Inspection on 07/03/06 for Franklin House

This inspection was carried out on 7th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 13/06/06

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 Michelle Haller Unannounced Inspection 7th March 2006 10:00 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.V280445.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. Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 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.V280445.R01.S.doc Version 5.1 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) Date of last inspection 13th July 2005 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.V280445.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In order to get a balanced view of this home it is vital that this inspection report is read in conjunction with the previous inspection dated 13th July 2005. This inspection took place on the 7th March 2006 and was unannounced; this means that the home was not informed that the inspection would take place. The inspection was conducted over a period of 4.5 hours. In the course of the inspection six service users files and other records concerning the support and care of service users were examined fully. Policies, procedures and other documents concerning the running of the home were also assessed. Four service users, one service user representative and two members of staff were interviewed. The interactions between service users, their representatives and staff were also observed. In addition a tour of the some of the private areas and all the communal parts of the building was undertaken. The manager is keen to improve all aspects of the service and the size of the home means that implementing and monitoring changes takes time. Although not discussed during the inspection, the home may benefit if the manager identified certain responsibilities that could be delegated to senior care assistants, this would give her more time to ensure that service user assessments and care plans are accurate, risk assessments put in place and supervision increased. Six service user and five relative comment cards were completed and returned and the vast majority of comments made were positive with two service users intimating that on occasion the food was not to their liking. What the service does well: What has improved since the last inspection? Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 Page 6 The revised assessment and care planning system continues to be introduced however further improvement is required. The weight of service users is now recorded, for the most part, on a monthly basis. The dietary intake of the most frail service users is now recorded in detail. 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.V280445.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 Franklin House DS0000005507.V280445.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): 2, 3 Service users are provided with information about their residency in the home. The homes assessment protocol does not ensure that complex and specialist needs are identified and therefore the need for specialist intervention is not routinely pre-empted. EVIDENCE: In the course of this inspection six service-user files were fully examined and all reports and records pertaining to these were individuals were scrutinised The files chosen for examination were those of the most frail service user, the most recent admission, a black service user and three of those interviewed. Each file contained a document of terms and conditions that had been signed by the service users representative. It was noted that separate and specialist assessments relating to complex and long standing mental health diagnosis were not in place. Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 Page 9 The assessments available did not provide a true picture of the persons needs, furthermore records and daily reports indicated that, at times, issues arose that may have been avoided or pre-empted had specialist assessments and care plans been developed. Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 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. The information contained in care plans fails to consistently provide appropriate guidance to care-staff about the actions they must take in order to promote the health and wellbeing of service users. Health and physical care in the home is provided at a frequency and in a manner that promotes the health, comfort and well being of the services users. The homes policy and procedures for dealing with the administration and storage of medication is safe, however the system is flawed because staff have failed to interpret the significance of their findings. The manner in which health and physical support is provided promotes the continued psychological well-being of service users. EVIDENCE: A new and improved system of care planning continues to be implemented. For general care the contents provides sufficient information for staff to know what each service user needs. However the manager must initiate corresponding assessments and care plans when specialist needs are evident. Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 Page 11 The manager needs to recognise the value of and seek the completion of specialist assessments and corresponding care plans, this is particular the case in respect of mental health issues. All files contained an agreement of the care plan; these had been signed by the manager, but not the resident or their advocate. Care plans and risk assessments were in place and were now reviewed, however cross-referencing with reports and the observations made by staff indicated that these were not always updated to reflect the changes in care needs and at times staff were dealing with complex needs, including the effects of mental health and behavioural issues, in an unplanned manner. It was also noted that risk assessments had not been completed for equipment that had been attached to beds such as a bedrail and pressure mattress. The language and tone in which daily records and reports were written was consistently respectful and demonstrated that staff were aware of the need to enable service users to maintain their independence and dignity. Discussion with staff indicated, however, that they were aware of the general needs of service and felt confident and supported in meeting these needs. Services users and their representatives were eager to state that the quality of care in the home was good and staff were kind, attentive and gentle. Observation of staff interaction with service users confirmed that assertion. Comments included ‘We are well looked after, staff ask us what we want.’ All the files examined contained a regular record of weight. Information about residents’ dietary needs and preferences were included in assessments and care plans, and the diet intake of the most frail service user was fully recorded. The medication fridge was checked and temperature records indicated that the fridge had been at room temperature 21- 22c for a number of days. This was discussed with the manager as a training and supervision issue, as senior staff had not recognised that the temperature was in excess of that stipulated in the storage guidelines indicated on medication information leaflets. Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 The diet in the home meets the needs and expectations of the service users and promotes nutritional wellbeing however more evidence is required to demonstrate that vegetarian service users are fully catered for. EVIDENCE: A record of meals was examined and this indicated that a variety of traditional meals were served. Three hot meals were offered each day with the main meal served in the evening. The meals included fish dishes, roast meats and poultry, meat pies, pasties and stews served with mixed vegetables, carrots, broccoli, cauliflower and other vegetables. It was noted on the day of inspection the choice for evening meal was either roast chicken or sausage casserole. When questioned about a diet that met the religious needs of a service user an alternative was stated, however it was not possible to confirm the homes assertion that the religious dietary needs had been discussed with family and that they were been followed. On the day of inspection the lunchtime meal was Cornish pasties, potato crockets and peas followed by fresh fruit salad or sandwiches. The vegetarian option was bread rolls filled with egg and cress. Service users were observed enjoying their meals and drinks. Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 Page 13 The dining room provides a spacious and comfortable eating area and staff were observed supporting those who required assistance with patience and understanding. Comments included ‘I enjoy all the food we get here.’ Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The homes complaints procedure is robust and provides service users and their representatives with information about how to make complaints. The home does not demonstrate adequate understanding of its responsibilities under the Protection of Vulnerable Adult (POVA) legislation, the Local Authorities POVA guideline or the Care Standard 2000 regulations concerning the safeguarding of service users. EVIDENCE: The homes complaint procedure was scrutinised and found to inform service users about how to make complaints and the manner and timescales in which they would be investigated. Discussion with service users and their representatives confirmed that they felt confident in directing any concerns to the manager. Reports made in files further demonstrated that complaints were treated seriously. In relation to adult protection it was noted that not all incidences as outlined in the Care Standard Regulation have been reported to CSCI, furthermore discussion with staff indicated that the issues concerning adult protection was not fully understood and neither care staff or management had undertaken the specialist Adult Protection training available from the Oldham Metropolitan Borough Council (OMBC). These matters were discussed with the manager. Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 Page 15 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 Service users can access the majority of the home safely however there are significant oversights that could impinge on the safety of some service users can safely access the majority of the home. EVIDENCE: As a part of the inspection process a tour of the building was undertaken and a number of bedrooms were chosen for examination at random. The majority were clean, comfortably furnished and pleasantly decorated. Furthermore service users commented that they were comfortable and content with the accommodation. However, the hot water taps in three bedrooms were checked and it was found that the water became hot enough to scald when left to run. This was also true of the hot water in one bathroom. A bath thermometer was in place however the temperature of baths was not been recorded. Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 Page 16 The need for temperature restrictors on hot water coming into bedrooms and maintenance of a record of bath temperatures was discussed with the manager. Rooms appeared clean and were, for the most part, free from unpleasant odours. Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 Page 17 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 The numbers and skill mix and number of staff on duty promotes the independence and well being of service users. EVIDENCE: The staff roster was examined and indicated that on the day of inspection there were five care assistants, one cook, a handy man, a domestic and the manager working to meet the needs of 37 service users. Observation of the interactions between staff and service users indicated that the pace of the support provided in the home was relaxed, with staff having time to sit and relate to service users. Previous staffing rosters indicated that this was the normal ratio of staffing. Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 Page 18 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): 33, 36 and 38 The quality assurance system is rudimentary and needs to be further developed before it can be fully assessed. The frequency of staff supervision has increased however the effectiveness of this supervision is not immediately evident. Some aspects of health and safety in the home need to be improved to ensure the continued safety of service users. EVIDENCE: Two staff members were interviewed and both stated that they received individual supervision with the manager about three times a year. The manager stated that she was in the process of increasing the frequency of supervision sessions. Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 Page 19 The minutes of the previous staff meeting was read and demonstrated open management and confirmed that discussion about increasing supervision, improving and maintaining a high standard of care and following policies and procedures had occurred. Staff stated and documentation confirmed that fire safety checks took place regularly, and fire safety equipment had been checked in accordance with fire safety regulations. Although Control of Substances Hazardous to Health (CoSHH) training had been undertaken the guidelines were not been followed in the home on the day of inspection and the home had introduced pest control methods without considering the potential risk to service users or following the manufacturers instructions. In addition there are inadequate checks and risk assessments pertaining to the hot water provided by the home and so there is a real risk of scalding which must be dealt with. Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 Page 20 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 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X x STAFFING Standard No Score 27 3 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X 2 X 2 Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes, see requirements 2 and 7. 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 OP3 Regulation 14 Requirement The registered person must ensure that comprehensive asessment and, when necessary, re-assessment of the service users needs are undertaken. The registered person must ensure that care plans and risk assessments are developed and reviewed to meet the changing needs of service users, and routinely at least once a month, and are signed by the resident or their advocate. Previous timescale immediate met. The registered person must ensure that medication is stored in accordance with the manufacturers instructions. The registered person must be able to demonstrate, through records, that sufficent consideration has been given to the needs of service users requiring special diets whether for reasons of health, chioce, culture or religion. The registered person must ensure that all staff receive upto date and effective training to DS0000005507.V280445.R01.S.doc Timescale for action 01/05/06 2 OP37OP7 13,15 01/05/06 3 OP9 13 (2) 17/03/06 4 OP15 17 Sch 4 13 01/04/06 5 OP18 13 (6) 01/05/06 Franklin House Version 5.1 Page 22 6 OP33 24 7 OP36 18 8 OP19OP38 13(4) (a) & (c) 9 OP38 16 (j) 23 (5) ensure everyone is aware of their responsibilities in the prevention, reporting and investigation concerning adult protection. The registered person must continue to develop a quality assurance system for the home so that all live, visit and work in the home have the opertunity to comment on the qulaity of service anonamously. The results of this consultation should be available on request. The registered person must ensure that formal supervision is provided for all staff in accordance with this standard. Previous timescale 01/12/05 not met. The registered person must ensure that health and safety policies and procedures are fully followed and understood, particularly concerning hot water and chemicals that could be a health hazard. The registered person must approach Environmental Health in order to ensure that pest control measures are safe and take into consideration any possible risks to service users. 01/07/06 01/05/06 01/04/06 07/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Franklin House DS0000005507.V280445.R01.S.doc Version 5.1 Page 23 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.V280445.R01.S.doc Version 5.1 Page 24 - 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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