Inspection on 23/04/08 for Fulford Nursing Home

This inspection was carried out on 23rd April 2008.

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

Fulford Nursing Home 26/04/07

Fulford Nursing Home 25/07/06

Fulford Nursing Home 18/10/05

Fulford Nursing Home 25/01/05

Fulford Nursing Home 27/07/04

Fulford Nursing Home 06/02/04

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

CARE HOMES FOR OLDER PEOPLE Fulford Nursing Home 43 Heslington Lane York North Yorkshire YO10 4HN Lead Inspector Denise Rouse Key Unannounced Inspection 23rd April 2008 11:40 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 Fulford Nursing Home DS0000028003.V364020.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. Fulford Nursing Home DS0000028003.V364020.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fulford Nursing Home Address 43 Heslington Lane York North Yorkshire YO10 4HN 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) 01904 654269 01904 651919 fulfordnursing@tiscali.co.uk www.fulfordnursinghome.co.uk Mr Raymond Hancock Mrs Donna Crockford Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Fulford Nursing Home DS0000028003.V364020.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 40 years plus Date of last inspection 26th April 2007 Brief Description of the Service: Fulford Nursing Home is a privately owned care home offering nursing care for up to 28 service users. The home is a large detached property with wellmaintained grounds. Service users can access the facilities in Fulford, which include shops, a local church, library, schools, hairdressers and the GP surgery. Information is provided in the service user guide and statement of purpose. Inspection reports are also available for people to read so that they have relevant information about what the home can offer them. On the day of the site visit the weekly fees ranged from £498.22 - £650.00. Fulford Nursing Home DS0000028003.V364020.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. The accumulated evidence used in this report has included: • A review of the information held on the home’s file since its last key inspection. • Information submitted by the registered provider in the Annual Quality Assurance Assessment, which was picked up from the home at the time of the site visits. • Surveys received from ten people living at the home, one relative, two health care professionals and three staff. • Two unannounced visits to the home, which lasted six hours forty minutes in total, undertaken by one inspector, this included a full tour of the premises. • Evidence was gained by direct observation during the site visits which involved talking with people living at the home, visitors, the manager, proprietors and other members of staff. Inspection of records, including care profiles, medication administration records, staff files and some of the home’s policies and procedures. • • What the service does well: Assessments of peoples needs are undertaken and include details of risks, to ensure people’s needs are known. Care documentation is thorough and includes all necessary information, which is stored in one place to ensure peoples care needs are known and can be met. People receive care in a way that respects their privacy and dignity. A robust complaint’s procedure is in place to ensure that any concerns raised are investigated and dealt with thoroughly. Training for staff is provided to ensure that care is given by people who have relevant knowledge of how to give care safely. Fulford Nursing Home DS0000028003.V364020.R01.S.doc Version 5.2 Page 6 Audits on how the home runs are carried out, to ensure the quality of the service is monitored and any shortfalls identified are dealt with thoroughly. 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. Fulford Nursing Home DS0000028003.V364020.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 Fulford Nursing Home DS0000028003.V364020.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): Standard 3 (6 not applicable) People who use this service experience good quality outcomes in this area. People are fully assessed prior to being admitted to the home, and have relevant information available to them. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Prospective residents have a full assessment of their needs undertaken to ensure their individual needs are known and can be met. Nurses discuss the information gained about prospective admissions to ensure that they have the right skills to be able to look after them. Admissions to the home are not made if the staff cannot meet their needs. Two staff go out to meet and assess prospective residents who are considering moving into the home. They are invited along with their family or chosen representatives to look round. Information in the form of photographs of the home, service user guide and statement of purpose are available to ensure they have enough information about the home to make an informed choice about if it is the right place for them. Fulford Nursing Home DS0000028003.V364020.R01.S.doc Version 5.2 Page 9 People considering living in the home are able to spend time there and move in for a trial period, to sample the services the home can offer them. Fulford Nursing Home DS0000028003.V364020.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): Standards 7 8 9 10 People who use this service experience good quality outcomes in this area. People have their health care needs met and their privacy and dignity is respected. Medication systems in operation protect people living in the home. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People receive personal and health care support that is person centred and based on meeting their individual needs. New care documentation is being used which is detailed and has all the relevant information contained in it so that each persons information is in the same place and it is kept up to date. Care plans are detailed and reflect what people can do for themselves and what help staff need to provide to support individuals. Risk assessments are in place in relation to preventing people from the risk of falling out of bed, evidence is available for the reason bed rails are required and the possible risks of using this equipment is discussed and documented with people, so that they can choose if they want these used. Fulford Nursing Home DS0000028003.V364020.R01.S.doc Version 5.2 Page 11 Special equipment is provided to ensure that peoples specific needs can be met, these improve people’s independence or quality of life. Advice is sought from specialist health care professionals to ensure peoples special need, relation to diet and skin care are met. People are accompanied to appointments at their general practitioners, dentist, chiropodist and hospital. The health care needs of people not able to leave the home are managed by visits from local health care services. Staff know people well and qualified and care staff attend handovers so that all staff can communicate any changes in peoples conditions or needs. These are then acted upon to ensure people’s needs are always known and met. People are treated with dignity and respect; they are addressed by their preferred name. Staff knock on bedroom doors before entering. Double bed rooms have screens available between the beds to ensure personal care being given is not witnessed by the other person. Medication systems in place are thorough and help protect people. Medication records are fully completed and provide an accurate record of medications given to each person. This ensures that the staff and general practitioner are aware of how the medications prescribed are affecting the health of each person. Controlled medication is handled correctly to ensure people’s safety is maintained. The home have introduced specific care pathways for people who are near to death, to ensure that care is individualised and people are well supported at the end of their life. Fulford Nursing Home DS0000028003.V364020.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): Standards 12 13 14 15 People who use this service experience good quality outcomes in this area. People’s social and dietary needs are met. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Peoples preferred social activities are recorded these preferences are provided. Local links with the community are maintained; a dance at a local school was attended by some people living in the home. An activities programme is available and includes activities such as carpet skittles, general knowledge Quiz ‘s and Nail and hand care. People have their Life history and family history recorded so that staff can help people reminisce if they want to. Trips are undertaken over the year and people have been to the Railway Museum, York Eye, Burmby Hall gardens, Scarborough, and into York shopping. One person had a separate Christmas Day for their family after Christmas, which the home catered for. Birthdays and Golden Weddings are celebrated at the home. Activities which people take part in are recorded and this information is reviewed by staff to ensure peoples preferred activities are taking place. Outside entertainers and “Pat the dog” activities are also provided for people at the home and their relatives to enjoy. Fulford Nursing Home DS0000028003.V364020.R01.S.doc Version 5.2 Page 13 Visiting is open and people can go out with their relatives. Staff also take residents out for walks in good weather. People’s religious preferences and needs are recorded and acted upon. Holy communion is held at the home once a month and a number of residents go out to a local church club. Local clergy can visit the home at any time. People’s dietary needs are known and catered for. Menus are available for them to choose from. The lunch menu is displayed in the dining room. People can choose where to eat, either in their bedrooms, other lounge areas or the dining room. Meals are balanced and nutritious with home baking provided. People who require help with feeding are assisted by patient staff in an unhurried manner. People with weight loss are monitored and supplements given as prescribed. Foods are fortified and records are made of what food and drink they are managing to take. Specialist advice is sought to ensure peoples dietary needs are met. The home celebrates different occasions with special meals and decorated the dining area for Christmas, burns supper, Valentines Day, and Bonfire night. Family are also invited to have a meal with their loved one and family meals can be served in a quiet lounge to ensure privacy for get together, and quality time with relatives. The home organise a holiday for some people who wish to stay in Blackpool for a few nights. Staff go with them to ensure their needs are met whilst away, this is commendable and helps people live a more fulfilled life. Fulford Nursing Home DS0000028003.V364020.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): Standards 16 18 People who use this service experience good quality outcomes in this area. People’s complaints are dealt with thoroughly and they are protected from abuse. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Complaints are dealt with appropriately, evidence of the complaint, investigation and outcome letters are evident. Issues are fully resolved. There is information available to people about how they can raise a complaint. People surveyed knew what to do to make their views known. They indicated that they knew how to raise issues with the home, and felt they would be dealt with. Criminal checks are undertaken on staff who apply to work at the home, to ensure that they are suitable to work with vulnerable people. The results of these are known before staff commence work there. Staff undertake in house and external training about how to protect people from abuse, this is also covered at induction for new staff. Induction training is provided for new staff, this includes information about different types of abuse and how to report any suspicions of abuse to ensure it is acted upon swiftly. Policies and procedures for protecting people are in place and staff questioned about what to do if an allegation of abuse was received knew what action they must take to protect people. Fulford Nursing Home DS0000028003.V364020.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): Standards 19 26 People who use this service experience good quality outcomes in this area. People live in a home that is clean and well maintained, with infection control measures in place. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home provides an environment, which is secure and homely. A programme of maintenance and improvements is undertaken to ensure it remains pleasant for people living there and their guests. There are two lounges people can use, with television and music, or they can be used as quiet areas for people to entertain their visitors or read. The front garden is accessible to people who can walk as well as wheelchair users. There is garden furniture available so that people can enjoy sitting in the garden if they wish. Fulford Nursing Home DS0000028003.V364020.R01.S.doc Version 5.2 Page 16 Some bedrooms are shared, and some have an en suite toilet and hand basin for people to use. Bedrooms are different sizes and have character due to the building being converted from a house into use as a nursing home, some years ago. People are able to personalise their own bedrooms to make them feel homely. Shared bedrooms have curtains between beds to ensure peoples privacy and dignity is protected. A passenger lift is available to all floors allows wheelchair access throughout the home. In view of this storage areas for hoists are not available and equipment has to be stored where it is not posing a problem for people living there. There is a wheelchair cupboard on the ground floor where wheelchairs are placed when not being used. The bathrooms throughout the home have all been refurbished to a high standard and are inviting and warm. The downstairs bathroom has been upgraded from a shower room to a walk in hydrotherapy bath with piped music and down lighters to aid relaxation. All bathrooms have signs on them to let people know if they are in use, to maintain peoples privacy. Hand wash facilities are available throughout the home, to ensure that staff can wash their hands regularly and prevent cross infection occurring. The laundry has infection control measures in place to protect people. Fulford Nursing Home DS0000028003.V364020.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): People who use this service experience good quality outcomes in this area. People are looked after by adequate numbers of well-trained staff. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Staff are provided in sufficient numbers to meet peoples needs. People receive timely care from patient staff who worked to ensure peoples privacy and dignity is respected. A thorough recruitment process is followed which includes recording the outcome and responses from potential staff at interview, as well as undertaking all necessary references and criminal checks. Ongoing training in all statutory areas is completed for all staff, a training matrix ensures that staff receive training at regular intervals which keeps their knowledge and skills up to date, and helps them provide good care to people living in the home. Other training in subject such as end of life care, dementia awareness etc was provided. The home places a high level of importance on providing training so that staff have the skills to give good care. More than 60 of staff hold a national vocational qualification in care, this helps to enhance the care being provided to people living in the home. Fulford Nursing Home DS0000028003.V364020.R01.S.doc Version 5.2 Page 18 Staff meetings take place regularly, along with supervision which is used to find out staffs views and highlight any training needs which is then addressed and reviewed to ensure staff are happy with the help and support they receive. Fulford Nursing Home DS0000028003.V364020.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): Standards 31 33 35 38 People who use this service experience good quality outcomes in this area. People live in a home that is well managed and their health and safety is protected. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: An experienced manager who is well liked runs the home. There is support for her provided by the proprietors, business manager and operations manager who all work well as a team. She operates an open door policy so that people can speak with her at any time. She has a clear understanding of the key principles and focus of the service, and works to ensure these are met. Equal opportunities are promoted. The manager updates her skills regularly and has just completed her Registered Managers Award. Fulford Nursing Home DS0000028003.V364020.R01.S.doc Version 5.2 Page 20 The views of people living at the home are always considered. This ensures that their wishes are reflected in decisions made about how the home runs and what improvements they make to the service. Staff spoken said that the manager was approachable and listens to them. Staff said the manager had worked hard and that they felt appreciated by the management team. Quality assurance audits are carried out for the kitchen, medications, accidents, care plans pressure sores and housekeeping. This ensures management are constantly monitoring how the home is running and act to address any shortfalls found. People are also asked in a yearly survey for their views of the services the home provides. The management team analyse the information and act upon it to ensure that the home delivers the services people want. Personal allowance account balances inspected are correct this ensures people are protected from financial abuse. Receipts are kept of transactions and money is stored separately for each person. Health and safety checks are undertaken for hot water temperatures in people’s bedrooms, and fire alarm checks weekly. As well as hoist and lift maintenance contracts. Gas and electric services are maintained and certificated as required. All areas of the home are maintained to ensure people are not placed at risk. Health and safety issues are discussed every day at handover and issues quickly acted upon. The operations manager checks all the equipment in the home. Staff are allocated tasks on a daily basis relating to fire and health and safety issues. Risk assessments are in place and reviewed yearly, updated as required. Any shortfalls identified, have a plan of action made which is reviewed to ensure the issue is resolved. Fulford Nursing Home DS0000028003.V364020.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 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 Fulford Nursing Home DS0000028003.V364020.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 Fulford Nursing Home DS0000028003.V364020.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Fulford Nursing Home DS0000028003.V364020.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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