Inspection on 17/06/05 for Frome House

This inspection was carried out on 17th June 2005.

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

Frome House 08/08/06

Frome House 13/12/05

Frome House 18/01/05

Frome House 17/08/04

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

CARE HOMES FOR OLDER PEOPLE Frome House Cranleigh Court Road Yate South Glos. BS37 5DE Lead Inspector Paul Clark Announced 17 June 2005 09:30 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 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. Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Frome House Address Cranleigh Court Road, Yate, South Gloucestershire, BS37 5DE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01454 866046 01454 866822 South Gloucestershire Council Mrs Teresa Bryant Care Home for Older Peoplr 31 Category(ies) of OP Old age for 31 registration, with number of places Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate 31 service users aged 65 years and over requiring personal care only. Date of last inspection 18 January 2005 Unannounced Brief Description of the Service: Frome house was purpose built in the 1960’s to provide accommodation, personal care and support for 31 older people. It is operated by South Gloucestershire Council.The home is situated off a busy main road in a residential area of Yate, South Gloucestershire. It is a short walk to shops and is within easy reach of the town’s main shopping centre where there is a full range of community facilities. There is a regular bus service to Yate town centre and to the centre of Bristol.The accommodation consists of a two storey building which is fully accessible to service users. There are ramps, a passenger lift and a staircase. All the home’s bedrooms are single. Each bedroom has a wash hand basin. The home has gardens that are well maintained and are easily accessible. Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. What the service does well: 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. Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 7 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 standard(s) 1-6 The home’s statement of purpose, service user guide and information documents are well written, providing residents, prospective residents and their relatives with details of the services the home provides enabling an informed decision about admission to be made. EVIDENCE: Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 8 The inspector reviewed a copy of the service users information guide about the Home, and a copy of the statement of purpose. The guide stated the aims and objectives of the Home, as well the type of care to be provided. The statement of purpose included information about the service provided, the qualifications of the staff employed, and the accommodation. There was information included about the services and the facilities that would be provided. There was a detailed assessment of the physical and mental health needs of each service user contained within individual care plans. Included in each assessment, were the likes and dislikes of the service user, their preferred foods and their choice of social activities. The assessments included information about the reasons for the service users admission. Service users the inspector met expressed a very high degree of satisfaction about the Home. This sentiment was also expressed in the Comments Cards that had been returned by service user’s relatives. The Registered Manager stated that prospective service users and their families are invited to visit before making any decision about the Home. The Home does not provide intermediate care. Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7-11 Residents health, personal, social and individual needs are well documented and clearly show how these needs are to be met. However, the system for the administration of medication is unsatisfactory and requires review. EVIDENCE: The inspector reviewed a random number of service users care plan records. Care plans had been written based on a social worker led assessment of the service users needs. The care plans clearly stated how to assist the service users to meet their physical and their psychological needs. Detailed care plans had been completed for each service user, and there was evidence of regular review and evaluation of care, on a monthly basis. Where they were able to, service users had signed to show they had been involved in the care planning process. The Home registers residents with the local GP surgery (some residents retain their previous GP if they lived locally), and it was reported that the GPs were supportive of the Home. The GP most frequently used by the Home had returned a Comment Card which stated “Frome House appears to provide a caring and supportive environment for the residents and medical conditions are managed appropriately according to instructions given by myself and district Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 10 nurses.” All residents are registered with a local optician who calls to the Home. The Dental practice at Yate Health Centre carry out domiciliary visits to the Home. The Home is visited by an NHS Chiropodist. Two private Chiropodists also call to the Home by private arrangement. A health record was maintained for each of the service users whose records were reviewed. This recorded when the service users had seen the doctor, the optician the dentist and the chiropodist. The inspector also reviewed recent service users accident records. There was evidence that follow up action was being carried out by the Home after each accident or occurrence affecting the well being of a service user. The procedures for the receipt, storage, administration and disposal of medication in the Home were reviewed. A random number of service users’ medication administration charts were reviewed. The charts included the signature of the member of staff giving medication as well as the reasons for any omissions. There was a photograph of the service user maintained with each record. The Home was using the blister pack dispensing system, and there is regular training and updating for staff on the safe dispensing of medication. However, the inspector noted that for one resident their morning medication had not been given and the administering member of staff had written an ‘L’ on the record chart. When the inspector asked what this meant the Registered Manager stated ‘On Leave’. After further discussion, the inspector was informed that the service user involved had had to attend a Doctors appointment on the morning of the inspection and their medication had not been administered. No discussion had taken place with the service user’s GP about this. The inspector formed the view that this practice is not acceptable and a requirement is made that the Home should review this practice. The medication was stored in a locked metal trolley and in a locked cupboard. Staff were observed knocking on bedroom doors before entering service users rooms. Staff communicated with service users in a polite and friendly manner. Some service users have mobile phones. There is also a portable telephone trolley which enables service users to make telephone calls from the privacy of their own rooms. The Home has a policy and procedure in the event of a death of a service user in the Home. The inspector was advised by Mrs Bryant that the philosophy of the Home would be to care for a service user who became terminally ill, as long as the home would be able to continue to meet service users needs. Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12-15 The meals in the home are good offering both choice and variety along with catering for special dietary needs. Activities are arranged and provided at the home on a regular basis. EVIDENCE: Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 12 Relative’s Comments Cards confirmed that they are able to visit the Home at any reasonable time of the day. Conversations with several relatives who were visiting on the day of the inspection confirmed that the Home operates a relaxed and open visiting policy. The Home’s diary recorded that a varied range of activities are arranged by the Home. These include bingo and keep fit exercises. There have also been recent trips to Slimbridge and to Bristol Zoo. To help with future activity planning, it is recommended that the Home keep a dedicated Activities Book where events can be logged and comments made. The Home has a licensed bar. The preparation and presentation of the lunchtime meal was observed by the inspector and a visual inspection of the kitchen took place. All parts of the kitchen were maintained to a high standard. A record of food provided was seen which indicated that a balanced and nutritious diet is provided. All of the service users the inspector met expressed very positive views about the quality, and the choices of food. It is evident the Home is providing meals that service users feel are of an extremely high standard. Residents meetings are held every three months where they can voice their preferences about day to day living in the Home eg menu choices, activities programmes etc. The Home produces a quarterly newsletter which provides residents with news and information about the Home. The Home organises an annual fete which is open to the wider community. Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16-18 Complaints are handled objectively and residents are confident that their concerns will be taken seriously, listened to and actioned. The home does have in place measures to ensure that residents are protected from abuse. EVIDENCE: The Home has an up to date complaints procedure that service users could easily access. The contact information for the area office of the Commission for Social Care Inspection was included. A copy of the procedure is given to service users on admission to the Home. The complaints logbook record was reviewed and it was noted that two complaints had been received since the last inspection. The logbook detailed the action taken in response to the complaints. Service users told the inspector they felt very able to speak to Mrs Bryant if they had any concerns. Mrs Bryant said that all service users are either registered for postal votes, or can vote at the nearby school that is used as a polling station if they so wish. The Home follows the South Glos. Council guidance addressing the protection of vulnerable adults This policy was held in the policies and procedures file in the office. Evidence seen in staff training records showed the staff attended training on issues around abuse. Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19-26 The home is well managed and safe and the quality of furnishings and fittings in the home is good, providing a warm comfortable and homely environment ensuring individuals needs are met. EVIDENCE: Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 15 The Home is a spacious two-story building with lift access to the top floor. There is a garden with patio furniture and a greenhouse that service users can use. There was a high standard of décor and furnishings in the lounges and dining room, which were also spacious. Service users were observed sitting in all the communal areas of the Home and looked very relaxed and settled in their environment. Toilets in the Home are situated in readily accessible parts of the Home near to communal areas and bedrooms. The bathrooms and toilets were clean, and were well stocked with towels and soap. There were assisted baths, located on both floors of the Home for service user’ use. There were grab rails located next to all toilets. Staff were using appropriate manual handling equipment, when assisting service users. There were call bells with accessible alarm facilities in every room including each service user bedroom. During the inspection the inspector tested the call alarm system and staff responded quickly. There was a lift that could provide access for service users in wheelchairs to all parts of the Home. The inspector viewed the majority of service users bedrooms. There was a wardrobe, a chest of drawers, and a comfortable chair, in every bedroom. Many rooms had been personalised with small items of furniture, pictures, photographs and mementos belonging to the service user occupying the room. Each bedroom had bright patterned curtains and bed linen. Rooms looked satisfactory in size for their stated purpose. The Home was clean, tidy, and odour free throughout. Domestic workers were carrying out their duties during the inspection. There was a separate laundry facility, which included washing machines with a separate sluicing programme. Residents stated that the laundry system was reliable and clothing was rarely lost or misplaced. Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27-30 There is a core of well-established staff with varying abilities most of which are skilled and experienced to meet the needs of the residents in the home. The relationships between staff and residents are good, and this creates a warm, supportive environment which promotes a good quality of life for residents. EVIDENCE: The inspector reviewed the staff duty record which showed that there are a sufficient number of staff on duty at all times of day and night to meet the needs of residents. Service users expressed very positive views to the inspector about staff. Staff training records were seen which showed that 4 care assistants had completed the NVQ level 2 in Care award and that 3 were registered candidates. There were certificates seen in the records that demonstrated staff had attended study days on topics that were relevant to the needs of the older person and the home generally. The authority has staff recruitment and appointment systems that are in line with the National Minimum Standards. Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-38 The home is well managed ensuring resident’s interests are promoted and protected by a confident, supported staff team, within a safe environment. EVIDENCE: Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 18 The Registered Manager, Teresa Bryant, has 20 years managerial experience and holds a NVQ Level 4 in Care Management and is working towards the Registered Managers Award. The inspector reviewed service users financial records. Service users money is stored in a secure locked cupboard. There were two staff signatures recorded for money withdrawn from service users personal spending allowance. There were receipts seen for items purchased by, or on behalf of, service users. There was a record kept that showed service users receive their weekly personal spending allowances, via South Glos. Council finance department. Staff check service users money on a weekly basis. There was evidence that regular staff supervision was being carried out on a one to one basis with staff. Supervision records were kept securely in the office. South Glos. Council’s Health and Safety Manager provides regular advice and support to the Home. The inspector reviewed the Homes policy relating to the safe storage of potentially dangerous cleaning substances (known as COSHH). Information included in the policy was detailed and informative. The fire logbook record was seen, and showed weekly tests of fire alarms being carried out. The fire fighting equipment had been checked regularly over the previous twelve months, and monthly fire drills had taken place over the last twelve months. It was noted that the Home has not had a Fire Officer inspection since 12/12/01 and it is recommended that the Home write to the fire authority requesting such an inspection. An Environmental Health Officer inspection took place earlier in the year and all necessary action has been taken in response to this. Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 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 Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 20 No Are there any outstanding requirements from the last inspection? 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 9 Regulation 13.2 Requirement The Home must review the practice of missing the administration of service users medication when they are absent from the Home for short periods. This must be subject to consultation with the service users GP. Timescale for action 1 August 2005 2. 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 12 38 Good Practice Recommendations It is recommended that the Home keep a dedicated Activities Book where events can be logged and comments made. It is recommended that the Home write to the fire authority requesting a Fire Officer inspection. Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos. BS32 4RG 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 Frome House D56 D05 S35230 Frome House V223927 170605 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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