Inspection on 30/08/05 for Foresters Nursing Home

This inspection was carried out on 30th August 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 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 Nursing Home 20/02/07

Foresters Nursing Home 31/10/05

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 Walton Pool Lane Clent, Nr Stourbridge Worcestershire DY9 9RP Lead Inspector Chrissy Presley Announced 30 August 2005 09:00 am 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 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 E52 S64130 Foresters NH V232488 300805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Foresters Nursing Home Address Walton Pool Lane, Clent, Nr Stourbridge, Worcestershire DY9 9RP 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) 01562 883068 01562 887474 Redwood Care Homes Limited Mrs Elizabeth Collins Care Home with Nursing 30 Category(ies) of A(E) Alcohol dependency over 65 (3) registration, with number DE(E) Dementia over 65 (6) of places OP Old age (30) PD(E) Physical disability over 65 (30) Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection First inspection since registration Brief Description of the Service: Foresters care home is registered for thirty 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 had made positive choice to share.The registered manager referred to in this report is Mrs Elizabeth Collins who is a first level nurse. The responsible individual is Huw James of Redwood care Homes Ltd. Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the morning and lunchtime. The announced visit focused on care planning, risk assessments in all areas of the home and outcomes for residents about life in the home. Seven residents, the registered manager and responsible individual were spoken to during the inspection. Staff were busy with residents and were not interviewed during this visit. Ten feedback forms from residents were received and had positive comments about the service such as;- Staff consistently demonstrated kindness, patience and a very caring approach, all relatives are warmly welcomed and offered a cup of tea during the visit; one less positive comment said;- shortage of staff leads to occasional lapse of overall service (the homes charges surely merit a higher level of care). What the service does well: What has improved since the last inspection? Since the last inspection the lift is now fully operational, and a dishwasher has been fitted. There is an ongoing programme of maintenance and renewal. Menus have been reviewed and now offer residents a wider choice of food, which is more nutritionally balanced. Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 4 & 5 Residents have enough information about the home regarding the service provided and are fully assessed prior to admission to ensure the home can meet their needs. EVIDENCE: The home had a statement of purpose and service user guide, which gave information about the service to prospective residents and also those residents in permanent residence in the home. These documents are being reviewed and updated in line with the new companies policies and procedures. All prospective new residents are invited to visit the home prior to admission and the contract states a trial period. Residents are assessed by a first level nurse to ensure the home can meet their needs once they are admitted. The information contained in the documentation seen was excellent. Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10 Core care plans are not developed in enough detail to ensure the care needs of residents are met; residents look and said they are well cared for and feel safe in the home. EVIDENCE: All residents had a care plan three of these were inspected in detail during the course of the inspection. Care plans contained the original assessment of need which was excellent. All elements of care required for residents had been developed, staff rather than re-write a core plan each time had used the evaluation sheet, which was confusing. There was evidence that July and August evaluations and reviews of care plans had been done together and not separately. Dates were not specific July 05 was used on numerous occasions. Wound dressing and pressure area care required further development to ensure staff had full and precise instructions. Noted weight losses had not been highlighted in the core care plan. Residents spoken to during the course of the inspection said they were able to get up and go to bed as they chose and were treated kindly by staff and felt safe. Staff were observed interacting with residents in a friendly manner. Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 Page 10 Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 & 15 Residents are offered some activities these could be further developed; food offered to residents was nutritious and wholesome. EVIDENCE: The home did not have an activities co-ordinator; this post was continuing to be advertised. Staff when they had time ensured activities took place and records were kept. There was no overview of which residents required one to one activities and those who were happy joining in-group activities. There were continuing visits from the local Church groups. Relatives were warmly welcomed into the home and could see their family in private, there being several areas of the home for this purpose. The menus had been recently re-evaluated as residents had said there were too many casseroles; lunch on the day of inspection was roast turkey with roast and boiled potatoes and fresh vegetables. Residents said they could chose where they ate their meals in the dining room or their room. Residents were observed being assisted with food in a manner, which promoted their dignity. Liquefied meals were served appropriately and looked appetising. Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 Page 12 Kitchen records were inspected and were in order. The kitchen had recently been fitted with a dishwasher. All staff had food hygiene training. Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & !8 The home has robust policies and procedures in place for the protection of the vulnerable adult staff require training in this field. EVIDENCE: The policies and procedures for the protection of the vulnerable adult are in place and are robust but need to be collated into one document. Staff had not received formal training in this field and this remains an outstanding requirement from the last report. The registered manager as part of her NVQ award in management had addressed these issues and felt confident to cascade information to staff. Residents said they would not be afraid to complain and had information about this process. Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of the standards in this section of the report were inspected during this visit. EVIDENCE: Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 Staff recruitment procedures are robust and ensure residents are safe; staff have relevant training to ensure residents needs are met. EVIDENCE: Four staff files were inspected during the inspection and robust procedures had been followed; all staff had a POVA first check and Criminal record check before being employed in the home, thus ensuring residents safety. The home has a stable workforce that know the residents well. The home used minimal agency staff. Overseas staff had a good command of the English language. Staff had an induction training which met the required standard, training documents seen did not contain written evidence and had just been ticked. The home did not have a TOPSS foundation programme in place as all staff employed had relevant experience or commenced an NVQ level 2 in direct care after their initial induction period. Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34 35, 36, 37 & 38 The health and safety of residents is paramount and systems and equipment checks are in place, which ensure a safe environment for residents and staff working in the home. EVIDENCE: The registered manager is a first level nurse and is competent to run the home and has the necessary experience and qualifications. The home did not have a specific health and safety officer who had had appropriate training, systems for the checking of equipment was in place and regular fire checks were evident including fire training for staff. Contract agreements with external companies were seen which ensure bathing hoists and lifting equipment are regularly serviced and checked. Policies and procedures in relation to health and safety were in place including COSHH hazard warning sheets giving instructions on what to do if products are ingested or spilt. Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 Page 17 Staff receive regular supervision from the registered manager who in turn has regular meeting with the responsible individual. The home did not as a matter of policy keep residents monies, residents were invoiced for extras and records were kept. All residents had lockable storage for valuable items and money in their bedrooms. The home continues to develop a quality assurance programme. Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 4 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 3 2 3 3 3 x 2 Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 Page 19 yes 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. 2. Standard OP7 OP7 Regulation 15 15 Requirement Care plans must reflect current care needs Residents who are identitifed as losing weight must have a care plan which reflects this care need Dates used in care plans must be specific Care plans must be reviewed monthly and as needs change Wound dressing and pressure area dressing must be specific and give enough instructions for staff to carry out these dressings Identified risks must be addressed within the care plan Staff must receive training in the protection of the vulnerable adult Timescale for action Immediate Immediate 3. 4. 5. OP7 OP7 OP7 15 15 15 Immediate Immediate Immediate 6. 7. OP7 OP18 15 18 Immediate Outstandin g requiremen t from last report. by 30th September 2005 Immediate and ongoing 31/03/06 Outstandin Page 20 8. OP30 18 9. 10. 11. OP30 OP33 OP38 18 24 13 The induction programme documentation must contain evidence of various elements of the induction process The home must develop a TOPSS foundation programme when the need arises A quality assurance programme must be developed A health and safety officer must E52 S64130 Foresters NH V232488 300805.doc Foresters Nursing Home Version 1.40 be identified within the work team and must have specific training in this field 12. OP38 23 Times of fire drills must be logged g requiremen t from last report Immediate 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. 2. Refer to Standard OP7 OP12 Good Practice Recommendations Wounds and pressure areas should be photographed whenever possible providing the resident consents. It is recommended all residents are assessed for types of meaningful activities which would be appropriate to their needs and records are kept of those residents who refuse activities and records of the one to one activities which take place. It is recommended the policies and procedures for the protection of the vulnerable adult are collated into one document 3. OP18 Foresters Nursing Home E52 S64130 Foresters NH V232488 300805.doc Version 1.40 Page 21 Commission for Social Care Inspection The Coach House, John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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. 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