CARE HOMES FOR OLDER PEOPLE
Foxes Moon 40 Ringwood Road St Ives Ringwood Dorset BH24 2NY Lead Inspector
Tracey Cockburn Unannounced Inspection 13:45 24 January 2006
th 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 Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 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. Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Foxes Moon Address 40 Ringwood Road St Ives Ringwood Dorset BH24 2NY 01425 474347 01425 474347 foxesmoon@btconnect.com 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) Mrs Christine Ramsey Mrs Jean Lubbock Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (24), Old age, not falling within any other category (4) Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Room 18 may accommodate two service users known to the NCSC. The registered persons in control work towards complete registration of the home in the categories DE(E) & MD(E) as OP vacancies occur. 4th July 2005 Date of last inspection Brief Description of the Service: Foxes Moon was registered to Mrs Ramsey and Mrs Lubbock in January 2002; before this, the home had been registered in the general old age category. 1 service user has chosen to continue living in the home. This service user is in the general old age category, however no new admissions in this category have taken place since the change in registration. This person had recently had a review held with their family and the care manager from the local authority and all had agreed that the placement should continue. The house is a detached older style property, which is situated in a residential area off the main A31 road between Ferndown and Ringwood towns. The home is about a mile and a half from Ringwood town centre. There is a large secure garden to the rear of the property, with car parking and shrubbery/trees to the front. The rear garden was entirely landscaped in 2002, with view to providing a safe and stimulating environment for service users, and there is ample seating and space available. Accommodation comprises 23 single bedrooms, some with ensuite facilities, over the ground and first floor of the home, 4 communal bathrooms, and a variety of communal areas. There is a main lounge/dining area, with an adjacent sun lounge and a small lounge area. The home has a block contract with Dorset Social and Health Care Services for two respite rooms. Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place as part of a site visit to assess the progress of building work taking place at the home. The inspection was the second in the annual cycle of inspections. Nine standards were assessed. 3 members of staff were spoken to and 4 residents were spoken to as part of the inspection. The activities taking place in the lounge in the afternoon were also observed. What the service does well: What has improved since the last inspection?
At the conclusion of the inspection in July 2005, there was 1 requirement and 1 recommendation. There was no medication left out unattended at this inspection and the management team have tightened their procedures. This means that vulnerable residents are protected. Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 Page 6 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. Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 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 Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 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): None of these standards were assessed at this inspection key standards were assessed at the previous inspection in July 2005. Standard 6 was not assessed as the home is not registered to provide intermediate care. EVIDENCE: Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 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): None of these standards were assessed as they were inspected at the previous inspection in July 2005. EVIDENCE: Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 Page 10 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): 14 The management approach and staff training in the home encourage residents to exercise choice and control over their lives. EVIDENCE: It is very difficult to establish if the residents feel they have choice and control over their lives most of the residents have some form of mental health problem. However during the course of the inspection care staff were observed supporting residents and asking them their opinion. The registered provider said that most residents finances are managed by someone other than the resident. Each residents room has evidence of their own possessions and the home keep a record of possession which come into the home at the time of admission. Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 Page 11 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): 16,18 The home has a robust complaints policy and procedure which means that residents and their representatives should be confident that their complaints will be listened to and acted upon. Adult protection training is provided for staff which means that they should understand how to ensure that residents are protected from abuse. EVIDENCE: The home has a complaints procedure. There had been no complaints since the previous inspection in July 2005. Staff receive adult protection training. Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 Page 12 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): None of these standards were assessed at this inspection. EVIDENCE: Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 Page 13 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): 29, 30 Robust recruitment practice ensures that residents are supported and protected. Care staff receive the training they need to meet the needs of the residents in the home. EVIDENCE: The homes recruitment practices are robust and there have been no changes since the last inspection. At the time of the inspection the home was able to demonstrate that it has a good take up of NVQ training by all staff. During conversation with some staff, they were enthusiastic about the specialist training in relation to dementia care. Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 Page 14 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): 31,33,35,38 The management of the home understand their responsibilities, residents live in a well managed home. The home has a thorough quality assurance system which means that the home is run in the best interests of the residents. Procedures in the home means that residents financial interests are safeguarded. Health and safety procedures promote and protect the care staff and residents. EVIDENCE: The manager of the home has been absent on and off for a number of weeks, the home has been managed in the interim by the co owner and a new deputy manager. The staff commented that the managers in the home are very accessible and approachable. The manager said that they encourage staff to come up with ideas and she gave an example of the chef who sees the care plans for the residents who are diabetic which give him a better understanding
Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 Page 15 of their needs. The chef is also undertaking the dementia care training which is a 3 month course. The home has a thorough quality assurance system which is collated into a report and made available to interested parties. The home managed money on behalf of 2 residents and the records were seen on the day of the inspection. All the records were up to date and accurate. All records seen within the home were accurate and up to date. Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 Page 16 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 x x x x x x x x STAFFING Standard No Score 27 x 28 x 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 Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP28 Good Practice Recommendations 50 of the staff team should achieve NVQ level 2. Foxes Moon DS0000026803.V260879.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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