Inspection on 14/02/07 for Framland Residential Home

This inspection was carried out on 14th February 2007.

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 Residential Home 09/01/09

Framland Residential Home 03/11/05

Framland Residential Home 05/07/05

Framland Residential Home 20/01/05

Framland Residential Home 01/07/04

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

CARE HOMES FOR OLDER PEOPLE Framland Residential Home The Mansion House 11 Faldo Drive Melton Mowbray Leicestershire LE13 1RH Lead Inspector Mick Walklin Key Unannounced Inspection 14th February 2007 10:30 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 Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Framland Residential Home Address The Mansion House 11 Faldo Drive Melton Mowbray Leicestershire LE13 1RH 01664 564922 01664 564922 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) Firstsmile Limited Mrs Eleanor Rosemary Cant Care Home 31 Category(ies) of Dementia - over 65 years of age (4), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (4), Old age, not falling within any other category (31), Physical disability over 65 years of age (4) Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No person in category PD(E) to be admitted to the home when there are 4 persons of that category already accommodated in the home. Service user numbers. No person to be admitted to the home in categories MD(E) or DE(E) when 4 persons in total of these categories/combined categories are already accommodated in the home. 3rd November 2005 Date of last inspection Brief Description of the Service: Framland Residential Home cares for thirty-one older persons who may have dementia or mental disorder in a purpose built property situated in a residential area in Melton Mowbray. The town centre of Melton Mowbray is within close proximity where residents have access to a variety of shops and other facilities. The home is easily accessible for private and public transport. The premise consists of three floors accessible by use of the stairs and passenger lift. There are a variety of facilities in the home including dining and lounge space. The home comprises thirty single bedrooms, twenty-eight with en-suite facilities. A garden is situated to the rear of the premises. The range of fees charged is between £365 and £395 per week. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken using a review of all the information available to the inspector regarding the service history of Framland Residential Home, and through undertaking a visit to the home. The fieldwork visit took place over 8 hours. The main method of inspection used was called case tracking which involved selecting three residents and tracking the support they receive through the checking of their records, discussion with the care staff and observation of care practices. A tour of the building was undertaken, and documents connected with the running of the care home were also inspected. A pre-inspection questionnaire had been completed in October 2006. What the service does well: What has improved since the last inspection? There were no issues found at the time of the last inspection. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 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 Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good procedures to ensure that residents are fully assessed before they are admitted to the home, so that their needs can be met. EVIDENCE: The manager talked about how a new resident to the home had been admitted. Her daughter had made the first enquiries, and visited the home. She had given some information about her mother’s needs, by completing an enquiry form. The manager had then visited the person in hospital, and completed a thorough assessment to ensure that her needs could be met. Information had been gathered from the hospital, and staff had been given information about her, before she was admitted, so that they were familiar with her needs. The pre-admission assessment on file covered care needs, diet, risks, hobbies and cultural/spiritual needs. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 9 The manager said that she prefers not to accept emergency admissions, as it is difficult to gather enough information to decide whether the person’s needs can be met. The home does not offer intermediate care. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are of a good standard, and provide staff with good information. There are good arrangements with local health providers, and medication procedures ensure that administration is safe. Staff treat residents with respect. EVIDENCE: Care plans contain good information about residents support needs. The manager explained that a temporary care plan is introduced on the day of admission, with risk assessments for pressure areas, nutrition, and moving and handling. A full care plan is in place after four weeks. Care plans cover a wide range of areas, and are in a concise format. They are reviewed monthly, and signed by the resident or their representative. A resident said, “My key worker talks to me about any changes in my care plan, and I sign it”. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 11 Residents are registered with the main surgery in Melton Mowbray. A district nurse visits as require, usually two to three times per week. A community psychiatric nurse visits every six weeks. There are also arrangements for opticians and chiropodists to visit the home, and dental services are available in Melton Mowbray. A resident said, “They always get a doctor quickly if I have any problems”. Senior staff administer medication. They have all received the ‘Safe Handling of Medication’ training. The deputy manager also does 1-1 training with staff. The manager and deputy have also done further training covering managing medication, policies and procedures, and actions in case of medication errors. The home uses a pre-dispensed administration system. Storage facilities are satisfactory, and administration records are fully completed. One resident selfadministers medication, and she has lockable storage in her room, and staff do regular audits. Staff from the home do not give out homely remedies without the agreement of the doctor. Residents confirmed that staff treat them respectfully, and this was observed during the course of the inspection. One said, “The girls (staff) are nice”. There was a discussion at the last residents meeting about residents being respectful to other less able residents. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have an activity programme to stimulate them. They are helped to maintain contact with family and friends. Residents exercise choices over their lives, and catering arrangements reflect individual choices. EVIDENCE: The home has a set activity programme, with activities planned every weekday. A range of activities are provided, including quizzes, reminiscence, carpet bowls, art, cake decorating and music and movement. There have been several outings over the Christmas period, and entertainers have also visited. One resident said, “The activities are better in the summer because of the outings, but we have had a good time over Christmas with outings and entertainers. We used to have are own mini-bus which was better”. Activities are discussed at residents meetings, and there was evidence that requests from residents for more quizzes had been acted on. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 13 Families and friends are able to visit when they wish. A residents said, “Staff are good to my visitors – they always offer them a coffee”. A relative said, “I visit every day, and feel like part of the furniture. I can have meals here, and I have also been on lovely outings in the summer”. Care plans contain ‘Personal Preference Sheets’ which inform staff about residents likes, routines, and areas of independence and support. Staff were observed to regularly consult residents, to ensure that their wishes are catered for. A resident confirmed that she is able to live her life as she wants. She said, “I get up and go to bed when I want. Staff respect my personal space – they don’t do things off their own backs – they ask you first”. Residents said that the standard of food served was good. One said, “The food is usually quite good – there is a choice of two main meals, but staff will always fix you something else”. Staff talk to residents about the menu before meals, to ensure that their choices are catered for. One resident said that food could be served more quickly, as there is sometimes a delay between courses. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know that their complaints will be taken seriously, and there are procedures in place to protect them. EVIDENCE: Although there have been eleven complaints since the last inspection, a majority of these were from residents complaining about the behaviour of other residents. On said that she had complained because another resident had entered her room in the middle of the night. She had reported this to staff, who had taken the matter seriously, and the resident now locked her door. A relative also said that she had complained about missing socks, but “staff had sorted this out. There had been a complaint about a member of staff, which the manager had dealt with, and a complaint from a neighbour about the noise that a resident was making. Complaints are well recorded, together with the action taken. The complaints procedure is contained in the service user guide, and displayed in the entrance hallway. There was also evidence that the complaints procedure is discussed at every residents and relatives meeting. Staff demonstrated a good knowledge of the adult protection procedures, and their reporting responsibilities. Staff receive training as part of their induction, Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 15 but have not been receiving periodic updates. The manager confirmed that further training was planned for this year. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and clean environment for residents to enjoy. EVIDENCE: There are a range of comfortable communal spaces for residents to enjoy, with three living rooms and a dining room. Residents said that they are happy with the standard of accommodation. One said, “I like my bedroom – I have a door into the garden”. Bedrooms are personalised to taste, with many pictures and mementos. One member of staff commented that the décor could be improved in some areas, and there was work going on to replace the flooring in one of the bedrooms. At a recent residents meeting, there had been comments about the condition of the dining room carpet, and this has now been cleaned. A Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 17 carpet in one of the bedrooms requires cleaning or replacing, and the general manager confirmed that this was being attended to. There are a team of three cleaners to cover seven days per week, and the home was clean at the time of the inspection. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are adequate to meet the needs of residents. Staff are well trained, and recruitment and selection of staff is thorough. EVIDENCE: Residents said that there are enough staff to meet their needs, but “staff are busy in the mornings”. A member of staff said “We have enough staff, but we are busy at the moment as we are full”. Another said, “Some days we could do with more staff – we are on the go all the time, especially in the mornings. A relative said, “They usually have enough staff – they always seem on top of the job”. There are usually three care staff on duty during the day, with a senior, kitchen staff and cleaning staff. Night cover consists of a senior and a carer on duty, plus a person on-call. Three staff files were inspected, all of whom had been employed between September and November last year. All the files contained evidence of a formal recruitment and selection process, and contained the necessary documents for the protection of residents. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 19 Training is co-ordinated by a senior carer, and staff said that they have received a wide range of training. All new staff complete a comprehensive induction and foundation course. Thirteen staff have completed a National Vocational Qualification, (NVQ), and a further three are undertaking this training. Kitchen and cleaning staff are also waiting to enrol on NVQ courses. Staff complete a self-assessment as part of their annual appraisal, which helps identify areas of training required. Staff have also received training from the district nurse and community psychiatric nurse on specialist subjects. A member of staff said, “The training is good – it has helped me a lot”. The company holds the Investors in People Award, which is due to be reassessed this year. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed. Residents and their relatives are consulted about how to improve care. The home is run in a safe manner. EVIDENCE: The manager started working at the home two years ago, and has completed the Registered Managers Award. Staff, residents and relatives said that the home is well managed and organised. Staff said that there is “brilliant” teamwork and morale, and there are regular staff meetings. One member of staff said, “We have staff meetings and supervision – we feel well supported and valued”. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 21 Relatives receive a questionnaire about their views on the home during the initial enquiry. There is a suggestions box in the entrance hallway. The manager conducts an annual survey of staff, residents and relatives. The recent survey had 17 responses, all overwhelmingly positive, with any issues being addressed. The results of the survey are discussed at the residents meeting. The manager and general manager undertake monthly audits, and the company has an improvement plan containing ideas on how to improve the service. Relatives and residents have responsibility for residents finances. Relatives top up petty cash floats, and there are good systems for accounting for monies. Three residents balances were checked, and all were correct. A resident said that she looks after her own money, and is provided with a lockable cabinet for safe storage. Health and safety records are up to date. There was an incident in January 2006, where a resident had fallen through the straps of a hoist, and the manager had taken action to ensure that this did not happen again. Some issues were identified during the inspection, but the manager took prompt action. Some refurbishment was being undertaken at the time of the visit, and a mattress had been left partially blocking a fire exit. This was removed. Two bedrooms were fitted with mortise locks, which could not be opened from the inside. Although these were not in use, they were disabled immediately. Some cleaning materials stored in the laundry were removed to a locked cupboard. Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 22 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 3 X X 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard Good Practice Recommendations Framland Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Residential Home DS0000001777.V324272.R01.S.doc Version 5.2 Page 25 - 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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