Inspection on 21/06/07 for Forrester Court

This inspection was carried out on 21st June 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

Forrester Court 14/09/09

Forrester Court 27/10/08

Forrester Court 09/06/08

Forrester Court 20/04/06

Forrester Court 11/01/06

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 21st June 2007 10:30 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.V343353.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. Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 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.V343353.R01.S.doc Version 5.2 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 excede 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. 20th April 2006 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 ninety-seven. Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over two days. During the course of the inspection three residents from each unit were case tracked, residents and staff spoken with and information collated was triangulated with records kept and care practices observed. A premises tour was also undertaken. A pre-inspection questionnaire was returned prior to the inspection. What the service does well: What has improved since the last inspection? What they could do better: Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 Page 6 There was a problem regarding the counter signing of the controlled register on one unit that had not been completed and a MARR sheet that had been completed a day in advance in error. 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. Forrester Court DS0000026014.V343353.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 Forrester Court DS0000026014.V343353.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): 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of eighteen assessments showed that full information was forwarded to the home by placing authorities prior to a decision being made if needs could be met. These were matched by corresponding assessments carried out by the home. One of the assessments pertained to a resident who was moving in on the first day of the inspection. The assessments covered all aspects required by the standards, two of which were for self-funding residents. The written assessment policy and procedure is the same for long-term residents and those receiving intermediate care. Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The sample of eighteen care plans randomly chosen from all units showed that the computerised system had greatly improved the quality and manner in which information is recorded. The care planning emphasis is now more focused on person centred planning with greater resident participation. However the quality varied between care plans as staff were still getting to grips with the new system and whilst some were very comprehensive with clear paths between aims, goals and tasks to be carried out, to achieve them and by whom others were lacking information in some areas. An example of this was in daily notes that sometimes did not indicate if actions regarding an identified goal had taken place and remained prescriptive of a resident’s day. Two residents had requested that they be kept informed of particular aspects of their care plans and this could not be evidenced within the daily notes over a significant period of time. The care plans demonstrated that lots of individual Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 Page 10 and group activities had been identified but the daily notes did not confirm if they had been attended or taken place. Some of the residents’ spoken with confirmed that the activities had taken place. The care plans were evaluated monthly, regularly reviewed and underpinned by up to date risk assessments. The care practices observed and documentation sampled demonstrated that the general health care needs of residents were being met. This was reflected in the conversations held with residents. The residents are all registered with visiting GPs and can retain their own if practicable. They also have full access to community based health services such as local hospitals, district nurses, chiropodist, dentist and opticians. Arrangements are made for these services to be made available in the home or residents access them within the local community. The medication administration sheets were checked for all residents and found to be accurately recorded except on one unit where a MARR sheet had been completed in error for the day after the first inspection day. One entry in the controlled drugs register had not been countersigned. The home has a policy and procedure regarding dignity and privacy that staff confirmed they have received training in and residents stated are observed. Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was a general activities planner that showed activities available and a bingo session took place on the first inspection day. There was also a ninetythird birthday celebration taking place. One resident was encountered in various parts of the building as they said they liked going around and saying hello to everyone. As the care plan emphasis has refocused towards person centred care there has been an increase in a range of one to one activities. The basis of this is staff interacting with individual residents by making more time for conversation. This is also reflected in more resident participation in their care plans and recording life histories that help identify activities they may wish to pursue. The home has a dedicated activities team although care workers are now expected to take a more active part in this area rather than having a more health based priority. Where possible the home tries to integrate with the local Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 Page 12 community and has received visits from local school children. Visits have also taken place to museums, art galleries and local pubs. Residents and relatives meetings take place, the last of which was on 14th April. The residents generally felt satisfied with the level and type of activities provided that are both person focused and promote group participation. A number of activities were observed taking place during the inspection. Staff training has focused on dementia care; provision of activities for people with dementia and this has been reflected in the increased participation levels of residents. These activities are designed to prompt and stimulate residents using reminiscence, appropriate era music and written materials. Residents confirmed they can receive visitors at any time they wish providing it does not inconvenience others. They also stated that they are encouraged to make their own decisions and this was reflected in the care plans and practices observed. The meals observed were hot, well-presented and plentiful food was available with choice provided. The menus available confirmed this. The residents spoken with said they found the meals very good. Nutrition and weight monitoring is included as part of the care planning process. Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints records are now computerised and showed no complaints recorded since 09/12/06. The last complaint was fully documented except for outcome. There is a written complaints procedure that residents confirmed they had been made aware of. They said that generally if they had a problem or complaint they would to whoever was on duty and this would be resolved. The residents spoken with said they currently have no complaints. Complaints are included as part of the quality assurance monitoring system. All staff have received adult protection training as part of induction and the rolling training programme. Adult protection is also included as part of the section leader and unit meetings. The CSCI have been informed regarding all adult protection meetings and invited to attend. All staff are CRB checked prior to commencing in post. There are currently no POVA referrals. The home has a policy regarding aggression by residents and how to address this. Staff confirmed they are aware of this. The handling of residents’ finances is fully documented and most are subject to appointeeship or receiver by Westminster City Council. Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is suitable for its stated purpose and a tour of the premises showed it to be clean, hygienic and generally odour free with care and support carried out in a safe, comfortable environment. There is a fulltime maintenance team in place. Residents spoken with were happy with their accommodation. Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff rota and training records demonstrated that residents’ needs are met by well-trained staff in suitable numbers. This was reflected in the care practices observed and attitude of staff towards their responsibilities. The training records detailed induction training and subsequent courses undertaken as part of the rolling training programme. They also detail if the courses were passed or required to be retaken. Approximately sixty percent of staff have attained or are working towards the NVQ level 2 award. The staff records demonstrated they are all CRB cleared before commencing work and have undergone a thorough recruitment procedure that meets the requirements of the standard. There are currently no staff vacancies. Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well run by a Care Manager with extensive experience in the field including previously in the post of Deputy Manager. They are an RGN and hold an NVQ level 4 management award. The management practices and overall service improvement demonstrate they are competent to fulfil the role of the post. There are clear lines of accountability and an appropriate management structure in place. There is a comprehensive quality assurance system that includes unannounced proprietor compliance visits, self audits, and clinical governance manager annual audits based on the CSCI standards. They contain measurable Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 Page 17 performance indicators that have been considerably improved by the introduction of a centralised computer system for the whole organisation. Quarterly monitoring reports include type, nature and amount of accidents and incidents. Safe working practices are followed and regular maintenance checks carried out and recorded by the in-house maintenance team. A fire risk assessment was carried out on 16/03/07, the fire alarm system is checked weekly, emergency lighting monthly and evacuations take place quarterly with one now due. Fridge and freezer temperatures are checked and recorded twice daily and PAT checks were carried out on the 7th June. Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 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 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 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 2 17 X 18 3 3 X X X X X X 3 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 Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 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. 1. Standard OP7 Regulation 15 (1) & 18 (1) (c) (i) Requirement The home must continue to support staff to become fully conversant with the new computerised system and ensure that all areas of care planning records reflect if identified needs and wishes are being met, particularly regarding daily notes. The medication administration sheets and controlled medication register must be correctly maintained. Any complaints made must record outcome. Timescale for action 01/09/07 2. OP9 13 (2) 21/06/07 3. OP16 22 (2) 28/06/07 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.V343353.R01.S.doc Version 5.2 Page 20 Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Forrester Court DS0000026014.V343353.R01.S.doc Version 5.2 Page 22 - 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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