Inspection on 28/04/06 for Foxton Grange

This inspection was carried out on 28th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Foxton Grange 08/04/08

Foxton Grange 19/04/07

Foxton Grange 17/11/05

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

CARE HOMES FOR OLDER PEOPLE Foxton Grange 571 Gipsy Lane Leicester Leicestershire LE5 0TA Lead Inspector Lesley Allison-White & Keith Williamson Unannounced Inspection 28th April 2006 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 Foxton Grange DS0000063830.V289358.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. 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. Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Foxton Grange Address 571 Gipsy Lane Leicester Leicestershire LE5 0TA 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) 0116 2460616 0116 2766593 home.fxg@mha.org.uk Methodist Homes for the Aged Care Home 36 Category(ies) of Dementia - over 65 years of age (36), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (36) Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To be able to admit the named person of category DE subject of variation application number V22608 dated 13/07/05. To admit the named person of category DE named in variation application V25523 received on 05/10/05 who is under 65 years of age. 17th November 2005 Date of last inspection Brief Description of the Service: Foxton Grange Nursing and Residential Home is a care home offering accommodation for up to thirty-six older people. The home is registered to accommodate older people with dementia and/or mental disorder. The home is divided into four separate units individually named. The home is located approximately fifteen minutes away from the centre of Leicester if travelling by car. Bus services are available near to the home. The home can be easily found just off the outer ring road. The building itself is purpose built and situated in a quiet area. There is parking available at the front of the building. All accommodation is provided on the ground floor level. All areas of the home is accessible to people who use wheelchairs. The home has a secure garden area for service users to walk. The home’s fees range from £567 to £660 per week. Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views of the service provided. The primary method of Inspection used was ‘case tracking’ which involves selecting clients and tracking the care they received through looking at their records, talking with them where possible, and looking at their accommodation. This was an unannounced inspection that took place on 28th April 2006. The inspection commenced at 09.30am and finished at 3.35pm. In the last report there were eight outstanding requirements and eleven recommendations. The home has made improvements since the last visit and a number of requirements had been met. There were 35 residents in the home on the day of inspection. What the service does well: What has improved since the last inspection? Over fifty percent of staff have obtained an NVQ level 2 qualification or above. The staff spoke of their need for continuity and hoped that their new manager would stay and continue to make improvements to the service. The impact of this to both residents and staff will be that the manager will be able to show a clear sense of direction and leadership which will relate to the aims and purposes of the home. Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 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. Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 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 Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 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): 3 Quality in this outcome area is poor. This judgement has been made using the available evidence including a visit to the service. The assessment process is not consistently documented so is ineffective in providing consistency in care for residents in the home. EVIDENCE: Safety of residents has been compromised by poor assessments before entering the home therefore not ensuring that a new person moving into the home will have all their needs met. The files seen of “case tracked” residents did not have the appropriate assessment documents in place to enable the staff in the home to compile an accurate initial care plan. A recommendation was left for the home on this issue. Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 Page 9 The home does not presently offer intermediate care. Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 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 and10 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Residents are generally looked after in respect of their health, medication and personal care needs, however there were some inconsistencies observed in meeting their personal care needs. EVIDENCE: Care plans were viewed of four case tracked residents in the home. These were found to be inconsistent in detail of personal and social care. There were no specific detail in plans with regard to the individual care and attention to residents oral, dental and nutritional care. One care plan reviewed was incomplete. One residents’ care plan indicated that she had a pressure pad although how it was used was not clearly stated in the care plan.. The staff on duty were not able to explain how the pressure Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 Page 11 pad was used. Records should be clear and the use of equipment should be recorded and evaluated within the plan of care. Health care was well documented in areas such as accident reports, these being completed appropriately having good correlation between those and the residents’ daily records ensuring staff have an ongoing knowledge of falls. Medication was not well organised with a number of errors within the recording system, one resident receiving an incorrect dose of medication. The security of medication administration must be tightened up immediately to ensure residents’ safety in the home. Medication prescribed on an “as and when” basis, is not appropriately risk assessed, and no specific instructions on the circumstances and frequency of administration are included in the care plan; these are required to be put in place, and shall ensure residents safety is ensured. A requirement was left for the home to action immediately. Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 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, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are offered a limited lifestyle resulting in restricted choice due to staff availability. EVIDENCE: A limited range of social and recreational activities for the residents is offered, these are currently not planned in advance and relies on staffs’ availability and personal knowledge of residents’ current abilities. There is a lack of detailed social care information in the care plan, to enable care staff to provide a suitable and varied social care programme, this does not provide a stimulating environment for residents. On the day of inspection there were no activities taking place and music was played in the back ground quietly in some sections of the home and a radio in the background giving current events. The Registered Manager explained that she was aware of this and will be addressing this by employing a member of staff for activities. During the inspection staff were noted to be friendly and helpful towards the residents in their care. Two members of staff worked in each of the four areas. Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 Page 13 Staff worked well together and was seen to help in each area once their own workloads were completed. During the inspection the staff were seen to use the hoist for totally immobile residents. This was done safely, but for residents that had limited movement staff were not observed to be using the appropriate equipment. Of the case tracked residents’ their diversity was not well recognised in the home, thereby reducing the overall individual attention offered to residents in the home. A catholic resident explained that she had not had any church services offered to her and had not been offered communion but the Registered Manager informed the inspector that she has made arrangements with the Chaplain at Burstall to discuss meeting the needs the multi faith community of residents living at the home. Meals in the home are varied, menus being compiled in advance offering a balanced diet. It was noticed that the residents were given individual attention during meal times but at lunchtime some residents had to wait a while before they could be assisted on a one to one basis with their meal. Meals were kept warm in a catering trolley. The meals served were satisfactory and of reasonable portions to suit individual needs. Staff assist residents to maintain links with relatives, visiting times to the home being flexible. Relatives were encouraged to visit whenever they wished to, one of the relatives confirmed that this was the case. Another visitor who was visiting a relative explained that they were there every day. One relative explained that he was not routinely consulted about his wife on changes. Another relative explained that he was happy with the care given to his wife. The homes records indicated that health care professionals also visited as required. The Chiropodist visited three monthly. Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by having information about the complaints procedure and staff who could action this on their behalf. EVIDENCE: One relative said that he would know who to go to if he had a complaint. The staff that spoke to the inspector was aware of the procedures for ensuring the safety of residents and could explain to the inspector the need for the Protection of Vulnerable Adults and for the reporting of accidents and incidents. Staff were able to explain how they would handle a complaint made by a resident or a visitor. The financial records of the four residents case tracked were now well managed and safely stored. Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, comfortable and clean environment. EVIDENCE: Residents’ personal bedroom space, and public areas of the home were viewed within the inspection process. The areas seen were pleasantly decorated; with an ongoing plan of decoration being in place, enabling the fabric of the building to be kept to a good decorative state. Control of infection is well recognised in the home, staff showing a good awareness of the issues of cross infection and cross contamination, this offering residents a good degree of personal protection. Residents’ personal equipment used by staff in caring for residents is also clean and well maintained. Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 Page 16 Bedrooms all had self-locking doors once outside but could be opened from the inside. Patio doors identified by the home as fire doors in the Hamilton and Humberstone lounge areas were closed. In the Hamilton Lounge staff locked the door with a key. The inspector tried to open the door and found it to be locked. A member of staff then opened the door using a key. Staff were questioned about this and a staff member explained “it was to keep residents in”. Both lounges lead to an enclosed gardened area that residents could be encouraged to use. The Manager refutes this comment and explains that “Fire doors are not locked with a key, staff use a key to soften the closure of these doors and to cause less strain to the locks. But they remain open as per in case of fire they automatically open on being pushed to exit in an emergency.” Staff were able to confirm that they were involved in the recording of accidents or incidents relating to residents and they were familiar with the action to be taken in the event of a fire. In the bedroom seen there were fire procedures on the wall and although the staff said that they were not aware of their new providers policy they were fully conversant in what they would have to do in the case of a fire occurring at the home and able to demonstrate that they would be able to protect the residents in their care. Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 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, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents needs are met by the numbers and skill mix of staff. EVIDENCE: Nursing staff and carers were seen to work together on the day of inspection. There were two Nurses on shift who divided their work between the four sections of the home. Rotas seen on day of inspection were satisfactory. A training matrix was commenced at the home and thirteen of the twenty three staff employed at the home were trained to NVQ level two and above. The recruitment process was checked and found to be satisfactory but the recording and number of supervisions were poorly monitored. This could impact on the care given to residents if formal discussions about care is not completed on a regular basis. Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Residents live in a homely environment where the management approach is relaxed and friendly. EVIDENCE: A manager has been appointed. An application has been made to the Commission for Social Care Inspection to register her formally. Staff spoken to felt confident that they would be supported by the management team. Staff confirmed that they had staff meetings. The manager said that she is fairly new and routinely walks about the home to talk to residents and is getting to know them better. Residents and their relatives spoken to were pleased to have a new manager and hoped that she would be able to stay in post. The Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 Page 19 home was well supported by senior care staff and Nurses on each shift that knew the needs of the residents in the home. The records inspected were satisfactory although not always complete. Of the records seen training was incomplete, fire records up to Dec 2004 no evidence of Portable appliance testing e.g. plugs fitted to toasters or radios. There were no records of Gas tests on file. Accident records and notifications to CSCI were evident. It is recommended that the new manager brings these records up to date to ensure the health and safety of all residents staff and visitors to the home. Kitchen staff spoken to were well organised and the kitchen was clean and well stocked. One freezer was not recording temperatures correctly the manager was aware of this and its pending repair noted. The staff had records of manual temperature recordings for this freezer. This would ensure that the food was being kept at the correct temperature for safe food storage. In all four case tracked residents written records of all transactions were clear and residents money was handled safely. Foxton Grange DS0000063830.V289358.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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 2 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x x 2 Foxton Grange DS0000063830.V289358.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13(2) Requirement Medication must be administered as prescribed on the drug administration chart. Timescale for action 28/05/06 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 Refer to Standard OP7 Good Practice Recommendations Resident assessments should be completed prior to admission into the home Foxton Grange DS0000063830.V289358.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 Foxton Grange DS0000063830.V289358.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. 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