH) has an admissions policy that complies with the regulations. EVIDENCE: Many of the residents have lived at Foresters for several years. The last person to move in settled well and has now become part of this established group. There is no anticipated change for this group of residents. The manager and staff confirmed their knowledge and understanding of the principles and good practice for admission procedures. Dorset Residential Homes’ policies and procedures are scheduled for review in October 2007. The current procedures are comprehensive and if implemented would ensure any prospective resident would only be considered or offered a place if the manager and staff felt they were able to meet that person’s assessed needs through the staffing and services and that the person would compliment the established group of residents. DS0000020466.V305435.R01.S.doc Version 5.2 Page 10 A random selection of the terms and conditions/contracts were checked and the address and details of the CSCI were incorrect – this needs to be changed and copies in the residents’ files should be signed. For most people living at Foresters a representative would need to sign the contract on their behalf. DS0000020466.V305435.R01.S.doc Version 5.2 Page 11 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 the following standard(s): 6, 7, and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has life support/care plans in place that reflect the assessed needs of the residents. The staff are committed to supporting and involving the residents in making decisions about their lives. Risk assessments are used positively to further independence and opportunities. EVIDENCE: Two residents’ Life support plans/care plans were read. The records contained comprehensive information and there was evidence that the plans were regularly reviewed. Risk assessments were contained in the files. DS0000020466.V305435.R01.S.doc Version 5.2 Page 12 The home has taken steps to make the plans more person centred with residents involved in developing and preparing their own plans within their own abilities and understanding. All records seen were well maintained and showed that the staff team operate a good system of recording and those checked were up to date. The support plans contained details of weekly and daily routines, the level of support required by each person to complete tasks, details about relationships, family contacts, health professional involvement, communication needs, their “work” and occupation, self help skills and mobility. A letter “prompting” people attending the residents’ reviews is circulated in advance and serves as a reminder of all the aspects of the person’s life, which might be discussed at the review. This is a good idea though it is suggested the correspondence and prompts are a little more personalised for each resident. It was evident when speaking and observing staff working with the different residents that each person in their own way is totally supported and encouraged to make their own decisions and choices. DS0000020466.V305435.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is good. The quality for standard 17 is excellent. The standard of meals and the management of the kitchen are excellent. All food is purchased locally and bought fresh. This judgement has been made using available evidence including a visit to this service. The home supports residents to lead individual lifestyles with a range of activities, which are appropriate to residents’ needs, age and are driven by individual choice. A wide variety of activities and community links help ensure that residents are informed about the opportunities that are possible. The range of activities and choice in daily routines enables residents to maximise their independence. DS0000020466.V305435.R01.S.doc Version 5.2 Page 14 EVIDENCE: The records showed that a great variety of holidays and different outings have been enjoyed by the residents since the last inspection. This has included holidays to Ireland and the Isle of Wight, plus a variety of day trips to national exhibitions, concerts, and theatre trips in addition to many local outings. Staff said residents particularly liked going out for “pub suppers” and those residents spoken with indicated they enjoy their own routines and equally enjoyed going out. They appeared relaxed and were being encouraged to be involved in different activities. On the day of the inspection one resident was going out with his family. The staff support residents to maintain family contacts both through visits and telephone calls. These contacts are recorded in the personal files. Residents are encouraged to make decisions about their daily routines and can choose to spend time alone or in the communal areas of the home. The home provides leisure and entertainment equipment including televsion, videos, DVDs, music systems and also a large garden and summer house. The kitchen is managed by three part time cooks and from discussions with the cook on duty on the day of the inspection this works very well. The kitchen was well stocked with fresh produce and the menu’s reflected personal tastes yet ensuring a well-balanced and healthy diet. The cooks have a copy of the residents’ goal plans, which identify their likes and dislikes and any specific needs or equipment required to ensure a pleasant mealtime for each resident. Based on this information and their own knowledge of the residents the cooks prepare a different menu every six weeks. All meals are home produced and the cooks use all local suppliers and fresh deliveries for all foods. Even the weekly treat of fish and chips are homemade. All related records are clearly well maintained and up to date and it should be noted Weymouth & Portland Borough Council awarded a Gold Star reflecting the high standard of hygiene in this kitchen. From observing residents and talking to staff and examining care plans it is evident that the daily routines are based on personal needs and wishes and promote choice. Individual files contain details of the various activities enjoyed by the residents. DS0000020466.V305435.R01.S.doc Version 5.2 Page 15 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 the following standard(s): 18,19, and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal care and health needs are met through support from staff and outside professionals. Changing needs are assessed to ensure that appropriate action can be taken. The home has a medication administration and storage system that is safe and complies with the regulations. EVIDENCE: It was evident on the day of the inspection that staff have a very positive relationship with the residents. Residents indicated they are able to choose what they want to wear and are able to choose what time they go to bed and what time they get up in the morning dependent on pre-arranged activities or days at the Social and Educational Centre. The personal care required is detailed in the individual support plans and where required re-assessments take place relating to moving and handling. DS0000020466.V305435.R01.S.doc Version 5.2 Page 16 The records showed the residents have regular health checks and are supported to attend appointments. All medication was correctly stored and the records were accurate and up to date. No residents’ currently self medicate however the home has a process in place to assess the ability of residents who maybe able to self medicate and support the practice if implemented. The home keeps a clear record of medication received and is administered by suitably trained staff. DS0000020466.V305435.R01.S.doc Version 5.2 Page 17 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 the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Listening to residents’ views and addressing any complaints ensures that the service develops to meet the residents’ needs. EVIDENCE: Staff spoken with very clearly described how they listen to the residents and have come to understand the residents’ non-verbal behaviours and gestures, which indicates the resident’s pleasure or dislike of a situation. The organisation has a detailed policy and procedures to address complaints, and adult protection issues and the manager and staff spoken with indicated their practical working knowledge of the procedures. All new staff as part of the induction receive specific training in Understanding abuse, it is recommended that all staff receive regular refresher training. DS0000020466.V305435.R01.S.doc Version 5.2 Page 18 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 the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and homely setting that is well maintained and meets the needs of the residents. The clean and well-maintained environment contributes to the quality of care and support being provided. The home provides a high standard of communal accommodation that promotes independence but also supports group living. EVIDENCE: The home provides spacious accommodation that allows residents to live comfortably as a group but also retain a degree of privacy and quiet if they wish. The home is generally well maintained and provides a safe, comfortable, large bright and homely environment. The home was clean and hygienic throughout. DS0000020466.V305435.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by an organised and motivated staff team. Staff training and supervision help provide staff with the required skills to support the residents. EVIDENCE: The home is fully staffed. The manager explained that all new staff undertake induction and foundation training leading onto NVQ training. All staff are up to date with the required mandatory training. At the time of the inspection there were sufficient staff on duty to meet the needs of the residents. The rotas showed that these levels are maintained. The home has regular staff meetings which residents are free to join in if they wish. DS0000020466.V305435.R01.S.doc Version 5.2 Page 20 The staff records were examined and contained all the required information in relation to recruitment and training. Staff training records were seen and provided evidence that all mandatory training is regularly completed. Staff were observed relating to residents in a positive manner and residents and staff appeared comfortable and confident in their relationships. Rotas evidenced that there are sufficient staff on duty to meet residents’ needs and staff and where possible resident confirmed this information. DS0000020466.V305435.R01.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Regular safety checks ensure that residents live in a safe environment. Valuing opinions from residents and visitors and staff ensures that the service develops with the changing needs of the residents. The home has some quality assurance systems in place but these could be expanded and formalised. DS0000020466.V305435.R01.S.doc Version 5.2 Page 22 EVIDENCE: Regulation 26 inspections have been completed and copies supplied to the home and the Commission. The home continues to be professionally managed with a clear commitment to meeting the needs of the residents and promoting choice and independence where possible. The manager has an organised and structured approach to managing the home and was clear of the tasks, checks and procedures that have to be completed over a twelve month period. These are all scheduled in on a monthly basis, with some tasks being delegated to senior staff. All health and safety testing and recording has been completed. All fire safety records were up to date and all equipment had been tested and serviced. All environmental risk assessments were up to date and appropriately reviewed. DS0000020466.V305435.R01.S.doc Version 5.2 Page 23 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 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X DS0000020466.V305435.R01.S.doc Version 5.2 Page 24 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 YA22 Good Practice Recommendations It is recommended that all staff receive refresher training in the Protection of Vulnerable Adults. Please note since this inspection a series of workshops have been arranged. The quality assurance system and consultation needs to be formalised and recorded to demonstrate the work. 2 YA39 DS0000020466.V305435.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole 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 DS0000020466.V305435.R01.S.doc Version 5.2 Page 26 - 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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