Inspection on 19/03/07 for Fountain Court

This inspection was carried out on 19th March 2007.

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

Fountain Court 12/01/06

Similar services:

Coton Hill House

Doddington Lodge

Far Croft

Churchill House Nursing and Residential Home

Field Farm House

Church Terrace Nursing & Residential Home

The Forbury

Evendine House

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

CARE HOMES FOR OLDER PEOPLE Fountain Court Residential Unit Millpool Way Bearwood Smethwick West Midlands B66 4HW Lead Inspector Maggie Bennett Key Unannounced Inspection 19th March 2007 10:00 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 Fountain Court Residential Unit DS0000064672.V330483.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. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fountain Court Residential Unit Address Millpool Way Bearwood Smethwick West Midlands B66 4HW 0121 565 2427 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) Sandwell Metropolitan Borough Council Mrs Michaela Wilson Care Home 16 Category(ies) of Dementia - over 65 years of age (16) registration, with number of places Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th January 2006 Brief Description of the Service: Fountain Court is owned and managed by Sandwell Metropolitan Borough Council. It is a newly built single storey property specifically designed to care for older people with dementia. The accommodation is arranged in two units, each having a separate lounge/dining area. All bedrooms are single and have an en suite toilet and shower. There are safe and secure gardens. Staff receive ongoing training in the needs of people with dementia. Fees charged at the home are £467.00 per week. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 2 weekdays from 10.00 a.m. to 5.40 p.m. on the first day and from 8.40 a.m. to 12.00 noon on the second day. All the National Minimum Standards were assessed on this occasion. Prior to the inspection a Pre Inspection Questionnaire was completed by the Registered Manager of Fountain Court and returned to the Commission. In addition satisfaction surveys were completed by a number of service users and their representatives and these were also returned to the Commission prior to the inspection. During the course of the 2 days a number of service users’ care plans were seen in order to inspect assessment practice and care planning. The medication procedure was assessed. Several staff files were seen in order to check recruitment practice and staff training. Various other documents were seen in order to assess the home’s policies and procedures and compliance with health and safety legislation. A tour took place of the building. A number of service users were spoken to, as were 2 members of care staff, a member of the kitchen staff and 2 visiting relatives. Discussion took place throughout the inspection with the Registered Manager and Assistant Manager. At the last inspection of the home, in January 2006, 2 statutory requirements were made. Both of these requirements have been met and no further requirements were made on this occasion. Three good practice recommendations have been made. What the service does well: In their returned surveys the service users (who were assisted by a staff member to complete the forms) made very positive comments about their care at Fountain Court. Many commented that they were very happy at the home and felt that staff cared for them well. One person said of the staff: “I love them.” In the surveys returned by relatives very high praise was made of Fountain Court. Here are some of the views expressed: “Everything, everyone is very helpful and caring. The home is always clean and tidy.” “The home is ideal…….We bless the day they agreed to take Mom permanently.” “They would be hard put to improve it as the standards are high.” “I can’t think of anything to say, just how impressed I am with Fountain Court.” Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 6 “Fountain Court should be congratulated for its level of care from all of its excellent staff.” “They treat each individual with respect, spending time with each one, talking about their lives, past and present. They create a “family” atmosphere, keeping the residents stimulated, occupied and welcome. They also make the family feel very welcome at any time, and are never too busy to talk.” “Just to reinforce how satisfied and pleased we are with my mother’s care at Fountain Court – lovely staff, lovely building, lovely atmosphere.” Clear information about the home is provided to all prospective service users and their representatives. There are excellent assessment practices in place, which ensures that the home is able to meet the needs of the service users. There is a strong ethos within the home of involving service users in all aspects of their care. This is true of care planning, with care plans being person centred and developed with assistance from the service user. The healthcare needs of service users are clearly documented and there is a very good working relationship with community based healthcare professionals. A full and stimulating range of activities are provided, with individual interests encouraged and developed. Local organisations, such as Sandwell Third Age Arts, have been invited to the home and have assisted the service users to design and provide artwork for their new bar area. The food provided is of good quality, offering several choices of nutritious meals. The management and staff of the home are well aware of their responsibilities with regard to the Protection of Vulnerable Adults. The building itself is well designed and offers very comfortable and homely accommodation, which meets the needs of people with dementia. There are excellent standards of hygiene. There has been a low staff turnover at the home, which reflects the commitment and enthusiasm of the staff group. Staff receive good opportunities for appropriate training. There are robust recruitment procedures in place to protect the service users. The home is very well managed and administered. The manager is well qualified and experienced and has particular skills and knowledge in the care of people with dementia. She is visionary in her approach and continually seeks to provide an imaginative service, with the wellbeing of the service users at its heart. There are systems in place to enable service users and their representatives to air their views of the home. The health, safety and welfare of the service users and staff are promoted by the home’s policies and procedures. What has improved since the last inspection? The introduction of the new bar area has provided the service users with an opportunity to personally engage in a new and innovative project in the home. Care plans have been improved since the last inspection and are now available in formats specially designed to meet the individual needs of the service users. This includes the use of pictorial illustrations. Plans are now reviewed on a Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 7 monthly basis. All those records required by legislation are now available on the premises. 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. Fountain Court Residential Unit DS0000064672.V330483.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 Fountain Court Residential Unit DS0000064672.V330483.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): Standards 1, 2, 3, 4, 5 and 6. Quality in this outcome area is good. Clear information is provided to service users and their representatives prior to their admission to the home. This information is available in formats to suit the individual needs of the service users. There are excellent assessment procedures in place to ensure that the home is able to meet the needs of the service users. Staff are briefed on the needs of any new service user. Appropriate training is provided to assist staff to develop the skills required to meet the specialist needs of the service user group. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Fountain Court has an up to date Statement of Purpose and separate Service User’s Guide, which meet the requirements of the Care Homes Regulations 2001, as amended in September 2006. The Service User’s Guide is produced in 2 formats, both of which are written in plain English. One Guide is available Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 10 in a pictorial format, which is accessible to the service users and is explained to them by an individual member of staff at the time of their admission to the home. The Registered Manager explained that different versions of the Guide were available to suit the differing needs of individual service users. There was evidence at the inspection that all service users had been given a copy of the Guide, which contained all those details listed in Standard 1.2 of the National Minimum Standards. In addition the Guide contains a copy of the Sandwell Social Services leaflet, “Tell us what you think” and a copy of the Social Services Adult Protection process. Copies of contracts seen at the inspection showed that service users and their representatives are provided with a statement of the terms and conditions (or contract if privately funded) at the point that they move to the home. Statements seen contained details of all those areas listed in Standard 2.2. Some of the statements seen did not contain a signature of the service user or their representative. The files of 3 service users were seen in order to inspect the home’s assessment practice. All the files contained evidence that the service users had received a proper assessment prior to their admission to the home. A copy of the Sandwell Social Services Single Assessment Process was available on file. All staff are asked to read the service user’s assessment and sign the file to verify that they have done so. The assessment information is used to develop the plan of care (see Standard 7). It was clear from observation during the inspection and from evidence supplied by the Registered Manager that the home is well able to meet the needs of the individual service users. Staff receive regular training in Dementia Care provided by the Bradford University Dementia Care Plus Group. The Registered Manager is an Advanced Dementia Care Mapper and also provides training to other Local Authority homes in Sandwell. Staff spoken to during the inspection were able to give clear examples of how the home met the individual needs of the service users. Where possible, visits prior to admission are arranged, to suit the needs of the individual. If appropriate, service users spend a day or days at the home before they make the decision to stay. Fountain Court does not provide intermediate care. Fountain Court Residential Unit DS0000064672.V330483.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 and 11. Quality in this outcome area is excellent. There is a strong ethos within the home of involving service users in all aspects of their care, wherever this is possible. There are clear care plans in place, which are person centred and developed with assistance from the service user. Plans contain risk assessments and are regularly reviewed and updated. The healthcare needs of service users are clearly documented and there is a good working relationship with community based healthcare professionals. The need to respect the privacy and dignity of service users is understood by the staff. The wishes of service users with regard to terminal care and arrangements after death are discussed and recorded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans were inspected in order to assess the home’s care planning practice with regard to personal, social and healthcare needs. Care plans were of good quality at the last inspection, but they have now been improved Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 12 further and provide an excellent working tool for staff. The plans provide clear evidence that they have been developed with the service user. They are in a pictorial format and include a “Map of Life”. All those areas listed in Standard 3 are covered and plans follow person centred principles, listing the preferred processes for each individual. The plan includes a risk assessment, including a falls risk assessment (signed by staff to indicate that they have read and understood the assessment). There is evidence that care plans are reviewed on a monthly basis and updated, if necessary, to reflect changing needs. The healthcare needs of service users are documented within their care plan and each plan contains a Healthcare Monitoring Form. This monitoring form includes dietary information, a record of weights and a pressure sore risk assessment. An example was seen in one care plan of how specific issues with regard to the care of the person’s legs were to be addressed. Pressure relieving equipment is available as required. All service users have access to assistance from the Community Psychiatric Nurse. Service users are given opportunities for exercise, with regular exercise sessions being provided. Service users have access to the full range of healthcare services and where possible are taken to appointments in the community. The home enjoy an excellent working relationship with the healthcare professionals, which has clear benefits for the service users. The home follows the Sandwell Social Services’ policies with regard to the receipt, recording, storage, handling, administration and disposal of medicines, a copy of which is provided in the medication room. None of the current group of service users take charge of their own medication. The home use a monitored dosage system, which is regularly audited by the supplying Pharmacist. There is a satisfactory system in place for the administration, storage and recording of controlled drugs. All staff who administer medication have received accredited training and certificates were seen to verify this. Evidence was seen that the temperature of the medicines’ refrigerator is checked on a daily basis. A random check was made of the medication and accompanying records and all were in good order. Service users have access to a telephone and if they wish to make or receive calls in private a portable telephone is available. Evidence was seen in a care plan of a service user’s wishes with regard to mail and correspondence, with relevant instructions to staff. All clothes are labelled and there are individual baskets in the laundry to minimise any “mix ups”. Service users are encouraged to choose what they would like to wear each day. Service users are asked at their assessment how they would wish to be addressed and this is recorded in their Care Plan. All staff have received induction training and this has included instruction on how to treat service users with respect. All bedrooms are single with en suite toilet and shower facilities and any medical examinations or treatment take place in the service users’ own rooms. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 13 The home has clear policies and procedures in place with regard to terminal care and death. Service users’ and their relatives’ wishes are sought at the time of admission and these wishes are clearly recorded in individual files. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 14 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 and 15. Quality in this outcome area is excellent. The routines within the home are service user focussed and are flexible in order to meet individual needs. A full and stimulating range of activities are provided and service users are able to participate in a number of communitybased projects. Individual interests are encouraged and developed. Family and friends feel welcome and know they can visit the home at any time. As far as possible, service users are enabled to make decisions about their daily lives. The meals at Fountain Court are of good quality, offering nutritious choices and the provision of any specialist dietary needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Social care activities are provided on a daily basis and it was clear during the inspection that service users are able to exercise choice as to whether or not they join in. They are also able to exercise choice in other aspects of their daily lives, such as times to get up and go to bed. Service users’ interests are recorded in their care plans and records are kept of activities undertaken and planned for the future. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 15 Some of the numerous activities provided are as follows: “Extend” classes, a Gardening Project (part of the “Active Sandwell Green Gym.”, who will be providing raised beds in the garden at Fountain Court) and a weekly Church Service (provided by the New Testament Church). Plants were being grown from seed in the home at the time of the inspection and it was good to see a pair of Wellingtons in the room of a service user who has a particular interest in gardening. Several service users recently attended a Tea Dance at Sandwell Town Hall and visited the Walsall Lights. Each month the home put on a cultural event, featuring themes, dress and foods from particular countries. So far the countries involved have been the Caribbean, India, France, Spain and Ireland. Another innovation has been the development of a Bar in the home. Service users have designed and provided the artwork for the Bar with assistance from Sandwell Third Age Arts. The artwork has included mosaics, Toby Jugs, personal photographs, paintings and beer mats. The result is a very authentic-looking bar, which is much enjoyed by the service users. During the course of the inspection a number of service users enjoyed a drink in the bar before their lunch. The development of the bar was the subject of an article in the Journal of Dementia Care. Further art project are being arranged with Sandwell Third Age Art. Service users are able to have visitors at any reasonable time and their wishes as to who they choose to see and not see are respected. The home’s policy with regard to maintaining the involvement of friends and relatives is stated in the Service Users’ Guide. Service users are able to use a number of facilities in the local community, including the hairdressing salon next door, the local Church, the Pub. and nearby shops. The home takes charge of some monies on behalf of service users (see Standard 35). Service users are, however, assisted to look after some money (for hairdressing, newspapers, etc.) as long as they are able. The home has details of the local Advocacy service, should this be required. Service users are encouraged to bring pictures and ornaments from home so that their rooms can be individually personalised. All service users and their relatives receive written confirmation that they have access to their personal records. Menus seen during the inspection show that a variety of nutritious foods are offered. Meals are cooked in the kitchen at Penmakers Court and taken to Fountain Court in a heated trolley. If service users wish to, they can have a meal with their visitors at Penmakers Court. There is always a choice for each meal and for the main meal, a choice of several hot dishes (including a vegetarian dish), a salad or jacket potato. Special therapeutic diets, religious or cultural diets can be provided as needed. Service users were observed to receive discreet assistance at lunchtime and were assisted sensitively if needed. The kitchen was inspected and was found to be clean and in good order. Very adequate supplies of food were seen, including fresh fruit (which is cut up and provided to service users each afternoon) and fresh vegetables. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 16 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, 17 and 18. Quality in this outcome area is good. There is a clear complaints procedure in place and service users and their representatives can be confident that their complaints will be listened to and acted upon. Service users’ rights are central to the aims and objectives of the home. The Adult Protection Policies and Procedures are robust. Staff receive regular training in Adult Protection and are aware of their responsibilities to protect service users from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home have a suitable complaints policy and procedure in place, which is also the Sandwell Social Services policy. Copies of the procedure are available within the home and the procedure is also in the Service User’s Guide. It is recommended that this is made available in a format accessible to the service users. One complaint has been made about the home since the last inspection and this was appropriately dealt with within the correct timescales. The Registered Manager has a thorough understanding of the service users’ legal rights. An Advocacy service is available locally if needed. All service users are on the electoral register. Staff are currently receiving training on the new Mental Capacity Act. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 17 The Registered Persons have clear Adult Protection Policies and Procedures in place and this includes a Whistle blowing Policy. The policies were updated in September 2006. Care staff are helped to familiarise themselves with the policy and procedure and have taken part in Adult Protection training, which is provided on a regular basis. Staff spoken to during the inspection were very clear of their responsibilities with regard to the Protection of Vulnerable Adults. The Registered Manager states that the home’s policy on restraint is currently being revised. There is an appropriate policy in place with regard to service users’ monies (see also Standard 35). Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 18 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, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is excellent. Service users live in a safe and secure environment, which is homely and comfortable and meets their needs. The home has been specifically designed to meet the needs of people with dementia and both communal and individual rooms are well planned. Fountain Court is very well maintained and there are excellent standards of hygiene. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Fountain Court is a purpose built establishment, specifically designed to meet the needs of older people with dementia. All accommodation is on the ground floor. There are safe and secure gardens and the building complies with the requirements of the local fire service and environmental health department. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 19 All service users have their own single room, which is provided with an en suite toilet, wash-hand basin and shower. The rooms are individually decorated, with personal bed linen. The home is divided into two units, each of which has its own lounge and dining area and a kitchenette. There is a conservatory area dividing each unit. Furnishings are of very good quality and meet the needs of this service user group. In addition to the en suite showers, there is an assisted bathroom. All rooms are provided with an emergency call system. The home is centrally heated and radiators are low surface temperature. The temperature of the water at outlets accessible to service users is checked on a weekly basis and records maintained. There is a sensor system in each bedroom, which alerts staff should a service user get out of bed or have a fall during the night. All the bedrooms seen during the inspection were in good order, tastefully furnished to suit the individual wishes of the service user. Specialist equipment, including hoists and raised toilet seats are available. There is appropriate signage throughout the home. The home is clean, warm and comfortable. Staff are to be congratulated on the excellent standards of hygiene within the home. No offensive smells were detected. There is a very well equipped laundry, with two washing machines and one tumble dryer. The washing machines have a sluice facility and any foul linen is washed in “dissolvo” bags. There are clear policies and procedures in place for the control of infection. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 20 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 and 30. Quality in this outcome area is good. The staff at Fountain Court are enthusiastic and committed and staffing levels are appropriate to the needs of the service users. There are robust recruitment procedures in place to protect service users. There are excellent induction procedures for new staff and ongoing training opportunities to ensure that staff are competent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rotas seen at the inspection show that there are 4 care staff (2 on each unit) on daytime and evening shifts, plus a Manager. At night there are 2 waking carers. Overnight there is a senior member of staff available “On Call” in the event of any emergency. Kitchen and domestic staff are employed in sufficient numbers throughout the week. Apart from one member of staff, who is currently undertaking the training, all care staff have achieved at least NVQ level 2. All the Senior staff (apart from one, also currently training) have the NVQ level 3 qualification. Catering staff have successfully completed NVQ2 in catering. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 21 A number of staff files were seen in order to check recruitment practice. At last year’s inspection staff files did not contain all the required documentation. It was found on this occasion that staff files contained all the documentation required by law. All those seen contained a fully completed application form, two written references and evidence of satisfactory Criminal Records Bureau and POVA checks. Copies of the staff’s terms and conditions were available in their files. All staff have received a copy of the General Social Care Council Code of Conduct. There is a staff training and development programme in place, which was seen at the inspection. New members of staff receive induction training to Skills for Care specifications and evidence of this was seen in staff files. All staff have a Personal Performance Development Profile, which is written on an annual basis and reviewed every six months. In addition to the statutory health and safety training areas (see Standard 38) staff receive training in a number of relevant areas, including: Dementia Care, Risk Assessment, Adult Protection, Care Plans, Palliative Care and the Mental Capacity Act. Staff spoken to during the inspection were enthusiastic and committed. One said: “I love it here”. Another person said that the home was “very special”. There has been a very low staff turnover since the home opened. Staff gave a good understanding of the needs of people with dementia and demonstrated through their examples that they were “person centred” in their approach. They were fully aware of their responsibilities with regard to the protection of vulnerable adults. Staff felt that they were a good team, who were well led by their Manager, who one described as “wonderful”. Service users, both in their returned questionnaires and during the inspection, made very positive remarks about the staff. They said: “They’re lovely.” “….is like a friend – they all are.” “They look after us.” “They are always pleasant”. A visiting relative said that the staff were “excellent” and provided “wonderful care”. A very friendly and happy rapport was observed between service users and staff during the inspection. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 22 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, 32, 33, 34, 35, 36, 37 and 38. Quality in this outcome area is good. The home is very well managed and administered. The manager is well qualified and experienced and has particular skills and knowledge in the care of people with dementia. She is visionary in her approach and continually seeks to provide an imaginative service, with the wellbeing of the service users at its heart. This has encouraged the development of a strong and committed staff group. There are systems in place to encourage service users and their representatives to air their views. There is a satisfactory business plan in place. Any monies or valuables looked after on behalf of service users are kept securely and appropriate records maintained. The health, safety and welfare of the service users and staff are promoted by the home’s policies and procedures. This judgement has been made using available evidence including a visit to this service. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 23 EVIDENCE: The Registered Manager is very experienced, having been working in the care profession for 22 years. She is qualified to NVQ level 4 and has successfully completed the Registered Managers’ Award. The manager continues to update her skills by undertaking periodic training. The Manager is an Advanced Dementia Care Mapper and is planning to train staff across Sandwell Social Services in Edition 8 of the University of Bradford’s Dementia Care Mapping Scheme. There are clear lines of accountability within the home and the Manager’s Job Description enables her to take responsibility for fulfilling her duties. It is clear from observation, discussions with staff and representatives of service users and from returned surveys that the Manager has strong leadership skills and has created a transparency within the home which welcomes the views of service users, their representatives, staff and all other stakeholders. The Manager is visionary in her approach and continually seeks to provide an imaginative service, with the wellbeing of the service users at its heart. Service users and staff have regular meetings and there is a commitment within the service to equal opportunities. Fountain Court uses the Sandwell Social Services Quality Assurance system to ensure that policies and procedures are followed by staff. Service users’ and their representatives’ views of the home are sought on a regular basis. The results of these questionnaires, plus results from the staff satisfaction survey are analysed twice a year, published and displayed in the home. It is recommended that the views of other stakeholders, such as visiting healthcare professionals and social workers also be sought. There is a Business Plan in place for 2007 and this was seen at the inspection. Evidence was also seen of proper insurance cover. The home keep in safekeeping some personal monies on behalf of service users. Appropriate records and receipts were seen at the inspection. A random check was made of some of the monies and records and all were in order. All monies and records are kept securely. Staff confirmed during the inspection that they receive regular supervision. Evidence of this was also seen in staff files. Formal supervision takes place every six weeks and covers all aspects of practice, philosophy of care in the home, career development needs, as well as issues relating to Adult Protection. All those records required by Regulation are kept securely in the home. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 24 Staff files and the home’s Training Matrix show that staff receive regular training in the core health and safety areas of: moving and handling, fire safety, first aid, food hygiene and infection control. Fire safety checks are carried out at the required intervals and there is a comprehensive Fire Risk Assessment in place. Evidence was seen of the regular testing and maintenance of the gas system, the fire alarm system, the hoist and the wheelchairs. The water system is regularly chlorinated and steps taken to prevent any legionella. The temperature of the water at outlets accessible to service users is regularly taken and recorded. All substances hazardous to health are kept securely and an up to date analysis of all products used is kept and regularly reviewed. There are clear risk assessments in place for all safe working practice topics. It was discovered during the course of the inspection that the home had not been sending in Regulation 37 notices to the Commission as required by law. This was dealt with immediately at the time of the inspection and therefore a statutory requirement is not made. All staff receive induction training to Skills for Care specifications on safe working practice topics. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 25 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 4 4 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 4 3 3 4 4 3 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 3 3 3 3 3 Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action 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 OP2 OP16 OP33 Good Practice Recommendations It is recommended that the home check individual statements of terms and conditions or contracts to ensure that they are all signed and dated. It is recommended that the Complaints Procedure be provided in a format accessible to the service users. It is recommended that satisfaction surveys are sent to visiting healthcare professionals and social workers. Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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. Extracts may not be used or reproduced without the express permission of CSCI Fountain Court Residential Unit DS0000064672.V330483.R01.S.doc Version 5.2 Page 28 - 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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