Inspection on 03/08/06 for Fornham House Residential Home

This inspection was carried out on 3rd August 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 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

Fornham House Residential Home 18/01/06

Fornham House Residential Home 17/10/05

Fornham House Residential Home 17/12/04

Fornham House Residential Home 27/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Fornham House Residential Home Fornham St Martin Bury St Edmunds Suffolk IP31 1SR Lead Inspector Mike Usher Key Unannounced Inspection 3rd August 2006 10:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fornham House Residential Home DS0000024389.V302699.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. Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fornham House Residential Home Address Fornham St Martin Bury St Edmunds Suffolk IP31 1SR 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) 01284 768327 01284 768040 Pri-Med Group Ltd. Mrs Jean Mary Murphy Care Home 66 Category(ies) of Old age, not falling within any other category registration, with number (66) of places Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2006 Brief Description of the Service: Fornham House provides personal care and accommodation to 66 older people. It is owned by Pri-Med Group Ltd, a company with a number of other homes in Suffolk. The home is situated in the village of Fornham St Martin, which is about five miles from the market town of Bury St Edmunds. There is a public house and church in the village but other facilities (such as shops) are located in Bury St Edmunds. All the home’s bedrooms are single with en-suite toilet and shower facilities. Shaft and stair lifts provide access to all floors of the home. There are several communal rooms and an accessible and well-maintained garden. The standard of accommodation is very good, and the home has consistently achieved a high degree of compliance with national standards and regulations relating to care homes. In early 2006, the Pri-Med Group were acquired by the Healthcare Homes Group, which has retained the Pri-Med name. The range of fees is £450 - £630. Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the first Key Inspection of the service following the recent developments in the regulation of care services. It focused on the key National Minimum Standards identified by the Commission, previous requirements and recommendations, and the management of the home, particularly with reference to caring for people with dementia. The inspection used observation, discussion with the manager, staff, and service users, and examination of records and other documentation to evaluate the current standard of service provided. A detailed questionnaire was completed by the manager as part of the background to the inspection. In addition, a number of survey forms were distributed to service users and their relatives, and the results have been included in the various sections of this report. Although the inspection was unannounced, the manager, was able to assist throughout the visit. The inspection found that the home continues to deliver a very high standard of care, and achieves an equally high level of customer satisfaction. The service met all of the standards examined, and in several cases exceeded the minimum requirement. The management and staff are to be congratulated on providing such an exemplary service. What the service does well: The home provides a very comfortable level of accommodation, which is spacious, well furnished, decorated, and well maintained. A homely feel is maintained, with good attention to detail. Relations between staff and residents were very relaxed and friendly. The grounds are well-kept and accessible to service users. Staffing levels are good, and the staff group is well trained and well motivated. The service users and relatives consulted during the inspection were very pleased with the standard of service provided, and spoke most highly of the staff and management. Carers were described as friendly and kind, polite, respectful, and very supportive in maintaining residents independence. The home is well managed, with excellent leadership from the manager and senior staff. The ethos of the home is very focused on the care of residents, and promoting choice and autonomy. There is an excellent provision of activities and entertainments, and the home’s procedures and policies are effective and actively promote and protect the well being of residents. Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 6 Residents and relatives consulted during the inspection found the standard of service to be very high and provided many positive comments. Some typical examples follow: “This is a very efficient well run home. All staff are proficient at their jobs and show kindness and respect to residents and visitors alike. Well done to them all.” “No home could provide a better balance care.” “I have been very impressed with the care and attention that my mother has received…” “The food is of a very high standard, and the kitchen staff really meet my every whim and fancy – so I am satisfied.” (a resident on a specialised diet). “I think this is a lovely home.” 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. Fornham House Residential Home DS0000024389.V302699.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 Fornham House Residential Home DS0000024389.V302699.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5 Quality in this outcome area is good. Service users are properly assessed prior to admission and are able to make positive choices. The home does not ofer intermediate care, and therefore Standard 6 is not applicable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A detailed assessment of each service users needs is undertaken prior to their admission, and this is usually followed by a visit to the home. Admission is on a trial basis and these events are well documented. Care records referred to specific requirements and preferences of individuals, including matters such as preferred form of address, and included risk assessments. As noted in previous inspections, the home has an admissions’ folder that contains essential information for new or prospective residents, including the Service User Guide, the Statement of Purpose, the Complaints Procedure, Terms and Conditions document, and the most recent inspection report. The Statement of Purpose and Service User Guide are currently being re-written to take account of the new owners. Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 9 Service users consulted during the inspection confirmed that they were able to visit the home prior to admission, and had received the relevant information from the home, including a copy of their contract (though a number indicated that this had been dealt with by their relatives). Fornham House Residential Home DS0000024389.V302699.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. The home has very good care planning in place, and service users’ health needs are well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users have an individual plan of care. These are detailed and thorough, and cover the whole range of care needs and preferences. Each area of assessed need has a series of aims and objectives set out, and these are regularly reviewed and updated frequently. Risk assessments are detailed and appropriate formats are used to gain a consistent and objective measure of the risk, and to monitor changes over time. Guidance for staff is clear and concise. The overall standard of documentation is very good, and exceeds the minimum standard. Careful attention is paid to the healthcare needs of residents, with easy access to health care professional services. General Practitioners (GP’s) and Community Nurses are frequent visitors to the home (as was evident on the day of the inspection and from care records). Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 11 One of the small lounges on the first floor has facilities for the Hairdresser who visits regularly. On the day of the inspection a visiting Chiropodist was using this area. Inspection of the arrangements for the storage and administration of medicines found these to be satisfactory. The home uses a monitored dosage system supplied by a local pharmacist, who also undertakes regular audits. Medicines (including controlled drugs) are stored in a secure, walk-in cupboard, and all records examined were clear and accurate. Service users consulted during the inspection were very pleased with the care provided, and felt that their health was well looked after. They described the staff and management as attentive and supportive, and confirmed that they were always treated well, and that staff were polite and respected their choices and preferences. Observations during the inspection confirmed this approach by staff. Fornham House Residential Home DS0000024389.V302699.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. A good variety of activities are provided, and care is taken to meet individual needs and preferences. The home promotes independence and choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs a dedicated Activities Co-ordinator – an experienced Senior Carer. She is responsible for a monthly schedule of activities, which is drawn up and circulated throughout the home. This ensures that there is an appropriate variety of structured activities on a daily basis, with regular entertainments laid on. Activities suit large and small groups of residents, and care is also taken to ensure that every service user is spoken with regularly so that their own needs and preferences can be catered for. At the time of the inspection, there was a display of memorabilia in one of the lounges, from the 1920’s and 30’s, and followed other such displays from other decades. A number of residents commented on the display and it was clearly a focus for reminiscing about their earlier lives. During the day, a Communion was held for residents in the main lounge. Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 13 Service users spoken with during the inspection found the routines of the home very relaxed and able to meet their individual need and preferences. There was a strong consensus that the ethos of the home was supportive of residents making their own choices and they felt that their independence was valued and promoted in a very positive manner. Overall, the provision exceeds the standard required. During the day of the inspection there were a significant number of visitors to the home, and it was noted that many came to speak to the manager and were on very friendly terms. Several took the opportunity to express their satisfaction with the standard of service the home provides. Further visitors were spoken with during private conversations with residents and the outcome was similarly positive. Residents consulted during the inspection process describe the food provided as very good, with plenty of choice and variety, good-sized portions (with further helpings offered), and special diets (such as diabetics or vegetarians) also catered for. Many residents choose to have their meals in their rooms, and this is positively respected by the staff, who do not pressure residents to spend their waking time in communal areas. Fornham House Residential Home DS0000024389.V302699.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. The home has good policies and procedures in place to safeguard service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an appropriate complaint procedure in place that is known to residents. A record is kept of all complaints, and examination revealed that only a small number had been made in recent months, none of which were significant (being mainly of the minor everyday variety). Service users and relatives consulted during the inspection felt confident that any concerns they might have would be properly addressed. The manager was described as very approachable and considerate, and all service users consulted said that they had never needed to complain. All felt safe and secure living at the home. Staff are well trained, and this includes courses such as Abuse Awareness. Records are kept of all such training, and a training session on this topic was planned for later in the month. Care plans and assessments take safety and protection into account, and focus on maintaining the well being of service users. Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 15 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 the following standard(s): 19,20,23,24,25,26 Quality in this outcome area is good. The home provides a good standard of accommodation that has been well adapted to meet the needs of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection the home was found to be clean, tidy and fresh, with no odour. The level of wear and tear was very low, and the home is well maintained. The standard of décor, furniture and furnishings is very good, offering very comfortable and pleasant surroundings. The extensive grounds are accessible to residents and are well kept. The home benefits from having a number of different lounges and sitting areas available for residents and visitors to use, ensuring that there is always a good choice according to preference. Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 16 The home is well equipped to assist residents and staff, and all bedrooms have en suite shower and WC. The older part of the home has been well converted, although there are several changes of level, and some steps. A stair lift has been installed on one small set of stairs, and there are two shaft lifts serving all floors. Service users spoken with were very pleased with their rooms, confirming that they were satisfied that they met their needs. Rooms have been nicely personalised and residents are able to bring in their own furniture and possessions. A number of radiators have been fitted with safety covers, which have been carefully chosen to fit in with the décor. It is recommended that remaining unguarded radiators are similarly guarded, to enhance the safety of the environment. Regardless of this, a suitable risk assessment needs to be undertaken to ensure that the current provision is adequate. Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is excellent. Staffing levels are good and staff training provision is very good. Recruitment procedures are satisfactory. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection there were 7 carers on duty in the morning. This was one less than planned, due to staff sickness. The manager, Mrs Murphy, was providing some cover for this post. In addition, the Activities Co-ordinator was on duty, and a team of ancillary staff consisting of Administrator, Housekeeper and Domestics, Cook, Kitchen Assistants, and a Maintenance Worker. In the afternoon a total of 6 carers (including a Senior Carer) were due to work. Staff rotas were displayed in the main office, and these confirmed that adequate staffing levels are planned and maintained. Some care staff work long shifts (12 hours), but Mrs Murphy stressed that this was due to their preference, and she was well aware of the implications – and monitors the situation closely to ensure that the standard of care delivered does not suffer. Examination of staff records confirmed that recruitment procedures are thorough and meet all requirements regarding checks and references for all staff. Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 18 A number of staff are employed from abroad, and the management take care to ensure that they have adequate English skills. In some cases, staff have been assisted with local English classes. During the inspection, service users confirmed that there were no problems with communication between any staff and themselves. The Company’s training unit is now based at another care home, and this is where much of the training is organised and delivered. The induction for new staff consists of one day at Fornham House and 2 further days at the training unit. Staff records confirm that staff receive adequate training in essential subjects such as Fire Safety, Moving and Handling, and Health and Hygiene. In addition, there is a comprehensive training programme covering a wide range of topics, including: • • • • • • • • Communication & Listening Adult Abuse Awareness Care Planning Role of the Care Worker Continence and Catheter Care Bereavement Nutrition Diabetes Many other topics are available, and the overall provision for training is very good, exceeding the standard required. Training certificates are displayed throughout the ground floor corridors, and a notice board near the office displays information on upcoming training sessions – Fire Safety, Abuse Awareness, Moving and Handling, and Communication. The notices also identify who will attend the sessions, ranging from named individuals, to ‘all new staff’. The home has maintained a rate of 50 of staff being qualified with the National Vocational Qualification (NVQ) at Level 2, and several have achieved Level 3. In addition, 11 carers have First Aid certificates. Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37,38 Quality in this outcome area is excellent. The home is well managed, with effective policies and procedures, and a good standard of record keeping. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager, Mrs Murphy, is an experienced and qualified manager, and continues to manage the home very well. Many service users and visitors remarked on her competence, and the fact that she makes herself available to visitors, and is very approachable. She maintains good contact with service users on a daily basis, and those spoken with during the inspection were confident that she would address any concerns that they may have. Consequently, they felt very safe and secure living in the home, and ensure that this standard is exceeded. Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 20 There was a very high level of agreement between service users and relatives that the home is run very much on a basis that is aimed at supporting residents in maintaining their independence and exercising choice. This was also evident during the inspection, in the attitude and approach taken by the staff and management. A new Responsible Individual (RI) is in place and the manager confirmed that they visit on a regular basis and maintain a suitable level of involvement in the continuing operation of the home. In addition, the monthly assessment visits required by regulation are being carried out by a senior manager within the organisation, and the resulting reports are on file and available for inspection. The two most recent reports were viewed during the inspection and confirmed that these visits are being conducted appropriately. In both cases, there is a good level of contact between senior managers and the service users. Mrs Murphy reports that the RI was due to attend the resident AGM, which was due to take place the week following the inspection. Essential records examined during the inspection were in good order. These included staff rotas, medication records, fire safety records, and those relating to residents’ finances, where staff are involved in assisting them. An examination of these records, together with funds held on residents’ behalf confirmed that they are accurate. Staff are appropriately supervised. The home has benefited from recent inspections by Suffolk Fire Service, and the recommendations arising from those visits are being actioned. Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 3 3 3 Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 22 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 OP25 Regulation 13(4)(a) (c) Requirement The risk posed by all exposed hot surfaces (radiators and pipe work), must be fully assessed and remedial action taken as appropriate to ensure the safety of service users. Timescale for action 31/08/06 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 OP25 Good Practice Recommendations All radiators should be of the low surface temperature type, or suitably guarded. Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Fornham House Residential Home DS0000024389.V302699.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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