Inspection on 11/01/06 for Forrester Court

This inspection was carried out on 11th January 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

Forrester Court 14/09/09

Forrester Court 27/10/08

Forrester Court 09/06/08

Forrester Court 21/06/07

Forrester Court 20/04/06

Forrester Court 12/05/05

Forrester Court 11/11/04

Forrester Court 17/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Forrester Court Cirencester Street London W2 5SR Lead Inspector Wynne Price Rees Unannounced Inspection 11th January 2006 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 Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 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. Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Forrester Court Address Cirencester Street London W2 5SR 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) 020 7266 3174 020 7286 1068 manager.burroughs@careuk.com Care UK Community Partnerships Limited Mrs Hansa Menon Care Home 110 Category(ies) of Dementia (60), Old age, not falling within any registration, with number other category (50) of places Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Nursing beds on Richmond unit not to exceed 20 DE (E) male and female. Nursing beds on St James unit not to exceed 20 OP male and female. (This unit cannot admit service users with a primary diagnosis of dementia). Nursing bed on Hyde Park unit not to exceed 20 OP male and female. (This unit cannot admit service users with a primary diagnosis of dementia). Victoria unit not to exceed 20 DE (E) male and female Regents Park unit not to exceed 10 OP and 10 DE (E) male and female. A Total of 20. Kensington unit not to exceed 10 DE from 45 years to 70 years male and female. Only one resident, Jerimiah (Jerry) O`Sullivan, to stay in unit past age of restriction as he has lived there since 1979. 12th May 2005 2. Date of last inspection Brief Description of the Service: Forrester Court is located in the Royal Oak area with good access to local shops and transport links. It is registered to provide care including nursing for up to one hundred and ten residents of either gender and recently it has been registered for up to sixty beds for people with dementia and fifty for older people. The building opened approximately five years ago and was purpose built. It is owned and run by the Care UK organisation. There is a current occupancy of one hundred and one. Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over five hours and was focused on the care and activities provided for people with dementia. During the inspection care files for two residents on each unit were case tracked, care and activities in relation to dementia were observed and staff, residents and relatives spoken with on each unit. Specialist training received was also discussed and records seen. A Development Officer for dementia and Placement and Resettlement Manager for Mental health were also visiting during the inspection and their views were sought in relation to the dementia care provided. A complaint made regarding the care of a resident was also investigated and the requirements from the previous inspection followed up. The complaint was not upheld and the requirements were met. What the service does well: What has improved since the last inspection? There is a much-improved atmosphere at the home with staff going about their duties in a friendly approachable manner that residents enjoyed. Staff said much of this was due to their roles and responsibilities being clarified and understanding that these did not stop at providing care. Rather they included working towards providing the best quality of life for residents as well and this meant they in turn looked forward to coming to work. This was underpinned by the specialist training provided and working more in tandem with the activities team. Previously unit staff perceived activities as the domain of the activities Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 Page 6 team. Now they were taking more responsibility for providing activities themselves. 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. Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 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 Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 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): This section was not inspected. EVIDENCE: Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, & 10. Residents health care needs are recorded in individual care plans that also incorporate social and personal needs. Their privacy is observed and they are treated with respect. EVIDENCE: A sample of two residents’ care plans were case tracked from each unit and found to contain identified goals that were up to date, regularly reviewed and underpinned by risk assessments. Progress towards the goals set was recorded in the individual daily logs with entries numbered that corresponded with the numbered goals identified. The activities recorded and those observed being provided corresponded and tallied with the activities programme set out for each unit. They were sympathetic to and reflected the needs of residents suffering from different levels of dementia. The residents spoken with felt they are treated with respect, dignity and this was reflected in the care practices observed. On each floor staff referred to residents as “My residents” or “Our residents” and it was clear that bonds and good relationships had been developed. A complaint had been received regarding the health care, hygiene and diet of one resident. The Inspector met the resident whom was well groomed, Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 Page 10 assisted to eat a balanced meal and had their health needs documented with treatment given with their care plan. Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 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 the following standard(s): 12, 13 & 14. The residents’ lifestyles match their expectations; preferences and they are encouraged to maintain contact with family and friends. They are facilitated to exercise choice and control over their lives. EVIDENCE: There are a variety of different activities that are geared to the differing levels of dementia in group and individual settings. The early onset dementia unit provided cookery classes, a staff member was teaching a resident the correct way to deliver supervised massage and the residents were encouraged to socially interact. A resident was also being supported to choose photographs from the Christmas party to make a collage. Other dementia units were using a number of activities and visual and written tools as prompts. One staff member was hosting a current affairs discussion by reading out articles from the daily paper that residents said they enjoyed. One resident said “It was good because it kept the brain working”. Comparisons were made between attitudes towards the topics now and in the past. There was also a picture of a ship that a resident had worked on in 1939 on a unit notice board. Elsewhere a staff member was sitting with a resident helping to compile and write down major personal events in their lives. One unit had a display cabinet containing pottery Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 Page 12 made the residents that had one a first prize of £50 in the inter unit competition. One resident had spent their working life in a wool shop and their knitting skills were utilised to show other residents’ and staff how to knit. They also enjoyed looking out the window and waving to passing school children whom returned the wave. Their seat was positioned to enable them to do this. It was noticeable that activities carried out maintained good eye contact and the body language used was non-threatening. Staff would either be sitting or kneeling so that they were at the same eye level as residents when carrying out activities. The activities were approached in a patient manner and broken off as and when a resident indicated they did not wish to continue. Whilst activities were provided and residents’ encouraged to participate those that did not wish were not pressured to do so and made up their own mind. One resident whom had been living alone for a number of years, before entering the home, did not interact and tended to stay in their room. With encouragement and support from staff they have gradually participated in the life of the home and now fully participate. A number of relatives were spoken with during the inspection and felt there has been an improvement in the type and levels of activities provided. They also said they can come and visit as they please. A mass was held at the home the day prior to the inspection and some residents also attend religious services outside the home as they wish. During the inspection a resident expressed the wish to move rooms, as another resident was very noisy. The Care Manager agreed to look into the possibilities and have a meeting with them to discuss options. Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 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 the following standard(s): This section was not inspected. EVIDENCE: Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 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 the following standard(s): 26. The home was clean, pleasant and hygienic. EVIDENCE: A tour of the building took place as part of the inspection and it was found to be clean, pleasant, hygienic and odour free. Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 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 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 & 30. The residents’ needs were met by the numbers and skill mix of staff that are trained and competent to do their jobs. EVIDENCE: A new activity programme has been devised by a staff member for the period January to April that staff are familiarising themselves with. The home is operating a policy of devolving day to day responsibility for the running of the individual units to the respective team leaders and clinical nurse specialists who in turn delegate tasks to individuals within the teams. This has given the individual more responsibility and the care practices and attitudes towards tasks and activities observed indicates staff feel more valued for their contribution and this has resulted in a better quality of life for residents. It has been underpinned by training focused on better understanding of dementia and the best methods to provide a good quality of life. There is a rolling training programme with the tools provided by the Alzheimer’s Society that takes place on Fridays. This is attended by batches of staff and undertaken over an eight-week cycle. At this point staff undertake an exam and if successful receive a certificate in dementia awareness and recognition badge. Twenty-four staff have received the certificate and more are nearing completion. The unit teams also work in tandem with the activities co-ordination team. There are two full time and two part time designated activities co-ordinators of which one is bank staff. One staff member has been identified with an aptitude Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 Page 16 for activity organising and it is proposed that they will be sent on a college course to this affect. A dementia consultant also provides three day lecture centred training that all staff attends. The staff spoken with said they are now far more aware of dementia, it’s affects and the triggers that may provoke some reactions both positive and negative. On one unit there was an activity and action sheet outlining stages of dementia, planned actions and exploratory acts such as goal directed actions that are quantified into manual, postural and automatic. The care plans also facilitated reaction to certain situations to better understand the individual. A member of the St Mary’s Hospital medical team is also providing training regarding conditions that may prevent unnecessary hospital visits to accident and emergency. Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 Page 17 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): This section was not inspected. EVIDENCE: Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 Page 19 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. 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. Refer to Standard Good Practice Recommendations Forrester Court DS0000026014.V257926.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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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