Inspection on 29/01/09 for Frank Foster House

This inspection was carried out on 29th January 2009.

CSCI found this care home to be providing an Excellent service.

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

Frank Foster House 04/01/07

Frank Foster House 05/01/06

Frank Foster House 30/06/05

Frank Foster House 07/10/04

Frank Foster House 05/05/04

Frank Foster House 22/01/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Frank Foster House Loughton Lane Theydon Bois Epping Essex CM16 7LD     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Diane Roberts     Date: 2 9 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Frank Foster House Loughton Lane Theydon Bois Epping Essex CM16 7LD 01992812525 01992814753 frank.foster@runwoodhomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Runwood Homes Plc Name of registered manager (if applicable) Mr Teshwar Seeratun Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Persons of either sex, aged 65 years and over, who only fall within the category of old age (not to exceed 71 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 35 persons) The registered person must not admit persons subject to the Mental Health Act 1983 or the Patients in the Community (Amendment) Act 1995 The total number of service users accommodated in the home must not exceed 71 persons Date of last inspection 0 0 Over 65 35 71 care home 71 Care Homes for Older People Page 4 of 29 Brief description of the care home Frank Foster House is owned by a private organisation named Runwood Care Homes Ltd. The home is located in the village of Theydon Bois, Essex. The home was opened in 2002 and consists of a two-storey building that has been upgraded and refurbished to a high standard. Frank Foster House provides personal care with accommodation for up to 71 older people, including 35 older people with dementia. Whilst the home is unitised the resident groups are mixed within those units. The home also provides short stay step down beds for people rehabilitating with a view to ultimately going home. There are 71 single en-suite bedrooms on two floors with access provided by two passenger lifts in addition to several staircases. There are a number of communal rooms used for relaxing and dining and a small multi-denominational chapel. The home has an enclosed courtyard garden that is accessible to wheelchair users. Frank Foster House is accessible by road and parking is available in the car park. The fees range between £471.95 and £675.00 weekly but do not include, hairdressing, chiropody, newspapers, toiletries or transport. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We visited the home for a whole day and met with the manager and the deputy manager. Prior to this we reviewed all the information that we already had on the home and this included the managers Annual Quality Assurance Assessment. The manager was asked to complete this and this tells us how well they think they are doing, what they do well and what they would like to improve upon. We refer to this throughout the report as the AQAA. On the day of the inspection we spoke to three residents and 4 staff at the home and prior to that we sent out surveys to residents, relatives and staff, asking for feedback on the home. The response was very good and these comments are referred to in the report. Whilst at the home we also reviewed a range of records and undertook a tour of the home. Care Homes for Older People Page 6 of 29 Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that they would have a full assessment of their needs to ensure that the home is appropriate for them and that they would have sufficient information about the home. Evidence: The manager has an up to date Statement of Purpose and Service User Guide in place. These are both available in the reception area along with the last inspection reports for the home, brochures and plenty of other useful information for both residents and their families. The service users guide was reviewed and found to contain all the required information. Consideration should be given to reviewing the format to make it more user friendly especially for people with dementia and it also needs to be made clear that although the home is unitised, the residents groups in the home are mixed within those units. Care Homes for Older People Page 10 of 29 Evidence: The manager and the deputy undertake all the pre-admission assessments. Occasionally one of the care team managers attends as well. Three assessments were reviewed and found to be completed well giving a good level of information on the prospective resident and their needs, in order to make a decision about whether admission to the home would be appropriate for them. Peoples abilities had been identified as well as their needs, however more person centered information could be obtained about the individual and their preferences and goals. Assessments had been completed in a timely manner and where possible, the people being assessed, had signed to say that they agreed with the assessment. In addition to the management assessment, additional information from the referring authorities, where appropriate, was available. The manager in his AQAA said each resident has a comprehensive pre-admission assessment of their needs carried out prior to moving into the home. The evidence would concur with this. The majority of residents who commented said that they had sufficient information at the time of admission and those spoken to confirmed their assessment. Respite residents spoken to had been to the home before and were happy to come back, they said I am quite happy here, I get on alright, next best thing to home and I have a copy of the guide. Care Homes for Older People Page 11 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care needs meet in a way that they would wish and which respects their dignity. Evidence: The manager has a care planning system in place. This consists of an assessment of needs, a range of risk assessments and care plans. Additonal records are made for health care professional visits etc. Three care plans were reviewed in full and a further care plan was used for cross checking. This included care plans for respite residents. Overall the care plans were found to be very good. They were up to date and contained sufficient detailed information to guide care staff. More could be done to introduce a fully person centered approach to care planning, so that residents preferences etc. are always evident along with any goals they may have, for example retaining skills. All the staff spoken to however, demonstrated a very resident led approach to the delivery of the care and whilst it is not always evidenced in the recording, it is in the practice. Care Homes for Older People Page 12 of 29 Evidence: Residents had the care plans that they needed in place and where possible they had signed their own care plan. There was also evidence of staff trying to get families to sign where needed and discussion of care planning with family members. Where required, assessments had been regularly reviewed in full. Care plans covered a range of both physical, mental and social needs and were seen to promote residents independence and rights. Night care plans were in place for all residents and these were more person centered, identifying residents preferences regarding their sleeping pattern. Care plans were seen to be appropriately updated at the time of review, in line with new identified needs and/or risks, for example, one resident had their call bell lead changed to reduce the risk of trips/falls in their room as this was identified as a risk and fully documented. Care staff complete daily notes and these were very informative giving an overall picture of the care provided, the residents mood and wellbeing and dietary intake. Residents had a range of up to date risk assessments in their care plans. Where needed the risk assessment linked into the care plan and the management of the risk was consistent. Risk assessments were completed for manual handling, falls, nutrition, pressure sores etc. Those residents seen, from the records, to be at risk nutritionally were appropriately monitored and records showed that staff were good at noticing steady declines in weight and referring them to the appropriate health care professional. For example, we noted that over a period of time one resident had steadily lost small amounts of weight. On tracking this, staff had already noted this and referred to the GP and professional visit sheets recorded his views and the management of the issue. Residents were being weighed regularly and monitored closely. Some residents were noted to be steadily gaining some much needed weight. Residents with behavioral needs had risk assessments completed which covered such risks as aggression or wandering from the home. Risk assessments around aggression should be revisited to ensure that they do identify the trigger points and so that they are clear on the management for staff. On the whole this information was in the care plan but not always in the actual risk assessment, for example, some valuable information on triggers was contained in the social profile for one resident. It is clear from the professional visits that residents have good and timely access to their GP service and other health care professionals, and on observation, relationships with the local practice are very positive. They had recently reviewed all the residents with dementia in the home, including a review of their medication. Staff were observed to handle an incident, where a resident was found to be unwell, efficiently and when speaking to the medical services, the care team manager knew the resident well and could give clear information. Care Homes for Older People Page 13 of 29 Evidence: The manager in his AQAA said that care plans and risk assessments are in place for each residents individual needs and are reviewed on a regular basis to reflect their changing needs. The evidence seen would concur with this. Residents who commented on the care said the standards here leave me nothing unkind to say, there are no problems, the care staff keep us happy and I am happy here, they look after you well. The majority of residents responding to our surveys said that they always got the care and support they needed and that staff listened to them and acted upon what they said. They also said that they always got the medical attention that they needed. Relatives who commented said that they treat my relative with respect and kindness at all times, When I visited, staff informed me how my relative was doing, The residents are very well cared for, Staff show respect and consideration and a very good level of care. Medication management was reviewed and found to be in good order. The team used a blister pack system and this was checked and tallied with the medication administration sheets. Medication profiles are in place for each resident that gives staff an outline of what the medication is for. Signing for medication was good, including as and when medications, and the appropriate omission codes are used. Medications were stored correctly and a fridge was also available for storage, with records showing that staff check the temperatures daily. Controlled medications were checked and found to be managed correctly. The management team undertake weekly audits of the medication systems and from the records in care plans, it is clear that medication reviews are undertaken regularly. Items raised at the last key inspection had been addressed fully. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect a good experience in relation to choice of daily routine, mealtimes and activities. Evidence: From discussion with residents and staff it is clear that, as far as possible the routines of the day are resident led. Residents spoken to said I have absolute choice about getting up, what I do, when I go to bed - absolute freedom and no rushing, you can please yourself what you do and when and theres no bossing, they let me be as independent as I can be. Staff spoken to demonstrated a very resident led approach being clear about the fact that residents have choice and that you offer care and see how residents feel about it. They discussed flexibility within their routine to suit residents and identified residents who often choose to lie in in the mornings. Within the care plans, residents were seen to have family and social history profiles in place that had been completed quite well giving some useful information so that staff can get to know them and their lifestyle. On discussion with staff they did not all know the residents that they were caring for well, from a social point of view and this could be promoted more. Care Homes for Older People Page 15 of 29 Evidence: The manager employs a full time activity officer who works Monday to Friday. It was not possible to speak to this person as they were on leave, so the activities programme was discussed with the deputy manager. An activities assessment is completed for each resident, which outlines their social preferences, family history and abilities etc. These are good records to inform staff but could be developed further to identify any goals, for example that promote independence and self worth. Records show that residents take part in a good range of social activities both in and out of the home. For example, arts and crafts, bingo, reading, games, exercises, religious services, piano playing, clothes parties, entertainers etc. Residents had also been on visits to garden centres, had meals out, attended local events in the village hall and had various parties, including cheese and wine, canapes and cocktails etc. Some records, for example, for residents who are reluctant to take part in activities, do need further work as the weekly one to one visits made, just tended to reflect the status of the resident rather than the actual interaction, however minor, that had taken place. The deputy manager did report that some residents do take part in daily living skills such as cooking, laundry etc. Care staff also confirmed that during the morning shift they do take an active part in any activities that are taking place and that there is time to do this. Residents who commented on the activities said the activities are good, yesterday I went to a Christian meeting and we had a speaker who was quite good and I saw the entertainer later and If there are any activities I always go and spend time, they are usually quite good. The majority of residents who commented on surveys said that there were always activities that they could go to, with the rest who commented saying there were usually activities for them to attend. Residents were seen to be involved in looking at a variety of books and pictures relating to past events in the home. Residents later played bingo and those spoken to around the home were aware of what activities would be available to them that day. Posters for forthcoming events, into 2009 were seen to be displayed around the home and in lounges. In the reception area there is a notice board especially for relatives giving useful information about a variety of subjects. The manager in his AQAA said that we have a full comprehensive activities programme with lots of outside entertainers. Activities are geared towards individual needs and capabilities. Unfortunately mealtimes were not observed on this occasion however feedback from residents on the meals service was positive. They said the food is nice, its hot and Care Homes for Older People Page 16 of 29 Evidence: there is enough of it, The food meets my needs, I avoid eating between meals as it can ruin my appetite, you get plenty to eat and as we have a choice there is usually something I can choose that is to my liking. Residents who commented on surveys said they either always or usually liked the meals at the home. Residents were observed to have plenty of drinks available to them both in their rooms and in the lounge areas throughout the day. A four week rolling menu is displayed in the main dining area and on each day a large print version is displayed around the home. Alternatives are also permanently displayed but this could be more prominent. The minutes of the residents meeting in January 2009 evidenced that residents were happy with the food in the home and particularly the catering arrangement over the Christmas period. Catering surveys are undertaken so that residents can feedback and be consulted with. The last one was March 2008 and the results were very positive with residents saying that the menu was to their liking, mealtimes were pleasant, not rushed and they got the help they needed. They had plenty of drinks and meals were hot and they had choices. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured that they would be listened to if they had a complaint and that they ill be protected, as far as possible, by the adult protection systems that are in place. Evidence: The manager has a complaints procedure in place. This is displayed in the main reception area and can be found in the service users guide, which is easily available around the home. Again consideration could be given to the format for the resident groups. In the last year the manager has not received any formal complaints. He has a logging system in place should the need arise. Residents who commented said I would happily raise any concern I had with the staff and I do not have any complaints but if I did it would not be a problem, I would speak to the manager. On the surveys sent back to us, all but one of the residents said that they knew how to make an complaint. Relatives also all knew how to make a complaint and all said that when needed the response to any concerns raised had been appropriate. The manager also has a suggestion box in the main reception where people can leave anonymous concerns/complaints should they wish. The manager has policies and procedures in place for staff around adult protection, including local guidelines. Staff spoken to demonstrated an understanding of abuse issues and reporting procedures. They also confirmed that they had attended training Care Homes for Older People Page 18 of 29 Evidence: on the subject. Records for the whole team showed that there was a 100 compliance with staff training on this subject, completed in either 2008/9. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe, clean and well maintained home that meets their needs. Evidence: A partial tour of the home was undertaken with the deputy manager. All floors and units were visited, which included lounges and bedrooms. Although this is a large home it has a very calm and homely atmosphere. This is aided by the use of small, homely lounges and the staff efforts to provide a cheerful and stimulating environment for the residents. There are plenty of pictures and items to look at around the home and these include interactive and textural items. One of the small lounges is also used as a snoezelem, containing visually interesting specialist equipment and it also has a small annexe that is used as a prayer room, where church services are held. Residents spoken to commented on actively using this room. Signage around the home is particularly good and this helps with promoting residents independence. Residents all have individual signs on their bedroom doors which they have made or that relate to them in some way, for example, an interest they may have. The home was seen to be very clean and well maintained. No odours were noted apart from the smoking room, when the extractor has not been switched on and this can then permeate down the adjacent corridor. The home has a central courtyard with wheelchair access for residents and other small Care Homes for Older People Page 20 of 29 Evidence: garden areas. Some of the downstairs bedrooms open onto the courtyard. The manager in his AQAA says that he plans to improve the garden facilities for residents in the next twelve months. The manager has a local fire plan in place and an up to date risk assessment. Records show that regular fire drills have been carried out for staff, including night staff. Records also show that regular tests and maintenance are undertaken on the fire alarm systems in the home. A maintenance man works at the home full time and records show that he undertakes a regular series of checks on systems and fittings in the home, including hot water temperatures, security, electrical equipment, refuse arrangements etc. Residents who commented on the fabric of the home said I am happy with my room, the cleaning is thorough and I am very comfortable, I like to spend time in different parts of the home. All of the residents who commented said the home was always fresh and clean. On the managers AQAA he records that 46 staff have received infection control training. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are cared for by a caring and competent staff team. Evidence: The staffing levels for the home are downstairs for 30 residents, 1 care team manager and 3 care staff and upstairs for 41 residents, 1 care team manager and 6 care staff, dropping to 5 care staff in the afternoon and evening. Overnight there is 1 care team manager and 4 care staff on duty covering the whole home. The manager confirmed that he uses the residential care homes forum guidance to set these levels. Residents spoken to felt that there were enough staff in the home and residents and relatives who commented in the surveys did not raise staffing levels as an issue. Copies of staff rotas confirmed that these levels are maintained and that no agency staff are currently being used. The manager in his AQAA said that the home has an enthusiastic, dedicated and caring staff team who take a great pride in the service they provide. The number of staff allocated on duty and the training they receive ensures that residents needs can be met at all times. Staff were observed to respond quickly to residents call bells and very quickly and efficiently to an emergency call bell. Staff who commented on surveys said that they always had enough staff and made comments such as we always have enough staff, we never work short. Residents who commented on the staff team said the staff are very nice, no rushing Care Homes for Older People Page 22 of 29 Evidence: you, the staff here are good models for society and the staff are very friendly and caring. Relatives who commented said all the staff are polite and friendly and treat the elderly residents with care and respect, all the staff are caring, The care staff show respect and consideration to people and the staff are caring and thoughtful. Out of 30 care staff working at the home, 14 have completed NVQ qualifications, several of which have NVQ 2 and 3. The deputy manager has NVQ 4. This means that the home is just under the desired 50 standard and the manager in his AQAA acknowledges that this is an area for improvement. Staff training records do show that there are 16 staff currently undertaking either NVQ 2 or 3 and this should bring the team well over the 50 standard during 2009. Recruitment processes at the home were reviewed and found to be in good order with the required checks and documentation in place, including references, identification etc. 4 staff in the home are working under supervision, as they are awaiting CRB checks back, which are delayed over the Christmas period. On checking these staff did have POVA First checks in place. Staff files showed that they had been issued with contracts that reflected their working status in the country and that they had been issued with the General Social Care Council- Code of Conduct. Records showed very good levels of compliance with staff training for, first aid, moving and handling, food hygiene, fire safety, health and safety and adult protection. The majority of staff had also attended training on dementia, dealing with aggression or challenging behavior and the management of continence. The care team managers who administer medication were all up to date with their medication training. Overall the level of training at the home is very good and all the staff surveyed confirmed that the training they received was relevant to their roles. Comments on staff surveys included we always have training when its needed and the training at the home is good. Records showed that staff are completing the Skills for Care, Common Induction Standards and staff spoken to confirmed this and said that their induction was very good. The manager and the deputy said that they are responsible for signing these off and ensuring that the quality of this training is maintained. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interests of the residents. Evidence: The manager demonstrates good leadership skills and guidance was seen around the home from the manager to care team managers to help with good communication and to ensure the smooth running of the home, for example, any issues that should be reported to him or the deputy at the end of a shift, such as who is unwell and what has been done about it and any complaints, accidents etc. The manager has been working at the home for the last five years, is a qualified nurse and has completed the NVQ level 4 in management. Record show that both the manager and the deputy keep themselves up to date with appropriate training. The manager holds regular meetings with both the residents and staff and minutes are available, which show that a wide range of issues are discussed and that residents are consulted well about life and changes in the home. For example, decor colour in communal areas, pets in the home, standard of Christmas decorations, activities and the general day to day management Care Homes for Older People Page 24 of 29 Evidence: of the home. These meetings are well attended by the residents. Meetings are also used as an opportunity to informally train and update staff, for example regarding the legal aspects of record keeping. Relatives who commented regarding the management of the home said they provide an excellent service, I would recommend Frank Foster House, I feel Frank Fosters standards are very high and I cannot fault the home in any way. The company have an internal auditing system in place that incorporates a questionnaire to residents and relatives. This is usually completed annually but records show that this home has not been audited since October 2007. The results are used in the welcome pack but these are seen to be out of date now. This should be addressed. From records, it is clear that through meetings and small feedback audits, for example, on catering, that residents have been asked for their comments in the meantime but these were not available, for example, in the service users guide. The management team at the home also undertake internal audits on areas such as medication etc. to ensure that standards are maintained. The management team at the home hold small amounts of monies for residents but on the whole they encourage relatives to deal with this issue. A double signatory system is in place and the administrator audits the system regularly and the company undertake a full audit every six months. The manager has a staff supervision system in place and this was reviewed and discussed with the manager. It is clear from the records and confirmation from staff directly, that they are being supervised regularly by staff senior to them. Records showed that staff are having one to one meetings and a yearly observation of practice. The records of practice observations were detailed and informative. Supervision records contained valuable general reminders of good practice and these were the same for all staff. Staff conducting supervision, do need to evidence where they have explored individual issues or areas for development or training with staff in order to make this a more meaningful exercise. All staff have had a yearly appraisal and the manager stated that extra supervision sessions are arranged should the need arise. No major health and safety issues were noted in the home. Domestic staff were noted to be using decanted cleaning chemicals in unlabeled containers and this needs to be addressed as it is not in line with COSHH regulations and could potentially put people at risk. Accident records were reviewed and found to be completed well, with evidence of follow up in individual care records, where appropriate. There was good evidence of prompt referrals to the local fall prevention team and accident analysis sheets are Care Homes for Older People Page 25 of 29 Evidence: completed monthly and submitted to head office for checking. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 Make the service users guide more user friendly with regard to the format and ensure that the set up of the home is clear to prospective residents. Develop a more person centered approach to care planning so that residents preferences etc. are evident to all staff. Develop further the activities records for residents who have one to one visits. Give consideration to improving the format of the complaints procedure to ensure that it is user friendly for the resident groups in the home. The company should ensure that up to date audit results/feedback are available to interested parties. Records of staff supervisions should be developed further to evidence an individula approach for each staff member. Ensure that decanted chemical are appropriately labeled. 2 3 4 7 12 16 5 6 7 33 36 38 Care Homes for Older People Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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