Inspection on 27/02/06 for Fosse House

This inspection was carried out on 27th February 2006.

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 11/07/05

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 Inspection 27th February 2006 09:00 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 DS0000002359.V275863.R01.S.doc Version 5.1 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 DS0000002359.V275863.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Fosse House Address Hykeham Road Lincoln Lincs LN6 8AA 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) 01522 524612 manager.fosse@ The Orders Of St John Care Trust Mrs Susan I Green Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places Fosse House DS0000002359.V275863.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th July 2005 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 DS0000002359.V275863.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 5 hours and was carried out by one inspector as the 2nd of two statutory inspections for 2005/6. 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 two of them, the care staff and observation of care practices. A number of other residents were spoken to whilst having breakfast and lunch. One bedroom was viewed and a selection of care records inspected. There was a relaxed but busy atmosphere in the home, and residents were observed to be socialising with each other and staff. At the time of this inspection the manager was attending a managers meeting and was not on the premises, therefore, the care leader on duty assisted with the inspection. A number of notifiable events received by the Commission were discussed with the care leader and it was concluded that satisfactory action had been taken to maximise the safety of residents in all but one. This related to a delay in a resident being taken to the accident and emergency department. What the service does well: What has improved since the last inspection? The medication policy has been reviewed and amended enabling care staff more time to administer medication, however, further work needs to be done to ensure safety. Fosse House DS0000002359.V275863.R01.S.doc Version 5.1 Page 6 A designated activity room has been made available where residents can display their work, play large floor/board games, offering much more space and residents are able to leave unfinished work out and return to it later. 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 House DS0000002359.V275863.R01.S.doc Version 5.1 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 House DS0000002359.V275863.R01.S.doc Version 5.1 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): Standard 3 was assessed during the previous inspection. Standard 6 is not applicable. EVIDENCE: Fosse House DS0000002359.V275863.R01.S.doc Version 5.1 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 Care planning in this home is good, providing detailed information on how the health and social care needs of residents are met. Medicines administration, recording and storage arrangements are mostly satisfactory, but with some potential to place residents at risk. EVIDENCE: Care plans set out clear information on how residents’ needs should be met. These are signed and dated by care staff and residents showing their involvement in this process. One resident confirmed that her present needs are being met. Medication is stored and recorded correctly. Two residents who self medicate have signed risk assessments which include their responsibility for safe storage and administration. The home has recently changed its arrangements for administering medication after two medication errors. Staff spoken to said that they feel practice has Fosse House DS0000002359.V275863.R01.S.doc Version 5.1 Page 10 improved, although further work is needed to reduce the risk of further errors. Observation of medication being given to residents during breakfast identified that due to the length of time this procedure now takes the time between each dose is significantly reduced. The manager is due to discuss this new practice with the ‘Trust’ today, and if necessary further advice will be sought from the home’s pharmacist. It was also noted that soluble aspirin medication for one resident was left at the table after she had left. During the visit a number of accidents and incidents reported to the Commission were discussed with the care leader. It was concluded that satisfactory action had been taken to maximise the safety of residents in all but one. This related to a delay in a resident being taken to the accident and emergency department and the home is asked to look at their procedure to ensure this situation does not re-occur. Fosse House DS0000002359.V275863.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 & 15 Residents are able to express choices in their daily lives. Residents receive a nutritious, varied diet which meets individual preferences and health requirements. EVIDENCE: Observations and discussion with residents indicated that they have a choice as to what they do at the home. For example, on the day, some residents were reading, some were watching television and others were in their own rooms. However, one resident said ‘it is like living in a prison’ as he felt he could no longer go out for a walk on his own. Care records pertaining to this resident showed that he has had a number of falls and is at a high level of risk of further falls. This was discussed with the care leader who said that wherever possible staff go out with this gentleman and he has a befriender visiting weekly who also goes out with him. Residents confirmed that meetings are held and day-to-day issues are discussed openly, the last meeting was held on 1st February 2006 and minutes were available for inspection. Care records identify residents’ likes and dislikes and any health requirements. During the visit residents were observed to receive their chosen food. Menus Fosse House DS0000002359.V275863.R01.S.doc Version 5.1 Page 12 and records of food provided were examined during the previous inspection. This inspection focused on the presentation of foods. Tables were nicely laid with tablecloths/napkins and condiments. Each table has a menu and during breakfast residents had individual tea/coffee pots and individual portions of jam/marmalade and butter. The lunch-time meal was mushroom soup, steak and kidney pie, mashed potato and swede or pasta bake. This was nicely presented, and there was a choice of rice pudding or yogurt for dessert. Residents all said they were happy with the food stating that it is ‘excellent’ ‘plenty of variety’ and ‘always appetising’. Fosse House DS0000002359.V275863.R01.S.doc Version 5.1 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): 16 & 18 The home takes the issue of addressing complaints very seriously and residents are confident that their concerns will be listened to. However, residents did not have a copy of the complaints procedure. EVIDENCE: The home’s service users guide is available for anyone coming into the home and is situated where visitors sign in/out. This contains the home’s complaints procedure. Residents said that if they have any concerns they speak with the care leader on duty, however, they did not have individual copies of the written procedure themselves. Complaint records were seen detailing complaints made since the previous inspection and the action taken to address them. However, records did not have a space for complainants to sign confirming that their complaint had been addressed satisfactorily and this is recommended. The Commission has been made aware of two complaints and the Trust are currently investigating these. Staff confirmed that they have recently received training in adult abuse including the reporting process. Two residents spoken to said that they felt very safe living in this home. Fosse House DS0000002359.V275863.R01.S.doc Version 5.1 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): 26 Residents living in this home live in a clean, pleasant and hygienic environment. EVIDENCE: The home employs a number of domestic staff and during the visit it was found to be clean and free of unpleasant odours. Residents said that their rooms are always kept clean and they are very satisfied with the standard of cleanliness of the home. Fosse House DS0000002359.V275863.R01.S.doc Version 5.1 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): 29 Residents are protected by robust recruitment practice. EVIDENCE: Recruitment records were examined of one member of staff newly appointed. These confirmed that a safe practice had been adhered to. CRB/POVA checks have been made and appropriate references obtained. Interview questions and answers are kept on individual files together with induction training records. Fosse House DS0000002359.V275863.R01.S.doc Version 5.1 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): 35 & 38 The health, safety and welfare of residents are promoted in this home. Residents financial interests are safeguarded in this home. EVIDENCE: The home employs an administrator and his responsibilities include the safe keeping of residents personal allowances. Invoices and receipts are kept and two signatures are required when accounts amended. Risk assessments are documented in relation to health and safety issues that may arise from the environment of the home. Maintenance records are kept and there are a range of policies and procedures available relating to fire safety and fire risk assessments. Certificates were available showing that the stair lift, hoists and electrical equipment is regularly tested. Fosse House DS0000002359.V275863.R01.S.doc Version 5.1 Page 17 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 3 Fosse House DS0000002359.V275863.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 OP33 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 home.(Previous timescales of 31.08.04, 31.05.05 and 31.10.05 not met) Timescale for action 30/04/06 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. Refer to Standard OP9 OP16 OP16 Good Practice Recommendations The administration of medication should ensure safe practice and ensure residents have sufficient time between each dosage. The complaints procedure should be re-issued to all residents. Complaint records should provide a space for complainants to sign confirming that their complaint has been addressed satisfactorily or not. Fosse House DS0000002359.V275863.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 DS0000002359.V275863.R01.S.doc Version 5.1 Page 20 - 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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