Inspection on 05/01/06 for Frank Foster House

This inspection was carried out on 5th 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 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 29/01/09

Frank Foster House 04/01/07

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Frank Foster House Loughton Lane Theydon Bois Epping Essex CM16 7LD Lead Inspector Diana Green Unannounced Inspection 5th January 2006 09:00 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 Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Frank Foster House Address Loughton Lane Theydon Bois Epping Essex CM16 7LD 01992 812525 01992 814753 frank.foster@runwoodhomes.co.uk 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) Runwood Homes Plc Mr Teshwar Seeratun Care Home 71 Category(ies) of Dementia - over 65 years of age (35), Old age, registration, with number not falling within any other category (71) of places Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 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 total number of service users accommodated in the home must not exceed 71 persons The registered person must not admit persons subject to the Mental Health Act 1983 or the Patients in the Community (Amendment) Act 1995 30th June 2005 Date of last inspection Brief Description of the Service: Frank Foster House provides personal care with accommodation for up to 71 older people, including 35 older people with dementia. 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 was a former local authority home and consists of a twostorey building that has been upgraded and refurbished to a high standard. There are 71 single en-suite bedrooms. There are two passenger lifts. 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. Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 13/12/05, lasting 6 hours. The inspection process included: discussions with the registered manager, nine staff, five service users, seven relatives and feedback from health and social work professionals; a tour of the premises including a sample of residents’ rooms, bathrooms, communal areas and the laundry; and inspection of a sample of policies and records (including any records of notifications or complaints sent to the CSCI since the last inspection). All seventeen standards inspected were met and one was commended. No requirements were made. The acting manager and staff were welcoming and helpful throughout the inspection. What the service does well: Frank Foster provides a welcoming, homely environment. Despite being a large home, there is a family atmosphere throughout that several relatives commented on. The standards of care have improved considerably in the last two years. Residents’ personal care needs are well met and there is good access to health care services. Care staff were observed to be friendly to residents and treated them with respect. Relatives spoken with said that call bells are answered promptly and communication with the home is good. One relative said that staff are excellent and provided good care in a professional way. They also said they were impressed at how the mobility and nutritional status of their loved had improved since admission to the home. There is an active social and therapeutic programme of activities that are provided throughout the day by care staff and designated activities coordinators who have received additional training in dementia care. There is an emphasis on teamwork at all levels. Staff spoken with said they felt supported by the manager and felt they worked well with their colleagues. One relative said ”there has been a big improvement since Tesh came”. Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 This home does not provide intermediate care EVIDENCE: Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 10 The care planning process provides good information for care staff to satisfactorily meet residents’ needs with the agreement of residents and/or their representatives. Staff have a caring approach towards residents and aim to uphold their privacy and dignity. EVIDENCE: Four care files were inspected. These contained care plans that covered the key needs (physical and social) as detailed under this standard. All four care plans had been regularly reviewed and agreed with the resident and/or their relative as evidenced by signature. Assessments for moving and handling/mobility, risk of falls, pressure areas and continence needs were recorded in all of the files inspected. Care plans were person centred, focussing on the individual and contained good details of the action required to meet residents’ needs and were regularly reviewed. Daily records were well recorded with evidence of close monitoring of residents needs and action taken as required. Residents on the care programme approach had six monthly reviews undertaken. Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 10 Positive feedback was received from health care professionals indicating that the manager and staff were proactive rather than reactive to residents’ changing care needs, referred promptly to GPs and district nurses and always followed instructions as requested. Residents and relatives spoken with said that staff were caring, helpful and provided personal care in a way that upheld their dignity and respected their privacy. Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 Daily routines are flexible, and choices are actively promoted. A good range of therapeutic activities is provided to a high standard in the home that provides residents with social stimulation and interaction. Visiting arrangements are open and relaxed; staff encourage contact with the local community. EVIDENCE: The home had an activities coordinator who had undertaken an eight-week dementia care training course and attended a study day on dementia care therapy. The social /therapeutic activity programme was organised by her supported by care staff throughout the home. The home had an active programme that included outings and entertainment and this was displayed in large print for residents’ information with photograph of past events on display. Visitors were also encouraged to take part in activities. A visitor was playing the piano during the inspection. Residents were enjoying listening to some classical music and were singing along to old time music and were clearly stimulated by the event. Other activities comprised card games, bingo, karaoke with music being played during lunch. Comprehensive records were maintained to a high standard that included a life history, social care plan, record of activities undertaken with the outcome for each service user. Reminiscence memorabilia were on display in the activity room and in each of Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 12 the units throughout the home. The home is commended for the number and range of items obtained and the efforts made in research that were evident by the quality of this display. Several relatives spoken with said they were able to visit at anytime and found the home and staff very welcoming and they were always offered a drink. Relatives said they found the manager and staff friendly and supportive and communication was very good. The service users’ guide and record of activities confirmed that links were made with the local community. Residents were observed to be enabled a choice in time of getting up, in where and when to eat and in taking part in activities. All residents had a representative or advocate to act on their behalf. Information on advocacy services was displayed for their information and arranged as needed. The service user guide detailed residents’ rights to access their personal care records in accordance with the Data Protection Act 1998. Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Appropriate policies, procedures and practices were in place to promote the protection of residents from abuse. The manager actively promoted awareness of protection issues through staff training, recruitment practices and respecting individual rights. EVIDENCE: The home had a protection of vulnerable adults policy and procedures and a whistle blowing policy. All staff had received copies of the revised local Essex multi-agency guidance. The records provided evidence that staff had received training in POVA, and those spoken with were clear on the procedures to be followed. Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, 26 Frank Foster was safe, well maintained and had a homely environment; residents rooms were individually furnished and equipped for their safety, comfort and privacy. The home was clean and hygienic with safe infection control practices evident. EVIDENCE: A partial inspection of the premises was made that included communal areas, three bathrooms, a number of residents’ rooms and the laundry. The home was in a good state of maintenance and decoration. There was a programme of refurbishment in place and several residents’ rooms had been redecorated in the last year. Communal rooms were clean and well decorated and furnished to provide a homely environment for residents. Residents spoken with said their rooms were always kept clean. The gardens were well maintained and provided a pleasant outlook with good access for residents. Records provided evidence that the building complied with the requirements of the local fire and environmental health department. Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 15 The home provided private accommodation for each service user that was furnished and equipped for comfort. Service users were enabled to bring in personal items of furniture subject to availability of space and records were maintained. Action had been taken to provide tables to sit at as required at previous inspections. Lockable storage facilities were provided for medication and valuables. All rooms were single en-suite. The home was clean and hygienic throughout with no malodorous smells. Staff hand washing facilities were now provided in all en-suite rooms and safe practices in infection control were evident. The laundry had been extended since the previous inspection to more appropriately accommodate the needs of residents. Once the refurbishment is complete the increased space will enable linen and residents’ clothing to be well organised and should not compromise health and safety standards. Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 30 Staff morale is high resulting in an enthusiastic and stable workforce that works positively with residents to improve their whole quality of life. EVIDENCE: There were 69 residents at the home. Staffing levels were appropriate to meet the needs of residents and were confirmed at 2 care team managers and 9 care assistants. The registered manager, deputy manager, administrator, laundry assistant, cook, kitchen assistant, 4 domestic staff and maintenance person were also on duty. The home maintained a staff rota confirming the number of staff on duty and the capacity in which they work. The staff records confirmed that no one under the age of eighteen was employed to provide personal care. There were eight care staff with NVQ level 2 qualification and all other staff were undertaking a basic skills course from which they would proceed to NVQ training. The manager said the home aimed for 100 of staff to achieve NVQ level 2. The home had a comprehensive training programme in place. Records summarising training were seen, and showed that most staff were up-to-date with all mandatory training including health and safety, fire safety, basic first aid and moving and handling. Training had also been provided in care planning, dementia care, abuse awareness, food hygiene and health and safety. Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 The manager is supported well by senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The financial interests of residents are protected by the robust systems that are well adhered to. EVIDENCE: The manager is a first level registered nurse with current NMC (Nursing and Midwifery Council) registration, holds the Registered Managers’ Award and has previous experience in managing care homes He also held ENB N11’ Caring for People with a Dementia Illness and their Carers’, a Diploma in Nursing Studies and a NEBS Management Certificate for Residential and Nursing Care. Residents and staff said that they found the manager approachable and supportive. From discussion with the manager it was evident that he kept updated and was motivated to also ensure his staff were informed on current Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 18 issues in care. The manager had been awarded ‘the Manager of the Year Award’ in recognition of his services by the organisation. Representatives of the organisation undertook monthly visits. Twice yearly relatives’ meetings were held and service users’ questionnaires were distributed annually to obtain feedback on how the home was meeting their needs. An annual audit was also undertaken from which an annual plan was developed for the home. The deputy manager also undertook monitoring to ensure standards were observed and to enable action to be taken to address relevant issues. Service user’s monies were sampled. All residents had an advocate/representative to manager their finances on their behalf and there was evidence that this was monitored to ensure they received sufficient funds. Appropriate procedures were in place with receipts held for expenditure. All records were confirmed as correct. There was evidence from observation, inspection of the records and in discussion with staff and residents, that the manager made efforts to ensure the health and safety of staff and residents as far as reasonably practicable. Hand-washing facilities were now provided in all residents’ en-suites as required at the previous inspection. Risk assessments had been undertaken to determine the need for adjustable beds when moving and handling residents. However no adjustable beds had been provided and due to the dependency of some residents this needs to be closely monitored. Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 19 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 3 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 20 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. 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 Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Frank Foster House DS0000017823.V276680.R01.S.doc Version 5.1 Page 22 - 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!