Inspection on 11/07/05 for Fosse House

This inspection was carried out on 11th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fosse House 04/09/06

Fosse House 27/02/06

Fosse House 21/03/05

Fosse House 24/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Fosse House Hykeham Road Lincoln Lincs LN6 8AA Lead Inspector Elisabeth Pinder Unannounced 11 July 2005 at 12:00 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 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 House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Fosse House Address Hykeham Road Lincoln Lincs LN6 8AA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01522 524612 01522 514014 manager.fosse@osjctlincs.co.uk The Orders of St John Care Trust Mrs S I Green Care Home Only (PC) 42 Category(ies) of Old Age, not falling within any other category registration, with number (OP) of places Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21.03.05 Brief Description of the Service: Fosse House cares for older people needing personal care in a detached property situated on the outskirts of the historic City of Lincoln. The home stands in its own grounds and gardens with car parking facilities to the front. Local facilities include shops, churches, pubs, and a recreational centre. Transport is required to access the main city. The home has two floors and there is a passenger lift to the bedrooms on the first floor. There is a variety of aids and adaptations around the building to allow residents to move around the home more independently. All of the bedrooms are single, none have ensuite facilities. The home is one of 16 operated by the Order of St John Care Trust, which is a Registered Charity. Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 4 hours and was carried out by one inspector as the first of two statutory inspections for 2005/6. Before the visit information was gathered from the pre-inspection questionnaire. The main method of inspection used was “case tracking”. This involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. It also included a general discussion with other residents. One bedroom was viewed and a selection of care records inspected. What the service does well: What has improved since the last inspection? What they could do better: One of the requirements made during the last inspection was for a copy of the report reviewing the quality of care provided at the home to be sent to the Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 Page 6 Commission. Although the manager has raised this with the organisation’s head office, to date this has not been received. 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 House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 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 standard(s) 3 Standard 6 does not apply as the home does not provide an intermediate care service. Residents are admitted into the home only after a full care needs assessment has been carried out and written confirmation has been sent assuring them that their needs will be met. EVIDENCE: Care records were examined of three residents, one who had been admitted since the National Minimum Standards were written. This showed that a preadmission assessment had been carried out forming the basis of their care plan. One resident spoken to could clearly remember the arrangements for coming into the home and their records showed that these had been carried out. Both staff spoken to knew about the care needs of residents and were aware of the homes pre-admission assessment procedure. They also confirmed that information is passed on to them by senior staff and the needs of residents coming into the home are discussed prior to their admission. Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 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 standard(s) 7, 8 & 10 There is good care planning in this home. This ensures that the health, personal and social care needs of the people living in this home are identified. Individual risk assessments are of a good quality, stating who is at risk and the action needed to minimise the risk. EVIDENCE: Individual care plans contain sufficient information to ensure that all aspects of health, personal and social care needs are identified and planned for. Those examined were up to date and showed that residents and/or their representatives have been involved. Individual risk assessments regarding falls, flooding and other risks, for example, using a kettle in the bedroom, have been drawn up and give clear instructions as to the action needed to minimise these risks. Both staff spoken to were aware of residents needs and are involved in writing care plans. They also said that they are kept informed of all changes by senior staff or the manager. Residents said that staff treat them well and that their privacy is respected. One resident said that her dignity is “definitely respected, staff knock on my door and I am able to stay in my room if I wish”. Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 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 standard(s) 12 & 13 Social activities and meals are arranged after discussions with residents. Relatives and friends of residents are made welcome in this home. Meals are well managed and reflect residents likes and dislikes. EVIDENCE: A number of people living in the home were spoken to and everyone who commented on the food said how good it is and that they were happy with the food provided. Menus were supplied with the pre-inspection information and when inspected were found to be balanced and interesting. The cook has meetings with residents about the meals and their likes and dislikes including dietary requirements are recorded in their care plans. Visitors to the home are asked to sign in/out and there were a number of relatives visiting during the inspection. However, all declined to see the inspector. Residents said that they are able to see their visitors when they want and in private, they also said they can also choose not to see a visitor if they wish. Another resident said that she ‘has regular visits from her grandson and that a cup of tea is made for him or he can make his own if he wants’. The home provides a range of activities which are carried out by the home’s activity co-ordinator who works for 17.5 hrs per week. Activities include movement to music, inter-home quizzes, craftwork, baking, shopping trips and Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 Page 11 bingo. Three residents were busy folding napkins and when they were spoken to about activities, they said that they enjoy the variety of things to do and have been busy making things to sell during the summer fair which is to be held in August. Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16 The home takes the issue of addressing complaints very seriously and residents are confident that their concerns will be listened to and acted upon. There is a complaints procedure for residents and/or their relatives to follow. EVIDENCE: The home has a detailed complaints procedure and this is given to all prospective residents and their relatives/representatives. No complaints have been received by the Commission since the last inspection. One resident said that she felt able to raise any issues herself whilst others said they would speak to their families. Staff spoken to knew the complaints procedure well and said that they felt confident to make a complaint if necessary. Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19 Residents living in this home live in a safe and comfortable environment. The standard of the environment is good with the home continuously improving the decor on a planned basis. EVIDENCE: The home is clean and well decorated. All furnishings are of a domestic nature and residents said they like the home, and are happy with their bedrooms and felt that they were kept clean. One bedroom was viewed, this was individually decorated and furnished and contained personal items reflecting individual interests and taste. There is an on-going programme of redecoration and refurbishment. Maintenance records identify the work that has been undertaken and projected work for the coming year. Building risk assessments are written and regularly reviewed and updated. Bathrooms and toilets were clean and are lockable. There are hoists available and handrails to assist residents. Staff said they felt they worked in a safe environment and had received training in health and safety. Residents also said they felt safe living here. Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 30 The staff group are an established team and staffing levels are sufficient to meet the current needs of residents. Staff are provided with training to ensure they have the skills needed to carry out their roles and are committed to the work they do. EVIDENCE: There is a fairly small staff turnover in this home with two staff leaving since the last inspection. Residents did not express any worries about the level or availability of staff and during the inspection staff were seen to promptly attend to residents needs. Residents spoken to said “all staff are very nice” and “the staff are very kind and helpful”. Records showed that there are always four care staff on duty each morning and three care staff each afternoon. In addition to this there is always a team leader on duty. There are two wakeful night staff on duty each night. Staff said they felt there is sufficient staff on duty to care for residents. A training programme is in place and this includes all statutory training as well as more specific training to meet individual residents needs. Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 & 33 There is clear leadership within this home. It is led by a trained and committed manager with the support of the organisation of The Orders of St John Trust. EVIDENCE: Residents and staff gave positive comments about the management of this home and said that they feel they can approach them at anytime if they have any concerns. Records are available to show that staff receive regular one to one time with their supervisors and staff spoken to confirmed this. There are regular resident and staff meetings and records were available. Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A 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 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x x 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 Standard No 16 17 18 Score 3 x x 3 x 3 x x x x x Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 Page 17 Yes 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. 1. Standard 33 Regulation 27 Requirement The Commission must be supplied with a copy of the report undertaken regarding the review of the quality of care provided at the care home.(Previous timescales of 31.08.04 and 31.05.05 not met) Timescale for action 31.10.05 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 Good Practice Recommendations Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Lincoln Office, Unity House Weaver Road off Whisby Road Lincoln LN4 2ST 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 Fosse House C53 C04 S2359 Fosse House 236116 110705 Stage 4.doc Version 1.40 Page 19 - 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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