Inspection on 05/05/06 for Foxhill Manor Nursing Home

This inspection was carried out on 5th May 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Foxhill Manor Nursing Home 17/03/09

Foxhill Manor Nursing Home 08/06/07

Similar services:

Hunter`s Lodge

Lester Hall Apartments

32 Bentinck Road

50 Stoneygate Road

Harvey House

St Bernards

Landmere Care Home

Stoneygate Oaklands

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Foxhill Manor Nursing Home Foxhill Road West Haddon Northants NN6 7BG Lead Inspector Mrs Sarah Smart Unannounced Inspection 09:15 5th May 2006 X10029.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 Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 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 and 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. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Foxhill Manor Nursing Home Address Foxhill Road West Haddon Northants NN6 7BG 01788 510885 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) Mr Ramsamy Nullatamby Mr Ramsamy Nullatamby Care Home 26 Category(ies) of Past or present alcohol dependence over 65 registration, with number years of age (26), Past or present drug of places dependence over 65 years of age (26), Dementia - over 65 years of age (26), Mental Disorder, excluding learning disability or dementia - over 65 years of age (26) Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The total number of Service Users must not exceed 26 Service Users under the age of 65 years must not be admitted to the home Service users must fall into at least one of the following categories: past or present alcohol dependence, past or present drug dependence, dementia or mental disorder The home may accommodate three named service users for whom variations were granted prior to April 2002, (the NCSC), who are under the age of 65 years 21.9.05 Date of last inspection Brief Description of the Service: Foxhill Manor is a large converted house set in its own extensive grounds and situated on the outskirts of a village. It is a Care Home providing Nursing Care for up to 29 Service users of both sexes who are over 65 years of age and within the categories of Dementia, Mental Disorder, past or present Alcohol dependence and past or present drug dependence. The home currently have permission to care for three named service users under the age of 65 years. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken between the hours of 09.15 and 1.30pm. Preparation for the inspection included, review of the previous inspection report, requirements and recommendations, and took approximately 3 hours. The pre-inspection questionnaire had been completed and returned to the inspector prior to the inspection. The primary method of inspection used was ‘case tracking’. This involves selecting a number of service users and tracking their care and experiences through review of their records, discussion with them, the care staff and observation of care practices. The following areas were covered during the inspection: case tracking, medication, sample of policy review, staff rota, staff files, quality assurance, staff supervision, accident records, complaints records, tour of the premises, previous requirements made, and staff and service user interviews. service users were case tracked, and were selected at random during the tour of the premises. Three staff members, plus the manager, were spoken to at length, and several others briefly, whilst four service users were spoken to in detail. What the service does well: Thorough assessments were recorded and reviewed. Positive feedback was received from service users and relatives throughout the inspection. Care plans were written to a high standard. Healthcare assessments were generally recorded satisfactorily. Medication was managed to an acceptable standard. Observations of care practices, and discussions with staff, service users, and visitors, indicated that service users privacy and dignity is maintained at all times. Service users are offered choices. A selection of activities is offered, and service users were seen to be given choices in relation to this, and enjoying the activities. The kitchen was in good order, and positive feedback was received about the food. Complaints and protection of service users is managed to an acceptable standard. The premises is satisfactory although developments are planned. The grounds of the home are maintained to a high standard. Service users were happy with their rooms, which were personalised. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 6 The home was clean and tidy. Staffing levels were satisfactory. Communication by staff towards service users was noted to be pleasant at all times. Management of the home was satisfactory. Quality monitoring had been undertaken. Fire records were adequately maintained. What has improved since the last inspection? 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. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome group is good. This judgment has been made using available evidence, including a visit to the service. Service users are adequately assessed, and their needs are met. EVIDENCE: A total of three service users were case tracked. Each service users file contained a thorough assessment, which had been reviewed. From observations carried out during the inspection, review of documentation, and discussion with staff, service users, and relatives, the inspector was satisfied that service users needs are met. Staff demonstrated a good knowledge of the service users in their care. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are 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 Quality in this outcome group is good. This judgment has been made using available evidence, including a visit to the service. The health and personal care needs of the service users are met, however in some instances documentation to back this up is omitted. EVIDENCE: The care plans belonging to three service users were viewed. These were written to a high standard, contained clear instruction to staff, and were Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 10 reviewed at least monthly. A previous requirement in relation to care plans had been met. Healthcare assessments were recorded in all instances. One of the six viewed was not totalled correctly, and in two instances there was no evidence that a high score had been referred to a member of the multidisciplinary team, although the manager assured the inspectors that this had been done, but not recorded. All of the assessments were reviewed timely. A previous requirement had been met in relation to healthcare assessments. The daily summary for one service user was not recorded daily, although others were recorded timely. A sample of medication was viewed. This was generally maintained to a high standard. In some instances service users were noted to refuse medication, again there was no documented evidence that the GP had been advised of this, although the manager stated that this had been done. Observations of care practices, and discussions with staff, service users, and visitors, indicated that service users privacy and dignity is maintained at all times. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome group is good. This judgment has been made using available evidence, including a visit to the service. Service users social care needs and wishes are met. EVIDENCE: An activity programme was displayed on a notice board in the dining room. There were numerous activities going on during the inspection, and service users were heard to be given a choice of what to do, or, whether they wished to join in or not. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 12 Records were held of activities, and service users were observed to enjoy, and benefit from the activities offered. None of the service users gave negative feedback about activities within the home. The manager stated that over the next few weeks the grounds of the home will be secured, so that service users are able to wander outside as they wish. The home have purchased a minibus for outings etc. The home have employed a new cook. The kitchen appeared clean, tidy and well organised. Records were kept appropriately. The inspector was advised that all of the equipment was working. The chef stated that those service users who have the capacity to make a choice, are offered such, and for others he relies upon knowledge of their likes and dislikes. Service users and relatives stated that the food is nice. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) 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 Quality in this outcome group is good. This judgment has been made using available evidence, including a visit to the service. Management of complaints and protection is satisfactory to meet service users needs. EVIDENCE: The complaints and protection of vulnerable adults policies were viewed. These were noted to contain satisfactory information to the reader. Staff spoken to by the inspectors demonstrated an acceptable knowledge of these areas. The home have not received any complaints since the last inspection. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome group is good. This judgment has been made using available evidence, including a visit to the service. The environment of the home was satisfactory to meet the service users needs, but would benefit from the proposed improvements. EVIDENCE: Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 15 A sample tour of the premises was undertaken. The manager explained the proposals for improvements within the home over the coming months. Communal rooms were noted to be maintained satisfactorily, and the dining room was furnished pleasantly with fresh flowers on the tables. Several of the service users rooms are shared, but despite this, they were personalised by the individuals. The grounds of the home were very well maintained, and service users stated that they like to enjoy the gardens. Two relatives were spoken to by the inspector. They gave very positive feedback, and were generally happy with the room occupied by their relative. Service users stated they were happy with their rooms. Bathrooms and toilets were satisfactory. The inspector was advised that a new hoist has been purchased, and that all of the equipment provided is in working order. One service users stated that she had moved to another bedroom since the last inspection, which she liked, and was easier for her to access. There were no infection control issues noted, and the home was clean and tidy. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome group is adequate. This judgment has been made using available evidence, including a visit to the service. Whilst staffing levels were satisfactory, recruitment could be more robust to ensure service users are protected. EVIDENCE: The staffing rota was viewed. This contained all of the required information. Service users and relatives stated that the staff are pleasant, and appropriate communication was observed by staff at all times. Staff training was noted to be satisfactorily maintained, meeting a previous requirement. The home has strong links with the local college of nursing and educate student nurses and those from overseas going through an adaptation programme. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 17 A sample of staff files were viewed. One file contained only one reference, and a second had none. Two files did not contain application forms. This had been the subject of a previous requirement which remains unmet. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) 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 Quality in this outcome group is adequate. This judgment has been made using available evidence, including a visit to the service. The home is satisfactorily managed to meet the service users needs. EVIDENCE: Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 19 The owner is also manages the home, however he has recently employed a part time administrator, and additional nursing staff in order that he has sufficient time to carry out management duties. The management of the home appeared satisfactory. The manager does not carry out formal staff supervision or appraisal, but he and the staff stated that he is always available should a discussion be required. The money held by the home on behalf of the service users was viewed. This accurately matched the records held, and was available to the service users. Quality monitoring was viewed. The information contained positive feedback. Comment cards were available in the reception area of the home. Fire records were maintained accurately. Portable Appliance Test records were considerably out of date, last being documented in July 2003. These should be updated. Accident records were maintained to a high standard, with reviews recorded in all instances. This meets a previous requirement. One service user who goes out of the home to visit the village alone, did not have risk assessments recorded in relation to this, or his other activities. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 3 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 3 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 3 34 X 35 3 36 X 37 X 38 2 Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 21 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. 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 2 3 Refer to Standard OP29 OP38 OP38 Good Practice Recommendations Staff files should contain all of the required information in line with schedule 2. This was a requirement which had a timescale of 20.10.05, which remains unmet. Portable Appliance Tests should be carried out annually, and records held. The plan of care should include a full range of care needs for every service user. I.e. risk assessments. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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. Foxhill Manor Nursing Home DS0000066413.V293131.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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