Inspection on 05/05/05 for Framland

This inspection was carried out on 5th May 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

Framland 10/05/07

Framland 16/02/06

Framland 25/02/05

Framland 20/10/04

Framland 11/02/04

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

CARE HOMES FOR OLDER PEOPLE Framland Naldertown Wantage Oxfordshire OX12 9DL Lead Inspector Jane Handscombe Unannounced 05 May 2005 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 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. Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Framland Address Naldertown, Wantage, Oxfordshire, OX12 9DL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01235 769876 01235 762090 wantage@pilgrimhomes.org.uk Pilgrim Homes Mrs Barbara Joy Margetts Care Home 21 Category(ies) of Dementia - over 65 years of age (9), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (21), Physical disability over 65 years of age (1). Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The total number of persons that may be accommodated at any one time must not exceed 21. Date of last inspection 20 October 2004 Brief Description of the Service: Framland is situated in a residential area of Wantage with easy access to the town centre. The house is a period property that was converted for its present purpose before it opened in 1986. It was sensitively adapted so as to retain some of the original period features and the original house contains the main dining room/lounge on the ground floor and there is a second lounge in the extension. The home has six single bedrooms on the ground floor and eleven single and two double bedrooms on the first floor. There is a passenger lift and stairs to the first floor. The home offers 24hr care by a well-trained and committed staff group and is managed by an experienced manager. A hairdresser, chiropodist, dentist and optician are available at an additional cost by appointment at the home and local services in Wantage town can also be visited for these services. The home is registered to care for 21 elderly people who, for one reason or another are no longer able to live in their own homes. The staff cater for a range of needs which have been assessed by the registered manager. Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, lasting 5 hours, which took place during the afternoon on 5th May. The purpose of the visit was to see how the home is meeting the National Minimum Standards. The visit involved speaking to residents in order to ascertain their views on the care they receive at the home, staff members and the manager, viewing care plans and assessments, whilst also observing the general day to day operations of the home. The home presented as clean and tidy with a homely atmosphere, with residents going about their daily activities in a calm relaxed atmosphere. Staff were observed to provide care and support to the residents in an unhurried manner and respecting their individuality and dignity at all times. Comments received from residents during the inspection included: ‘I have a lovely room’ ‘The food is very good, I couldn’t ask for better’ ‘The food is nice and plenty of it’ ‘I wouldn’t wish to be anywhere else, they are very caring and they go the extra mile to make sure we are comfortable’. ‘I am very well looked after here’ I could no longer cope on my own…they do a wonderful job, they are lovely’ The inspector’s overall impression was one of a well run caring home, in which the residents were happy with the high level of care they receive. The inspector would like to thank the residents and staff for making her feel welcome and for their assistance during the inspection. Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 Page 6 What the service does well: 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. Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 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 standard(s) 1, 2 and 3 The home gives very good, clear written information about the home and the services it offers to prospective residents and their families. EVIDENCE: Information contained in the Service User Guide and the home’s Statement of Purpose is very comprehensive allowing prospective residents and their families to get a ‘feel’ of the home. Information within these gives the prospective service user detailed information on the aims and objectives of the home, the facilities and services that are provided, details about the qualifications and experience of the manager, staff at Framland and information on the individual and communal room sizes and their facilities. No prospective resident moves into the home without having had their needs assessed and both the manager and prospective service user are satisfied that they will be able to meet those needs in full. Where a prospective resident is referred via Social Services and has undergone an assessment by their care manager, the manager of the home will undertake her own assessment to ensure the home can meet those needs. Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 Page 9 A sample of records were viewed, all of which were very detailed providing a full picture of the health, personal and social needs of the service user and the action to be taken to address these needs, along with long term goals. All but one of these records were signed by the service user/their representative, acknowledging that they were involved in the process; likewise this same service user’s record of nutritional assessment failed to have been signed by the person who undertook the assessment, nor was it dated. Recommendations are made within this report to address this. When a prospective service user is offered a place at Framland they are given a written contract which includes details of the room to be occupied, the rights and obligations of both the resident and the home, the terms and conditions of the occupancy, who is to pay the fee, what is covered by the fee, what additional services are offered at an extra cost and what happens in the case of a breach of the contract. Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 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 standard(s) 7 and 8 The residents’ health, personal and social care needs are assessed and reviewed regularly, providing an individual plan of care to ensure their needs are identified and met. EVIDENCE: Within the first week of admission, a senior member of staff along with the resident and/or their representative discuss and review the care needs identified prior to admission and draw up an individualised care plan setting out in detail, the action staff will take in order to meet the needs. This care plan is reviewed regularly, together with the service user or their representative. Care plans viewed were very comprehensive detailing the resident’s identified care and equipment needs, long term and short term goals, appointment dates, moving and handling assessments, nutritional assessments, pressure sore risk assessments, weight monitoring and monthly reviews of the care plans. Of those viewed it was apparent in all but one case that the residents or their advocates had been involved in discussions and agreed to the contents of the care plans. A recommendation has been made within this report with Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 Page 11 regard to seeking the resident’s or their representative’s signature wherever possible, to evidence that they have been involved in the process. Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 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 standard(s) 12, 13, and 15 The home provides a variety of leisure and social activities, which residents are encouraged to take part in if they wish. The activities and meals offered at the home are well managed, provide daily variation and interests for the residents living in the home. EVIDENCE: The staff and management at Framland were observed to respect the residents’ right to privacy, dignity and independence. Staff were seen to knock on residents’ bedroom doors and bathrooms before entering and were addressing residents by their preferred names. The activities programme and the subject of meals offered at the home are regularly reviewed and discussed with residents at the quarterly residents meetings in order to ascertain their views and preferences. The varied programme of activities is displayed on a notice board within the home, informing residents of what is available throughout the week, and care staff inform residents on a daily basis of the activities for that day. It was reported to the inspector that the meals offered at the home are wholesome and appealing and visitors are welcome to enjoy a meal with residents for a small fee. Special diets can be catered for and kitchenette facilities are available for residents and relatives to provide light refreshments if required. On the day of the inspection, residents were seen to be enjoying Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 Page 13 their lunch, which consisted of steak pie, or salad with mashed potatoes, broccoli and carrots followed by semolina or fresh fruit. Staff were observed to be offering assistance sensitively to those who required it and in an unhurried manner. Residents are able to receive visitors at any reasonable time, and are able to entertain them in their own bedrooms or in the communal lounges. Residents are free to make arrangements to visit friends and relatives and take holidays if required. One resident spoke of recent visits to friends and a planned holiday she was taking later in the year. Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 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 standard(s) 16 and17 An open culture is apparent in the home enabling residents to be confident in bringing any concerns or make constructive suggestions to the manager. Residents spoken to knew who to speak to if they had any concerns and felt that they would be dealt with both seriously and appropriately. EVIDENCE: On the day of inspection, the manager assisted some residents to visit the local polling station enabling them to take part in voting in the General Election, others took part through the postal system of voting. There is a complaints procedure in place at the home, although this was not on display at the time of inspection; when mentioned to the manager she took immediate action to rectify this and placed the procedure upon the notice board within the home for all residents and visitors to access if required. Residents spoken to were aware of the procedure and who to speak to if they had any concerns and were confident that they would be acted upon appropriately. All residents are invited to residents meetings, which are held every three months. These meetings encourage residents to become involved and make contributions to various matters surrounding every day matters within the home. Minutes of these meetings are put on display within the home for those who did not attend and for family and friends to keep them updated and informed. On display within the home, were minutes taken from a residents meeting held in March. Matters discussed included meals, staff updates, Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 Page 15 resident updates, social activities, travel tokens and feedback on questionnaires regarding the service at Framland. Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 Page 16 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 standard(s) 21, 24 and 25 The home provides comfortable surroundings, which are equipped to meet the residents’ differing needs. EVIDENCE: The home encourages residents to bring small items of furniture and memorabilia to personalise their rooms. On the day of the inspection, the home was generally well maintained and clean with a homely atmosphere. However, one service user’s room did present with an offensive odour, and a recommendation has been made at the end of this report. There were a satisfactory number of bathrooms and bathing facilities all of which were easily accessible and clearly marked. Hot water tested in a number of these, was of a very high temperature, which could pose a risk to the health and safety of the residents, and a requirement has been made at the end of this report to address this. Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 Page 17 Problems with the heating system due to the system being old and therefore leaking has led to damaged ceiling tiles on the ground floor. The manager is addressing this and replacing the damaged tiles at present and is awaiting a quotation for the necessary works to remedy the problematic heating system. Residents have the use of a small lounge, which can be used to entertain their visitors and is also used as a surgery when the Doctor does his monthly visits. However, at present the small lounge is being used by staff whilst their office undergoes redecoration. Speaking with residents, this has not caused too much of a problem, the Doctor and District Nurses see residents in their own rooms when privacy is required. The redecoration is close to a finish at which point the staff will return to their office. Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28, 29 and 30 The home follows a thorough recruitment process to ensure that residents are in safe hands and training opportunities are readily available to all staff to ensure competency in their roles and to allow for personal development. EVIDENCE: The recruitment of staff is thorough and a sample of staff files were viewed which showed that there are good systems in place. A recent aid memoir drawn up by the manager has been an effective tool in monitoring the progress and stage of all new recruits. All new staff undergo an induction programme, which consists of five units that can later be built upon to prepare for the NVQ qualification. At present there are 5 members of staff who possess NVQ qualifications and a further 2 members are undertaking the training with a further 2 undertaking the pre NVQ training. 12 members of staff are presently undertaking training in the safe handling of medicines. Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, and 33 Framland is a well managed home, run in the best interests of the residents using the service, with safeguards in place to protect their health, safety and welfare. EVIDENCE: The manager of the home has undergone registration with the CSCI, deeming her a fit person to manage Framland. She has gained the Registered Managers Award NVQ level 4 to complement her experience in caring for older people. Residents and members of staff reported that the manager runs the home in an open, positive, inclusive way and they would have no worries approaching her if they had any concerns and were confident that they would be listened to and dealt with appropriately. Whilst there are policies and procedures in place to promote and protect the health, safety and welfare of the residents, hazardous substances were found Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 Page 20 in the greenhouse and a requirement has been made within this report to address this. Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION x x 2 x x 3 2 x STAFFING Standard No Score 27 x 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x x x x x x x x 3 Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 38 21 Regulation 13.4 13.4(a), 23.2(c) Requirement The registered manager must store hazardous substances safely. The registered manager must consult with environmental health regarding the hot water temperature in the home and the residents ongoing safety; any actions reccommended to be implemented as directed. Timescale for action Immediate and henceforth June 30th 2005 3. 4. 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 3 and 7 Good Practice Recommendations It is a good practice reccommendation to gain a signature from the service user/representative evidencing that they have been involved in the assessment and care planning processs and for all staff undertaking the assessments, to sign and date the relevant documentation. It is strongly reccommended that the floor surfacing in the room identified be deep cleaned or replaced to alleviate the offensive odour. H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 Page 23 2. 26 Framland Commission for Social Care Inspection Burgner House, 4630 Kingsgate, Cascade Way, Oxford Business Park South, Cowley, Oxford OX4 2SU 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 Framland H57-H08 S13088 Framland V224722 050505 Stage 4.doc Version 1.30 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!