Inspection on 29/06/05 for Fourways

This inspection was carried out on 29th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fourways 12/02/09

Fourways 13/02/07

Fourways 13/12/05

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Fourways 3 Bramber Avenue Peacehaven East Sussex BN10 8LR Lead Inspector Melanie Freeman Announced 29 June 2005 10:00 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. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Fourways Address 3 Bramber Avenue Peacehaven East Sussex BN10 8LR 01273 585670 01273 580370 None Mrs Pamela Dorothy Darch (Person) 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) Mrs Pamela Dorothy Darch Care Home with Nursing 21 Category(ies) of Old Age, not falling within any other category registration, with number (OP), Physical Disability (PD), Terminally Ill (TI), of places 21. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the maximum number of service users to be accommodated at any one time is twenty one (21) 2. That the care home provides general nursing care to older people aged sixty five (65) or over on admission. Can provide personal care to older people aged sixty five (65) or over on admission to maximum of nine(9) For a maximum of 13 service users in reciept of nursing care and 9 service users in reciept of personal care. 3. 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 eighteen (18) or over with a terminal illness up to a maximum number of six(6). Date of last inspection 30.11.04 Brief Description of the Service: 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 Huntington’s disease and at present have five residents with the illness.Fourways is situated in a quiet residential area on the coast with views over the channel. It provides 19 single rooms and 1 shared room. Bus routes and local shops are nearby. The home has a rear garden with seating and tables. There is also a patio area that is well used by service users. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. 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 an announced inspection carried out over one full day in June 2005. Comment cards were received from 3 visitors and 3 General Practitioners. One of these GP’s provided a comprehensive report. This inspection focussed on the experience for residents living in the home. The inspector met with all the residents and was able to speak in depth to 5 residents about the home. In addition 2 regular visitors were seen in private. The inspector also observed staff working and spoke informally to staff members and to the home’s management team. The care documentation pertaining to 2 residents were reviewed in depth along with 3 staff recruitment files. The inspector toured the home and was able to review the environment and facilities. What the service does well: During the inspection residents and visitors confirmed a very high satisfaction with the care at Fourways. The inspector observed a good standard of care and this view was supported by feedback received from 3 GPs. The home focuses on providing a home like, caring environment where residents feel safe and supported, and able to have their varying health care needs responded to. One resident said ‘the atmosphere is one of a loving family home’ and another said ‘this is a wonderful place I am very well looked after’. The activities and entertainment provided is again focussed on family life. The outings and parties held were complimented by the residents and visitors, who enjoyed the fact that everyone is involved and often children are also included. One relative said ‘Christmas was very good with the manager giving presents to all the children as well as the residents’. The manager/owner is in the home most days and works closely with the staff residents and relatives, to provide a home and care tailored to the individual resident’s needs. Fourways Nursing Home is a converted premise that provides a home like environment that is pleasant. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 and 6 Information on the home is available to people to inform their choice of home. The pre admission assessment is limited and does not ensure the needs of residents are fully assessed. Residents and their representatives are involved in choosing and deciding if Fourways is suitable for them. EVIDENCE: The home has a full and comprehensive statement of purpose and service users guide. This is available in the front entrance area. Further information including room sizes and resident’s views should also be included. Terms and conditions of residency are agreed in respect of each person in the home and individual fees are agreed. A record of these agreements are retained within the home. Although the manager/owner confirmed that residents are assessed prior to admission records confirming the content of this assessment are not kept. During the inspection it was clear from observation and confirmation from residents and health care professionals that the needs of residents are being fully met. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 9 All admissions are planned and trial periods are catered for which can include day visits as necessary. During the inspection 1 new resident was returning to the home for respite care, which he had requested. Intermediate or rehabilitative care is not provided at Fourways Nursing Home however respite and holiday breaks are provided. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 10 The home was found to be meeting the health care needs of the residents with the support and advice of community health care professionals who are closely involved. The privacy and dignity of service users is respected. EVIDENCE: Two individual plans of care were inspected and were found to contain full assessments and comprehensive plans of care. This care documentation was found to be up to date and reflect the health care needs of residents, giving clear guidance to care and nursing staff. The management of the home have very good links with the community health care professionals and this provides a multi-disciplinary approach. This was found to be reflected in the care documentation. Feedback provided by 3 visiting GPs was very positive and with the overall opinion of 1 GP being ‘that the care is excellent’. The inspector noted that residents who have varying needs and dependencies were receiving appropriate nursing and personal care tailored to meet their care needs, with the support of appropriate equipment and staff. A recognised pressure sore assessment tool is used to identify residents at risk of pressure sore development. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 11 Discussions with residents and visitors confirmed that there is a high satisfaction with the care provided and the way the staff treat the residents, and said ’wonderful here, residents are very well looked after’ ‘I am well looked after 100 ’. Resident rooms are very personalised and seen as their own private accommodation. Residents spoken to confirmed that they felt well respected and that staff always knock on the door before entering. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13 Fourways provides and promotes family activity and entertainment that meets the resident’s needs. Contact with visitors and the community is given a high priority. EVIDENCE: Fourways is home to people from different age groups and with different care and nursing needs and is run to promote a family environment. Entertainment and leisure time is therefore based on the family activities. Any birthday or seasonal event is celebrated and parties are held regularly in the home and residents said that they enjoyed these. Staff and visitors also attend these along with their relatives and children. Staffing numbers allow for residents to go out of the home on a daily basis. The homeowners have a caravan located within walking distance where residents are taken for an outing. On the day of this inspection 4 residents went to the caravan and 1 resident was taken out by a member of staff to visit her son. One resident spends much of his day helping with gardening and general maintenance under the supervision of a staff member. In discussion one resident said although the home was busy and vibrant it was a place where she ‘felt at peace’ and that she had a special place in the garden. Visiting is encouraged and 2 visitors spoken to said that they were made to feel very welcome by all staff and residents. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Procedures training and practices in the home ensure that adult protection issues and complaints made are managed appropriately. EVIDENCE: The home has a clear complaints procedure and this is available in the service users guide which s found in the front entrance. Residents spoken to said that they would raise any concern with the staff in the home and would be happy to do this. Some of the staff have recently attended formal training on adult protection provided by Social Services and this has identified that they need to update their adult protection policy which is being progressed. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,21,23,24,25 and 26 The home provides residents with a comfortable safe environment that has a home like feel that is suitable for meeting the resident’s needs. EVIDENCE: Fourways Nursing home is a converted family home and as such has retained a home like environment. The home is decorated to a good standard and ongoing redecoration was noted. This home has an attractive garden and patio area along with some balcony areas. Residents enjoy these areas and are able to grow their own plants. As a converted premise it does have some limitations. Some of the rooms are small and the only fully assisted bathing facility is on the ground floor. Where residents are accommodated therefore needs to be fully assessed and reviewed regularly, to ensure resident’s needs can be met in the area they are living in. There is a well-appointed fully disabled bath on the ground floor and a further assisted bath is located on the first floor. Resident’s rooms are very individual, furnished and decorated to meet their tastes and needs with safe heating and water supply. Fourways was found to be very clean on the day of this inspection. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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) 27,28,29 and 30 Staffing numbers and skills are appropriate and enabled the needs of the residents living in the home to be fully met. The recruitment practice was full and robust ensuring suitable staff are employed. EVIDENCE: At the time of this inspection 19 residents were living in the home. Staffing levels seen confirmed that they are good and appropriate to meet the specialist care and social needs of residents. Records confirmed that these levels are maintained and that staff turnover is low, and that agency staff are never required. The manager/owner along with the lead nurse have qualifications in palliative care. Residents and visitors spoken to confirmed that there was ‘plenty’ of staff on duty and that the staff are ‘caring, excellent’ ‘friendly’ and ‘efficient’. One visitor commented that the ‘staff enjoy their work never moaning, and this leads to a happy home where staff are stable’. Staff training is well developed and records confirmed that this was full. Staff are encouraged and supported through their NVQ training. During the inspection 3 care staff recruitment files were examined and were found to be complete. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 32 and 38 The home is well managed in an open and positive way with a clear ethos and purpose supported by staff and residents. Health and safety are good and ensure staff and resident’s safety. EVIDENCE: The registered manager/homeowner and her husband are very involved in running the home and are in the home most days. Relatives were very complimentary about the manager/owner and her management team that works in a very close and consultative way. A visitor when asked about the home said ‘homely, friendly and efficient’. Relatives and visitors confirmed that they were always able to talk to the manager and that they were asked for their opinion. All records relating to health and safety matters were found to be full and thorough. During the inspection it was however noted that oxygen was in the home without appropriate safety signage. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 17 An immediate requirement form was left in the home for the registered manager/owner to review the storage and use oxygen in consultation with the fire brigade. Written confirmation has been received to confirm that this matter has been addressed with the fire brigade and BOC Ltd. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 1 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x 3 x x 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 4 x x x x x 2 Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 19 yes 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. 2. 3. Standard 3 38 38 Regulation 14(1) 13(2)(4) 13(2)(5) Timescale for action That all prospective residents are 18.7.05 fully assessed prior to admission. That a procedure for the use of 1.8.05 oxygen in the home is provided. 1.9.05 That the safe moving and handling procedure is updated and that all policies and procedures in the home are dated and demonstrate regular review. Requirement Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 20 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. 4. 5. 6. Refer to Standard 1 18 21 29 30 31 Good Practice Recommendations That residents views are included in the service users guide. That the adult protection procedure includes a flow chart with relevant telephone numbers. That the bathing facilities in the home are reviewed to ensure appropriate facilitis for all residents. That the General Social Care Council code of conduct is provided to all care staff. That the staff training provided is cross referenced with the National Training Organisation workforce training targets. That the registered manager obtains an NVQ level 4 in management or equivalent. Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 21 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Fourways H59-H10 S13989 Fourways V224646 290605 Stage 4.doc Version 1.20 Page 22 - 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!