Inspection on 16/10/07 for Fosse House

This inspection was carried out on 16th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Fosse House 30/04/07

Fosse House 06/06/06

Fosse House 08/11/05

Fosse House 05/05/05

Fosse House 09/12/04

Fosse House 01/07/04

Fosse House 26/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Fosse House Ermine Close St. Albans Hertfordshire AL3 4LA Lead Inspector Mrs Sheila Knopp Unannounced Inspection 16th October 2007 09:15 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 House DS0000019349.V353108.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. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fosse House Address Ermine Close St. Albans Hertfordshire AL3 4LA 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) 01727 819 700 01727 819 768 fosse@quantumcare.co.uk www.quantumcare.co.uk Quantum Care Limited Jennifer Barbara Gauthier Care Home 61 Category(ies) of Dementia - over 65 years of age (61), Old age, registration, with number not falling within any other category (61), of places Physical disability over 65 years of age (61) Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th July 2007 Brief Description of the Service: Fosse House is a purpose built care home for 61 older people, including two rooms for short (or respite) stays. It is a two-storey building, with two units on each floor. Three of the units have 15 rooms and one has 16 rooms. Each service user has their own bedroom with an en-suite toilet and washbasin. Each unit has it’s own lounge, dining room and kitchen. There is a hairdressing salon and a sensory room on the first floor. There is a day centre on the ground floor, which is separate from the residential accommodation. There is a large garden with wheel chair accessible, paths, patio areas and summerhouse. The home is close to the parkland leading to St. Albans Abbey. It is in a modern residential area, next to a small shopping parade and a Waitrose supermarket. The current fees for privately funded people range from £505 - £590 per week depending on an assessment of care needs (correct on 16/10/07). Variable charges are made per bed depending on funding arrangements. A copy of the most recent inspection report is available from the home or company on request. Information about the service is also available on the Quantum Care web site. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second unannounced key inspection to this service since 30/4/07. A further unannounced random inspection took place on 25/7/07 to monitor the action plan provided by Quantum Care following the April inspection. The information in this report is based on an unannounced visit to Fosse House by two inspectors and an Exert by Experience who spent time talking with the people who live at Fosse and the staff and management team. The Expert by Experience also joined the residents for lunch in one of the dining rooms The Commission is involving Experts by Experience in it’s inspections to encourage people who use care services to share their experiences more openly. Expert by Experience volunteers are recruited trained and supported by Help the Aged. Information received by us since the last key inspection has also been reviewed. This includes company monitoring reports and notifications of accidents and incidents that are a legal requirement. Where we are confident that standards have been consistently met over time information from the previous key and random inspection reports has been used to form our judgement. Since the April inspection Quantum Care have provided considerable management and training resources to improve standards. This inspection has identified a continued improvement in services provided to residents as a stable management team is established and staff have received further training in the care practices and values required to support older people. We now need to see consistency over time to ensure this trend is maintained. What the service does well: Residents are encouraged to visit Fosse House before they make a decision to stay and are made to feel welcome. Our Expert by Experience said, “I felt there was a pleasant and relaxed atmosphere in the home”. Residents are provided with warm, comfortable, well-maintained accommodation in single en-suite rooms, which they can add their personal possessions and belongings to make it their own. Our Expert by Experience said “On entering the premises the hallway and the reception area give the impression of being in a hotel. It was clean, smelt fresh and spacious with a seating area for the use of visitors or service users”. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 6 Residents are positive about the choice of meals they are served. Changes to the way medication is given out at meal times should mean residents are able to enjoy their meal with less disruption but not all staff are following the new procedures. Residents receive support from local General Practitioners (GPs), community nurses and specialist teams. Residents who wish to continue to manage their own medicines are supported to do so. Staff are checked for their suitability to work with vulnerable people and Quantum Care have training programmes in place which develop the skills of staff from their induction onwards. This includes a programme of dementia care training. The company quality assurance systems seek out the views of residents and relatives. Complaints are listened to and acted upon. The home receives many compliments. What has improved since the last inspection? The care team managers are continuing to review and update each person’s care plan so that they reflect the wishes and preferences of the individuals concerned and provide clear guidance for staff on the action they need to take. Staff have received further training as part of a group or in one to one sessions on their responsibilities to protect residents from inconsistent and impersonal care practices. However further supervision is required to ensure these principles are understood and followed by all staff. A system has been set up for managers to review the needs of residents who have accidents or are unwell so that their changing condition and comfort is monitored at frequent intervals. Hoist scales have now been provided to enable staff to monitor the weight of residents not able to use more traditional scale chairs. Another activities organiser has been recruited which means that social events and recreational activities can be extended to cover evenings and weekends. There have been no further reports of residents missing items of value to them. The standards of cleanliness and hygiene within the home have improved greatly under the new housekeeper and her team. Further wheelchair accessible pathways, handrails and a summerhouse have been provided in the garden to encourage residents to go out more. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 8 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 House DS0000019349.V353108.R01.S.doc Version 5.2 Page 9 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): Standard 3 (standard 6 does not apply to this service) People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are assessed before coming to live at Fosse House to ensure it is a suitable place for them and staff can provide the level of support they need. EVIDENCE: Before admission the manager or deputy manager visit people in their own home or hospital to carry out a full assessment of their needs. Individuals and their families are encouraged to visit and spend time in the home. They may have already attended the day centre or been on respite stays before so the home would be familiar to them. Information requested from other health & social care professionals is used as part of the assessment process and development of an individual plan of care. We spoke to a person who had recently moved into Fosse House. They said they were happy with the arrangements that had been made for them and that Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 10 the other residents and staff were making them feel welcome. Together with their family they had been involved in putting together a plan of care that said how they wished to be looked after and how staff were going to meet their daily needs. Previous inspections and survey responses from residents and relatives have told us that they are given contracts detailing the costs and terms and conditions of their stay. The manager is in the process of updating the published information about the service provided at Fosse House and will send us copies of the revised Statement of Purpose and Service User Guide when they become available. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 11 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): Standards 7, 8, 9 & 10 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Work is continuing to develop a more person centred approach to describing the care needs of each resident and monitoring that staff are providing it. Residents are well supported by the General Practitioners and Community Nurses who visit Fosse House. Closer monitoring of residents who have falls or accidents means their comfort is now reviewed by senior staff at frequent intervals. Not all staff follow the medication procedures in place, which could put service users at risk. EVIDENCE: We were able to see that the process of updating and reviewing care plans so they provided a clearer picture of the day-to-day needs of each resident was continuing. One care team manager was involving care staff in this process Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 12 with positive results. Quantum Care are also going to pilot a system to make staff responsible for specific residents on each shift and provide them with a card record they can take with them identifying the individual preferences of that person and record the care provided as it happens. Two members of staff who completed survey forms for us said that care plans and reports were not always up to date which made it difficult looking after people. People had received good attention to their personal care and the manager reported that none of the residents had pressure sores and pressure relieving equipment is available to prevent problems. A male carer acted sensitively to a lady who identified they would prefer a female carer to help them to the toilet. Staff have continued to receive training and updating in care practices. Overall staff were positive in their approach to residents and good examples of interaction were observed with staff taking time to talk to residents. Some staff still find it difficult to move away from a task-based approach particularly when they are not familiar with the residents they are supporting. Staff need to make sure they talk to the residents they are assisting or moving to reassure them and make them comfortable. The incidents of falls and accidents is monitored by the deputy manager to identify whether any further action is required for the individual concerned or adjustments need to be made to the routines of the day or staffing levels. Managers are now also making a record of their checks on residents who are unwell or have had falls or accidents so any changes requiring further help can be identified at an early stage and their comfort monitored. Residents are weighed regularly and where their body mass index calculations identifies a risk they are referred to their GP. It was advised that staff use the same unit of measurement on each record to enable changes to be identified more easily. The GP’s are reported to carry out regular reviews of medicine. Medicines are stored appropriately. It was identified on one of the units that staff had not signed the administration chart each time a medicine had been given. This is unsafe practice that could lead to residents receiving incorrect doses. Overall the medication systems within the home support good practice in this area. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 13 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): Standards 12, 13, 14 & 15 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The range and quality of activities available to the residents is improving. Some care staff still lack the confidence or skill to find time to engage with individual residents other than when they are carrying out a caring task. Residents are provided with a good range of nutritionally balanced meals, which they enjoy. The arrangements made to change how medication is given at meal times so that the enjoyment of the meal is not disrupted is still not clearly understood by all staff. The staff serving meals need to understand the individual needs of residents so they are aware of those requiring special diets or assistance and encouragement. EVIDENCE: There has been an increase in the number of activity organisers so it is planned to extend their working hours to cover evening and weekend events. Residents have been able to go out on trips as well as social events arranged in the home. A weekly afternoon tea event is well supported and enjoyed. Where spaces are available there are opportunities to spend time in the day Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 14 centre. A multi-cultural event complete with steel band enables residents and staff to share each other’s cultures and experiences. The hairdresser was present on the day of inspection. Generally the interaction between residents and staff was positive with good examples of staff providing sensitive support and reassurance. Some staff missed opportunities to open up discussion with individuals and develop group interaction. The same CD was allowed to pay through three times on one unit. Staff turned off the TV without consulting the residents in another area. The recording of information about each person’s life history and interests to help staff engage with them is improving. Our Expert by Experience had lunch with a group of residents and made the following observations. ‘Lunchtime was a bit disorganised. One of the staff didn’t know the names of the service users and didn’t seem to understand the menu list on which those on special diets were noted. Everyone was eventually served with their choice of meal and they were all asked how much they would like. Second helpings were also offered. On the whole interaction between staff and service users was good. There was one lady that didn’t eat very much of the first course and although this was noted by the staff no encouragement was given to eat. She did eat her sponge and custard. The food was well presented and hot. Two service users chose to eat in their rooms and meals were taken to them on a tray but the plates were not covered. I was also concerned that medication was given before service users had finished their meal. Several said how much they had enjoyed their lunch and at least three people said ‘The food is always good here’. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 15 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): Standards 16 & 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that concerns brought to the attention of the management team or company will be listened to and acted upon. EVIDENCE: We have not received any formal complaints about this service since the last key inspection. The records in the home indicate the manager has received four complaints since the last key inspection. Two were issues of poor communication where relatives felt they had not been kept informed and two related to concerns about the standard of housekeeping. Quantum Care are pro-active in making referrals under the Hertfordshire Safeguarding Adult procedures regarding issues brought to their attention so that they can be investigated by an independent agency. Incidents are also reported to the Commission as required. This demonstrates an open and transparent approach. One referral made by the company since the last key inspection led to an investigation and two meetings under the Hertfordshire Safeguarding Adult procedure. It was concluded there was no evidence to support the statements made by a resident who due to their dementia was not able to give a clear account of events or could have been expressing past memories or feelings of anxiety or discomfort. This shows us that residents are listened to and their descriptions of their experiences are followed up. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 16 Staff have received training in the responsibilities placed upon them to safeguard the well-being of people in their care, protect them from abuse and report any concerns they may have. While inconsistencies in the approach and skills of staff were identified at this inspection the interaction observed between staff and residents was generally positive and did not reflect the concerns of the earlier inspection in April. The residents appeared to be much more comfortable and relaxed. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 17 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): Standards 19 & 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Fosse House provides the people who live there with comfortable well maintained accommodation. The large garden has recently benefited from further landscaping and provision of wheelchair accessible pathways and a large summerhouse to encourage people to go outside. Now that a housekeeping team has been established, residents are experiencing a fresher, cleaner home. Relatives continue to be concerned about the standard of the laundry service provided and the plans reported following the April inspection to have laundry cover in the evening to improve standards have not yet been put in place. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 18 EVIDENCE: The lounge carpet on Swallow unit needs to be replaced, as other measures to control the odour have not been effective. This issue has been outstanding since the home was inspected in July and needs to be addressed as a matter of priority. The housekeeper reported that the housekeeping team are now able to implement routine cleaning schedules and attend to the deep cleaning required to maintain standards. The housekeeping staff need to be aware of not disturbing residents meal times by using the vacuum cleaner outside the dining room at these times. The homes own quality assurance audit has identified that the biggest concern of relatives is the poor quality of the laundry service. The previous inspection identified that an evening laundry service was to be introduced to reduce the effect of care staff overloading machines causing clothing to be creased and staff putting laundry back in the wrong rooms. This has not yet been put in place. Staff had access to liquid soap, gloves and aprons in the areas they need to prevent the spread of infection. Quantum Care update their policies and procedures in line with changing national guidance on preventing infection. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 19 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): Standards 27, 28, 29 & 30 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Some residents experience inconsistent and routinised care practices from staff not familiar with their needs as a permanent team of care staff has yet to be established. EVIDENCE: Our Expert by Experience observed that ‘The staff worked together and were happy to help out on other units if required. Although not over staffed there were no complaints about that’. While the staffing levels provided appear to be sufficient to meet the needs of residents when things are going well there is very little flexibility in the system to provide cover when unexpected crises or events occur. On the day of inspection a resident who had fallen was accompanied to hospital by the activities organiser. While this meant the personal care of residents was not disrupted by sending one of the carers the planned activity for the morning did not take place. It is positive to note that residents needing to go to hospital unexpectedly are supported by a member of staff. On the day of inspection casual and agency staff had been brought in to enable the permanent staff to attend moving and handling training. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 20 Recruitment and retention of suitable care staff continues to be a problem. Casual and agency staff are used to cover shifts where there are not enough permanent staff. This means there are times when residents experience inconsistent and routinised care practices from staff not familiar with their needs. This appears to impact disproportionately on the residents of Dove and Swallow unit where for various reasons the last three inspections have identified they are being supported by less experienced staff than the other two units. This is reflected in the observations made in this report regarding some poor interaction with residents and an impersonal approach to the organisation of their day. This observation was also made by a relative who contacted us the day after this inspection. Although Quantum Care supports it’s staff to achieve qualifications in care at NVQ level 2 this staff team has not achieved the 50 staff ratio described under these standards to ensure residents are in safe hands at all times. The records of four newly recruited staff were reviewed. This confirmed the required checks on their suitability to work with vulnerable people are carried out before people are employed. Seven staff returned completed survey forms directly to us. Overall the response was positive and they spoke of the values they place on caring for residents. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 21 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): Standards 31, 33, 35 & 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Quantum Care have provided resources in terms of management time and training to re-instate the stated principles and values of the company towards providing good quality outcomes for the people who live at Fosse House. The health and safety auditing and monitoring systems within the home protect residents and staff. EVIDENCE: Mrs Gauthier has completed the qualifications that are the standards set for care home managers. She is supported by Quantum Care senior managers who make regular visits to the home. The monthly reports provided to the board of directors reflects the direction of the work which has been going on to Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 22 improve standards and identified in the action plan provided to the Commission. The care team managers have a key role in setting standards and observing practice on each of the units. Five care team managers have been replaced since August 2006. Now that a new team has been established we are beginning to see the outcome of their work with staff to improve standards. Two staff who completed survey forms felt that managers needed to be more encouraging and supportive. Monthly health & safety visits and audits are completed to check the safety of systems. Previous inspections have identified that clear, well organised, up to date records of safety checks and fire safety checks are maintained. Policies and procedures are regularly reviewed in line with changing legislation and good practice advice. Records of the statutory training required by new staff and at regular intervals to update existing staff show that staff receive the health and safety training they need to provide safe working practices. On the day of inspection staff were receiving moving and handling training. Previous inspections have confirmed there are suitable systems in place to enable residents to have access to small amounts of money deposited on their behalf. The accounts are regularly audited. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 23 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 2 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 Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 24 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 OP15 Regulation 18 Requirement Timescale for action 30/11/07 2 OP19 23 3 OP31 26 To make sure people get the care they need staff serving meals need to be familiar with the procedures in the home for identifying dietary requirements at meal times. To improve standards for 30/12/07 residents the lounge carpet on Swallow Unit must be replaced as other measures to address the odour have not been effective. Continue to send the 30/12/07 Commission monthly reports under this regulation so we can monitor the progress being made to establish a permanent staff team and promote person centred care. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Fosse House Refer to Good Practice Recommendations DS0000019349.V353108.R01.S.doc Version 5.2 Page 25 1 Standard OP15 To reduce the effect of cooling and risk of contamination meals should be covered when taken to residents in their rooms. Fosse House DS0000019349.V353108.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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. 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