Inspection on 18/06/07 for Fourways Residential Care Home

This inspection was carried out on 18th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Winton House

Newbeech House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Fourways Residential Care Home 45 Scotland Hill Sandhurst Berkshire GU47 8JR Lead Inspector Julie Willis Unannounced Inspection 18th June 2007 11:50 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fourways Residential Care Home DS0000069103.V339495.R02.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. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fourways Residential Care Home Address 45 Scotland Hill Sandhurst Berkshire GU47 8JR 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) 01252 871751 A. V. Atkinson (Fourways) Limited Mrs Angela Barwick Care Home 20 Category(ies) of Physical disability over 65 years of age (20) registration, with number of places Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: Fourways is a care home providing residential care services for people over the age of 65 years. This home is not registered to provide nursing care services. The home is situated within the village of Sandhurst, located between Wokingham and Camberley. Fourways is a detached house, which has been adapted and extended to provide care and accommodation for up to twenty service users. On the ground floor there is a lounge and a dining room leading into a large conservatory. Bedrooms are located on the ground and first floors. Most of the bedrooms are for single occupancy and some have en-suite toilets. There are two bathrooms and a shower room on the first floor. There is access from the conservatory to the rear garden. The cost of the service is between £450 - £500 per week. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was the first inspection since the home registered with the CSCI and opened for business and was an unannounced ‘Key Inspection’. The inspection took place on Monday 18th June 2007 between 11:50 am and 5.30 pm. and covered all the standards for older people. Prior to the visit a questionnaire was sent to the Manager along with survey and comment cards for residents, relatives and visiting professionals such as doctors and nurses. Any replies were used to help form judgements about the service. Consideration has also been given to other information that has been provided to the Commission. The inspector toured the building, examined records and met most of the residents and 2 relatives that were visiting at the time of the inspection. The inspector also met a Community Nursing Sister that was visiting a patient at the time of inspection. The inspector spent time talking to staff and observing how care was being delivered to the residents. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals with various religious, racial or cultural needs. The inspector gave feedback about her findings to the homes Proprietor at the end of inspection. There were 4 legal requirements made as a result of this inspection that should improve the outcome for service users. The Commission has not received any information about complaints about this service since it opened for business. What the service does well: It is clear that the new owners of Fourways are working hard to improve the standard of décor and furnishings at the home. The home is generally clean and hygienic throughout and is adequately maintained to be safe and comfortable for the residents. Residents are encouraged to personalise their own bedrooms and these are decorated and furnished in a homely way. A number of the staff have worked at the home for a long while and know the needs of the residents well. There is effective team working and the staff team appear motivated, caring and kind. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 6 The food is good and residents are very complimentary about its taste and presentation. The Chef has recently incorporated ‘healthy eating’ guidelines into the weekly menu and the extra fruit and vegetables in the residents diet have been well received. Residents say “the food is good”, “there is more variety now” and “its something to look forward to each day”. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 Quality in this outcome area is adequate. Service users benefit from having their needs assessed prior to admission but the content of the assessment varies considerably from person to person and should more accurately reflect the needs of the individual. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From examination of the documentation of 4 residents it was clear that a needs assessment was carried out on each person before they were admitted to the home. The quality and content of the assessments varied considerably from person to person and in some cases provided only limited information about their particular needs. The home has recently changed hands and the new proprietors showed the inspector the documentation they are introducing to the home. The new assessment tool was comprehensive and holistic in detail and used clinical Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 9 tools to assess risks to residents. All future prospective residents will be assessed using this new documentation. Information about the needs of the potential resident is gathered from a variety of sources including the person themselves, a friend, relatives, advocates and other social & health care professionals. Where the Local Authority refers a person to the home a copy of the care management needs assessment is sought. The information gathered forms the basis of the care plan. All prospective residents and their families are offered a visit to the home prior to agreeing admission, where they can meet staff and other residents. The inspector spoke with several residents that confirmed that the admission process had been well managed. One resident said “I came here from hospital, they made me feel welcome” and “I like it here, I have a comfortable room and the staff are kind”. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 7, 8, 9, 10 Quality in this outcome area is adequate. The content of care plans require further development to ensure that they accurately reflect the needs of residents and provide staff with sufficient information to provide the right care. There are safe procedures in place for the storage, handling, receipt and administration of medication and all staff have received training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From examination and case tracking of 4 people it was clear that although they had care plans the practice of involving residents in the development and review of the plan was minimal. The plans contained little detail and only included the most basic information necessary for staff to provide care. Risk assessments were limited in detail and did not always provide sufficient information to the staff on how to reduce the risk identified. The new Proprietors showed the inspector the format of the care plans that they use in their other homes and are currently introducing to Fourways. These Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 11 were highly detailed and were underpinned by effective risk assessments and risk management processes. The new Manager is in the process of developing a new care plan for each of the residents with their full involvement. This will involve a full review of the resident’s needs and consultation with relatives and advocates where appropriate. Management informed the inspector that this is an on-going process and will take time to be fully completed for all existing residents. Residents have access to health care services that meet their assessed needs. The inspector had the opportunity to meet and talk with a Community Nursing Sister that was visiting a patient at the time of inspection. The nurse confirmed that the Community Nursing Sisters are regular visitors to the home to do dressings, take bloods and to carry out routine treatments. The nurse said that they were well assisted by staff in the home, which were always on hand to guide them to the patient and assist as necessary. Residents confirmed that they could choose their GP although most are registered with the local practice. All residents have access to chiropody, dentistry and opticians and are offered routine screening and preventative treatments. The new proprietors have recently introduced a new medication administration system to the home. This system is used in all of the new proprietors other homes. An examination of the storage, handling and administration procedures demonstrated compliance with the standards and regulations for the safe administration of medicines. Residents confirmed that their healthcare needs are well met. One resident told the inspector “I see my doctor regularly, they are very understanding”, “staff know me well here, they know when I’m not feeling too good and they let me stay in bed until I’m feeling brighter” and “I have the flu injection each winter, just in case”. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15 Quality in this outcome area is good. Residents are provided with the opportunity to engage in a range of worthwhile activities and to attend day services if they so wish. Residents are offered a varied and nutritious diet designed to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The routines of the home are designed flexibly around the needs of residents whenever possible although meals are generally taken at a set times. Meals may be plated and re-heated for those residents who are out during the day and that require a hot meal on their return. This is usually as a result of hospital appointments. Residents may choose when to get up and to go to bed and where they wish to spend their time. A large number of residents attend a local day centre several times a week where they meet friends and stay in touch with the local community. Outings and entertainments are a regular feature of their day. At the time of inspection residents were reading, watching television or entertaining their visitors in the communal lounges. One resident said, “I like Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 13 to go out, I’m a local and I am able to meet my friends at the day centre”. Another said, “I tend to like to stay in my room and watch TV, I’ve never been a mixer and prefer my own company”. Relatives confirmed that they may visit at any time and are always made to feel welcome. The Inspector examined the menus and spoke with the chef. Lunch on the day of inspection was boiled gammon with a slice of tomato & onion quiche, new potatoes and fresh runner beans followed by pineapple upside-down-cake with custard. The chef is currently following general health advice by incorporating ‘5 a day’ fresh fruit and vegetables into the menu. This has proven popular with residents. One resident said, “the food is always nicely cooked and there is a choice if you don’t like what’s on offer”. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 16, 18 Quality in this outcome area is good. The home has a satisfactory complaints system. Service users feel their views are listened to and acted upon. Service users are protected from abuse and exploitation by staff that are able to demonstrate knowledge of the homes abuse of vulnerable adults and whistle-blowing policies This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a complaints procedure, which is clear and accessible to residents. Service users are provided with information on how to make a complaint to the home, the time scale for response, and the stages and process of the Organisations complaint process. The CSCI has not been provided with information about any complaints at the home since the last inspection Relatives spoken to at the time of inspection confirmed that they felt confident that concerns would be taken seriously by the home and efforts would be made to remedy any problems in a timely fashion. Staff interviewed were aware of the homes whistle-blowing policy and understood the importance of protecting users from abuse and exploitation at all times. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 15 Residents made comments such as, “I feel safe living here, people are kind and I know they take care of me well” and “I know who to make a complaint to but have never had to make one”. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 16 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, 26 Quality in this outcome area is good. Standards of cleanliness and hygiene in the home ensure service user safety and provide users with a comfortable and homely place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the new Proprietors have been running the home there have been a number of improvements to the environment. New carpets have been fitted to the hallway and communal lounges. Decorating has been undertaken on communal areas and is continuing in bedrooms. There is a new key coded lock on the front door and a new call bell system has been fitted. The chef confirmed that a new kitchen has been fitted with all new catering equipment. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 17 Residents and relatives confirmed that they were happy to see the improvements. One resident said, “the new décor and carpets are long overdue, they look so much better” Discussion with management confirmed that they have embarked on a programme of up-grade and will be continuing to improve the environment for all of the residents. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 18 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, 30 Quality in this outcome area is good. The staff team were able to demonstrate that they have the necessary skills and experience to effectively meet the needs of residents in their care. Staff recruitment procedures protect residents from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of inspection the home was adequately staffed with nurses, carers and ancillary staff to meet the needs of the residents. The home appears to have a stable staff team of committed individuals who provide quality care to the residents. The new Proprietors have been recruiting to vacant posts and a new Manager and several qualified nurses now work at the home alongside the team of care staff. The new Proprietors have been auditing the staff files and have been identifying any deficits in the recruitment process. They have already introduced their corporate procedures to the home and will be using inhouse and external trainers to refresh the staff team in core skills and provide induction and NVQ training. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 19 An examination of 4 of the homes staff files evidenced that all necessary checks are carried out on new staff prior to their employment. All staff are required to provide a full employment record, to provide two verifiable references and complete a criminal records and POVA check before being allowed to work at the home. Staff interviewed informally by the inspector seemed knowledgeable, motivated and caring and clearly knew the needs of individual residents well. The relatives of residents were very positive about the qualities and attitude of the staff team. They made comments such as “warm & welcoming”, “kind” and “always cheerful & helpful”. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 20 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, 33, 35, 38 Quality in this outcome area is adequate. Service users benefit from living in a well run home, where there is evidence that their health welfare and safety is of primary importance. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager – Angela Barwick is new in post. She has the necessary qualifications and experience to manage the home effectively and is currently studying for the Registered Managers Award. The home operates an ‘open door’ policy and actively encourages suggestions, comments and recommendations from residents and relatives. The Manager works hands-on in the home and residents confirm that she is available to them on a daily basis. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 21 The new Proprietor is currently introducing the companies quality assurance systems into the home. This will include Proprietors monthly visits and regular residents surveys. The new owners have already undertaken an audit of staffing and as a result new policies and procedures are being introduced to the home. From discussion with management it is clear that the home is currently reviewing how it manages residents personal monies. Most residents have a relative or advocate that deals with their financial matters on their behalf and therefore the home will not be holding cash accounts on a resident’s behalf in the future. Instead a system of billing for extras such hairdressing, newspapers and chiropody will be introduced which already operates in the Proprietors other homes and has been proven to be safe and secure. Examination of a sample of the health & safety records indicated that they were up to date and in good order. Routine servicing and maintenance of equipment is undertaken at appropriate intervals to maintain the home as a safe and risk free environment for residents. There is a need to improve the residents risk assessments to ensure that they are protected from harm. Resident’s said, “The new manager seems kind, caring and effective” and “is approachable and will listen”. Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 22 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 x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 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 3 x 2 x 3 x x 3 Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14 Requirement Timescale for action 18/07/07 2 3 OP7 OP38 15 13 (4) b 4 OP33 24 Ensure that all prospective residents are fully assessed before admission to ensure the home will be able to effectively meet their needs Ensure that all care plans contain 18/08/07 sufficient information for staff to be able to provide the right care Ensure that all risk to residents are fully assessed and guidelines 18/07/07 are put in place to reduce the likelihood of occurrence Ensure that a quality assurance 18/08/07 system is introduced which seeks the views of residents, relatives, staff and other stakeholders. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Fourways Residential Care Home DS0000069103.V339495.R02.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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