Inspection on 24/01/06 for Francis House

This inspection was carried out on 24th January 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Francis House 19/10/06

Francis House 03/05/05

Francis House 01/11/04

Francis House 04/06/04

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

Broadreach

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

CARE HOME ADULTS 18-65 Francis House Dennington Swimbridge Barnstaple Devon EX32 0QG Lead Inspector Dee McEvoy Unannounced Inspection 24th January 2006 10:00 Francis House DS0000022184.V260409.R01.S.doc Version 5.0 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 Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Francis House Address Dennington Swimbridge Barnstaple Devon EX32 0QG 01271 830030 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) info@francishouse.com Assisi Community Care Limited Mr Michael Crumpton Care Home 40 Category(ies) of Past or present alcohol dependence (40) registration, with number of places Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age range 25 years plus Date of last inspection 3rd May 2005 Brief Description of the Service: Francis House is an inter-denomination Christian home providing care for up to 40 men who have problems relating to the use of alcohol. The homes philosophy of rehabilitation is based on an abstinence model where service users are offered an opportunity to explore an alcohol free future. All service users are expected to contribute to community living with personal skills and commitment. Accommodation is offered in two buildings, Francis House and Clare House and is mainly single occupancy. The grounds comprise of nearly seven acres, and include trout ponds, vegetable gardens, greenhouse and lawned areas. Frances House are unable to offer places via court orders. Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the second inspection of the current year and took two inspectors five hours to complete. National Minimum Standards, which have been met at the previous inspection on 3 May 2005, were not inspected on this occasion. This inspection focussed on key National Minimum Standards, which had not been inspected at the previous inspection or those, which were the subject of previous requirements and/or recommendations. The inspectors spoke in private with 9 residents, as well as meeting others in communal areas of the home; one visitor and 5 staff were also spoken with. The provider and manager were available throughout the inspection. The inspectors toured the premises and inspected a number of records including residents’ care plans, and records relating to training, quality assurance and health and safety. The Commission has received one complaint since the last inspection; the providers worked with the inspectors to investigate several elements of the complaint, which was unresolved or not up-held in some instances. One issue within the complaint was up-held and the providers have ensured that this has been dealt with. What the service does well: What has improved since the last inspection? Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 6 Residents have been offered access to an in-house computer course, which will develop skills, confidence and independence. Staff have been offered Drug and Alcohol National Occupational Standards (DANOS) training, which is relevant to their work and ensures they have a good understanding of residents specific needs. New heating systems have been installed; ensuring residents live in a warm environment. 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. Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Key standard was met at the previous inspection. EVIDENCE: Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&9 Whilst some care records and risk assessments were of a good standard, there was insufficient detail in others to ensure staff had the information to meet those residents’ needs. EVIDENCE: Care plans reflected the needs identified through the assessments conducted and provided some though not sufficient description of how those needs should be met. For example the care plan of a resident who has chronic breathing problems mentioned the importance of improving their diet but did not describe any treatment they should receive, signs of deterioration that staff should look out for or what should be done in case of deterioration. Another regarding a residents diabetes mentioned that this persons urine should be tested daily but did not say by whom, what the results should be or what to do if the results are not within acceptable limits. However, both residents felt that their conditions were managed well and that most staff had a good understanding of their needs. The daily care record provides a profile of the residents’ day-to-day care and contained some useful information, for example a good record of what residents eat is available and reflections on their mood, which can identify changes and may trigger a review of care. Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 10 Two of three care plans seen had been signed and three of four residents asked said they were aware of and consulted about their care plans. Care plans showed evidence of regular review. One resident told an inspector that they felt much better, physically and mentally, since moving to the home, describing how through 1 to 1 counselling sessions with the manager they had been encouraged to take control of their life and be proactive in their own recovery. Four of the five residents asked said they come and go as they please. One person said that due to previous incidents when visiting the local town they had agreed not to visit the town unless accompanied by staff. Risk assessments seen in resident’s files had been completed and though providing fairly basic information, described what was to be done to manage/reduce risks identified. Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Residents are supported to maintain contact with family and friends as appropriate. EVIDENCE: Residents are encouraged and supported to sustain, and in some cases reestablish, relationships with family members. The manager and staff are aware of how important these relationships are but also consider the negative effect of maintaining past relationships which may put the residents recovery at risk. One relative was met during the inspection and expressed their satisfaction with the service provided and the progress made by their relative; the inspector was told, “They look ten years younger”. The majority of ‘lifestyle’ key standards were met at the previous inspection. During this inspection two residents described the opportunities available for personal development at the home. Since the last inspection the home has developed a six-week computer course to improve residents’ skills and encourage independence. One resident found the course particularly useful for college work being undertaken. Another resident said that since being at the home they had been on a Food hygiene course, done gardening, helped with decorating and Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 12 that, having regained much of their self confidence, they were now beginning to look at how they could get themselves back in the jobs market. Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key standards were met at previous inspection. EVIDENCE: Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home deals with complaints in a robust manner. EVIDENCE: The Commission has received one complaint since the last inspection, which was jointly investigated by the providers and CSCI. The home was proactive and worked with CSCI to look at concerns raised about the maintenance of the building; food and general care issues. Various elements of the complaint were unresolved or not up-held but aspects concerning maintenance of the environment were up held. Residents raised no complaints or concerns during the inspection. Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Appropriate heating now provides a homely and comfortable environment for all residents. The standard of the décor within the home is satisfactory although some areas are damaged and need attention. The home is clean but the lack of hand-washing facilities may increase the risk of poor basic hygiene and infection control. EVIDENCE: The inspectors looked at communal areas in both Francis House and Clare House and in eleven bedrooms. All areas were clean but routine maintenance and refurbishment is still required to replace broken and missing tiles in a toilet and bathroom on the first floor of Francis House. Currently the home does not have a planned maintenance and renewal programme for the premises. Resident’s rooms were personalised with pictures, hi-fi and TVs etc. Residents told the inspectors they liked their rooms and found them comfortable. All residents asked said that the home is now always kept at a comfortable temperature and confirmed that they are happy with how the home is maintained. Bathrooms and toilets were clean, most but not all were provided with soap but most did not have facilities for drying hands. Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 16 Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Residents benefit from a committed group of care staff that are supported and supervised in their roles, and receive the necessary training. EVIDENCE: Since the last inspection the manager has commenced training in order to be competent to assess NVQ training. She has obtained suitable and relevant training for staff, which reflects the Drug and Alcohol National Occupational Standards {DANOS} for this specialist area of care. One carer currently doing NVQ 3 in care commented that the assessor had tried to focus the qualification around the care of people receiving a service for alcohol abuse. Staff reported that they had also received training about health & safety, safe handling of medicines, food and hygiene and regular fire training over the past year. A senior member of care staff said they had just completed their NVQ 4 and the Registered manager’s award and had done other required safety related training in the last year. Individual training records for staff confirmed this. Staff spoken with were keen to develop their skills and described the training at the home as a strength and felt they were supported in their role. One described their induction period as “comprehensive” and records would confirm this. Residents spoken with felt that staff understood their needs and experiences, one told the inspector, “The staff are brilliant.” Another resident described the support provided by staff as “great”. Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 18 Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Residents and staff benefit from the competency and experience of the management. Residents are involved in the running of the home, with evidence that their views are sought. However, formal review of the quality of care is less well addressed. There are reliable systems in place to ensure the good health safety and welfare of residents and staff. EVIDENCE: The provider and manager are experienced and competent, and provide strong leadership. The manager undertakes periodic training and development to maintain and up date her skills and knowledge. Staff described the managers as approachable and supportive. The home has a number of quality assurance systems, such as regular residents’ meetings, annual quality questionnaires and exit surveys. No formal review/analysis has been completed of the ‘quality of care’ survey results and residents and the commission have not received a report on any review of quality Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 20 of care. The manager, in line with the Investors in People award, is completing an annual development plan for the home. Safe working practices are employed and risk assessments are undertaken to reduce environmental risks, including risks posed by unrestricted windows. Records showed and staff confirmed that regular fire drills and staff training are undertaken. Fire alarms and safety lighting are regularly checked. A visit by Devon Fire and rescue in September 2005 found satisfactory standards. Staff receive mandatory training to ensure safe working practices are maintained, such as food hygiene and health & safety. Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Francis House Score X X X X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 3 X DS0000022184.V260409.R01.S.doc Version 5.0 Page 22 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 YA39 Regulation 24 Requirement The registered person shall supply a report to the Commission in respect of any review of the quality of care provided at the care home, and also make a copy available to residents. Timescale for action 24/05/06 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. 2. 3. Refer to Standard YA6 YA9 YA24 Good Practice Recommendations It is recommended that more detailed and relevant information be included in care records, for example the acceptable ranges for glucose. It is recommended that risk assessment be developed further to provide staff with the detail of information they need to meet individual needs. It is recommended that a planned maintenance and renewal programme for the fabric and redecoration of the premises be developed, with records kept. The broken and missing tiles in the bathroom and toilet of Francis House are to be replaced as part of routine maintenance. It is recommended that liquid soap and towels are DS0000022184.V260409.R01.S.doc Version 5.0 Page 23 4. YA30 Francis House available in all communal bathrooms and toilets to maintain good hygiene and prevent infection. Francis House DS0000022184.V260409.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Francis House DS0000022184.V260409.R01.S.doc Version 5.0 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. 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!