Inspection on 17/10/06 for Fosters

This inspection was carried out on 17th October 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 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

Fosters 17/10/08

Fosters 08/12/05

Fosters 09/06/05

Fosters 06/12/04

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

CARE HOMES FOR OLDER PEOPLE Fosters Fosters Lane Woodley Reading Berkshire RG5 4HH Lead Inspector Sandra Grainge Unannounced Inspection 17th October 2006 09:50 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 Fosters DS0000030852.V306218.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. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fosters Address Fosters Lane Woodley Reading Berkshire RG5 4HH 0118 9690630 0118 9695113 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) Wokingham District Council Pat Brecknock Mrs Ann Martin Care Home 36 Category(ies) of Dementia (8), Old age, not falling within any registration, with number other category (28) of places Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th December 2005 Brief Description of the Service: Fosters is a residential care home that was built in the 1960s; it is operated by Wokingham District Council Unitary Authority. The home provides accommodation and care for up to thirty-six Service Users over the age of sixty-five years who have needs associated with old age. Fosters has been organised to provide separate dining, kitchen and lounge areas for 4 distinct groups. One of these areas is registered to provide care for people diagnosed with a dementia related problem. The building is situated in a residential area in Woodley. Local transport services are nearby. There are limited parking spaces available on site. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection includes the report of an unannounced site visit that was carried out by a locum inspector on a weekday morning. Records and evidence about Fosters held by CSCI informed the inspection; also included was data submitted by the Registered Manager. Service Users and their relatives had been supplied with survey forms “Have your say about.” Eleven surveys were returned to CSCI; comments made on these forms focused the inspection and are included in the report. All eleven praised the care; two contained comments about concerns, so these were included in the inspection agenda. There were no major problems. During the site visit the Inspector spoke to Service Users, three visiting relatives and the staff on duty. Some of the Service Users have dementia and are unable to represent themselves, so care practice and their response was considered. Files and records were inspected and found to be in order. A tour of the premises shows a property that is dated and aging. The requirements of the precious inspection had been met; new requirements are made; they include provision of new entrance carpet and a plan for refurbishment of the first floor toilets and bathrooms. In order to protect Service Users there must be evidence in the staff files that all recruitment checks for new staff are carried out. Both Service Users and their relatives commended the Manager and staff for the care that that is provided. Scale of charges as at 17.10.06: - £ 487.37 per week. What the service does well: The home provides good care for Service Users; many of these are confused and dependent people. Service Users themselves reported that they are very pleased with care given by staff; relatives agreed with this. Staff practice observed during the visit was good; staff are well trained and treat residents as individuals with politeness and courtesy. Care plans and records in the home contain evidence of care and good management. The aim of the Registered Manager and her staff is clearly to improve the conditions and lifestyle of those who live in the home. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 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 Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, and 5 Quality in this outcome area is good. Service Users and their families are able to make a choice about the suitability of Fosters using the information documents that the Registered Manager has provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the Statement of Purpose is available in the entrance hall with a Service User guide and the complaints procedure. Surveys stated that all had received enough information and support to make an informed choice about living in the home. Trial visits to the home can be arranged and several of the relatives informed the Inspector that the home had provided respite care for their relative on several occasions before admission became necessary. The Registered Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 9 Manager would like to be able to offer planned visits to everyone before admission. Each Service User had a contract of terms and conditions of occupancy of the home on their file together with a detailed assessment of their need. Needs are assessed by the Local Authority Care Managers prior to admission and then senior staff in Fosters carry out further assessment to produce an initial care plan. One Service User Survey had been completed and returned on behalf of a partially sighted resident. There is evidence that the service is staffed and equipped to meet the needs of those within its registration category, however, it is not registered for partially sighted Service Users and the Inspector met this Service User who had experienced some additional difficulties due to poor vision. The general care given by staff was very much appreciated so the concerns were referred to the Manager to rectify. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is good. Service Users receive health and personal care to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is evidence on file that Service Users receive the care that they need. Each file examined contained a comprehensive assessment that includes risks. These had informed an individual care plan of specific details for staff action. The plan format is new and has clearly been carefully done. Care plans are reviewed monthly and as necessary and there is evidence that both the Service User and next of kin have been involved in the process. Service Users are referred to medical and specialist nursing care when needed. A dentist was visiting some residents in Fosters during the inspection visit. There is evidence that individual nutritional screening takes place and at least monthly weight monitoring is recorded. Medication was stored correctly, prescribed for each individual and administered by staff trained to do so. The records that were inspected had been completed correctly. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 11 Service Users felt that they are treated with respect and their privacy is upheld. This view was contained in the questionnaires and also stated by the relatives during the visit. Staff were observed to behave in accordance with these principles. The Manger had carried out Quality surveys that contain evidence that healthcare professionals who visit the home have the same view. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15 Quality in this outcome area is good. Service Users reported that although they would prefer to live in their own homes the staff care and service that they receive in Fosters is good and meets their needs. This judgement has been made using available evidence including a visit to this service EVIDENCE: An Activities Officer is employed for twenty hours a week; Service Users were seen to be enjoying the activities that she planned for them. As she can only be there for a short time all care staff are encouraged to be involved in the interests and leisure activities of Service Users. Detail of panned outings and events is displayed on the notice board so that family and friends can join in if they wish. Those individuals who do not like group activity have been assisted to pursue their own interests; one gentleman continues with his ornithology. A group of local inter - denominational Christians offers regular Church Services in the home. One of these was held during the morning of the visit; it was well attended and the group was made welcome by staff who made space available for the service and provided coffee and biscuits at the end. A Service User told the Inspector that he enjoyed the religious worship and the opportunity to sing hymns. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 13 The Inspector met a volunteer worker who has been helping in Fosters for many years. He considers that the home provides good care and would be “delighted” if a member of his family lived there. The inspector spoke to several families who were visiting during the inspection. One visitor was impressed with the infection control practice in the home; hand wipes are made available to visitors as they enter the building. Another liked the offer of refreshments and the ability to make a drink. The relatives who spoke to the Inspector reported that they are pleased with the service. This includes the relative of a partially sighted Service User who had used the survey to express some problems arising from lack of sight. The Inspector discussed the problems with them because the service is not registered to provide specialist care for those who are partially sighted. They are aware of this and feel that otherwise the home is very good. The difficulties were outlined to the Inspector who, with their permission, then raised them with the manager. Each Service User has an individual room where their own personal possessions are in evidence. No one was able to manage their own financial affairs but they are given opportunity to exercise choice. A varied menu is offered. Service Users commented in the surveys that they enjoy the food offered to them in the Fosters. The cook knew each individual and was seen as she went round the home asking for comment about a new addition to the menu. Special food was prepared for those unable to eat a normal diet and staff were observed to skilfully and discretely give assistance to those who are unable to feed themselves. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. Service Users and their relatives are aware of how to complain if necessary and procedures are in place to protect the vulnerable from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the complaints procedure has been given to all Service Users and a copy is displayed in the home. No complaints about Fosters had been received by CSCI and only three had been received in the home in the last year. There was evidence that these had been managed quickly and to the satisfaction of the complainants. Staff are trained to be aware of the protection of vulnerable adults and they know the procedures to follow in the event of an allegation. Individual staff were able to confirm this to the Inspector. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 15 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, 20, 21, 22, 23, 24, 25, 26 Quality in this outcome area is good. Service Users live in a safe environment that is clean and meets their needs. The building and facilities are dated and the communal areas lack a homely feel. There has been investment in the laundry system that results in good infection control procedures and improved care of the Service Users’ own clothes and bedding. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service Users live in a safe environment. The property was designed and built in the 1960’s and although spacious the communal areas lack a homely feel. The entrance and stair carpet is stained and needs to be replaced. The building has four areas that can be self-contained; one area is registered to provide specialist care for those who have increasing dementia needs. The upstairs corridors were re-carpeted and decorated during the last year. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 16 Service Users bedrooms are single and contain their own personal possessions; the rooms are redecorated and have new flooring fitted as this is needed. The bathrooms on the first floor are spacious and equipped with assisted bathing facilities; however they are not homely, the tiles are cracked and damaged, the décor is faded, the hot water pipes are not boxed and the rooms do not have curtains. A plan for refurbishment in the near future is required. Sluices are provided separately in the building and initial sluicing of linen takes place here, relying on good infection control practice and provision of equipment for staff protection. New boilers have been installed together with a new laundry system. The washing machine is able to clean to infection control standards and in addition does not require such hot wash temperatures. This results in softer, less irritant clothing for the Service Users. The laundress was very enthusiastic about the new system that is easier for staff to operate correctly when she is not there. In order to assist them to recognise their own bedroom and other areas of the home the doors in the home have been named individually according to Service Users choice. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 17 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): 27, 28, 29, 30 Quality in this outcome area is good. Service Users are given care and support by a sufficiently large team of trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff rotas have been changed during the last year to better meet the needs of the Service Users. Less agency staff are used because the home has bank staff who have been trained and are familiar with the Service Users. The provision of domestic staff was reviewed but regretfully care staff are still needed to clean the areas of the home where they are working to provide care for Service Users. Several members of staff have been absent during the year due to long-term illness; this has put strain onto existing members of staff who have had to cover the vacancies. Staff files were examined and the recruitment procedure is robust; each member of staff now has a photo on file as required following the previous inspection. There was no evidence in the files seen that a POVA check is carried out and the Manager was required to provide evidence of this to CSCI. Volunteers who help in the home are checked in the same way in order to protect vulnerable Service Users. The Manager has been responsible for a staff-training programme that has achieved 51 of staff who have NVQ 2 or above. In addition the service has trained and now employs three staff who are manual handling trainers. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 18 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): 31, 32, 33, 36, 37, 38. Quality in this outcome area is good. Service Users live in a safe home that is well managed and operated in their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manger is both experienced and qualified to operate the home. Service Users felt that they could trust her to arrange care for them. Families who commented said that she “operates a well run home”; the staff on duty at the time of the visit agreed with this view. There is a quality assurance process in place; Service User views are sought; six monthly reviews are carried out and the Registered Individual carries out and reports on unannounced monthly inspections. The finances of the home were not examined as part of this inspection. The Manager had provided information to CSCI as part of the AQUA pilot. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 19 There was evidence that care staff receive regular supervision that is recorded and contributes to staff training programmes. Records are kept for effective operation of the service and the requirements of the Fire prevention Officer and Environmental Health Authority are met. Health and safety legislation is followed for the wellbeing of Service Users and staff. Three staff are now trained as manual handling trainers. Accident records are kept and reviewed. Infection control practice is good. This includes the provision of medicated hand wipes for use by visitors to the home. Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 2 2 3 3 3 3 4 STAFFING Standard No Score 27 4 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 21 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. 2. Standard OP24 OP21 Regulation 16(2)(c) 23(2)(b) Requirement The Registered Provider is required to provide new carpet for the entrance area of Fosters The Registered Provider is required to send a detailed plan and schedule to CSCI for the refurbishment of the toilets and bathrooms on the first floor The Registered Manager is required to provide evidence that the Authority carries out POVA checks for staff to protect Service Users. Timescale for action 15/12/06 01/12/06 3 OP36 19(4) 01/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Fosters DS0000030852.V306218.R01.S.doc Version 5.2 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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