Inspection on 28/06/06 for Foxby Hill Nursing Home

This inspection was carried out on 28th June 2006.

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

Foxby Hill Nursing Home 14/09/05

Foxby Hill Nursing Home 21/04/05

Foxby Hill Nursing Home 06/12/04

Foxby Hill Nursing Home 26/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Foxby Hill Nursing Home Foxby Hill Gainsborough Lincs DN21 1PN Lead Inspector 0Mr Toby Payne Unannounced Inspection 28th June 2006 08:05 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 Foxby Hill Nursing Home DS0000002578.V301256.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. Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Foxby Hill Nursing Home Address Foxby Hill Gainsborough Lincs DN21 1PN 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) 01427 611231 Mrs Juliet L Smith-Evans Mrs M P Smith Mrs Karen Beverley Johnson Care Home 36 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (25), of places Physical disability (5) Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users in the category of Physical Disability must be aged 47 years or over. The home is registered to provide personal care with nursing for service users of both sexes whose primary needs fall within the following categories:Old age, not falling within any other category (OP) - 25 Dementia - over 65 years of age (DE(E)) - 5 Physical disability - 50 years and over (PD) - 5 Bedroom 3 can be registered for 2 x OP, bringing the total registration of the home to 36 service users, or it can be used for 1 x PD (55 years and over), keeping the total registration of the home at 35 service users. The maximum number of service users to be accommodated is 36. 3. 4. Date of last inspection 14/9/2006 Brief Description of the Service: Foxby Hill is a care home, which provides both personal care and nursing care for 35 older people over 65 years of age, including 4 residents over the age of 47 years with a physical disability and one resident under the age of 50 years. On the day of the inspection there were 29 people living in the home. Foxby Hill is a detached property set in 1 acre of ground and is situated on the outskirts of Gainsborough, close to local facilities. The home has a sunroom and an enclosed garden with raised beds, and a fishpond. There is some parking space available. The home’s mission statement states that ‘Foxby Hill Care Home’s philosophy is to provide the highest possible standards of care based on individual needs’. The owners visit on a weekly basis to ensure that both the care standards and training are maintained. The fees at the inspection on the 28/6/2006 ranged from £335 to £547 per week. Extras are for hairdressing which range from £3 to £20, chiropody £7, newspapers and magazines. Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and started at 8.05 am. It was undertaken using a review of all the information available to the inspector regarding our service history about Foxby Hill. It took place over six hours. A tour of the building was carried out and resident and staff records were looked at. The inspector spoke to 8 residents, 2 visitors, 7 members of staff, the training co-ordinator, the deputy manager and the manager. The main method was called “case tracking”. This involved selecting two residents and tracking the care they received through the checking of records, discussion with them, the care staff and observation of how staff responded to their needs and that of the other residents. What the service does well: What has improved since the last inspection? A new manager has been registered by CSCI and 4 additional registered nurses have been recruited. Regular staff supervision sessions have been introduced to give support to the nurses and care staff. One bedroom has been repainted and a new more accessible and safer shower room has been provided. Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 6 Two new hydraulic profile nursing beds have been provided together with 6 hospital type beds to provide safer access and 6 new mattress overlays have been provided to prevent pressure sores and aid sleep. 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. Foxby Hill Nursing Home DS0000002578.V301256.R01.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 Foxby Hill Nursing Home DS0000002578.V301256.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. People coming into the home make an informed decision whether they wish to come in to the home or not. Residents’ benefit from the provision of contracts for their placement at the home and from comprehensive needs assessments. They are assured that their needs can be met as a result of the assessment. EVIDENCE: There is a detailed statement of purpose and service user’s guide and a copy of the service user’s guide is given to each person entering the home. The aims and objectives for the home are displayed in the entrance to the home. Each person is assessed before they enter the home and written confirmation is sent to them to confirm that based on this assessment the home is able to meet their needs. Each person receives written terms and conditions. The home does not provide intermediate care. Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 9 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 the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. People living in this home are treated with respect; their right to privacy and their health care needs are met. Care records are detailed, up to date and identify the person’s health and welfare needs. However efforts need to be made that the care plans are written with the resident’s involvement. Medication is safely stored and administered to residents. EVIDENCE: Each person had a care plan outlining their needs. Care records were detailed, up to date and showed evidence of being reviewed. However there was no evidence to show that they had been devised with the involvement of the resident or their relative. There was space in the records for the signature of the resident but this had not been completed. There was however clear evidence to show that they had been reviewed monthly. Care records included a detailed assessment, social care profile, moving and handling, risk assessment, nutritional, continence assessments and daily records. The home also uses body maps for the mapping of any cuts or abrasions to residents. Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 10 Throughout the inspection staff were seen to be talking with residents in a respectful, considerate manner. They were also seen to knock on doors before entering and ensuring that residents confined to wheelchairs were seated with their legs raised on padded leg supports and foot plates were used when pushing people in their wheelchairs. Since the last inspection an incident was reported to the CSCI of a theft of 2 of the medicine trolleys. This was thoroughly investigated with police involvement and the Commission was kept fully informed. As a result of this, improved security has been introduced. Medication administration records were well maintained and appropriate administration procedures were observed by the inspector. All staff who administer medication have been assessed as competent and have been trained to safely administer medication. Since the last inspection locks have been fitted to resident’s bedroom doors following a risk assessment. Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 11 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 the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. There is a leisure activities programme provided. Residents enjoy a varied and nutritious diet, which is based on their likes, dislikes and needs. They benefit from being able to exercise choice in their diet and control over their lives. EVIDENCE: On admission to the home details of resident’s likes and dislikes and interests are obtained. Details of activities and handicrafts information are displayed on a notice board at the entrance to the home. An activities programme is provided and a pianist plays the piano each Monday and the activities coordinator provides activities one day a week. There were also details about the CALL advocacy service for Lincolnshire and religious services as well as the Dial A Ride service in Gainsborough. The home also has use of a mini-bus. Visitors were made welcome. They commented, “I can visit whenever I wish and always receive a friendly welcome and am offered a cup of tea”. Care records contained detailed nutritional assessments. Residents said that the food was always good and there was plenty of it. They said that they could choose what they wanted to eat if they don’t like the menu. The head cook said that he speaks to residents every morning about what is on the menu and takes orders for alternative choices. There are lists Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 12 of likes, dislikes and dietary needs, and records of what people have eaten, kept in the kitchen area. Food was well presented and the portions were ample. In recognition of its standards of food West Lindsey District Council awarded a level one Food Safety Award to the home in December 2005. Comments from residents and visitors were, “I was got up this morning, enjoyed a nice shower then enjoyed my breakfast”, “the food is lovely”, “there are not many activities” and “ meals are good and nicely served”, “there is a smoking room provided where my mum can have a smoke” and “my mother enjoys her food”. On the day of the inspection one resident was enjoying her lunch sitting outside in the central garden area with her daughter. Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 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 the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Residents are protected from abuse and they and their relatives know that any complaints they make are taken seriously and acted upon. EVIDENCE: Each person receives a copy of the complaints procedure when being admitted to the home. The home has comprehensive complaints and adult protection policies. There have been no complaints or adult protection issues raised since the last inspection. No complaints have been received by the CSCI or the home. Records showed that staff receive training in adult protection issues, and staff knew what constituted abuse and what they should do if abuse was suspected. Induction packs include information on adult protection. None of the residents or visitors had any concerns and felt they could approach staff if they had any complaints. Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 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 the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home is well maintained and provides comfortable accommodation. The home is clean, comfortable and safe. EVIDENCE: A partial tour of the home by the inspector found it to be clean and smelt fresh. This was also confirmed from a previous inspection in November 2005. Residents said they liked their bedrooms and spoke of how satisfied they were with the cleanliness of the home. Individual bedrooms were comfortably furnished with personal possessions, individual adaptations and specialist equipment provided to aid the person’s independence. Since the last inspection opening windows in the upper level have had restrictors fitted following a risk assessment. The home has 2 commercial washing machines and commercial tumble dryers. Residents were very complimentary about the way their clothes were cared Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 15 for. Staff had access to gloves and aprons and alcohol rubs in order to prevent cross infection when attending to the residents. Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Residents are protected by robust recruitment procedures and they benefit from an appropriately trained staff team who understand their individual needs. EVIDENCE: None of the residents expressed any worries about the level or availability of staff. During the inspection staff were seen to attend to residents promptly. Residents commented, “I was got up today by very kind staff”, “they are very nice you know”, staff are very kind and helpful” and “the staff are very friendly”. Records of 2 personal files examined showed that staff had been correctly recruited with checks by the CRB (Criminal Record Bureau), references, application forms and interview notes. Staff also received a supported induction. Care workers are given a copy of the General Social Care Council’s Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults The home has a training policy and a dedicated training manager. There is an annual training plan available. Training is provided in house and training in care (National Vocational Qualifications). Thirteen care staff out of 19 have either obtained or are about to study for a qualification in care. Eight staff have obtained NVQ level 2, 2 staff are studying level 3 and in July 2006 a further 3 staff are to start NVQ level 2. Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 17 Comments from staff were, “I attended a moving and handling course last week and have a fire lecture next week” and “I have received training on the use of the hoist”. Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Foxby Hill is managed properly by a competent and experienced nurse. There is leadership, guidance and direction. This allows the staff to ensure residents receive consistent quality of care. EVIDENCE: The manager was registered by the CSCI in March 2006. She is a registered nurse and has considerable experience with elderly people and young physically disabled people. She is studying for a management qualification. Since the last inspection a deputy manager has been recruited. Since the last inspection nurse and care staff have started to receive formal supervision and support. There are regular staff and resident meetings. Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 19 Residents, visitors and staff were positive about the staff team throughout the inspection. Comments from residents and visitors were, “I have been here 9 years and it deserves 9 stars”, “”staffing levels have increased recently”, “I am very happy here” and “I have confidence in the staff”. Staff comments were, “the owners are so helpful”, “things here have improved a great deal”, “there is no scrimping or saving”, “I have returned to this home after several years and find things are so different” and “I enjoy working here”. The home carries out regular quality surveys to obtain the views of residents and visitors. The last resident’s survey was carried out in February 2006 and the visitors in January 2006. Comments were very positive. The manager on request handles resident’s money. Where this takes place detailed records are kept together with receipts and signatures. Records examined showed they were well maintained and kept securely. Staff receive annual appraisals and care staff and nurses formal supervision. Foxby Hill has comprehensive policies and procedures including clinical procedures. There are equal opportunities, ethnic minority, racial harassment policies and the manager agreed to expand the information to include issues of equality and diversity. The home also had detailed health and safety policies including risk assessment. Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 20 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 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 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 3 x 3 x x 3 Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 21 No 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. 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. Refer to Standard OP7 Good Practice Recommendations It is recommended that the manager ensure that care records are produced wherever possible with the involvement of and consultation with residents or their relatives. It is recommended that a survey is carried out to obtain residents’ views to the type and range of leisure activities provided for the people living in the home. 2 OP12 Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Foxby Hill Nursing Home DS0000002578.V301256.R01.S.doc Version 5.2 Page 23 - 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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