Inspection on 26/10/05 for Foxgrove Residential Home

This inspection was carried out on 26th October 2005.

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

Foxgrove Residential Home 15/11/06

Foxgrove Residential Home 04/01/06

Foxgrove Residential Home 09/03/05

Foxgrove Residential Home 13/09/04

Foxgrove Residential Home 27/10/03

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Foxgrove Residential Home High Road East Felixstowe Suffolk IP11 9PU Lead Inspector Jane Offord Unannounced Inspection 26th October 2005 09:30 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 Foxgrove Residential Home DS0000024392.V261473.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. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Foxgrove Residential Home Address High Road East Felixstowe Suffolk IP11 9PU 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) 01394 274037 01394 274037 Pri-Med Group Ltd. Mrs Jennifer Ann Coulson Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th March 2005 Brief Description of the Service: Foxgrove is a large Victorian house that has been extended and provides accommodation for up to twenty-four older people. It is situated in a residential area of Felixstowe, not far from some shops and other local amenities. There are sixteen single rooms and four double rooms although only one of the double rooms is now shared. On the day of inspection there were twenty residents and a new admission for respite care arrived during the morning. The accommodation is over two floors that are linked by a passenger lift. There is a large lounge facing the gardens with level access to the outside and a separate dining room on the ground floor. All the rooms have at least a toilet and wash basin with some having a full ensuite facility. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a weekday between 9.15 and 15.00. The service was busy with three residents being escorted to appointments at two different hospitals and a new admission awaited. Matron was available to assist during part of the day and a manager from the Pri-Med Group was also present to help with finding information and files. Three staff files, three residents’ files and care plans, the policy folder, the complaints log and some fire and equipment certificates were seen in the course of the inspection. The manager offered a tour of the house and a medication administration round was observed. The inspector spoke with a number of residents and several staff, including a housekeeper and the chef. The home was clean and tidy with an attractive décor and appeared well maintained. Residents were pursuing individual occupations in the communal rooms or their own rooms. Lunch, which was served in the dining room or residents’ own rooms as they chose, looked well presented and appetising. What the service does well: What has improved since the last inspection? Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 6 The home has successfully recruited staff for the care team and now has a full complement. A problem with damp in the entrance hall has been resolved and the hallway is being redecorated. 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. Foxgrove Residential Home DS0000024392.V261473.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 Foxgrove Residential Home DS0000024392.V261473.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): 2, 3, 4, 5 People who use this service can expect that they will have their needs assessed and they will have the opportunity to visit the home before admission. If they choose to enter the home they can expect to have a written contract with the service. EVIDENCE: The residents’ files seen all contained evidence of pre-admission assessments. There were records of the person’s Next of Kin and GP. Assessments under headings for mobility, nutrition, personal hygiene, sleep, pain and medication were completed. There was also a brief social history of the person. Matron confirmed that all prospective residents were assessed prior to admission to ensure that the home could meet their needs. Each file seen contained a copy of a contract with details of the terms and conditions and signed by the resident or their representative. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 9 During the day a visitor came enquiring about vacancies in the home for a relative. They said that another relative had visited previously and been shown around the home. One of the residents said that they had been shown around the home before they decided to enter it. Matron confirmed that the relative of the newly admitted resident had seen the home and the room being offered before bringing their relative in. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 People who use this service can expect to be treated with respect, have their needs recorded in a care plan and have any health needs fully met. They can expect that the homes practice with regard to medication will protect them but they cannot be assured that the present recording of doses will allow for an audit trail. EVIDENCE: The residents’ care plans that were seen were well compiled with clear details of how to meet the identified need. Some areas that were covered included the help needed with personal hygiene, privacy and personal space, maintaining independence, night care needs, a resident’s final wishes, managing pain and pressure area care. All the care plans had evidence of being regularly evaluated and updated to remain relevant. There were records of visits from health care professionals such as the community nurse, chiropodist and GP. Three residents were being escorted to appointments at different hospital outpatients’ clinics on the day of the inspection. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 11 Moving and Handling assessments were seen in the files and risk assessments had been completed if there was evidence of poor mobility and a risk of falls. Further risk assessments were seen which identified one resident was at risk of bleeding due to taking Warfarin; another resident had a problem swallowing and was at risk of choking. One resident spoke about a time they had fallen and needed hospital treatment. They said the staff had acted very efficiently to get them to hospital. There was documented evidence that residents’ weight is monitored and that specialised equipment is used if required to protect skin integrity. Some residents seen were sitting on pressure relieving cushions and there were special mattresses on some beds. A medication administration round was observed. The medication administration records (MAR sheets) had no gaps in the signature boxes and correct codes were used if medication was not given for any reason. Details of the dose administered when a prescription allows for one or two tablets to be given were not recorded. The controlled drugs (CD) register was seen and a check was made on some CDs, which tallied with the records. Some residents manage their own medication and a lockable container is provided to keep the medication safely in their room. A pharmacist who advises the home on medication issues helps assess a resident’s ability to self medicate. A staff member said that recently there had been concerns about one resident’s continuing ability to safely manage their medication. They explained how they had tactfully approached the problem so the resident did not feel pressured into having the home take over the task. Staff were observed knocking on residents’ doors and waiting to be invited in the room. All interactions between staff and residents were respectful and appropriate. Residents were asked when they arrived how they would like to be addressed by staff and this was respected. Daily records documented briefly how a resident had spent their day and any concerns that had arisen. Residents’ moods were noted. ‘They really enjoyed watching the tennis from Wimbledon this afternoon’. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 People who use this service can expect to be offered a balanced diet and a range of activities to suit their abilities. They can also expect to be encouraged to maintain contact with their family and friends. EVIDENCE: Copies of the menus were seen. There is a four-week rotation and the range of dishes offered is wide. There is a choice of two cooked meals for lunch ranging from beef cobbler to chicken and leek pie with fish and chips on Fridays and a roast on Sundays. The evening meal offers soup and two other choices each day. On the day of the inspection the menu offered boiled beef and carrots with a selection of other fresh vegetables or a cheese pasta bake. Both dishes were well cooked and presented. Residents had a choice of drinks to accompany their meal including wine if they wished. Tea or coffee was served at the end of the meal. One resident did not eat meat and found the pasta bake too dry to manage. A carer consulted with the chef and a suitable alternative was offered that satisfied the resident. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 13 Residents had a choice about where they ate their meals, some ate in the dining room but others preferred to be served in their rooms. The notice board in the hallway had information about visiting entertainers and a list of items sold by the in-house shop, which opened once a week. There was also a list of individual residents choice of daily newspapers. In the dining room there was the programme for weekly outings in the minibus that included visits to local beauty spots and villages. In the lounge there was a good selection of books, magazines and compact discs. The large photo album contained photographic records of events that had taken place in the home. There were some pictures of Father Christmas visiting and a party that had taken place. Staff said that they had had a party a week ago to celebrate Victory Day and a further one is planned for Christmas when all staff, residents and their families are invited. One resident talked of staff playing cards and Scrabble with groups of residents. Another resident was promised that a member of staff would join them for afternoon tea and seemed delighted at the prospect. The home will accommodate residents’ pets if required but none of the present residents has a pet. The home has its own cat, which has the freedom of the building and is a favourite with some residents. Visitors came and went throughout the day. They were welcomed by the staff. One resident said they had just had a visit from a relative who lives in another part of the country. They had stayed in Felixstowe and visited daily during their short break. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 People who use this service can expect that complaints will be taken seriously and investigated, however, although staff have an understanding of dealing with abuse they cannot be assured that the present training programme will cover Protection of Vulnerable Adults (POVA) training for all staff. EVIDENCE: The complaints log was seen and showed evidence that any complaints had been investigated and the outcomes conveyed to the complainant. There had been no recent complaints made. Residents spoken with were clear about whom to approach if they had any concerns or issues that needed attention. Staff said they would report any incident that they felt could be potentially abusive to senior management. The staff files seen showed that they had had training in POVA. However in discussion with a housekeeper they said they had not had POVA training. This was raised with matron during the initial feedback from this inspection. The training programme for ancillary staff now includes POVA training but this member of staff has been with the service for a number of years and due to an oversight has not received the updated training. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 15 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, 20, 22, 24, 26 People who use this service can expect to live in a safe, comfortable and well maintained home with their own possessions around them and specialised aids to help them remain independent for as long as possible. EVIDENCE: The home is a Victorian building with large rooms and high ceilings. All the rooms have big windows that make the home light and airy. Residents’ rooms are all individually decorated and furnished. There was evidence of personal furniture and ornaments in the rooms seen. One resident had a small desk, a footstool and an armchair that belonged to them in their room. Another resident had a mounted collection of football memorabilia. The lounge had a variety of armchairs of different heights arranged in small groups. A standing platform to help residents negotiate the two steps down into the lounge has recently been installed. The depth of the tread of the steps has also been increased to allow a resident to use the steps with a Zimmer frame. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 16 The lounge faces a large garden and there is level access through a patio door and out to the lawn. There are a number of seating areas in the garden to take advantage of the sunshine or shade as needed. The communal bathrooms and toilets have adaptations to assist access by residents with reduced mobility. There is a passenger lift between the ground and first floor for residents who have difficulty with stairs. There is an ongoing programme of spring-cleaning for the residents’ rooms. All the rooms looked clean and tidy on the day of inspection and there were no unpleasant odours. Any damaged or broken items are removed and repaired or replaced. The housekeeper was observed taking a small table for repair. All hand washing facilities had liquid soap and paper towels available and the housekeeper said there was a supply of disposable gloves and aprons for use in rooms where a resident had an infection. They explained the precautions that were in place for a resident with a wound infected with MRSA. The staff were later observed following the correct procedures. An external contractor deals with large items of laundry so the laundry in the home is just for personal items. The laundry room is very small but equipped with an appropriate washing machine. On the day of this inspection the laundry was very cluttered and untidy. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 17 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, 29, 30 People who use this service can expect that the staff team are recruited with all the correct checks being made and that they receive the training needed to do their work however they cannot be assured that there will always be sufficient staff on duty to meet their needs. EVIDENCE: There was evidence in the staff files seen that Criminal Record Bureau checks (CRB) and POVA 1st checks were received before new members of staff began work. There was also evidence of identity and at least two references in the files seen. New staff had a planned induction that was ticked off and signed when completed. It covered fire awareness, Health and Safety, moving and handling, first aid, principles of care and needs of the resident. A recently appointed member of staff said they had had fire awareness training on their first day at work. The staff rotas were seen and showed that there were two carers each shift with the addition of matron during the week who worked flexible hours during the day. Some residents and some staff spoken with indicated that there were times when this was insufficient. The opinion was expressed that newer residents were more dependent and required more assistance thus having an impact on the daily routine. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 18 This issue was raised with matron and the Pri-Med manager during feedback and they said that they were alert to the possibility that residents with higher dependency levels could affect the staffing needs. The guidance for calculating staff numbers has been used in the past and the numbers rostered at present are deemed appropriate for the identified needs of the residents. Records showed that after six weeks in post staff receive training in POVA, communication, care planning, last offices, missing persons and nutrition. Further training in infection control and medication administration is available at a later stage. Moving and handling, fire awareness, POVA and health and safety training are updated each year. There was documented evidence of this and staff spoken with confirmed that it happened. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 19 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): 37, 38 People who use this service can expect their health and safety to be protected and their interests safeguarded by the policies of the home. EVIDENCE: All records seen were well compiled and appropriately stored. The policies and procedures folder was kept in the office and accessible to staff for reference. In the kitchen there were records of temperatures of refrigerators and freezers that showed all appliances were functioning within the temperature range for safe storage of food. There were records of probe testing on prepared meals and delivered food. These were also within safe ranges. Food stored in the refrigerators was labelled and dated. The main dry store is situated outside and was tidy with a wide range of basic ingredients. There were records of checks carried out on electrical equipment such as fans, vacuum cleaners, radios, televisions and lamps. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 20 The certificate for the service of fire extinguishers was valid and a health and safety audit had taken place early in September 2005. The accident and incident records were seen and were correctly completed. One incident of a resident suffering a choking episode had generated a risk assessment for future care. Another risk assessment had been completed to allow a resident to have their own electric fire in their room. This was a personal preference and not because there was an issue about heating. The home was a comfortable temperature throughout on the day of inspection. The housekeeper had had training in Control of Substances Hazardous to Health (COSHH). They demonstrated a clear understanding of the requirements and explained where chemicals were appropriately stored in locked facilities. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 21 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 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 X 3 X 3 X 3 STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X 3 3 Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? None 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 OP9 Regulation 13(2) Requirement The MAR sheets must record the number of tablets administered when a prescription allows a range of doses. All staff who have not yet had any must receive updated POVA training. Timescale for action 26/10/05 2 OP18 13(6) 31/12/05 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 OP27 Good Practice Recommendations The ratio of rostered staff to meet residents’ identified needs should be monitored regularly to ensure staffing is adequate for the workload. Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Foxgrove Residential Home DS0000024392.V261473.R01.S.doc Version 5.0 Page 24 - 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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