Inspection on 24/10/05 for Fort Horsted Nursing Home

This inspection was carried out on 24th October 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 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

Fort Horsted Nursing Home 19/09/07

Fort Horsted Nursing Home 29/03/07

Fort Horsted Nursing Home 05/05/05

Fort Horsted Nursing Home 27/01/05

Fort Horsted Nursing Home 30/04/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Fort Horsted Nursing Home Primrose Close Chatham Kent ME4 6HZ Lead Inspector Lucy Ansell Announced Inspection 24th October 2005 09:30 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 Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 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. Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fort Horsted Nursing Home Address Primrose Close Chatham Kent ME4 6HZ 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) 01634 406119 Dr Prathap Padmanabhan Jana Mrs Jyothi P Jana Mrs Anne Taplin Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26), Terminally ill (2) of places Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th May 2005 Brief Description of the Service: Fort Horsted is a privately owned, purpose built, 26 bedded home, providing 24 hour nursing care to older people. The property is a single storey detached bungalow. There are a variety of aids and adaptations around the home, which enable more independence for the residents. The home is in the process of building an extension to provide 4 further bedrooms with ensuite facilities, a bathroom, staff room and office for matron. The home is situated in a residential cul-de-sac close to Gillingham and Chatham town centres. The home is located on a main bus route and within walking distance of shops and a Post Office. The home has an attractive garden to the rear of the property and also some limited parking facilities. Parking on the road is time restricted. Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced Inspection took place on 24th October 2005 by one inspector Lucy Ansell. The Inspector agreed and explained the inspection process with the Registered Owner and the manager. Documentation and records were read, including care plans. Time was spent reviewing a sample of written policies and procedures, looking at care plans and records kept within the home. A tour of premises was undertaken. The focus of the inspection was to assess the Home in accordance to the National Minimum Standards for older persons and to seek resident’s and representatives views of the home. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. Some Standards were not inspected in full and the last report should be read in conjunction to obtain a full picture. What the service does well: The staff has a good understanding of the support needs of the residents. This is evident from the positive relationships, which have been formed between staff and residents. All the comment cards received from service users, relatives and other professionals contained positive comments and all were pleased with the care received at the home. It was evident from discussion with the residents at the home that the primary focus was on developing a tailor made service to enable the residents to maintain independence and enable choices. Evidence was seen that the daily routines of the home were entirely focussed on the choice and freedom of the individual service users. The meals in this home are good offering both choice and variety and cater for special dietary needs. The home has a comprehensive and robust policy and procedure on recruitment that they follow meticulously. The information retained by the home on staff files is kept well maintained. Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 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 Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 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): 1,2,3 EVIDENCE: The home now has its statement of purpose and service users guide as two separate formats. They were clear and concise with all relevant information included, and are now used for their correct purpose of informing residents prior to choosing a home and as a source of reference after moving into the home. Residents are provided with a statement of terms and conditions when moving into the home. Evidence was seen of the homes contracts, which were very detailed and signed by the resident or their representative. The Local Authority contracts with the home were also seen, these all appeared to cover overall care provided and fees payable. Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 Page 9 The pre-assessment paperwork seen was very detailed and had been updated to include the date, signature, care manager details and the place where the interview was conducted. A new residents care plan was looked at and she had only been in the home for four days and already a comprehensive care plan and risk assessments had been made from the pre-assessment. It was agreed with the matron to archive pre-assessment paperwork after the first reassessment at six months. A good practice recommendation was also made to provide evidence of trial visits being offered and when relatives came for an initial visit whether service users were also invited. The home does not offer intermediate care. Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 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): Residents benefit from a high standard of care planning and are treated with respect and dignity. All residents’ benefit from being consulted regarding their wishes concerning terminal care and arrangements after death. Resident’s benefit from their health care needs being fully met. EVIDENCE: Three residents plans of care were looked at all of these were detailed records that contained good personal and health care recording. The care plans had all been reviewed monthly and rewritten six monthly. The plans of care were excellent, detailed and well written promoting the independence of the service users. The Care plans were completed and reviewed in consultation with the residents; signatures of residents on all consent forms confirmed this. In all the files sampled the inspector saw risk assessments, which included moving and handling, and areas of risk to the residents as well as the staff these where very detailed and ensured protection for everyone. Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 Page 11 The manager needs to have in place a system to monitor all care plans after the staff have completed their reviews. The home operates a key worker system where residents have an identified staff member. The staff have now started to recording enough detail in the daily report, however it was also noted that when events and care delivery occurs after the morning shift has gone off duty there is not a detailed and comprehensive record being kept. The home promotes and maintains residents health through supporting and facilitating medical appointments as required. The home is well able to manage residents with pressure areas with treatment and also support from the tissue viability nurse. The home has good links with other professionals e.g. dietician O.T, physio and the home can offer a choice of G.Ps from the many surgeries situated locally. The home uses a waterlow score every month, after discussion with the matron it was agreed to change this to tri-monthly to see if these can become useful working tools. Weights, feeds and diets were seen to be recorded as required. The falls clinic has provided new risk assessments and the home is trialing these along with the hip protectors, and hopes to change all residents over to these new assessments. The staffs on duty were observed indirectly throughout the inspection, they were seen to interact in a positive and respectful manner with residents. One relative gave positive feedback during the inspection about the approach of the staff team, comments included “so kind and caring” and “they are very nice”. In the residents shared rooms it was noted that privacy curtains were in place that ensured privacy and dignity for the occupier. Residents are consulted regarding their wishes concerning terminal care and arrangements after death and this is recorded on their care plans. Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 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): Not Assessed EVIDENCE: The homes Activity co-ordinator although very experienced has only been in post for 3 weeks and has spent that time getting to know all the residents and writing up pen pictures about their life and likes and dislikes. Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 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): Residents are protected from abuse and benefit from having access to a clear complaints procedure which ensures they are listened too. EVIDENCE: The home has a clear step-by-step complaints procedure that meets the requirement of the regulations. The residents know the complaints procedure and were able to tell me quite clearly whom they would tell if they had any concerns, the home has received two complaints since the last inspection both of these have been dealt with satisfactorily. The home now ensures the residents are safeguarded from any abuse, neglect or harm by incorporating all the policies into one for the home. The owner gives training for all staff at induction, then they attend courses in the Local Authorities protocols on Adult Protection, as well as having a copy of the updated policy on file. The home has a whistle blowing policy. Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 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): Resident’s benefit from living in a safe, well maintained, clean and homely environment in which there are good standards of décor, furnishings and fittings. EVIDENCE: This home has had to endure a lot of upheaval due to the building work not being able to be completed at the side of the building due to pipe works needing to be removed. The extension is now after eighteen months nearing completion and this will mean new offices, staffroom and four en-suite bedrooms. This also means for the rest of the home new carpets in all the communal areas, redecoration and refurbishment of the lounge, dinning room and the last of the residents bedrooms. The kitchen is also having a complete refurbishment and redecoration. The home was clean and pleasant and no odours were detected. Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 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): Resident’s benefit from the homes recruitment policies and procedures. The residents benefit from being cared for by competent staff that receives regular, on-going training. EVIDENCE: A number of staff files were sampled, which included all types of staff, who had been at the home for varying lengths of time. The files seen did contain all the correct information. Evidence was seen of actual photos of staff; rather than relying on a blurred copy of the passport photo, which had been happening. The reference request now asks managers to confirm dates that an employee worked for the said firm. Good practice was seen of recording dates when asking for any references or CRBs and then consequently when received. Evidence was not seen of interview notes on one of the files and staff needs to be aware of also recording these even if someone is not suitable for the job. All staff had completed CRB disclosures. A good practice recommendation was made for staff files to include a front sheet with a checklist to record on information on. The home’s staff has completed NVQ’s level 2 and 3, for 7 of its staff and a further 4 staff are nearing completion. The home also is sending a further 7 staff to be enrolled on the new course. The home will meet the requirement of 50 of its staff having an NVQ by the end of 2005.The home has a very robust and inclusive induction programme and another good Practice noted was getting all new staff to sign key policies and keeping a copy for them selves. Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The resident’s benefit from having a well supported and well led staff team who are appropriately supervised. The resident’s best interests are safeguarded by the homes policies and procedure and their health, safety and welfare are promoted and protected. EVIDENCE: The owner is experienced and competent to run the home as has over 20 years Nursing experience. She is enrolled on the RMA and will be hopefully finishing this at the end of the year. The manager need to ensure periodic training is undertaken to maintain and update skills and knowledge. The resident’s benefit from the management approach of the home and an open and inclusive atmosphere is created. The processes of managing and running the home are open and transparent. The home does have a quality assurance and monitoring system in place and annually surveys the residents. The home collates and produces the results and outcomes for all interested parties to see. The home received six Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 Page 17 comments cards back from family and health and social care professionals all praising the service and care received. The home does have all the policies and procedures required, and yearly updates and reviews them. The policies seen had all been dated with the reviews and signed. The records required by regulation for the protection of residents and for the effective and efficient running of the home are all maintained and up to date. The home complies with the Data Protection Act. The manager ensures as far as is possible the health safety and welfare of the residents. Their moving and handling training is up to date, they are current with fire safety equipment and procedures and testing. They hold current first aid certificates, food hygiene and infection control training, which is current. The home has safe storage for hazardous substances and COSHH sheets have been obtained. The home has fitted a valve to regulate the water temperatures, and risk assessments for the property have been carried out. The home is financially viable and finances are spent on improvements as are needed. A copy of the homes development and financial plan was seen. Insurance cover for the home was seen. Lines of accountability are clear and well evidenced. The manager ensures supervision is carried out at least six times a year and this is split between herself and her deputies to complete this. The manger receives informal supervision from the owner but it would be good practice to receive some practice based formal supervision. Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 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 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 x 3 x x x x 3 3 STAFFING Standard No Score 27 x 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 x 3 3 3 Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 Page 19 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. 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. 1 Refer to Standard OP4 Good Practice Recommendations A good practice recommendation was also made to provide evidence of trial visits being offered and when relatives came for an initial visit whether service users were also invited. A good practice recommendation is made to ensure a record is kept of all interview notes made. The staff files would also benefit from a checklist to ensure all required information contained and when they need rechecking. A good practice recommendation is to ensure care plans contain an up to date front sheet containing all relevant information. A good practice recommendation is to ensure late staff also write up a handover in the daily records. A good practice recommendation is made to ensure the DS0000026168.V260311.R01.S.doc Version 5.0 Page 20 2 3 4 5 6 OP29 OP29 OP7 OP7 OP36 Fort Horsted Nursing Home manager recieves formal supervision which is practice based. Fort Horsted Nursing Home DS0000026168.V260311.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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