Inspection on 04/04/07 for Freestones Residential Care Home

This inspection was carried out on 4th April 2007.

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

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

CARE HOMES FOR OLDER PEOPLE Freestones Residential Care Home 85 Finedon Road Irthlingborough Northants NN9 5TY Lead Inspector Mrs Carole Burgess Key Unannounced Inspection 4th April 2007 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 Freestones Residential Care Home DS0000068547.V333613.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. Freestones Residential Care Home DS0000068547.V333613.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Freestones Residential Care Home Address 85 Finedon Road Irthlingborough Northants NN9 5TY 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) 01536 512762 Caroline Davidson Christopher Mole Caroline Davidson Care Home 22 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (19), of places Physical disability over 65 years of age (2) Freestones Residential Care Home DS0000068547.V333613.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Freestones care home is registered to provide personal care to male and female service users who fall within the following categories: Old age, not falling within any other category (OP) 19, Physical disability p over 65 years of age (PD(E)) 2 and Dementia - over 65 years of age (DE(E)) 8 No persons falling within the category of OP should be accommodated at Freestones care home when 19 persons of category OP already reside in the home No persons falling within the category PD(E) should be accommodated at Freestone care home when 2 persons of category PD(E) already reside at the home No persons falling within the category DE(E) should be accommodated at Freestones care home when 8 persons of category DE(E) already reside at the home. The maximum number of persons to be accommodated at Freestones care home is 22. 26th February 2007 2. 3. 4. 5. Date of last inspection Brief Description of the Service: The home was registered to new providers in December 2006, but has been a residential home since 1989. It is situated in the small town of Irthlingborough, with the usual amenities such as a post office, shops and a library. There is a local bus service, with a bus stop, close to the home providing access to the town and surrounding villages. It is within a short travelling distance to Wellingborough, Northampton and Kettering. There are seventeen single and two double rooms. Many of the rooms have ensuite facilities with additional bathrooms on the ground and first floor. There is a chair lift to the first floor. All rooms have a ‘nurse call’ system newly installed. There is a pleasant television lounge, sitting room and dining area. Meals are cooked on site, with choices offered. Meals can be taken in the resident’s rooms if preferred. Statement of Purpose and Service Users Guide (both give information about the home) are provided for all new residents, and a copy is available in the hallway. Fees at the time of inspection were: £331 - £390 Freestones Residential Care Home DS0000068547.V333613.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views of the service provided. The site visit was unannounced and took place over five and three quarter hours. The Inspector selected three residents and tracked the care they receive through a review of their records, discussion with them (where possible), their relatives, the care staff, visiting health care professionals and observation of care practices. The inspector spoke with staff members regarding training and support. The Provided/Registered Manager and other staff spoken with were positive and helpful during the inspection. Planning for the Inspection included assessing notifications of significant events sent to the CSCI by the home. There have been no complaints received by the Commission for Social Care Inspection regarding the home since its registration in December 2006. ‘Have Your Say About Freestones Residential Care Home’ These are questionnaires sent out to homes to enable residents to give the Inspector their opinions of how well the service is doing. Sixteen replies were received. About half were completed with the help of a relative or care staff. All showed that residents were satisfied with the care received. There were no negative comments about the home. Comments included; ‘I don’t want to leave Freestones, I like it here, I like the hairdresser’, and I’ve come here to get better, I have no worries’. What the service does well: The new providers have made an excellent start to providing a high standard of care for their residents. They have introduced new, improved care plans and a ‘key worker’ system to enable residents’ health, personal and social care needs to be identified and met. They have commenced a programme of refurbishment and improvements to the home. They have introduced a quality assurance system to obtain the opinions of residents and stakeholders so they can continue to improve the service. Freestones Residential Care Home DS0000068547.V333613.R01.S.doc Version 5.2 Page 6 They have introduced a structured training programme for staff. Residents spoken with said that the care received was very good and that they were happy living in the home. 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. Freestones Residential Care Home DS0000068547.V333613.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 Freestones Residential Care Home DS0000068547.V333613.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): 1, 2, 3 and 6. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with sufficient information, and have their health, welfare and social care needs assessed, so that they can be met once they move into the home. EVIDENCE: The home provides prospective residents and their relatives with a detailed Statement of Purpose and Service Users Guide (both give information about the home) to help them decide if the home is the right one for them. Freestones Residential Care Home DS0000068547.V333613.R01.S.doc Version 5.2 Page 9 Copies of the residents’ contracts are kept in the home. Three of the sixteen replies form ‘Have Your Say About Freestones Residential Care Home’ stated that they were unsure if they had had a contract. The new Provider/Registered Manager has agreed to review these and provide a copy for all residents (or their representative). The three residents’ care plans reviewed contained a pre-admission assessment to show that the home could meet their health, welfare, and social care needs. The home does not provide intermediate care. Freestones Residential Care Home DS0000068547.V333613.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. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are well looked after in respect of their health, personal and social care needs. EVIDENCE: The Provider/Registered Manager is in the process of introducing new care plans for all of the residents. The new care plans are more detailed and give carers more information about the health, personal and social care needs of the residents. Care plans are reviewed monthly or more frequently where necessary. She is also introducing a ‘key worker’ system to make sure that all residents, and their relatives, have a specific person who will ensure that the residents’ needs are fully met. Contact with other healthcare professional such Freestones Residential Care Home DS0000068547.V333613.R01.S.doc Version 5.2 Page 11 as GP’s was recorded in the care plans to ensure that healthcare needs and treatments were actioned. Residents spoken with all said that they were always able to see the doctor if they needed to. Medication policies and procedures were sound. There were a few gaps on the prescription sheets where residents had either refused or did not require the medication, which should have been completed with the appropriate code such as ‘O’ for omitted. This was discussed with the Provider/Registered Manager who will undertake medication audits to ensure that these are completed in the future. All other medication had been signed as given. Residents are able to continue to self medicate following a risk assessment to ensure that they are safe to do so. Staff receive appropriate medication supervision and training to safeguard the residents and ensure that they receive their prescribed medication. Observation during the inspection showed that staff have a good awareness of how to protect residents privacy and dignity. Staff spoke to residents in a respectful, friendly, quiet and supportive way. Three residents, spoken with during the inspection, said that they were very well looked after and that staff were kind, caring and respectful. A visiting relative said that the home provided a good standard of care and they were satisfied that their relative was well cared for. One resident was particularly complimentary about a member of the night staff and said that she ‘felt safe’. Freestones Residential Care Home DS0000068547.V333613.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. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The staff appear to work hard to ensure that residents experience a safe and homely life style. EVIDENCE: The home has an information board in the hall detailing forthcoming activities. On the day of the site visit residents were watching television and listening to music and had a clothes show after lunch, and the chance to buy new items of clothing. Residents are able to have their own television and telephone in their rooms should they choose to do so. Freestones Residential Care Home DS0000068547.V333613.R01.S.doc Version 5.2 Page 13 Birthdays and festive days are celebrated. Residents were making Easter cards and bonnets in preparation for the Easter celebrations and two residents were looking forward to having a birthday party. One resident was to have a themed birthday party to reflect the county from which she came. Specific religious and cultural needs are met. The local church provides a service and communion every two weeks. Residents said that they are able to have visitors at any time and a number of people came to visit during the course of the site visit. Staff support residents with making choices in their everyday life. All residents spoken with said they got up and went to bed when they wished, were able to choose what they wanted for their meals and were well supported by staff. The Provider/Registered Manager shops for food locally and all meals are prepared in the home’s kitchen by the cook. Residents said that the food was very good and that there were always choices and that they could take their meals in their room if they wished. Special diets such as diabetic diets are catered for. Residents have a nutritional assessment in their care plan to ensure that their dietary needs are being met. One resident said that he enjoyed his food and had put on weight since he moved to the home. Freestones Residential Care Home DS0000068547.V333613.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. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Arrangements for receiving and responding to complaints are sound resulting in satisfactory protection of residents’ rights. EVIDENCE: Residents and staff comments showed that people feel at ease discussing any concerns with the staff. The CSCI has not received any complaints regarding the home. The home has received one complaint from a relative since the last inspection, but prior to the new provider taking over the home. The new provider has dealt this with in a satisfactory manner. The home’s complaints process reflects the Safeguarding Adults policies and procedures and staff are being provided with appropriate training. Freestones Residential Care Home DS0000068547.V333613.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. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. A comfortable, clean and safe standard of accommodation is provided for the residents. EVIDENCE: The new providers have made an excellent start to improving the home; in the short time they have been there, with a programme of improvements and maintenance, including redecoration. Freestones Residential Care Home DS0000068547.V333613.R01.S.doc Version 5.2 Page 16 They have purchased a number of new beds and mattresses, had carpets professionally cleaned, replaced some of the flooring in residents’ rooms, bought new towels and flannels, put up new signage, colour coded cleaning equipment (to improve infection control) and organised repairs and maintenance to the boiler and washing machine, and installed grab rails in the corridors an updated ‘nurse call’ system. The list is not exhaustive. The home is safe and well maintained with adaptations to suit residents’ specific needs. It is decorated and furnished to a good standard that creates a comfortable and homely environment and is fresh and clean throughout. Water temperature control valves have been fitted to the taps in a number of residents’ rooms and the remainder are to be done in the near future. Those that have been done first are in the rooms of residents who do not require assistance with their personal hygiene to ensure that these were made safe first. There is limited access the main area of the garden for residents who find steps difficult or who use a wheelchair. The Provider/Registered Manager is looking to installing a ramp to make for easier access, with additional longterm plans for improving the garden. Freestones Residential Care Home DS0000068547.V333613.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. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff at the home are sufficient in numbers to meet the residents’ needs. EVIDENCE: There were sixteen residents at the time of the site visit. Staffing levels, at the point of inspection, were in line with those suggested by the Department of Health Residential Forum Guidelines and were sufficient to meet the residents’ needs. During the day there are three carers, a cook and maintenance person, plus the Manager or the assistant manager. There are two carers at night. Residents said that their needs were fully met by the staff, although one resident said that there were times when staff appeared ‘pushed’. Three staff files were checked during the inspection and showed that there is a satisfactory recruitment process. All staff had had Criminal Records Bureau (CRB) checks, two references, and a satisfactory interview process followed by a recorded induction to ensure that residents were in safe hands. Freestones Residential Care Home DS0000068547.V333613.R01.S.doc Version 5.2 Page 18 The home has a training matrix. Staff undertake training in specific areas such as fire training, first aid, moving and handling and safeguarding adults. Six staff have, or are completing, National Vocational Qualification (NVQ) in Care and the assistant manager is currently undertaking Level 4 and the Registered Managers Award. This ensures that staff have the necessary skills to provide safe care for the residents. Freestones Residential Care Home DS0000068547.V333613.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. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The Provider/Registered Manager provides strong and supportive leadership to staff, ensuring that residents receive a high standard of care. Freestones Residential Care Home DS0000068547.V333613.R01.S.doc Version 5.2 Page 20 EVIDENCE: The Provider/Registered Manager is a Registered Nurse with many years of experience in nursing and care. She has introduced a quality assurance system to enable residents and stakeholders to give their opinion of how the home is doing and provide ideas for future improvements to the service. There is an ethos of warmth and openness in the home and residents, relatives said that staff deliver a good standard of care and are well organised. There are regular staff and residents meetings. Residents said that their request and ideas are responded to, such as the introduction of name badges for the care staff. The home does not keep any money on behalf of residents. Those who are able keep their own; otherwise receipts are kept and passed to the resident’s relative or representative. The home’s health and safety arrangements such as regular maintenance and servicing of equipment, regular fire drills and the installation of the new ‘nurse call’ system, heat control valves on hot water taps and grab rails show that the providers are mindful of their responsibilities to make sure that residents live in a safe environment. Freestones Residential Care Home DS0000068547.V333613.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Freestones Residential Care Home DS0000068547.V333613.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 Freestones Residential Care Home DS0000068547.V333613.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Freestones Residential Care Home DS0000068547.V333613.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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