Inspection on 12/02/09 for Fourways

This inspection was carried out on 12th February 2009.

CSCI found this care home to be providing an Good service.

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

Fourways 13/02/07

Fourways 13/12/05

Fourways 29/06/05

Fourways 30/11/04

Fourways 04/05/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Fourways 3 Bramber Avenue Peacehaven East Sussex BN10 8LR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kathy Flynn     Date: 1 2 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Fourways 3 Bramber Avenue Peacehaven East Sussex BN10 8LR 01273-585670 01273585670 fourways3@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Pamela Dorothy Darch,Mr David Charles Darch Name of registered manager (if applicable) Mrs Pamela Dorothy Darch Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability terminally ill Additional conditions: Can provide care to people aged eighteen (18) or over with a physical disability up to a maximum number of fifteen (15). Can provide care to people aged eighteen (18) or over with a terminal illness up to a maximum number of six (6). Can provide personal care to older people aged sixty five (65) or over on admission to a maximum of nine (9) That the care home provides general nursing care to older people aged sixty five (65) or over on admission. That the maximum number of service users to be accommodated at any one time is twenty one (21). Care Homes for Older People Page 4 of 25 care home 21 Over 65 21 0 0 0 15 6 Date of last inspection Brief description of the care home Fourways is registered as a care home providing nursing care and personal care for 21 residents under the categories of old age, physical disability and terminally ill. The home have a special interest in Huntingtons disease and they also provide specialist palliative nursing care. Fourways is situated in a quiet residential area on the coast with views over the channel. Bus routes and local shops are nearby. The home has a rear garden with seating and tables and a patio area at the front of the home that is well used by residents. The home provides care and support to residents who are both privately funded and those who are funded by Social Services and by Primary Care Trusts. The homes fees range between 450 and 800 pounds per person per week. Additional costs are charged for chiropody, hairdressing, massage and aromatherapy, newspapers and magazines. Fourways literature states that its aim is to provide a relaxed atmosphere where you will feel safe and secure receiving a high standard of care from the staff, who have time for their individual needs. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Fourways Nursing Home will be referred to as residents. This was a key inspection that included an unannounced visit to the home. This inspection was facilitated by the homeowner/registered manager, the lead nurse, training coordinator, administrator the care staff and the cook. Care Homes for Older People Page 6 of 25 A tour of the premises was undertaken and a range of documentation was reviewed including the care plans, staff duty rotas, medication records, and recruitment files. There were 20 residents on the day of the inspection, six were spoken with and a visitors to the home was happy to discuss the support provided. The Annual Quality Assurance Assessment (AQAA) was completed by the manager, within the required timescale, and identified areas where improvements have been made, and where others are planned for the benefit of residents. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All prospective residents are assessed by a competent person. They and their families are encouraged to be involved in this process, and a place is only offered if the home can meet their individual needs. Intermediate care is not provided. Evidence: A pre-admission assessment is completed for all prospective residents, these are completed with their involvement, and their relatives, with places at the home offered only if the home can meet their individual needs. The manager confirmed that residents and their relatives are encouraged to visit the home, and the residents and relatives spoken wirh said that they were very happy with their choice of home. Care Homes for Older People Page 10 of 25 Evidence: As admissions to the home are often completed quickly to respond to the acute needs of people the lead nurse who completes the assessments confirms that the home can meet the needs of the prospective resident verbally. Intermediate care is not offered or provided at Fourways Nursing Home. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning system enables staff to provide the care and support residents at the home need. Medication training is provided for trained staff to protect residents. The emotional and specialist care needs of residents who are dying are very well met. Evidence: The manager advised that the care planning system has been reviewed, a new format has been introduced by the lead nurse, and this enables staff to access all information quickly and easily. Four individual plans of care were viewed, some for recent admissions and others who have been at the home for some time. They were up to date and had been reviewed on a regular basis, in additional to when any changes were identified, with the involvement of relatives and residents if appropriate. The care plans included relevant risk assessments including moving and handling, pressure area care and the support provided, falls assessments, and nutritional assessments if required. Care Homes for Older People Page 12 of 25 Evidence: The registered nurses follow the homes policies and procedures for the administration of medicines, to protect residents. Systems are in place to offer appropriate support for residents at all times, particularly at weekends and overnight, when the residents GP is not available. The recommendation made at the last inspection regarding two signatures for controlled drugs has been introduced at the home. Communication between staff, residents and visitors was open and friendly, staff were noted to treat residents with respect. The staff spoken with said that this is the residents home and they should be supporting them to live and do what they like. Residents said the staff provide the support they need and nothing is too much trouble. Fourways Nursing Home provides a high standard of nursing and residential care with a particular skill in specialist palliative care. In order to promote and maintain high standards of care in this area they have adapted and introduced the Liverpool Care Pathway and the Gold Standard Framework. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The routines of the home are flexible, this enables the residents to have control over their lives and encourages them to make choices about all aspects of their day to day living. The meals are good, choices are offered and assistance is provided if required. Evidence: Fourways provides nursing care and support for people from different age groups who have a range of needs, and with the involvement of relatives, friends and staff there is a family feel to the services provided. Birthdays or seasonal event are celebrated and parties are held regularly in the home and residents said that they enjoyed these. It was noted that a valentine day celebration was being organised for the following weekend, with fancy dress for some residents and a karaoke system being arranged, and residents were supported to go shopping for valentine day cards. It was quite clear that the home is run for the benefit of the residents, those spoken with said they can make choices about everything they do, and if they need help the staff are more than willing to assist them. Care Homes for Older People Page 14 of 25 Evidence: The lunchtime meal looked appetising and residents said the food is always very tasty and good. The cook advised that residents can have anything they want, with the emphasis is on home cooking and fresh ingredients at all times, and at least one resident is involved in preparing some meals and organising the dining room. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate complaints policies and procedures are in place. Training in protecting vulnerable adults is provided for staff to protect residents. Evidence: The complaints procedure has been reviewed since the last inspection and the manager advised it has been used effectively following a concern being raised. Residents and visitors spoken with said they had no reason to complain about any aspect of the support and care offered at the home. They also said that if they had they would just talk to the staff who were always very helpful. Staff spoken with said they had attended training in protecting vulnerable adults and were aware of what action they should take if they have any concerns. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment within this home is good providing residents with a homely and comfortable place to live. All parts of the home are accessible and infection control systems are in place to protect residents, visitors and staff. Evidence: Fourways nursing home is a converted family home, with residents encouraged to personalise their own rooms with ornaments, pictures and furniture if they wish. The lounge and dining room on the ground floor continues the homely feel and they are used by residents, visitors and staff throughout the day. Appropriate equipment is available to ensure the support needs of residents can been met safely, and includes a stair lift for access to the first floor. Improvements to the bathing facilities have been made since the last inspection, as part of the ongoing maintenance programme. Fourways was found to be clean on they day of the inspection, and staff spoken with have attended training in the prevention of infection. Care Homes for Older People Page 17 of 25 Evidence: Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff morale is high resulting in an enthusiastic workforce that work positively with residents to improve their whole quality of life. Recruitment procedures are satisfactory and protect residents. Evidence: The manager confirmed that there are sufficient staff on duty to meet the needs of residents. Staff spoken with said they had time to do the work they were allocated and did not feel that they needed to hurry. They also said they had time to talk to residents or visitors and this was an important part of their work. The staff turnover is low and agency staff are not employed at the home. It was noted that all staff work well as a team for the benefit of the residents and are very well thought of by residents and visitors. Several stated that nothing was too much trouble and the staff are very good and help us as much as we need. Three recruitment files for the most recently employed staff were reviewed and found to include the relevant information, including application forms, interview records, references and POVA and CRB checks. The training coordinator confirmed that all new staff are required to complete an Care Homes for Older People Page 19 of 25 Evidence: induction programme in line with Skills for care. This is regarded as an important introduction to the home for staff, who then continue to attend relevant training to ensure the needs of the residents are met. A training matrix has been developed and introduced which clearly identifies which staff have attended training. Staff spoken with said they are able to attend specific training, including those provided by a local hospice, and are encouraged to work towards the National Vocational Qualifications. The training coordinator confirmed that the home meets the required 50 percent of staff with NVQ level 2 or above. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management style at the home is open and inclusive with residents, relatives and staff are encouraged to participate in developing the services provided. Systems are in place to protect the health and safety of residents. Evidence: The registered manager/owner and her husband are very involved in running of Fourways Nursing Home and are in the home most days. Residents and visitors spoken with said it is like living with a very supportive family, with staff and other residents helping each other. The relationship between staff, residents and visitors was relaxed and friendly during the inspection. Residents and relatives spoken with said that they are able to discuss anything with the staff and feel that they are able to contribute to the care and support provided if they wish. Care Homes for Older People Page 21 of 25 Evidence: The quality monitoring system enables all interested parties to give their views on the services provided. Questionnaires are used and the responses audited to identify areas where change would be appropriate. Some small amounts of money and valuables are kept by the home when requested to by residents or their representatives and procedures followed in respect of this are now clear and thorough and include relevant records including receipts. The manager advised that all the records relating to health and safety are in place and all staff receive the mandatory training required. The use of door stoppers to keep residents doors open was discussed with the manager, and she stated that they were aware of the need to introduce door guards or a similar safe system, and this had been discussed with the fire service. At the time of the inspection the managers husband was not available to discuss this, he is responsible for maintenance at the home, and the manager said he would write to the Commission outlining exactly what they are doing to ensure the residents safety with regard to open doors. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!