Inspection on 11/06/07 for Foxglove Care Ltd.

This inspection was carried out on 11th 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Foxglove Care Ltd. 25/11/09

Foxglove Care Ltd. 27/06/06

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Foxglove Care Ltd. 47 Cottesmore Road Hessle East Riding of Yorks HU13 9JQ Lead Inspector Pam Dimishky Key Unannounced Inspection 11th June 2007 09:00 Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 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 Foxglove Care Ltd. DS0000064116.V340726.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 Adults 18-65. 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. Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Foxglove Care Ltd. Address 47 Cottesmore Road Hessle East Riding of Yorks HU13 9JQ 01482 629187 01482 826937 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) Foxglove Care Ltd Yvonne Lesley Graham Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2006 Brief Description of the Service: This care home, registered for two younger adults with a learning disability, is situated in a domestic dwelling on the outskirts of the small town of Hessle. The accommodation is on two floors with bedrooms and bathroom/toilet on the first floor and lounge/dining room and kitchen on the ground floor; outside is a pleasant, secure garden. Shops, cafes, pubs and a church are located in the town centre approximately a quarter of a mile away and there is a bus route nearby; train services are also available to Hessle. Fees are £2291 per week and there are no additional charges. Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of 3.25 hours and was the second key inspection following the home’s registration inJanuary 2006. Only one resident was living in the home and evidence in some areas of the report is in general terms to protect the confidentiality of the resident. The inspector looked around all of the building and a number of records were examined. Two staff were on duty and they were joined by the manager who assisted the inspector and provided information and records for examination. The resident and two members of staff were going bowling, therefore only brief discussion took place before they left. Twelve survey forms were sent to staff, one health professional, one care manager and a relative; the Commission received six responses in total. What the service does well: What has improved since the last inspection? New carpets have been laid in the lounge/dining room and stairs and new vinyl flooring in the kitchen, along with some redecoration. Ongoing training is Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 6 taking place for mandatory and specialist subjects. From observation the resident was much more relaxed and appeared “more at home” than a year ago at which time, they had only recently moved into the home. Staff are being trained in use of sign language which is proving very successful in communicating with the resident. Staff supervision is taking place at least six times a year according to the needs of the particular member of staff. All staff have had the Learning Disability Award Framework (LDAF) induction training and have, or are training for, a certificate at NVQ level II and above. The manager has achieved a qualification at NVQ level IV in care and has registered to take the Registered Managers Award. Foxglove Care now has a certificate for Investors in People. 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. Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The assessment procedure for prospective service users is excellent and ensures individual needs can be met by the home. However, the service user guide and statement of purpose does not provide all the information needed to make an informed choice about where to live. EVIDENCE: A requirement made at the last inspection to provide all the information required by regulation in the statement of purpose and service user guide has only partly been met and the documents are not yet in a format which could be understood by the resident. The home’s assessment procedure for prospective residents prior to coming into the home ensures individual needs can be met. The current resident attended for day care for some months followed by overnight stays prior to making the transition to permanent care Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Good assessment and care planning systems, involving the service user and other significant people, ensure support is given by well informed staff in making choices and maintaining an independent lifestyle. EVIDENCE: The case file for the resident is very comprehensive and includes the individual plan of care and detailed assessments covering all possibilities of identified risk and hazard. The care plan has been developed, and agreed, with involvement from the parents and the community continuing care team including health professionals; Makaton, symbols, and pictures are being used as vehicles for communication to judge the resident’s own choices and decisions made about her life. Staff questionnaires indicate the resident is present at care reviews and staff meetings about her welfare. Arrangements are in place to access other professional health service support as needed eg specialist dentist for people with a learning disability and community dietician. Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 10 Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users are supported to establish good, meaningful and rewarding lifestyles by being able to choose and take part in a range of activities both in and outside the home and to influence the routines and service provided; family and community links are promoted. EVIDENCE: The resident is able to take part in activities of her own choosing; these include bowling, swimming, shopping, walks, lunches out, visits to and from other Foxglove Care Homes, an annual disco for people with a learning disability; visits home for tea also take place twice a week. At the time of this inspection the resident was being taken to meet residents from other homes for a game of bowling, which she was clearly looking forward to, followed by a pub lunch. Three members of staff accompanied the resident in completing the recent “Race for Life”. Arts and craft, jigsaws, television, and assisting in small domestic tasks are some of the activities which the resident takes part in Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 12 inside the home; the staff play a key role in supporting the resident to live a meaningful life both inside and outside the home. A community dietician has provided advice and support to the home in ensuring the resident has a healthy diet. The manager stated the resident is able to choose what to eat from a selection of food in the home and a record is being kept of that choice. A choice of cereals and fruit is available at breakfast, the main meal of the day is lunchtime and there is a light evening meal with a light snack available at supper-time if required. A bowl of fruit is always available for the resident to choose from between meals. Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Personal support and emotional health needs are met according to the care plan and preferences of the resident. EVIDENCE: The resident’s care plan is very detailed in identifying the personal support and physical and emotional health needs, and the manager stated the resident is able to choose which member of staff she prefers to provide the support needed. The home understands the principles of giving personal support which is highly individual, flexible, consistent and reliable. Positive risk taking assessments are included which take into account behaviour factors to ensure suitability. A medication policy and procedure is in place and the staff receive appropriate induction and in-house training in the administration of medicines. The manager confirmed one member of staff has almost completed her training and therefore, does not give out medication at the present time. The resident is not able to administer and control her own medication which is kept under review with the general practitioner. Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s policies and procedures for making complaints and for safeguarding residents from abuse. EVIDENCE: The home has a book for recording complaints, however, it contains no entries and the manager assured the inspector no complaints have been made. Policies and procedures for making complaints, for safeguarding adults and for whistle blowing are in place and all staff have received safeguarding adults awareness courses; the manager attended a course last year specifically for managers in care homes. Surveys completed by staff indicate their knowledge of the processes of making a complaint and for safeguarding adults. Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The environment is domestic, homely and comfortable with an attractive and secure garden providing residents with a good and pleasant place to live. EVIDENCE: This home is a domestic dwelling, situated in the town of Hessle. There is a large, secure garden with flower beds, lawn and trampoline which, according to staff, the resident enjoys sitting on. At the time of the inspection a member of staff was busy constructing a new garden swing purchased by relatives for the resident’s enjoyment. A requirement was made at the last inspection to improve the décor in the home and this is now partly complete, with the hallway scheduled to be redecorated in the near future. New carpet has been laid in the dining room/lounge and on the stairs, and in the kitchen new vinyl flooring has been installed. The lounge/dining area is comfortably furnished and includes television with DVD player. Maintenance and service records detailed in the pre-inspection questionnaire indicate these are being kept up to date. A bathroom and toilet are situated on the first floor and the hot water is Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 16 regulated to be delivered at no more than 43°C. No unpleasant odours were detected throughout the home. Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the person who uses the service and for their needs to be met. EVIDENCE: Staff duty rotas were examined and indicate the resident is supported by sufficient staff on duty at all times; an on call rota is available at night to support the member of staff who sleeps over. The manager was advised to indicate on the rota the actual days she spends in the home as her role also requires spending time in other homes belonging to Foxglove Care. Personnel records for four new staff were examined and generally found to be in order. However, advice was given regarding the need for job application forms to provide a full previous employment history with actual dates so that any gaps can be explored and documented. One such application appeared to have a gap in employment between 2004 and 2006 and the manager stated she would obtain further information from the member of staff concerned. Agreement had been obtained from the Commission earlier in the year for a new member of staff to commence, following a POVA first (protection of vulnerable adults) check, to meet the resident but only to work under supervision and as an extra pair of hands in order to meet the resident. The Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 18 staff training is well under way and a matrix of all staff is kept to ensure all mandatory and specialist training is being covered. The company has gone to some considerable expense to arrange training for staff in all the homes to undergo challenging behaviour and adult protection/safeguarding training. All staff have had the training except one person who failed to attend. Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is being managed well with guidance and direction given to the staff and ensuring residents’ views underpin the quality of care provided; systems are in place for maintaining health, safety and welfare of residents and staff. EVIDENCE: The registered manager works in the home three or four days a week and has completed a qualification at NVQ level IV in care and is to commence the Registered Manager’s Award later in the year. Certificates are displayed in the hall for Investors in People and Employers Public Liability, current to December 2007. The manager confirmed the resident is involved in decision making about the care and services provided and views expressed are taken into Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 20 account in the care provided and development of the home. The home has a policy and procedure for confidentiality but needs amending to include security of the information. Most of the requirements and recommendations made at the last inspection have been addressed. Records and receipts are being kept of personal allowances held by the home on behalf of the resident and these were checked. However the records could not be reconciled with the actual monies as the resident had taken it with her on her bowling trip. Maintenance and service records detailed in the pre-inspection questionnaire indicate they are up to date. Fire extinguishers and fire alarm was checked 5/3/07, a current landlord’s gas safety certificate was dated 12/7/06 and the electrical wiring certificate was dated 11/3/06. All staff hold a qualification in first aid and have received infection control, health and safety and basic food hygiene training. One member of staff is awaiting fire safety training. Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 X 3 X 3 x x Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 22 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. Standard YA1 Regulation 4,5 Sch1 Requirement The statement of purpose must be accurate and include all areas included in Schedule l of the Care Homes Regulations ie organisational structure of the home, arrangements for contact with relatives, friends and representatives, arrangements for respecting privacy and dignity, sizes of bedrooms must be accurate. The service user guide must include terms and conditions including amount and method of payment, standard form of contract for the provision of services and facilities, the most recent inspection report. Local authority placements, or their representatives, must have a copy of the agreement specifying the arrangements A copy of the amended documents to be forwarded to the Commission All areas of the care home must be kept reasonably decorated Timescale for action 31/08/07 2. YA24 22 31/12/07 Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 23 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 Refer to Standard YA40 YA37 YA34 Good Practice Recommendations The policy for confidentiality should be amended to include security of information The manager should complete NVQ level IV or equivalent in management It is good practice to ensure job applicants provide consecutive dates of employment in their application and any gaps in employment history is explored Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Foxglove Care Ltd. DS0000064116.V340726.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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