Inspection on 09/06/05 for Fosters

This inspection was carried out on 9th June 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 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 17/10/06

Fosters 08/12/05

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 RG5 4HH Lead Inspector Susan Cledwyn-Davies Unannounced 9 June 2005, 8.45 am 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. FOSTERS H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Fosters Address Fosters Lane, Woodley, Reading, RG5 4HH 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) 0118 9690630 Wokingham District Council Mrs Ann Martin Care Home (CRH) 36 Category(ies) of Old age, not falling within any other category registration, with number (OP) 28, Dementia (DE) 8 of places FOSTERS H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 6 December 2004 Brief Description of the Service: Fosters provides accommodation and care for up to thirty-seven service users over the age of sixty-five years who have care needs associated with old age. The home is one of two local authority homes within the Wokingham District Council Unitary authority. Fosters is a purpose built home built in the 1970’s. The home has been organised to provide separate dining, kitchen and lounge areas for 4 distinct groups. The home has recently registered an area to provide care for people diagnosed with a dementia. FOSTERS H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included a partial tour, discussion with residents and staff, discussion with senior staff and records. There are 31 residents in the home. It was agreed that within the report the term residents would be used for service users. What the service does well: 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 H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 6 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 FOSTERS H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 7 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 Residents’ needs are assessed prior to entering the home. EVIDENCE: Each resident is visited and assessed prior to admission. This assessment was seen in a recent admission. A summary of needs assessment had also been received from the Social Services Department. Each resident has a care plan and care is reassessed to ensure that the home is able to provide for his or her needs. FOSTERS H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 8 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, 9 and 10. Care plans including the residents’ health, personal and social care needs are largely in place. Health care needs are met. Medication administration and practice is safe and residents are treated with respect. EVIDENCE: Care plans are reviewed monthly and in the care plans seen were up to date. In discussion it was encouraged to put in more detail of how care should be given e.g. lifting, bathing. Risk assessments were found in place but not in all care plans in the same detail. Risk assessments for service users requiring bedsides are not in place. This requirement is repeated. Health care needs are met by a local GP surgery. There is a team of nurses that visit the home, one of whom was in the home during the visit. There had been a prompt response to a phone call from the home for a visit. The nurse was positive about the care offered in the home and the good working relationships with staff. Prevention and management of pressure sores training is being given to staff this week. Residents were happy with the care and spoke of being listened to. The inspector observed good relationships between staff and residents. FOSTERS H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 9 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, 14 and 15. Residents are encouraged to maintain interests and activities. Contact with families and the local community are encouraged. Residents are given choice and control over their lives and receive a wholesome balanced diet. EVIDENCE: The activities arranged varied. During the morning some residents were visiting the local library. The part time activities organiser has just left and replacements for the organiser are being sought. The activities include art and crafts, exercises, trips out to local garden centres etc. Families and friends are encouraged to visit. Staff are taking part in the local carnival. Contact with local day centres is maintained. Residents confirmed that they have choice over their lives, firstly in how they spend their day and in the meals that they have. Main meals are prepared centrally. A new assistant cook has just started and now the kitchen is covered 7 days a week. There are plans to amend the menu and include more cooked breakfasts. Breakfast was observed, largely prepared by care staff in units. The tables were laid attractively and included small teapots and condiments. Service users were given assistance sensitively. The menu showed variety and conversations with residents and the cook showed that residents’ views are listened to and acted upon. FOSTERS H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 10 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 Residents are confident that they will be listened to and complaints acted upon. EVIDENCE: The complaint record demonstrates that complaints are taken seriously and investigated fully. This was also confirmed in conversation with residents who had experience of queries and concerns being listened to and resolved. FOSTERS H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 11 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 and 24 The home is comfortably decorated and furnished. Residents’ individual rooms reflect their own interests and taste. EVIDENCE: The house has had a lot of essential maintenance over the last year and the establishing of a unit provided for people with dementia in a converted wing has been very successful. The house is comfortably decorated and furnished. Repairs are completed as necessary. A shower was being replaced during the visit. Individual rooms were decorated and furnished according to personal taste. Residents are encouraged to bring in their own furniture and personal belongings. FOSTERS H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 12 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 and 30 Sufficient staff meets residents’ needs. Staff training takes place and is considered important, some training has not been given. EVIDENCE: Staffing levels included a minimum during the day of 2 staff per unit plus 2 team leaders. There are 4 units in the home. At night there are 2 care staff to cover the home. There was a recent reduction as the unit for people with dementia has settled so people are not disturbed. Care plans confirmed that daily activities are encouraged to promote fulfilment and better sleep at night. Care staff complete both the care and domestic tasks on each unit. Staff confirmed that there is sufficient staff. The permanent and bank staff Numbers are now increasing to reduce use of agency staff. The disruption is minimised by using the same care staff. Staff training records were seen. These are organised in individual records. There is a previous requirement to have a centralised training record to ensure monitoring. On each unit a record of staff training is being started for this year and will be monitored by team leaders. It will be important to check that this method provides sufficient monitoring. Training in food handling and first aid is very poorly maintained. Only four staff have food handling training and two staff have first aid training up to date. It is very important that all staff receive this training as soon as possible. FOSTERS H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 13 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 and 35 The home is run well by the manager. Residents’ financial interests are safeguarded. EVIDENCE: Since the last inspection the CSCI registration of the manager has been completed. The manager is qualified and experienced. Monthly visits by the representative of the proprietor are now being completed. Reports are being received in CSCI. The residents finance held by the manager is being reorganised. A new central account is being opened and all of the residents finance held in the home will be placed in this. The manager is not acting as a power of attorney. The records kept included receipts for debits and regular audits by the administrator and the auditor from the local authority. Staff initialled each entry. There was always one staff signature, sometimes two. In discussion it was recommended that 2 people sign each entry to provide greater security. FOSTERS H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 14 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 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 x x STAFFING Standard No Score 27 3 28 x 29 x 30 2 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 x x 3 x x x FOSTERS H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 15 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 7 Regulation 13 Requirement Timescale for action 1.9.05 2. 30 13 That risk assessments are prepared for all residents who use bedsides. THIS REQUIREMENT IS REPEATED. That staff training in food 1.10.05 handling and First Aid is provided 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. Refer to Standard 7 35 Good Practice Recommendations That care plans contain clear detail for staff to provide the care needed. That each entry in the residents finance records are initialled by 2 people. FOSTERS H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 16 Commission for Social Care Inspection 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 H52-H01-S30852-Fosters-V228012-090605-Stage 4.doc Version 1.30 Page 17 - 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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