Inspection on 20/02/07 for Foresters Nursing Home

This inspection was carried out on 20th February 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

Foresters Nursing Home 31/10/05

Foresters Nursing Home 30/08/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Foresters Nursing Home Foresters Walton Pool Lane Clent Nr Stourbridge Worcestershire DY9 9RP Lead Inspector Lorraine Briggs / Pat Scott Unannounced Inspection 20th February 2007 10:00 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 Foresters Nursing Home DS0000064130.V327342.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. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Foresters Nursing Home Address Foresters Walton Pool Lane Clent Nr Stourbridge Worcestershire DY9 9RP 01562 883068 01562 887474 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) Redwood Care Homes Ltd Mrs Carol Palmer Care Home 30 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (30), of places Physical disability over 65 years of age (30) Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Forresters nursing home is registered for 31 residents requiring nursing care. The home is situated in Clent, and is surrounded by extensive and wellmaintained gardens, which overlook open countryside. Accommodation for residents is provided in 24 single bedrooms; all are en-suite with the exception of one bedroom. There are three double rooms within the home. Residents sharing a bedroom have made a positive choice to share. The registered manager referred to in this report is Mrs Elizabeth Collins and is a first level nurse. The responsible individual is Huw James of Redwood Care Homes Ltd. The fee is £540 per week. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider, staff records kept in the home, medication records, discussion with people who use the service, discussions with the staff team, discussion with the manager, tour of the premises, previous inspection reports, quality assurance process, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. What the service does well: The home continues to offer a high standard of care to elderly residents with both physical and mental frailty. The home has a committed staff group who understand the needs of the residents well; the home uses agency staff infrequently. The registered manager spends time with the residents and ensures staff are aware of the needs of residents through documentation such as risk assessments and care plans. The home is clean and odour free. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Foresters Nursing Home DS0000064130.V327342.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 Foresters Nursing Home DS0000064130.V327342.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): 1, 2 and 3 Quality in this outcome area is adequate. Prospective service users and their representatives have information needed to choose a home which will meet their needs They have their needs assessed but no evidence of a contract which tells them about the service they will receive. This judgement has been made using available evidence including a visit to this service. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 9 EVIDENCE: Prospective service users are given the opportunity to spend time in the home. Records show that the staff team are qualified and experienced to work with the needs of the service user. Documentation and training logs show that specialist areas of work have been explored and that staff have access to guidance and training materials. The home provides a service user guide that provides clear information about the home. The guide is precise in what the prospective service user can expect and gives a good detailed account of the quality of the accommodation, qualifications and experience of staff and how to make a complaint. It does not contain comments and experiences of service users living at the home. But these were found within the outcomes of the quality assurance surveys. Neither does it comply with the changes in the Care Home Regulations as amended in September 2006. It must include the current fee levels. The manager stated that each resident is provided with a statement of terms and conditions prior to moving to the home but examples could not be seen. Admissions are not made to the home until a full needs assessment has been undertaken. The home is then able to confirm that they can meet the needs of the individual through the service they deliver as detailed in the service user guide. For people whom are self funding and without a care management assessment the assessment is always undertaken by a skilled and experienced member of staff. Evidence seen in care files confirms that the assessment is conducted professionally and sensitively and has involved the family or representative of the service user. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 10 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 and 10 Quality in this outcome area is good. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are generally put into practice. This judgement has been made using available evidence including a visit to this service. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 11 EVIDENCE: Four care plans were examined. The plan in most cases includes the basic information necessary to plan the individual’s care and includes a risk assessment element. The manager has worked to make the new system provide a more informed indication of care provided and progress made by individual service users. The service users charter of rights states that service users in the home have the right to be involved in the development and implementation of their care plan. The practice of involving residents in the development and review of the plan needs to improve as there is no recorded evidence of service user consultation. There was recorded evidence of updating information and changing actions in the care plans. This aspect has improved with the input of staff training. Service users have access to health care services that meet their assessed needs both within the home and in the local community. Service users have access to dentists, opticians and other community services. The service users’ health is monitored and appropriate action taken. The home seeks professional advice on health care issues, acts upon it and generally is able to provide the aids and equipment recommended. There is written evidence in the care plan of health care treatment and intervention, and a record of general health care information including weight monitoring, and nutritional information. Wound care is very well recorded. The home has a medication policy which is accessible to staff, medication records are up to date for each service user and medicines received, administered and disposed of are recorded. Regular audits take place to monitor that practice meets policies and procedures. The manager has been working towards improvement in this area. Staff were seen to be aware of the need to treat service users with respect and to consider dignity when delivering personal care. Service users spoken to stated they were happy with the way that most staff deliver their care and respect their dignity. However, the routine use of plastic aprons when assisting service users to eat their meals, is an aspect of institutional care practice in respect to maintaining dignity. The service user’s charter of rights displayed in each bedroom states “service users in our home shall have the right: to retain their personal dignity”. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 12 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 and 15 Quality in this outcome area is good. Service users are well supported by staff and relatives in continuing to live in a way that satisfies their interests and needs. This judgement has been made using available evidence including a visit to this service. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 13 EVIDENCE: The home tries to be flexible and now attempts to provide a service which is more individual by using its staff and resources effectively. Service users are consulted on how the home can work to provide them with a flexible lifestyle, and they have been able to make some changes which help to achieve service users’ wishes. A significant example of this is that the manager has introduced regular meetings for service users/families/supporters to provide a forum where they can air their views. Service users are given the opportunity to take part in a variety of activities both within the home and in the community, these are arranged by staff after consulting with service users. The service attempts to consider the preferences of the majority of its service users but may not always please everyone. The home has open visiting arrangements and service users spoken with know that they can entertain their family and friends in their own room. If they prefer they can use communal areas of the home to talk to visitors. The cook has basic food hygiene training, consults with service users and tries to meet the preferences and suggested dishes when preparing the menu. Service users are able to choose to eat in their own room if they wish. Regular drinks and snacks are available. Menus are currently being reviewed to incorporate choice. The menu board did not display a choice for the main meal of the day. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 14 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 and 18 Quality in this outcome area is good. Residents have access to a robust, effective complaints procedure, are protected from abuse and have their legal rights protected. This judgement has been made using available evidence including a visit to this service. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 15 EVIDENCE: The service has a complaints procedure that meets the national minimum standards and regulations. No complaints have been received since the last inspection in 31/10/05. The manager is clear when incidents need external input and who to refer the incident to. Links with external agencies are satisfactory and include the CSCI, police and adult protection teams The homes aims and objectives include the rights of service users. Service users are supported to live as independently as possible, exercising their rights to make choices and decisions with assistance when needed. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 16 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, 22, 24 and 26 Quality in this outcome area is adequate. The physical design and layout of the home has improved in part to enable service users to live in a better-maintained and comfortable environment. This judgement has been made using available evidence including a visit to this service. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 17 EVIDENCE: Redwood Care Home Ltd has provided resources to upgrade parts of the home. It has a programme that has improved the decoration, fixtures and fittings in some areas. The carpet outside the dining room is worn and uneven posing a hazard. The call bell system is stated to be unreliable and barely audible. Locks have not been fitted to bedroom doors. Service users can personalise their rooms. Choice of communal areas is satisfactory with lounges and separate dining rooms. There are quiet areas where service users can sit and/or entertain relatives/friends in private. Service users stated they are comfortable, the home is clean, warm and well lit. Potential risk to service users from excessively hot water has been minimised. The potential risk to service users from unguarded radiators has been addressed. The home is clean and tidy, and there have been no outbreaks of infection. The laundry room is well organised with satisfactory facilities. The home is on two floors with sluice rooms provided. The home only has one thermostatic sluice disinfector which is insufficient given the size and layout of the home. A service user comment from the home’s survey stated that “its lovely to visit my friend in such a friendly caring, clean home and to find her very happy”. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 18 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 and 30 Quality in this outcome area is good. Staff in the home are being trained and are in sufficient numbers to fill the aims of the home and meet the changing needs of residents This judgement has been made using available evidence including a visit to this service. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 19 EVIDENCE: Services users commented that they have confidence in the staff that care for them. The manager encourages staff members to undertake qualifications and recognise the benefits of a skilled, trained workforce. NVQ qualifications stand at above 50 of staff having level 2 in care. Mandatory training is provided following employment which is recorded within staff personal files. The service has a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the service recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of service users. Staff recruitment files seen showed that all checks had been carried out before the persons commenced employment at the home. A service user recently admitted commented: “staff are ever so kind and thoughtful”. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 20 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): 31, 33, 35 and 38 Quality in this outcome area good. The management of the home is based on openness and respect and has effective quality assurance systems developed by the provider so that the home is run in the best interests of service users. Service users can continue managing their own financial affairs if they wish to do this. When there is occasional need for the home to keep cash and valuables in safekeeping there are good records kept of all transactions so the resident knows how it is being handled. This judgement has been made using available evidence including a visit to this service. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager is working towards the required qualification to meet the National Minimum Standards. She is experienced and competent to run the home. She works to improve services and provide an increased quality of life for service users and is supported by a deputy manager. There is an ethos of being open and transparent in all areas of running of the home. The manager is resident focused and leads and supports the staff team. Efficient audit systems are in place to monitor staff adherence to policies and procedures during their practice. A quality assurance survey has been completed and awaiting collation. The results will be fed back to service users at their next meeting. The home works to a clear health and safety policy and benefits from central health and safety support from the organisation. Records seen are of a good standard and are routinely completed. Where issues have been identified, for example, in care plans, these have been acted upon successfully to ensure service user care is not compromised. The home has access to professional business and financial advice and has all the necessary insurance cover in place to enable it to fulfil any loss or legal liabilities. The provider conducts monitoring visits to the home under Regulation 26. Reports regarding these visits were unavailable. If they wish and are able to, service users are helped to take responsibility for managing their own money. They are provided with facilities to keep their valuables and money safe. Where the home is responsible for service user’s money it works to a structured system, it maintains very clear records that are routinely kept up to date and can be used to track individual residents finances. Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 22 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 2 2 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 X 2 X 2 STAFFING Standard No Score 27 3 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 Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 23 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 OP1 Regulation reg5A. SI No. 1493. The Care Standards Act 2000 (Establishments and Agencies)(Miscellan eous Amendments) Regulations 2006. 17(2) Requirement The registered person shall amend the service user guide to provide the detail required by the amendment Regulations 2006. Timescale for action 31/05/07 2 OP2 The home must retain a copy of individual contracts. The registered person shall maintain in the care home the records specified in Schedule 4. 31/05/07 Schedule 4 (8). The registered person shall maintain a record of the care home’s charges to service users, including any extra amounts payable for additional services not covered by those charges, and the amounts paid by or in respect of each service Version 5.2 Page 24 Foresters Nursing Home DS0000064130.V327342.R01.S.doc user. The registered person shall ensure that the records referred to 17(2), (a) are kept up to date; and (b) are at all times available for inspection in the care home by any person authorised by the Commission to enter and inspect the care home. Unless it is impracticable to carry out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan. The practice of issuing all service users with plastic aprons at meal times must be reviewed to ensure that that service users’ dignity is protected at mealtimes. The registered person shall maintain the premises in a good state of repair. The carpet adjacent to the dining room must be replaced. Locks must be available for all of the bedrooms. The registered person, having regard to the number and needs of the service users shall ensure that any 31/05/07 17(3) 3 OP7 15 (1) 4 OP10 12(4)(a),12(1)(b) 31/05/07 5 OP22 23 31/05/07 6 7 OP24 12 (4) 23 (k) 31/05/07 31/05/07 OP26 Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 25 necessary sluicing facilities are provided. A sluicing disinfector must be available on the ground floor. 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 Standard Good Practice Recommendations Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Foresters Nursing Home DS0000064130.V327342.R01.S.doc Version 5.2 Page 27 - 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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