Inspection on 27/06/06 for Foxglove Care Ltd.

This inspection was carried out on 27th 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 found no outstanding requirements from the previous inspection report, but made 7 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. 11/06/07

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 27th June 2006 09:30 Foxglove Care Ltd. DS0000064116.V300299.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.V300299.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.V300299.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.V300299.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection N/A 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. Foxglove Care Ltd. DS0000064116.V300299.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 5.25 hours and was the first key inspection following the home’s registration during January 2006. Only one resident, who only moved into the home during the two weeks before this inspection, currently resides in the home. 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 on duty, one director/manager and another director were spoken to; the resident was observed both directly and indirectly. All the key standards have been assessed at this inspection. Only one of the ten preinspection survey forms sent to staff, visiting professionals and those involved with the resident was returned to the Commission. What the service does well: What has improved since the last inspection? This is the home’s first inspection therefore this section is not applicable Foxglove Care Ltd. DS0000064116.V300299.R01.S.doc Version 5.2 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. Foxglove Care Ltd. DS0000064116.V300299.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.V300299.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service. The information provided in the statement of purpose and service user guide is not sufficiently detailed or accurate to enable prospective residents to make an informed choice about living in the home. The assessment procedure for prospective service users is excellent and ensures individual needs can be met by the home. EVIDENCE: The home has a statement of purpose and service user guide, which have been given to the resident although arrangements are being made for copies to be printed in Makaton so the contents can be understood. However, these do not contain all the information required by regulations and some of the information provided is not accurate. The home’s assessment procedure for prospective residents prior to coming into the home ensures needs can be met. The current resident attended for day care for some months prior to making the transition to permanent care; information and support has been provided, and continues to be provided, from other involved professionals. Foxglove Care Ltd. DS0000064116.V300299.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Good assessment and care planning systems, involving the service user and other significant people, ensure that service users can be supported by well informed staff in making choices and maintaining an independent lifestyle. EVIDENCE: The care plan, which is very detailed, is continuing to be developed, and includes risk assessments and information gathered during the time the resident was attending for day care; Makaton is used to judge the resident’s own choices and decisions about her life. The care plan has been developed, and agreed, involving parents, advocate, the community continuing care team including a range of health professionals; extensive meetings and reviews have been held during the day care period and are planned to continue every three months for the foreseeable future. Arrangements are in place to access other professional support as needed eg specialist dentist for people with a learning disability and community dietician. Foxglove Care Ltd. DS0000064116.V300299.R01.S.doc Version 5.2 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Service users are supported to establish good, meaningful and rewarding lifestyles by being enable 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 fostered. EVIDENCE: The home has an activities programme and uptake of this is according to the resident’s choice. Recent activities have included swimming, bowling, shopping, walks in the park and a trip to Bridlington was found to be very enjoyable. The activities programme is reviewed regularly to ensure it remains the choice of the resident, and according to staff knowledge of the resident. Introductions have been made to residents in other homes and the possibility of evening activities are being explored. Weekend visits home are taking place and the service user is being supported by an advocate to determine their future frequency. Staff promote independence by enabling the resident to indicate choices either through behaviour, speech, gestures and use of Makaton. Although menus are not developed, staff stated healthy options are Foxglove Care Ltd. DS0000064116.V300299.R01.S.doc Version 5.2 Page 11 offered at each meal and the resident selects her own choice of food on shopping trips. However, sausage casserole left from the previous evening was provided for lunch during the course of this inspection without any reference to the resident. Staff explained the resident had so enjoyed the meal the previous evening it was being given again and it was evident from observation that the resident very much enjoyed her lunch. Records are kept in the resident’s case notes of the choice of food being provided at mealtimes. Foxglove Care Ltd. DS0000064116.V300299.R01.S.doc Version 5.2 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Residents are given good support and care in accordance with the care plan which has been developed with the resident and their representatives and ensures individual needs are being met. EVIDENCE: Staff are aware of the importance of maintaining privacy and dignity when providing personal care which is in accordance with the wishes of the resident, her representatives, and the home’s policy and procedures. A telephone is available, and can be used in private, for maintaining contact with relatives and friends. Positive risk taking assessments are made, including behaviour factors to ensure appropriateness. A medication policy and procedure is in place and staff receive appropriate induction and in-house training. Residents would be supported in managing their medication when possible and following a suitable risk assessment. Medications are appropriately stored and recorded and were correct at the time of the inspection. The manager agreed to have some discussion with the pharmacist and general practitioner regarding medication during periods the resident is absent from the home. Foxglove Care Ltd. DS0000064116.V300299.R01.S.doc Version 5.2 Page 13 Foxglove Care Ltd. DS0000064116.V300299.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service. The home has an adequate complaints procedure which is being made available to residents, their families and residents advocates ensuring they have the information they need to raise concerns. Good vulnerable adults policies, procedures and staff training ensure residents are protected from abuse. EVIDENCE: The home has a policy and procedure for making complaints and raising concerns. This is currently being produced in Makaton and the manager stated a copy is to be provided to the family and resident’s advocate. A book is available for recording complaints, but none have been recorded since the resident moved into the home two weeks before this inspection. The home has a policy and procedure on abuse and whistle blowing and a copy of the Hull and East Riding Adult Protection Committee leaflet has been given to all staff who receive information and training at induction. Discussion with staff indicated they are aware of the procedures for protecting vulnerable adults. The procedure for the use of restraint seen in the document file is being replaced as the home has a “no restraint” policy. Foxglove Care Ltd. DS0000064116.V300299.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service. The environment is domestic and homely with an attractive and secure garden providing residents with a good and pleasant place to live. However, the décor needs some improvement and a programme of redecoration is currently being developed in conjunction with the resident. 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. The kitchen is fitted with cooker, washer and fridge/freezer. Staff stated that as part of their induction training, the resident is not allowed into the kitchen when the cooker is in use and hot water is immediately emptied from the kettle following the making of drinks. Whilst the décor in the home is in need of some attention the manager assured the inspector a programme of gradual redecoration is being developed in conjunction with the resident. Staff said they are to work with the resident in creating pictures, which will be acceptable to her, to decorate the walls. The lounge/dining room is comfortable and furnished with table and chairs, two settees, television, DVD player, bean bag and small fibre optic lamp which is also tactile; the resident finds this relaxing and can run her fingers through the Foxglove Care Ltd. DS0000064116.V300299.R01.S.doc Version 5.2 Page 16 fibre elements. The bathroom consists of a bath, shower, toilet and wash hand basin with paper towels provided for staff use. A towel rail had the sharp end of a screw protruding and the manager stated this would be taped to be made safe until it can be repaired. Some of the information provided in the pre-inspection questionnaire for maintenance and service records was checked and found to be correct, although some of these are almost due for renewal. A health and safety notice is displayed in the kitchen and the home has now received confirmation the water supply is compliant with the legionella test requirements. Foxglove Care Ltd. DS0000064116.V300299.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area was poor. This judgement has been made using available evidence including a visit to the service. Weaknesses in recruitment practice potentially place service users at risk of harm. Staff are provided in sufficient numbers. As a newly registered service the training programme in place is under development but should ensure that staff are competent to do their jobs as staff complete more of the relevant training. EVIDENCE: The manager stated she is introducing team meetings and staff supervision to take place every six to eight weeks; the first team meeting was held 21/6/06. Staff rotas are currently operating as two members of staff at all times to one resident and this level is adequate to meet current needs. Three members of staff records were checked and were found to be incomplete ie no application forms had been completed, not all had two written references or evidence of induction. (One of the company directors informed the inspector following receipt of the draft report that two references are obtained and are kept at head office along with induction records). The three staff records examined included a current Criminal Records Bureau check. Staff records are not held on site and the three seen had been brought to the home by one of the directors. Two staff were interviewed, one has a psychology degree and the other is taking NVQ level II commencing in September; training has been discussed with the manager and individual training needs identified during supervision. Some mandatory training is outstanding, including fire safety for Foxglove Care Ltd. DS0000064116.V300299.R01.S.doc Version 5.2 Page 18 one member of staff who missed the training session. Staff stated management support is good and residents’ needs are being met appropriately by the home and other healthcare professionals. The manager stated staff use the Learning Disability Award Framework (LDAF) for foundation training, leading into NVQ level II. Foxglove Care Ltd. DS0000064116.V300299.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service. With the exception of shortfalls identified in other sections of this report management of the home is good and support is also provided by another director of Foxglove Care. Good systems are in place to ensure residents, or their representatives, views are listened to and affect the services provided. EVIDENCE: The registered manager has almost completed NVQ level IV in care and is to enrol for NVQ level IV in management during 2007. The home uses the Mulberry House training package for in house training including some mandatory training. The home has achiev4d the Investors in People award and the manager stated they are exploring the possibility of applying for the local authority quality development scheme parts I and II. Questionnaires are to be sent every other month to relatives and others involved in the residents care. The manager confirmed the home is now compliant with legionella testing requirements; this was outstanding at the time the pre-inspection Foxglove Care Ltd. DS0000064116.V300299.R01.S.doc Version 5.2 Page 20 questionnaire had been completed. Other maintenance certificates were examined and found to be in order, although some were shortly due for renewal eg landlord’s gas safety certificate. The manager has not provided a written statement of the policy, organisation and arrangements for maintaining safe working practices. Foxglove Care Ltd. DS0000064116.V300299.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 2 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 X 34 1 35 2 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 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 2 x Foxglove Care Ltd. DS0000064116.V300299.R01.S.doc Version 5.2 Page 22 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 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 complaints procedure must be supplied to the service user and anyone acting on behalf of the service user All areas of the care home must be kept reasonably decorated Timescale for action 31/07/06 2 YA22 22 27/06/06 3 YA24 23 31/12/06 Foxglove Care Ltd. DS0000064116.V300299.R01.S.doc Version 5.2 Page 23 4 5 YA24 YA34 23 19 6 YA42 13 7 YA42 13 The screw protruding from the towel rail in the bathroom must be made safe People applying to work in the home must complete an application form and the home must obtain two written references, one being from the most recent employer Provide evidence the manager has a written policy statement of the organisation and arrangements for maintaining safe working practice To ensure safe working practices in the home, all staff must receive mandatory training and updates 27/06/06 27/06/06 31/07/06 30/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA20 YA40 YA40 YA37 Good Practice Recommendations There should be some discussion regarding medication with the supplying pharmacist and general practitioner for periods the service user is absent from the home The procedure for restraint should be replaced in line with the home’s policy for “no restraint” The policy for confidentiality should be amended to include security of information The manager should complete NVQ level IV in management Foxglove Care Ltd. DS0000064116.V300299.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: 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 Foxglove Care Ltd. 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