Inspection on 31/08/05 for Furzehatt Care Centre

This inspection was carried out on 31st August 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 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 15/02/06

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 PL9 8QX Lead Inspector Fiona Cartlidge Unannounced 31 August 2005 st 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. Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Furzehatt Care Centre Address 59 Furzehatt Road, Plymstock, Plymouth, Devon, PL9 8QX 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) 01752 484008 eileenharland@sanctuary-housing.co.uk Sanctuary Care Limited Christine Elise Johnson Care Home 62 Category(ies) of Old age, not falling within any other category registration, with number (32), Physical disability over 65 years of age of places (62), Terminally ill over 65 years of age (4) Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1.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. 2. Maximum of 29 DE(E) (Male and Female) Date of last inspection 16/12/05 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 who’s head office is in Worcester, this company owns several other homes and home care services. some external excavation/building works were in progress at the time of this inspection as it is planned for a new conservatory to be built. Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6hours and 50 minutes and was unannounced. A partial tour of the home took place when some bedrooms and all communal living rooms were viewed. Personal records of care of 5 residents and personnel records of 3 members of staff were inspected. The inspector spoke with 10 residents, 5 visitors, 2 staff members the registered manager, care manager and administrator. What the service does well: What has improved since the last inspection? Monthly departmental audits by staff in the home have recently commenced to ensure a culture of continual improvement is encouraged. Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 Page 6 A number of wheelchairs have been purchased since the last inspection ensuring those people with mobility problems are able to get around the home and grounds with assistance from staff. 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 D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 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 standard(s) 3,5. A proper assessment is performed on people considering admission to this home this provides information to the homes staff so they can be sure they can meet the individuals needs. EVIDENCE: Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 Page 9 The inspector examined personal records held on behalf of 5 recently admitted residents; all included pre-admission information supplied from care management or hospital settings. The Manager confirmed that staff from the home make every effort to perform the homes own pre- admission assessments on all prospective service users except those admitted via the early hospital discharge scheme or in an emergency where time does not allow, in these cases the home obtains detailed relevant information to enable them to make a clear decision about the homes ability to meet the needs of individuals. The manager showed the inspector the assessments that she had performed on 2 prospective residents earlier that morning. Both prospective residents were currently patients at the local General Hospital. The assessment tool has been provided by the registered company and is inclusive and encourages a consistent and comprehensive approach to assessing needs. The inspector spoke to a number of residents about how they had made the decision to be admitted to the home, the inspector was told that some had been given a list of homes by the placing authority and had visited several before deciding that Furzehatt was the one for them, others had heard about the home through word of mouth, all told the inspector that they (or their representatives) had been able to visit the home before making a decision. Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 A new documentation system for planning care has been introduced, despite this some plans had not been reviewed as regularly as recommended, this may pose a risk that some care needs may not be consistently met. Residents are referred to community and hospital health care professionals when specialist needs are identified to ensure their medical needs are met. EVIDENCE: The documentation tool used for the assessment and care planning of residents needs, has recently been changed. The documented assessments provide information about skin integrity, moving and handling, safety including risk of falls, nutritional screening and social needs. The information generates the plans of care, which provide the basis for the care to be delivered. The inspector viewed 5 care plans; three had been reviewed as recommended on a monthly basis. Two lacked detail about the social history and the record of social therapies to provide a plan to meet social needs. There was documentary evidence that residents and or their representatives had been involved in the planning process, one residents who’s care the inspector case tracked confirmed he had been involved in the plan to meet needs. Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 Page 11 Records are maintained for all visits to the home by social or health care professionals, all residents are registered with a GP although this is through an allocation process for those who were previously resident out side of the immediate area- this can pose a risk if medical cover is not agreed until after the individuals admission to the home. Records provided evidence that as well as visits from General Practitioners, district and specialist nurses, chiropodist and dentists visit. Records of outpatient appointments show that visits to community and hospital health resources are enabled. Residents told the inspector that the staff respect their privacy and dignity, the inspector observed that when personal care was being provided this was done behind closed doors, the staff spoke to residents in a polite manner and knocked on the doors to private accommodation before entering. Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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: During the inspection there was a game of skittles being played in the residential lounge. The atmosphere was relaxed and comfortable, people who were able wandered in and out of the living rooms and did as they pleased. Some residents stayed in their own rooms and received visitors and ate their lunch. A number of residents and their visitors where sat in the entrance foyer and confirmed they enjoyed seeing people come and go. The inspector examined 5 social care plans, two lacked detail about the residents’ social history and the record of social therapies provided to meet their needs. The document for assessing social need is of a good standard and if complete would include information about the persons - life synopsis, hobbies and interests, activities the individual enjoys, physical capabilities and limitations, mental capabilities/limitations, religious needs and relationships. Everyone said how much they enjoy the food served and praised the cook for the quality of the meals and the standard of cooking. Some people chose to eat in the dining rooms, the space in the dining room on the nursing unit is limited which means those people requiring assistance from staff are given this whilst sitting in their chairs in the lounge detracting from the usual dinning Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 Page 13 experience. Lunch provided was roast beef with vegetables potatoes, Yorkshire pudding and gravy or shepherds pie followed by rice pudding other alternatives advertised included cheeses/cold meat salad, scrambled egg, soup, sandwiches, ice-cream, yoghurt, and tinned fruit. The manager told the inspector that menus have recently been reviewed and these will be presented to the residents for their comments. Residents said that there were no rules as such: they could get up when they wanted and went to bed when they liked. Residents said they had recently enjoyed some trips out despite the weather not always being as good as it could be. The manager said that a care assistant has recently taken on the role of activities co-ordinator, but this position is not full time as the carer still works as a care assistant on some days. Activities in the home include weekly bingo sessions, exercises and sing-alongs as well as skittles, bowls and a gardening club, which has successfully grown tomatoes this season. The visitors and residents spoken to confirmed they were satisfied with the visiting arrangements and could visit socially in the lounges or privately in the resident’s bedroom accommodation. Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 People are safe living in this home and know who to speak to if they are dissatisfied. EVIDENCE: The home has a complaints procedure, which is included in the contract/information pack. There have been no complaints recorded in this inspection year. The home has an ‘Abuse of Vulnerable Adults’ policy. The policy has been updated to includes locality specific detail about who to contact and how, if an allegation or suspicion of abuse or neglect occurs and who and in what instance would lead the investigation. Policies and procedures for the protection of residents and staff are in place and they include information about dealing with challenging behaviour. All of the residents spoken to confirmed they feel safe living in the home. Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,26 The home is adequately decorated and furnished and clean, pleasant and hygienic. Lack of mechanical lifting equipment in the residential unit poses a risk of injury to residents and staff. EVIDENCE: A tour of the home provided evidence that the providers maintain an attractively presented environment for residents and staff that is well maintained. Resident’s rooms contained personal items of furniture and ornaments and pictures. All of those spoken to said they liked their rooms, some particularly commented positively about the fact they have there own en suite WC. Some doors into resident’s bedrooms banged shut when the handle was released. The nursing unit appeared well equipped to meet the needs of those residents identified with moving and handling risks and disabilities that affect their capability to bathe. One resident in the residential unit who was unable to weight bear was seen to have their weight fully supported by 2 Care staff and a transfer sling, the staff said they would have to go to the nursing unit to get Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 Page 16 a sling and this also posed postural problems to staff because of pulling the hoist along distance over carpet. Specialist mattresses were seen in place for those residents requiring them as were height adjustable beds. The communal areas of the home were fresh and clean in their appearance; the inspector identified verbally bedrooms that had an odour to the manager. Hand washing facilities are available throughout the home as were protective gloves, the staff toilet did not have a bin operated by a foot pedal this meant that when staff had washed and dried there hands they have to lift a probably contaminated lid. A recommendation has been made to replace the existing bin to minimise the risk of cross infection. Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 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 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) 27,29,30 The procedures for the recruitment of staff are robust and offer protection to people living in the home. The deployment and number of staff on duty during the inspection met the needs of the residents. EVIDENCE: Residents spoke of the kindness and helpfulness of the staff, all those spoken to said the staff had to work very hard and felt that there should be more staff in the home. Two staff members also commented that there should be more staff, it is recommended that constant analysis of staff numbers and deployment is performed to ensure that any changes in needs of residents are met. The staff on duty during the inspection were seen to be polite and attentive. Nurse call bells were answered in a timely fashion. Staff training records indicate that all staff receive regular training and updates on health and safety, fire prevention, manual handling, emergency first aid, abuse awareness, basic food hygiene and infection control. A staff training matrix has been devised to assist the allocated trainer to ensure staff have the above training at least annually and each member of staff has an individual training profile with a record of the above training as well as specialist training that they have chosen or have had identified as a need. The inspector examined the personnel files of 3 recently employed members of staff these contained all of the information and documents required to safeguard the welfare of residents and in addition showed a fair and equitable interview process is completed. Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 Page 18 Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 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 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) 33,35,38 There is a serious matter of concern which puts people at risk and that is fire doors being wedged open because residents want to sit in their bedrooms with doors open this does not provide a safe environment for those living or working in the home. The home is being managed properly and there is evidence of clear leadership, guidance and direction to staff. Systems for holding money in the home on behalf of service users are extremely safe. EVIDENCE: There were no door wedges seen during the inspection, however a visitor told the inspector that their relative likes to have their bedroom door open and this is usually done with the use of a wedge. Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 Page 20 Safety notices were displayed throughout the home and written information viewed by the inspector indicates that fire equipment is regularly maintained and tested, and shower- heads are regularly cleaned. The inspector viewed the personal records held on behalf of 5 residents these included individual assessments of risks connected to: use of the call bell, control of body temperature, use of bed rails, falls, climbing out of windows there was no checks for risk of scalds. The inspector examined the records and storage of personal money held in the home on behalf of residents. The actual balances were checked against the documentation and found to be correct. Best practise systems are in place for the protection of both residents and staff – 2 signatories are sought for each transaction, all receipts are stored for auditing purposes and the money is securely stored. Internal auditing processes are in place, the company regional manager visits the home on a monthly basis and performs a systems audit as well as feedback from residents and staff the results of which are reported to the manager to ensure a plan is made to address any short falls. Monthly departmental audits by staff in the home have recently commenced to ensure a culture of continual improvement is encouraged. Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 2 x x x 3 STAFFING Standard No Score 27 2 28 x 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 x 3 x x 3 x 4 x x 1 Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 Page 22 yes 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. 2. Standard 22 38 Regulation 13(4) 13(4) Requirement A mechanical hoist must be available for use at all times in the residential unit. 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. Timescale for action 01/11/05 01/10/05 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. 3. Refer to Standard 7 12 27 Good Practice Recommendations Care plans should be reviewed by care staff in the home ona monthly basis and updated when a change in need occurs. Every resident should have their social interests documented and a plan of how those needs will be met. A clear system should be operated for assessing Staffing levels based on assessed need and this should be communicated. Furzehatt Care Centre D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 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 D52-D04 S61636 Furzehatt Care Centre V235151 310805 Stage 4.doc Version 1.40 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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