Inspection on 15/02/06 for Furzehatt Care Centre

This inspection was carried out on 15th February 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Furzehatt Care Centre 18/09/07

Furzehatt Care Centre 23/08/06

Furzehatt Care Centre 31/08/05

Furzehatt Care Centre 16/12/04

Furzehatt Care Centre 27/07/04

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

CARE HOMES FOR OLDER PEOPLE Furzehatt Care Centre 59 Furzehatt Road Plymstock Plymouth Devon PL9 8QX Lead Inspector Fiona Cartlidge Unannounced Inspection 15th February 2006 11:00 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 Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 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. Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Furzehatt Care Centre Address 59 Furzehatt Road Plymstock Plymouth Devon PL9 8QX 01752 484008 01752 484082 cjohnson@sanctuary-housing.co.uk 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) Sanctuary Care Limited Christine Elise Johnson Care Home 62 Category(ies) of Dementia - over 65 years of age (29), Old age, registration, with number not falling within any other category (32), of places Physical disability over 65 years of age (62), Terminally ill over 65 years of age (4) Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Maximum of 62 Service Users of either gender over the age of 65 years from the following categories; TI(E) 4, PD(E) 62, OP 32 and DE(E) 29. Maximum of 29 DE(E) (Male and Female) To admit one service user under the age of 65 years, named elsewhere Date of last inspection Brief Description of the Service: Furzehatt is a purpose built care home situated in the suburb of Plymstock, Plymouth, Devon. The accommodation is provided in 2 buildings joined by a glazed walkway the buildings have two floors with a passenger lift providing access to the upper floors. All except three bedrooms have en suite toilet and washing facilities. The care home is registered to provide nursing and /or personal care to a maximum of 62 persons over the age of 65 years of either gender with physical frailty/illness or disability requiring nursing and/or personal care. The home is owned by Sanctuary Care whos head office is in Worcester, this company owns several other homes and home care services. Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5 hours 50 minutes and was unannounced. This was the homes second statutory inspection of the year 2005-2006 readers may wish to consider the content of both reports to gain a full picture of the homes achievements. A partial tour of the home took place when some bedrooms and all communal areas were viewed. Individual records of care held on behalf of 4 residents were inspected. The inspector spent the majority of the time talking with 15 residents and 1 visitor and 3 staff members the registered manager, registered providers and the administrator took time observing actual practise. The managing director of Sanctuary care and registered responsible individual on behalf of the company were visiting the home at the time of the inspection. The Commission had received pre –inspection information from staff at the home as well as written feedback from 2 residents and 2 relatives/visitors. What the service does well: Comments received from people living at Furzehatt included - ‘the staff are very sweet and tactful’ ‘I am very happy here, the staff are excellent’ ‘I have no complaints’. The staff were found to be polite, professional and helpful in their approach to the unannounced inspection, there was a calm, friendly but busy and organised atmosphere. The inspector witnessed good interaction between the staff and the residents. The level of documentation held on behalf of each resident is of a good standard, thorough assessments of peoples needs inform the care planning process. The home is well equipped to meet the needs of those residents identified with moving and handling risks and disabilities. A programme of internal auditing of the service is in place this provides evidence of a continued commitment to improvement and provision of quality in this home. Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 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 Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed on this occasion. EVIDENCE: Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9,10 The home provides a comprehensive care planning process Residents are referred to community and hospital health care professionals when specialist needs are identified to ensure their medical needs are met. A recently introduced process for removal and destruction of medication was poorly operated. This poses a risk that some medication could be misused or disposed of in a dangerous manner. EVIDENCE: The home provides a comprehensive care planning process for residents based on information received before and on admission as well as continual assessment of their needs. The care plans viewed during the inspection were fully completed and appropriately reviewed. The review processes in the nursing home include the resident’s views (where possible). The records in the residential unit did not provide evidence that this is always the case there. All the residents spoken to said that they feel well cared for, are treated well by the staff and that their privacy is respected, written feedback from 2 residents also indicates this. Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 Page 10 Documentation provided evidence that General Practitioners, chiropodist, dentist and opticians visit residents and that they are referred to specialist community and hospital health specialists when necessary. The inspector examined the system of medication management, one administration record seen, lacked signatories where medication should have been administered as prescribed. Some medication no longer in use had been placed in the correct bin for disposal by a licensed waste contractor; however there was no record of this disposed medication - best practise indicates a registered nurse and witness should record the actual date the medicine was added for disposal, with the name and strength of the medication, quantity, name of resident for whom the medication was prescribed, signature of the member of staff and witness and on removal by the contractor, date and signature of consignment of the waste to the contractor. The inspector observed that when personal care was being provided this was done behind closed doors, the staff spoke to residents in a polite and cheerful manner and knocked on the doors to private accommodation before entering. Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14,15 Social activities are organised and provide stimulation and interest for residents on most days. Meals are nutritious and balanced offering a healthy and varied diet for residents. EVIDENCE: On the day of inspection residents were seen to join in group activities organised and provided by staff; a light exercise class took place in the morning involving throwing and catching a large light ball. In the afternoon some residents were seen playing bingo whilst others were having a session on ‘places in Britain’ identifying areas to be placed on a large map. Others were observed spending time in their own rooms carrying out activities such as watching television, reading or listening to the radio. Documents seen showed that following admission to the home, the staff record details of each residents social history which includes past occupations, experiences, hobbies and interests this information aids the staff to put an individual social care plan in place. The feedback about food was positive all except one of the residents spoken to said how good it was; Written feedback from 2 residents also indicated they both like the food available in this home. On the day of inspection lunch was served, some residents were seen to eat lunch in the dining rooms others in their own rooms and a few who need assistance were being given this in the Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 Page 12 lounge whilst sat in arm chairs. Records seen provided evidence that resident’s weights are regularly monitored as part of the nutritional screening process and care plans are in place when a risk is identified. The Commission has been provided with copies of the 4 weekly rotating menu which offers a selection of cereals, porridge, grapefruit, prunes, toast or bread and butter, preserves and a selection of hot and cold beverages at breakfast. A choice of two hot dishes for main course at lunch time and cheese/egg/fish/cold meat salad, jacket potato with cheese or tuna filling as alternatives. A warm and cold option is advertised at tea time with sweets/cakes to follow. Supper advertised is a selection of hot and cold beverages served with biscuits, cake and sandwiches. The people living in the home told the inspector they were happy with the visiting arrangements, visitors said they feel welcomed into the home and are able to visit their relative/friend in private. One visitor/relative who provided written feedback indicated they feel welcomed into the home and able to discuss issues such as residents health, eating and general well being. Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 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 the following standard(s): 16 People are aware of the complaints procedure and know who to speak to if they are dissatisfied. EVIDENCE: The complaints procedure is communicated to residents and/or their representatives. A notice explaining the procedure was found displayed in the entrance hall, the information is in enough detail to ensure people have the means to refer a complaint to the Commission at any time. Residents told the inspector if they had issues or concerns they would speak to the senior staff; written feedback from 2 relatives/visitors indicates they are aware of the complaints procedure and one had made a complaint, which the manager had dealt with at the time. Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 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 the following standard(s): 19,26 Many environmental improvements have taken place during recent months making the environment lighter, larger, cleaner and more pleasant and practical for residents and staff. The home is clean and hygienic. EVIDENCE: A tour of the home provided evidence that the providers continue to improve and aim to provide an attractively presented environment for residents and staff; Since the last inspection a new lounge conservatory has been provided, the kitchen and laundry have been extended and refitted providing clean and practical space. A new reception area has been created and carpets and curtains and seating have been replaced in communal areas. Resident’s rooms were seen to contain personal items of furniture and ornaments and pictures. All of those spoken to said they liked their rooms. The home is well equipped to meet the needs of those residents identified with moving and handling risks and disabilities that affect their capability to bathe a Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 Page 15 number of assisted shower facilities are now available for use by residents. Specialist mattresses were seen in place for those residents requiring them as were height adjustable beds. The manager confirmed that further improvements to the environment have been identified and are planned for financial year 2006-7. The home was fresh and clean in its appearance, hand washing facilities are available throughout the home as were protective gloves and aprons and procedures followed by the staff minimise the risk of cross infection. Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 There are sufficient numbers of staff on duty whom have the skills and experience to care for residents admitted to this home. EVIDENCE: Most of the residents told the inspector that there were enough staff on duty, they said they ‘worked hard’ and were ‘very caring’ –‘nothing is too much trouble’ one resident said it sometimes feels like it takes a long time for them to respond when called. The staff spoken to said that they felt there was sufficient numbers of staff on duty and said they had access to training and development. The Commission was provided with training records these indicate that the staff receive regular training/updates. One staff member spoken to confirmed they had recently attended training on the prevention and management of falls in care homes and acts as link nurse for infection control issues, which requires regular attendance at study sessions provided by the Health Protection Agency. The home employs 7 Registered Nurses who are supported by a team of Care Assistants 16 of whom have achieved a National Vocational Qualification in care. Two relatives/visitors who provided written feedback indicated that in their opinion there are always enough staff on duty to meet the needs of residents. Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,38 The home is well managed. There is a risk to resident safety because some residents who like their doors open have doors that are not fitted with safe hold open devices. EVIDENCE: Residents, visitors and staff made positive comments about the management team in the home saying they felt comfortable approaching them with Issues. Communication systems are regular through staff handovers, and formal meetings are held. The Registered Manager attends management meetings with superiors and peers on a monthly basis and bi-annual conferences to up grade her knowledge and skills. The provider generally demonstrates a responsible attitude towards health and safety pre-inspection information given to the Commission by the provider Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 Page 18 indicates that services and equipment are routinely maintained and services by people trained to do so, many fire doors that were open were being held by ‘safe’ hold open devices and notices were displayed throughout the home. There was however one fire door being held open at the time of the inspection by a chair this was because the resident feels ‘penned in’ if sitting in their room with the door closed a requirement to ensure that people can have their doors safely held open has been made. Risks to residents are individually assessed and documented with an agreed plan in place to minimise risk where possible. Recent improvements to the environment and further plans to replace more carpets and tables in communal areas provide evidence of reinvestment in the business. All of the records seen during the inspection were clear, well maintained and secure. Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 X 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES 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 2 Standard OP9 OP19 Regulation 13(2) 13(4)(a) Requirement Medication no longer in use must be recorded and disposed of in a safe manner. The carpet in the walkway between the 2 units must be replaced as it poses a risk of trips and falls. When a resident wants their bedroom door held open, this must be done so with a safe hold open device following advice from the local Fire and Rescue department. Carried forward from 01/10/05 Timescale for action 01/03/06 01/05/06 2. OP38 13(4) 01/04/06 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 Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 Page 21 Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Furzehatt Care Centre DS0000061636.V262432.R01.S.doc Version 5.1 Page 23 - 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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