Inspection on 29/08/07 for Furzeham Lodge Care Home

This inspection was carried out on 29th August 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

Furzeham Lodge Care Home 06/07/06

Furzeham Lodge Care Home 06/12/05

Furzeham Lodge Care Home 10/05/05

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

CARE HOMES FOR OLDER PEOPLE Furzeham Lodge Care Home Higher Furzeham Road Furzeham Green Brixham Devon TQ5 8BL Lead Inspector James Rose Unannounced Inspection 29th August 2007 09:00 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 Furzeham Lodge Care Home DS0000063694.V347960.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. Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Furzeham Lodge Care Home Address Higher Furzeham Road Furzeham Green Brixham Devon TQ5 8BL 01803 856657 01803 859440 furzehamdash@aol.com 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) Mr David Malcolm Baker Mrs Sarah Jane Mary Dennis, Mr Howard Norman Dennis, Mrs Angela Martha Christina Baker Mrs Carol Eileen Griffett Care Home 21 Category(ies) of Dementia - over 65 years of age (21), Old age, registration, with number not falling within any other category (21), of places Physical disability (21) Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Dementia over the age of 65 (21) Old age (21) Physical Disability (21) Date of last inspection 6th July 2006 Brief Description of the Service: Furzeham Lodge is an extended detached building that provides 24-hour residential care for up to 21 persons in the categories of old age, physical disability and dementia over the age of 65 years. The home has a large communal lounge with a dedicated dining area attached. All the rooms are on suite; there is one double room available the remainder are all single occupancy. The home has two floors with a vertical lift provided for less mobile service users. Furzeham Lodge is situated by the green at the top of the hill above the harbour of Brixham. The home has a well-stocked garden with a central lawn area with easy access provided for residents; to the side of the building is a hard standing car park, which is large enough for several vehicles. The weekly cost of care at the home is, lowest £326.84 and the highest £423.00 at the date of this report. Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken over 8 hours in August 2006.Samples of the care records maintained by the home were examined and a complete tour of the home was carried out. Four residents were asked individually about life at the home and other residents were consulted in small groups. Four visitors to the home were also consulted. Three healthcare professionals were asked for their views of the service provided and two of the care staff were asked for their views. Many observations were also made of the way care was delivered. The inspection was undertaken with the assistance of the proprietors and the registered manager. What the service does well: What has improved since the last inspection? No requirements were raised in the last report and the two recommendations made have been adopted. The redecoration and refurbishment of the home continues with new carpets being provided in some residents’ bedrooms. Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 Page 6 A new gate has been provided that ensures that the main area of the well tended garden is secure, this enables residents with a elements of confusion to have access to this area without undue risk. The garden fence has also been replaced and garden furniture is now available for residents use. Since the time of the last inspection the manager has been registered and is now responsible for the day-to-day management of the home. 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. Furzeham Lodge Care Home DS0000063694.V347960.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 Furzeham Lodge Care Home DS0000063694.V347960.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. Quality in this outcome area is adequate. Adequate assessments are in place for each resident in the home, these are undertaken prior to the home offering a service, but need to be more client centred. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a system in place for undertaking assessment of a prospective residents needs to ensure the home is able to offer an appropriate service. The assessment is usually undertaken by the registered manager who records needs in the areas of health, personal and social. This process has just been reviewed by the home and it has been decided that the assessment of social needs should be developed further to enable the home to offer a ‘client centred’ service. This was discussed at the time of the inspection and it was understood that the new system would be operational within the next six weeks. Standard 6 refers to a service that is not offered at Furzeham Lodge. Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): ‘ 7, 8, 9 and 10. Quality in this outcome area is good. The home does have a care plan available for each resident in the home; these are being developed further to better provided a ‘client centred’ approach. Health care needs are met. Residents are able to self medicate where appropriate and they are protected by the home’s administration of medication. Residents felt they were always treated with respect and their privacy was maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a care plan available for each person receiving a service, these have recently been reviewed and a more developed approach is being introduced to ensure that a client centred approach is taken with particular attention to social elements. Health needs of residents are currently well covered in the existing planning. Three health care professionals were consulted as part of the inspection process and they all advised that they did not have any concerns about the service provided at Furzeham Lodge. Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 Page 10 The risk assessments that form part of the care planning undertaken are also being reviewed and will demonstrate how judgements are reached concerning the hazards found for each of the residents. It was understood that all the new care plans would be in place six weeks from the date of this report. Residents who wish are able to self medicate subject to a risk assessment approach to ensure they have the capacity and are safe. The recordings kept by the home of the administration of medication were examined and found to be complete and appropriate. Medication was checked and booked in when received, issue records were maintained and unused medication was returned and recorded to the pharmacist. Secure storage was provided and appropriate arrangements were in place for medication subject to the controlled process. Low temperature Storage was also provided where required. These systems ensure that residents are appropriately protected by the home’s policies and procedures. All the residents consulted as part of the inspection process advised that they felt they were always treated with respect by their carers and that priority was provided to ensure their privacy was maintained when personal care was delivered. These approaches were also confirmed from observations made on the day of the inspection and from conversations undertaken with visitors to the home. Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. Residents advised that they enjoyed life at the home and all their needs were met by the service provided. The home has an unrestricted visiting policy and procedure. Assistance is well provided by the care team to enable residents to maintain control over their lives. A wholesome balanced diet is provided at the home that is to the liking of the residents, choice is always provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents consulted as part of the inspection process advised that the lifestyle and activities in the home were to their liking. No suggestions could be made by them of any additions they would like to have available. A range of activities is provided for residents and trips out are regularly undertaken, accompanied shopping excursions are offered on a weekly basis. Since the time of the last inspection the home has recruited a new activities coordinator and when the new care plans are available a more ‘client centred’ approach will be employed. Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 Page 12 There is an unrestricted visiting policy and procedure at the home and visitors are always made welcome. Residents also confirmed that they could see their visitors at anytime and come and go as they pleased. Four visitors were consulted individually during the inspection, this was undertaken in private and they all confirmed that they felt welcome in the home and advised that they thought the service provided was of a high quality. Residents are consulted three times a day about what foods they would like to consume. A wholesome, well balanced diet is provided and residents advised that they enjoyed the meals they were served. In addition there is an option of a hot breakfast in the morning and wine is provided for residents at the weekends if they wish. Home made cakes and tarts etc are made on the premises and are much appreciated by the residents. One resident remarked, “We have had some changes to the menu, I eat very well” another resident advised, “I really like the food here especially the Cornish pasties”. Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. Residents were confident about using the complaints procedure and in the management of the home. An appropriate policy and procedure is in place to ensure that residents are protected and carers are trained in its use. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the complaints policy and procedure was readily available in the home and residents were confident that if they raised an issue it would be taken seriously by the management and resolved for them. No complaints were received during the inspection and none were outstanding. The home has available an appropriate comprehensive adult protection policy and procedure, all carers are trained in its use to ensure that residents are safe. Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. Furzeham Lodge is well maintained, comfortable and safe. The building was clean throughout with good standards of hygiene evident. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complete tour of the home was undertaken inside and out as part of the inspection process all rooms were seen. The home has a running refurbishment programme in place and several bedrooms had been redecorated and new carpets had been provided. The environment is clean, well furnished and comfortable for residents, high standards of hygiene were evident throughout. Currently the home stores residents’ continence aids in the on suite facilities, sometimes on the floor. These could be easily seen by anyone going into the room as the on suite facilities often had the door open. It is suggested that this approach is reviewed to better address the privacy and dignity issues of the residents. Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 Page 15 Outside the well-tended garden has had the addition of a gate added to enable the garden to be safely accessed by residents with a degree of confusion. A new fence has also been provided. Garden furniture is available and residents regularly use this area when the weather permits. Residents were asked individually in private and in groups about the environment and all the comments were very positive particularly about their own rooms. One resident said “You couldn’t do better than this” and another remarked “ I like the lounge here its very sunny and I can go into the garden if I want to”. Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 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 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 good. The home always has adequate numbers of experienced carers on duty to appropriately meet the needs of the residents. The recruitment practices in the home ensure residents are safe and there is a comprehensive active training programme in place for carers. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The number of care hours available at the home remains at the same level as at the last inspection, this provides sufficient staff to ensure that residents’ needs can be met at all times. All the residents consulted during the inspection advised that they could always get help quickly if they needed it. Three personnel files were examined at the inspection these were found to have the documentation necessary and demonstrated that the appropriate checks had been undertaken to ensure residents were safe. The home has an active training programme running, this encourages carers to take specialist courses and there is a high proportion of staff that have finished NVQ training or are currently completing the courses. This comprehensive investment undertaken by the home ensures a quality service is maintained to residents. Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 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 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. Furzeham Lodge is well managed by a competent person who provides a quality service to the residents. Residents’ financial interests are safeguard by the procedures in place. The health, safety and the welfare of staff and residents is promoted and protected by the management of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Furzeham Lodge is well run by a qualified, experienced and competent registered manager who runs the home in the best interests of the residents. Care is taken to consult the residents about the service being provided both in questionnaire form and at residents meetings, which are held regularly. Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 Page 18 The residents who were consulted in private and their visitors advised that they had complete confidence in the way the home was managed and felt they were consulted about issues that affected them The home assists some of the residents with the administration of their pocket money. Detailed records are maintained and four of these were examined in detail and all monies checked, these were found to be up to date and correct. Two staff signatures are used for each single transaction and all purchases made on behalf of a resident have a receipt available. This clear, well-recorded process ensures that residents are appropriately safeguarded. The management of the home gives a priority to the health, safety and welfare of residents and staff. All chemicals that could be a hazard are held in appropriate secure storage and reports are made of any dangerous occurrences as required. The management undertakes regular risk assessments of the building to ensure the environment is safe and all equipment is regularly serviced. The recording of the fire precautions undertaken were examined and found to be clear and up to date which ensures that residents are safe. Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 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 Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 Page 20 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 Furzeham Lodge Care Home DS0000063694.V347960.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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