Inspection on 20/03/08 for Freeland House Nursing Home

This inspection was carried out on 20th March 2008.

CSCI found this care home to be providing an Good 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

Freeland House Nursing Home 25/05/06

Freeland House Nursing Home 12/01/06

Freeland House Nursing Home 18/08/05

Freeland House Nursing Home 21/03/05

Freeland House Nursing Home 30/06/04

Freeland House Nursing Home 11/03/04

Freeland House Nursing Home 10/09/03

Freeland House Nursing Home 19/09/02

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Freeland House Nursing Home Wroslyn Road Freeland, Witney Oxfordshire OX29 8AH Lead Inspector Kate Harrison Unannounced Inspection 10.30a 20 March 2008 th 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 Freeland House Nursing Home DS0000027150.V359334.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. Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Freeland House Nursing Home Address Wroslyn Road Freeland, Witney Oxfordshire OX29 8AH 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) 01993 881258 01993 883963 frhouse@rock.com Dove Care Homes Ltd Frances Payne Care Home 76 Category(ies) of Old age, not falling within any other category registration, with number (76), Physical disability (2) of places Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. On admission persons should be aged 60 years and over. Admittance of two named under age service users The maximum number of service users must not exceed 76. Date of last inspection 25th May 2006 Brief Description of the Service: Freeland House is set in six acres of woodland and landscaped gardens at the southern edge of Freeland village, eight miles west of the City of Oxford and approximately 3 miles from the market town of Witney. The original house was built in 1807 and owned by a former Town Clerk of Oxford. From 1984 the house has been run as a care home for older people requiring nursing care. The home was extended in 1998 to provide further bedroom accommodation on two floors. The accommodation comprises 56 single rooms and 10 shared (double) rooms, most with en-suite facilities. There are three lounges and two dining rooms on the ground floor, with an additional sitting area in the link corridor to the new building, all with extensive views over the gardens and fields to the rear of the home. The original house is a three-storey building, with the kitchen, laundry room, administrative offices and a hairdressing room located on the basement floor. The current scale of charges is from £567 to £850 per week. Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection of the service was an unannounced ‘Key Inspection’. We arrived at the home at 10 am and were in the service for 6 hours. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the home’s manager, through the Annual Quality Assurance Assessment, (AQAA) and any information that we received about the home since the last inspection. We saw those areas of the home used by people living there and looked at records and documents relating to their care. We also looked at staff recruitment files and at training records. We spoke with the deputy manager of the home, a senior manager from the organsation running the home, and with other staff members. We asked the views of the people who live in the home, staff members and of people we saw during the inspection or who responded to questionnaires that we had sent out, and their views are reflected in this report. Over 25 replies were received. It was a thorough look at how well the home is meeting the standards set by the government and in this report we make judgements about the outcomes for the people living in the home. From the evidence we saw and from comments received, we consider that the home would be able to provide a service to meet the needs of individuals of various religious, racial, gender or cultural needs. What the service does well: People living in the home appreciate the good qualities of the staff team and say that they are treated with respect. Health care is good, and the organisation and range of activities provided is excellent. People living at the home said that the food provided is good, and that their views about food are listened to, so that the improvements they suggest are implemented. The dining facilities are well managed. People know how to complain if they need to, and suggestions and comments are welcome. People at the home enjoy the environment, and the gardens are being improved to make it easier for people using wheelchairs to move about in the gardens. Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Freeland House Nursing Home DS0000027150.V359334.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 Freeland House Nursing Home DS0000027150.V359334.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. The home does not provide intermediate care. Quality in this outcome area is good. The needs of individuals are assessed before they are admitted, so that the home is confident that their needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A senior member of the care team usually visits new people who contact the home, or who are referred to the home by health or social care professionals, and the home’s assessment form is completed. Information about the home is available, so that individuals and their relatives are aware of the service offered by the home. Other information about health and care needs is collected so that the home has all the information needed before making a decision about admitting the individual. We saw pre-admission assessment forms with all the necessary information about individuals recently admitted, and the home was meeting their needs. Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 Page 9 Freeland House Nursing Home DS0000027150.V359334.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and welfare needs of people living in the home are recorded and met, by a staff team who shows them respect. EVIDENCE: People living in the home who responded to our survey said that they ‘always’ or ‘usually’ received the care and support they needed. All the individuals living in the home are registered with a local general practitioner, and several said they were happy with the medical care they were receiving. The home is able to supply all the equipment people for their health and welfare requirements. We saw the care plans of three people, and saw that risk assessments, including nutrition, falling and movement were usually carried out. Good plans were seen about how to manage one individual’s behaviour, and there is a good system in place to make sure the care plans are reviewed. There is a good system in place to manage the receiving and administration of medication. The home keeps records of the medication returned to the supplying pharmacy, but it is not clear that this is appropriate, due to recent Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 Page 11 changes in legislation. The registered manager is looking into the issue, with a view to making sure that the home is meeting legislation. Several people commented on how staff members are aware of their need for privacy. Our observations show staff members addressing individuals by their preferred name, and showing patience and understanding of the needs of older people. Relatives expressed their appreciation of the staff team to us. Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living in the home can choose how to live their daily lives, supported by the home’s well-organised services. EVIDENCE: Meetings are held regularly so that people living in the home can make their views known. Routines are flexible in the home and individuals are supported to make choices in the major areas of their lives in the home. The home has an activity programme devised by the people living in the home with the activity coordinators, and this means that there is a variety of activities on offer. The majority of people who responded to our survey said that there were ‘always’ or ‘usually’ appropriate activities to take part in, though some said that they did not wish to take part in organised activities. Group activities take place most days in a downstairs room, and the activities organisers see individuals who cannot take part in organised group activities, or who prefer not to. People at the home decide with the activity coordinator which entertainment they would like in the home and this is organised regularly. Trips out are usually organised in the summer. Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 Page 13 Individuals and visitors use the home’s gardens and outdoor areas, and improvements are in hand to make the areas better suited to the needs of older people. People living in the home can book a room for family occasions, and one individual said that this was a very useful facility. Visitors are welcome and several were in the home on the day of our visit. People living in the home can purchase items from the home’s shop trolley, and this is a valued service in the home. Lunch and supper is served in two downstairs dining rooms, and are relaxed social times. Both dining rooms were well prepared with tables for four, with fresh tablecloths, serviettes and flowers. Recently, in response to suggestions from people living in the home, the chef trialled a cheese and fruit platter, and now this is provided at lunchtime. Fortified drinks and fruit shakes are provided daily. People who need help to eat are supported and the majority of people who responded to our survey said that the food is ‘always’ or ‘usually’ good. Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home know their concerns will be addressed and the home’s procedures protect people from harm. EVIDENCE: The home’s complaints procedure is displayed in the hall and complaints are taken seriously. There is a record of complaints, and the record shows that complaints are responded to appropriately. People who responded to our survey said that they knew how to make a complaint, and individuals we spoke to said that they were confident that their concerns would be listened to. We have not received any complaints about the home since our last inspection in May 2006. The home has a clear policy about protecting people from harm, and staff members receive training at induction and at regular intervals. Staff members are aware of the local procedures and know how to respond in the event of any concerns. Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Several improvements have taken place and there are systems in place to keep the home well maintained and safe. EVIDENCE: There are good systems in place to monitor the maintenance and safety of the home, including fire risk assessments for each room, and there is a named person responsible for general upkeep and maintenance. Several improvements have been carried out since the last inspection. A new boiler has been installed and this has resolved the problems with fluctuations in room temperature, and the hall carpet has been replaced. The home’s development plan includes the upgrading of the grounds, so that more areas are suitable for wheelchairs, and people living in the home can have better access to enjoy the scenery. The home has policies and procedures about controlling the spread of infection, and most of the staff team have attended training on infection control. Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 Page 16 The home has a housekeeping team responsible for keeping the home clean and hygienic, and we noted that the home was clean and free from unpleasant smells. One downstairs bathroom needed to be cleaned, as there was evidence that thorough cleaning had not taken place for some time, including lime scale deposits in the basin and toilet. The cleanliness of the bathrooms should be regularly monitored. The system for managing the laundry has improved, and now the risk of spreading infection is minimised. Most of the people who responded to our survey said that the home was ‘usually’ or ‘always’ fresh and clean. Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in the home are satisfied with the quality of the staff team, but the home’s recruitment procedure regarding references and numbers of trained care staff need to be improved. EVIDENCE: There is a staff rota to make sure that enough staff members with the skills needed to meet the needs of people living in the home are available over the 24 hours. The majority of individuals who replied to our survey said that there were ‘always’ or ‘usually’ staff members available when needed, and that the staff members listen and act on what they say. The home encourages staff members to enroll on the National Vocational Qualifications (NVQ) Level 2 in Care, and at present there are four individuals taking the qualification, four more individuals already enrolled and one individual with the qualification. This mean that the home has not reached the national minimum standard of 50 trained staff members (excluding nurses). More NVQ assessors are needed to improve the rate at which care staff members gain the qualification, and the home needs to address this issue. The induction programme for new staff members meets the national standard, and the home has a programme of further training to make sure that the care staff team is able to meet the needs of the people living in the home. Further Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 Page 18 training has included distance-learning courses with a local college on equality and diversity, nutrition, palliative care and dementia. We looked at three staff recruitment files to check the home’s recruitment procedures. Criminal Record Bureau checks had been carried out for all the individuals, and there was a photograph and proof of identity available for all the individuals. All the individuals checked had completed the home’s application form, and all the necessary information was available for one individual. One individual was recruited through an agency in September 2007, but there were no authenticated references available for that individual. There were two documents available called ‘Recommendation’ dated 2002 from Romania, not addressed to the home or to the recruiting agency, and these should not have been accepted as appropriate references. There was only one authenticated reference available for another individual. At the inspection of May 2006 a requirement was made that the home obtain written confirmation as to the authenticity of references for individuals employed through an agency. The manager subsequently confirmed that usually the references from an agency are authenticated, but on this occasion there was an error. An immediate requirement to seek the references, and a Notice in accordance with paragraph 6.7 of Code B of the Police and Criminal Evidence Act 1984 was issued. The registered manager has taken action to ensure that any agency acting on their behalf carries out the recruitment procedures necessary to meet regulation. Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s manager makes sure that the people living in the home are consulted regularly and are safe, and has taken action to fully implement the requirement made at this inspection. EVIDENCE: The manager is qualified, experienced and skilled, but was unable to explain why the requirement regarding the recruitment procedure at the inspection of 2006 was not fully implemented. Following the previous inspection she had taken action to make sure that the recruitment agency met the requirements of the organisation, but the monitoring arrangements made were not sufficiently robust. She took swift action to make sure that the issues arising at this inspection visit were addressed. Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 Page 20 She makes herself available to people living at the home regularly so that they can discuss any issues concerning them. She had completed the annual quality assurance assessment (AQAA) in detail, and stated what needs to be improved at the home. She has appropriate administrative support available. The organisation has management arrangements in place to help the manager run the home, and a senior manager visits the home monthly to carry out quality assurance checks. The home conducts regular quality assurance surveys to monitor the satisfaction of people living at the home and their relatives, and one was conducted in January 2008. No petty cash is kept on behalf of people living at the home, and individuals or their relatives or representatives manage their financial affairs. The home has a health and safety policy statement, and provides training for staff on relevant topics, such as moving and handling people. The manager is the named person responsible for health and safety, and has attended training on the topic. Several members of staff are fire marshals and a fire risk assessment has been carried out for the home to minimise the risk of fire. Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 Page 21 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © 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 Freeland House Nursing Home DS0000027150.V359334.R01.S.doc Version 5.2 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. 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