CARE HOMES FOR OLDER PEOPLE
Fosse Court 207-211 Fosse Road North Leicester Leicestershire LE3 2FU Lead Inspector
Keith Williamson Unannounced Inspection 17th November 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 Fosse Court DS0000053757.V267319.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. Fosse Court DS0000053757.V267319.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Fosse Court Address 207-211 Fosse Road North Leicester Leicestershire LE3 2FU 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) 0116 2518822 0116 2518822 Eastern Care Ltd Ms Sadhna Patel Care Home 22 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (11), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (11), Old age, not falling within any other category (22), Physical disability (11), Physical disability over 65 years of age (11) Fosse Court DS0000053757.V267319.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. No person under 55 years of age who falls within categories MD or PD may be admitted to the Home No person who falls when 11 persons of accomodated. No person who falls when 11 persons of accomodated. within categories MD or MD(E) may be admitted these categories/combined categories are already within categories PD or PD(E) may be admitted these categories/combined categories are already Date of last inspection Brief Description of the Service: Fosse Court is part of Eastern Care Ltd group of care homes. Fosse Court is a large care home made up of three large terraced houses, which is situated in the West End of Leicester. The home is on a main road, close to shops, parks, local amenities and places of worship. The home is on a bus route and ten minute bus journey to the city centre. Fosse Court is registered to accommodate service users requiring an Asian Lifestyle within the category of older people, physical disabled, mental health and the elderly. The home is registered to accommodate up to 22 service users, of which up to 11 with a physical disability or mental disorder. The service users have their own daily routine, choosing how they wish to spend the day. There are three separate lounges and to the rear of the home, a large dining room which overlooks the small flat garden. Bedrooms are located on the upper floors, which can be accessed via stairs or the passenger lift located at the centre of the home. The home provides Asian style meals that are culturally appropriate for the service users. Meals are prepared at another home close by and snacks and beverages are prepared within the home. The Registered Manager oversees the day-to-day management of the care home and has completed the National Vocational Qualification - level 4, Registered Managers Award. There is a stable staff group with language skills appropriate to the service users who receive a programme of induction and on-going training. Fosse Court DS0000053757.V267319.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views of the service provided. The primary method of Inspection used was ‘case tracking’ which involves selecting clients and tracking the care they received through looking at their records, talking with them where possible, and looking at their accommodation. The unannounced inspection took place over one day and commenced at 9.30am and took five and one half hours. An opportunity was taken to look around the home, view records and policies, speak to residents, and to staff; an interpreter was used in this process. The manager and senior care assistant assisted throughout the inspection process. No questionnaires were returned to the Inspector prior to the Inspection process, these shall be collated and responses studied for the next inspection of this service. What the service does well: What has improved since the last inspection?
Fosse Court DS0000053757.V267319.R01.S.doc Version 5.0 Page 6 There were nine good practice recommendations from the last inspection report, seven of which have been dealt with. Improvements are recognised in the availability of the Statement of Purpose and individual detail in plans of care. Further improvements are evident in the staff training for medical techniques overseen and delegated by the District Nurse. 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. Fosse Court DS0000053757.V267319.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 Fosse Court DS0000053757.V267319.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): 3. The admission process is not followed consistently for all planned admissions. EVIDENCE: Pre - admission assessments were not seen on any residents files viewed in the home on this inspection. Some files do contain assessments that are now out of date and require to be updated with each resident’s current abilities. Fosse Court DS0000053757.V267319.R01.S.doc Version 5.0 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, 9 & 10. Residents are looked after well in respect of their health and personal care needs. EVIDENCE: Care plans are in place, are detailed on a personal basis and are reviewed periodically. Residents and their relatives are included in the care planning process, though some have elected not to participate. The medication system is well managed in the home, with accurate recording and administration taking place on a consistent basis. Privacy and dignity are recognised, with staff indicating instruction and training are given on this from the point of induction and then periodically throughout their working life. Residents spoken with also confirmed that their privacy was recognised, and the staff “knock and wait before coming in”(to the bedroom). Fosse Court DS0000053757.V267319.R01.S.doc Version 5.0 Page 10 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): 14. Choices though limited are offered to residents in the home. EVIDENCE: Residents exercise limited choice over their lives within the home. Fosse Court DS0000053757.V267319.R01.S.doc Version 5.0 Page 11 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. Arrangements for receiving and responding to complaints are sound, resulting in satisfactory protection of residents’ rights. EVIDENCE: No complaints have been received by the Commission for Social Care Inspection since the last unannounced inspection. Staff questioned are aware of the complaints procedure and how to handle an internal complaint. Residents’ spoken with on the day were aware how and to whom to make complaints indicating, “if I had a problem I would tell X” (the manager). Fosse Court DS0000053757.V267319.R01.S.doc Version 5.0 Page 12 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, 21 & 26. The home is generally safe, and partially meets the needs of residents in the home. EVIDENCE: There is a plan of routine maintenance for the home, this covers the outstanding work for and completed by the handyperson for the home. The general décor in the home is reasonable and the plan of routine maintenance should be extended to cover for the general upgrading of the public areas of the home. The toilets and bathrooms throughout the home are bare, some with no curtaining or light shades; this was discussed with the manager and remedial action taken accordingly. There is a current policy and procedures for the hygiene and control of infection for the home. Staff when questioned were well aware of the need for such a policy, and were aware of cross contamination and cross infection issues and how to prevent these, and so protect the residents in the home.
Fosse Court DS0000053757.V267319.R01.S.doc Version 5.0 Page 13 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): 30. Residents are supported by a well-trained long-term staff group. EVIDENCE: Staff training and an overall training programme is in place for permanent staff. The induction training for new staff is not however comprehensive in vital areas such as Health and Safety and Control of Substances Hazardous to Health (COSHH) this must be remedied immediately. Fosse Court DS0000053757.V267319.R01.S.doc Version 5.0 Page 14 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): 33 & 35. Residents are not sufficiently questioned regarding quality issues and the running of the home. EVIDENCE: There is no current development programme in place for the home. Though questionnaires have been circulated in the past, there has been no consistent approach by the management to addressing the resident’s aspirations as far as the running of the home goes. Any feedback from questionnaires circulated to residents or their relatives should be included in the homes’ Statement of Purpose or Service User Guide. The manager stated that no monies are held for residents at this time. Fosse Court DS0000053757.V267319.R01.S.doc Version 5.0 Page 15 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X 3 X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Fosse Court DS0000053757.V267319.R01.S.doc Version 5.0 Page 16 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 The assessment of residents’ daily needs must be completed prior to the point of being admitted to the home. Timescale for action 17/12/05 1 OP3 14 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard OP7 OP7 OP7 OP7 OP19 OP33 Good Practice Recommendations It is recommended that all care plans have details on social care for residents. It is strongly recommended that all care plans have the individual risk assessments reviewed, and additional assessments being added as required. It is recommended that the assessment of residents’ daily needs be updated periodically. It is recommended that if required care plans are produced in a format appropriate to the resident group and their abilities. It is recommended that any “trailing leads or sockets” used in the home are appropriately stored. It is strongly recommended that the quality assurance
DS0000053757.V267319.R01.S.doc Version 5.0 Page 17 Fosse Court 7. OP35 questionnaires be given or sent out regularly to residents, their relatives or advocates who visit the home. It is recommended that all items of value are not kept in the resident’s main file, but is securely stored and a receipt issued. Fosse Court DS0000053757.V267319.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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