Inspection on 13/06/06 for Franklin House

This inspection was carried out on 13th June 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Franklin House 02/07/07

Franklin House 07/03/06

Franklin House 13/07/05

Franklin House 08/02/05

Franklin House 20/07/04

Franklin House 22/01/04

Similar services:

SignHealth

Mere Hall View

Beechfield Lodge

Christopher Grange (Rhona House)

Sense

Auden House

Deafway

Sign, 100 Bowfell Road

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

CARE HOMES FOR OLDER PEOPLE Franklin House 4 Franklin Street Oldham OL1 2DP Lead Inspector Steve Chick Unannounced Inspection 13th and 14th June 2006 11:00 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 Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Franklin House Address 4 Franklin Street Oldham OL1 2DP 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) 0161 678 7870 0161 785 0779 Mr Harold Hilton Mrs Margaret Smith Mrs Marie Louise Powers Care Home 38 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (23), of places Sensory Impairment over 65 years of age (1) Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 23 OP; up to 14 DE(E); and up to 1 SI(E) 7th March 2006 Date of last inspection Brief Description of the Service: Franklin House is a detached, purpose built property, registered to accommodate 38 people. The home is privately owned and is situated in fairly close proximity to Oldham town centre. Accommodation for service users is situated on the ground floor. All bedrooms are single, 28 of which have en-suite toilet facilities. The home is built on a quadrangle with a central courtyard. Lift access is provided to the lower ground floor, which houses the laundry and provides access to a garden area. Car parking space is available at the front of the building. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. For the purpose of this inspection three service users were interviewed in private, as were two relatives of service users. Discussion also took place with another visitor to the home and other service users. Additionally, discussions took place with the manager and two staff members were interviewed in private. The inspector also undertook a tour of the building and scrutinised a selection of service user and staff records, as well as other documentation, including staff rotas, medication records and the complaints log. This key inspection included an unannounced site visit to the home and a follow-up visit. All key standards were assessed. What the service does well: What has improved since the last inspection? Progress had been made in all areas which had been identified as needing improvement, although some required further work. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. Service users’ needs are assessed before moving to the home to ensure that their needs can be appropriately met. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: A selection of service users’ files was scrutinised. Those relating to service users who were admitted to the home since the previous inspection had a copy of an assessment undertaken by an appropriate community based professional. These assessments were complemented by the home’s own assessment. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 9 Discussion with the manager indicated that this was normal practice in the home. Franklin House does not offer intermediate care. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. Written care plans do not consistently give sufficiently detailed guidance to staff to ensure service users’ needs are met in a way which is appropriate for that individual. Service users have access to appropriate community based medical services to ensure their health needs are met. The home’s procedures in connection with administration of medication are implemented to the benefit of the service users. Practices in the home promote the dignity of service users. This judgement has been made using available evidence, including a visit to the service. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 11 EVIDENCE: In the selection of service users’ files seen, all had a copy of a written care plan. There was some documentary evidence that service users were involved in the formulation of their care plan, but this was not the case in all files. Similarly, discussion with relatives was inconclusive in evidencing their involvement. One relative confirmed their involvement and another could not recall having been involved. The manager cited an example where a care plan had been sent to a relative and had been amended as a consequence of their comments. A record of this communication had not been made. There was documentary evidence on the files of care plans having been periodically reviewed. There was also evidence of care plans being amended following a review. An example was seen where an amendment relating to eating had been made in one section of the plan (food and mealtimes), but not in another (diet and weight). This resulted in potentially conflicting information within the one plan. The home had recently acquired new software which may assist in minimising these sorts of difficulties. At the time of this site visit it was too early to assess the impact of the new system. The level of detail throughout the care plans was inconsistent. Some gave appropriate guidance to staff and others were too vague to be useful. For example, “to encourage X to communicate freely” gave no useful information to staff in respect of what type of encouragement X might respond to. Discussion with staff indicated that on a day to day basis greater emphasis was given to personal knowledge of the service users, the care plan summary kept in each service user’s room and verbal communication during and at shift changes, than to the written care plans. Written risk assessments were seen on service users’ files. As with the care plans, these were not always in sufficient detail. For example, a risk assessment in relation to the use of bed rails did not address the reason for their use, nor the need to ensure the correct rails were used on the specific bed. Discussion with the manager indicated this was an administrative oversight, as those issues had, in practice, been considered. Service users and visitors to the home who were spoken to, were all positive about the quality of care offered at Franklin House. There was documentary evidence that service users had appropriate access to the full range of medical and para medical services available in the community. This was confirmed by discussion with service users and visitors. At the time of this site visit an optician was also visiting the home. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 12 There was documentary evidence that the weight of service users was regularly checked to identify any weight loss which may be indicative of action being required. Franklin house uses a pre-dispensed monitored dosage system to administer service users’ medication. Medication was seen to be appropriately and securely stored. Since the last inspection, a new medication fridge had been purchased which was maintained at an appropriate temperature. A sample of medication administration records was examined. These presented as being appropriately maintained. Observation and discussion with service users and visitors indicated that service users were treated with dignity and respect. Interactions between staff and service users presented as relaxed, with assistance and support being offered in a sensitive manner. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 13 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 and 15. Quality in this outcome area is good. Appropriate social contacts and activities are facilitated within the home to give service users the opportunity for social fulfilment. A varied and nutritious diet is provided to service users, promoting their health and well-being. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The manager reported that Franklin House provided a range of social activities. This included occasional entertainers coming to the home; cards; board games; dominoes, and one to one activities, such as nail care. This was confirmed by staff who were spoken to. Service users who were asked expressed satisfaction with social activities. One service user said she was always doing something and was never bored. Involvement with activities is voluntary and one service user said she didn’t do anything because she didn’t want to. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 14 The home operates a voluntary social fund to which service users can contribute one pound per week. The manager reported that service users who choose not to contribute are not excluded from activities within the home. The home has a policy of allowing visitors at any reasonable time. This was confirmed by visitors spoken to during the visit, who said they felt welcomed at the home. The manager reported that service users are able to attend local churches and that a minister comes in to the home fortnightly. Observation and discussion with service users and staff indicated that service users were able to exercise personal choice and autonomy within the context of communal living. One meal was sampled during the visit. It was pleasantly presented and tasty. Staff were observed to be checking with service users that they had had enough and the cook confirmed that ‘seconds’ were always available. Fresh fruit was available as an alternative or complement to the pudding. A choice of menu was offered and publicised on a white board in the dining room. This included a vegetarian option. The cook reported that she was aware of individual service users’ preferences and special dietary needs. Service users were complimentary about the provision of food at Franklin House. As with several areas of administration, the record of food eaten by individual service users was inconsistent. In one example seen, a potentially useful record was rendered ineffective by poor dating. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 15 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): 16 and 18. Quality in this outcome area is good. Service users were confident that the views would be taken seriously and any complaint they may have would be dealt with appropriately. Service users are protected from abuse or exploitation by the home’s policies and practices. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The home has an effective written complaints procedure which has been identified as appropriate during previous inspections and was not scrutinised on this visit. A record of complaints was maintained. Service users and visitors spoken to, were confident that any complaints they may have would be appropriately dealt with by the home. This view was shared by staff who were spoken to. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 16 All service users and visitors spoken to during the visit were confident that service users were protected from abuse or exploitation. Staff who were interviewed demonstrated an understanding of the need to be vigilant about the possibility of abuse and of appropriate action to take. This included the ‘whistle blowing’ procedure. The need for specific training, identified at the previous inspection, had not been completely resolved. However, the manager was able to provide evidence that she had approached Oldham MBC to request access to the next training opportunity. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 17 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 and 26. Quality in this outcome area is adequate. In the main, the home is appropriately maintained to provide a safe and homely environment for service users. The home is clean, tidy and hygienic to promote the comfort of service users. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: During the visit to the home a tour of the building was undertaken. This included communal areas and a selection of service users’ bedrooms. There were several communal areas where service users could spend their time, or they could access their rooms when they chose. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 18 There was one designated area where service users could smoke. All bedrooms were single and the manager reported that service users could have a key to their room if they wished. Service users’ bedrooms had an appropriate degree of personalisation. The home presented as clean and tidy, with no unpleasant odours. This was confirmed as the usual state of the home by service users and visitors spoken to. There was a large inner quadrangle paved area which was being used by service users to sit in the sun. The quadrangle was functional, but a little utilitarian and not in keeping with the otherwise pleasant environment. The home kept a maintenance book and employed the services of a handyman to address the routine repairs and maintenance issues. It was reported by the handyman that water temperatures in the home were controlled at the boiler end of the system rather than at the taps. He undertook weekly monitoring of the temperature of the water. Unfortunately, the records of this monitoring were inadequate to offer clear evidence of this. Best practice suggests that to prevent risks from scalding, pre-set valves of a type unaffected by changes in water pressure and which have failsafe devices are fitted locally to provide water close to 43o C. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 19 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, 29 and 30. Quality in this outcome area is adequate. The numbers and skill mix and number of staff on duty promotes the independence and well-being of service users. Staff vetting is not sufficiently robust to minimise the possibility of recruiting staff who may pose a risk to service users. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The staff rota for the week 12th June was examined. This demonstrated that staffing levels were maintained at a minimum of five carers between 08:00 and 15:00, four carers between 15:00 and 22:00 and three carers at night from 22:00 to 08:00. Additionally, the home employed cooks, domestic staff and a handyman. The manager’s hours were in addition to those identified above. The manger reported that nine carers hold NVQ II and four hold NVQ III. A sample of certificates were seen to verify this. The manager also reported that six carers were undertaking NVQ II. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 20 The manager was able to identify a number of training courses which a variety of staff had attended. All staff had received moving and handling training. The manager reported she was an approved moving and handling trainer and, consequently, staff also received regular updates. It was also reported that there is a minimum of one staff member trained in first aid on each shift. Staff confirmed the home’s practice regarding compulsory induction training. Staff who had been employed for a while were also able to confirm the availability of a range of training opportunities. Records relating to the recruitment of staff since the previous inspection were examined. These demonstrated that the majority of required vetting procedures had been appropriately followed. Two issues were identified as being inadequate. The application form used only asked applicants to give details of employment in the last ten years, as opposed to a full employment history. Examples were also seen where anomalies were identified regarding information given by the applicant, which had not been explored before employment. Service users and visitors were positive about the attitude and competence of the staff team. One visitor cited “the staff” as the best thing about Franklin House. One service user commented on the staff by saying “… they can chat, they are like friends.” Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 21 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 and 38. Quality in this outcome area is adequate. The manager is appropriately skilled and experienced to ensure the smooth running of the home to the benefit of service users. Quality Audit and Quality Monitoring systems are insufficiently structured to ensure service users’ views are taken into account and influence the running of the home. The arrangements in place ensure that the financial interests of service users are appropriately protected. Not all health and safety procedures are robust enough to maximise the health and safety of service users. This judgement has been made using available evidence, including a visit to the service. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager had several years’ experience in a management position. In discussion, she demonstrated a good understanding of the service user group and her managerial responsibilities. Staff described the manager as approachable, supportive and appropriately responsive. There was a range of systems to monitor the quality of the care service in operation, including staff and service user meetings, and staff supervision. A more structured Quality Audit and Quality Monitoring system was still in the developmental stage. The manager reported that a quality audit proforma was being developed and would be distributed to service users and relatives shortly. A selection of records relating to money held by the home on behalf of service users was scrutinised. This presented as being appropriately maintained, with receipts kept for purchases, and signatures obtained for the return of cash. A selection of records relating to maintenance, health and safety matters and accident records was examined. These presented as being predominantly appropriately maintained. Staff confirmed the availability of disposable gloves to help minimise the risk of cross-infection. Apart from issues identified elsewhere relating to risk assessments and hot water, no obvious risks to the health and safety of staff or service users was identified. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15 Requirement Timescale for action 17/08/06 2 OP19 13 3 OP19 13 4 OP29 19 The registered person must ensure that written care plans are in sufficient detail to inform staff how the individual’s needs are to be met, including cultural, spiritual and social needs. The registered person must 01/08/06 ensure that accurate records are maintained for all health and safety checks undertaken. The registered person must 01/08/06 ensure that the local environmental health officers are consulted about the system for controlling water temperature. A copy of the written response must be available for inspection. The registered person must 01/08/06 ensure that all new staff are vetted in line with the requirements of the Care Homes Regulations 2001 as amended by the Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 25 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. 5. Standard OP33 Regulation 24 Requirement The registered person must continue to develop a quality assurance system for the home so that all those who live, visit and work in the home have the opportunity to comment on the quality of service. The results of this consultation should be available on request. (Timescale of 01/07/06 not met). The registered person must ensure that all risk assessments record all factors taken into account in reaching a conclusion and identifying a risk management strategy. Timescale for action 01/09/06 6 OP38 13 17/08/06 Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 26 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 Refer to Standard OP7 OP19 Good Practice Recommendations The registered person should ensure that service users, or their representatives if they are unable to, sign to confirm their agreement with the written plan of care. The registered person should ensure that consideration is given to improving the facilities for service users in the quadrangle. Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Franklin House DS0000005507.V298856.R01.S.doc Version 5.2 Page 28 - 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. 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