Inspection on 17/10/06 for Hft - Falstaff House

This inspection was carried out on 17th October 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hft - Falstaff House 06/10/08

Hft - Falstaff House 10/03/06

Hft - Falstaff House 26/08/05

Hft - Falstaff House 30/11/04

Hft - Falstaff House 21/07/04

Hft - Falstaff House 05/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Hft - Falstaff House 12 Victoria Road Bidford On Avon Warwickshire B50 4AS Lead Inspector Martin Brown Key Unannounced Inspection 17th October 2006 12:45p Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 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 Hft - Falstaff House DS0000004243.V360153.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 Adults 18-65. 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. Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hft - Falstaff House Address 12 Victoria Road Bidford On Avon Warwickshire B50 4AS 01789 490526 01789 772790 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) www.hft.org.uk Home Farm Trust Mrs Carolyn Margaret Manktelow Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th March 2006 Brief Description of the Service: Falstaff House is situated in Bidford On Avon. It is part of the Home Farm Trust group, which owns 14 homes nationwide and provides a day service separate but close to this home. People who live here usually attend HFT day services. It is a large traditional, detached property with a large, wellmaintained garden. People who live here receive personal care, 24-hour supervision and accommodation. The home can accommodate 8 people in 2 ground floor and 6 upper floor single bedrooms. Fees are currently £790 per person per week, with additional charges for holidays, hairdressing, toiletries, holidays and other leisure activities. Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been made using evidence that has been accumulated by the Commission for Social Care Inspection. This includes information provided by the home, and a visit to the home. The inspection visit was unannounced and took place on 17th October 2006, between 12.45 pm and 6pm. All the residents were seen over the course of the inspection, as were the staff on duty and the manager. A tour of the premises was made, relevant documentation was looked at, staff and residents spoken with, and observations of the home in action were made. Staff and residents were welcoming and friendly throughout. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The service is working hard to be able to re-admit a service user who wishes to return, but who requires, for the present at least, a higher level of care than was previously the case. People can be confident that they are only admitted, or re-admitted, once the home is clear that they are able to meet their needs. The service must ensure that it does not permanently commit to attempting to meet the needs of people it cannot meet on a long-term basis. EVIDENCE: There have been no new admissions since the last inspection. One service user has been in hospital for a prolonged period and the manager advised that it is planned that he will return, although his needs have increased, at least temporarily. He was visiting the home on the day of the inspection, accompanied by an Occupational Therapist, who was helping to assess what additional facilities would be needed to enable him to return. This included, at the least, one –to- one staffing and the use of a downstairs bedroom. A former bedroom, used as an additional lounge, is being temporarily converted back to a bedroom for a three month period, during which time it is hoped that the person’s needs will reduce to their former level so that he can successfully be accommodated back into the home on a permanent basis. The manager is aware that the use of the downstairs room is for a strictly limited, three-month period. When spoken to, the resident concerned said he was looking forward to coming back to the home, giving the principal reason as ‘going out’ to Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 8 ‘Stratford’ and ‘discos’. Other residents spoken to looked forward to him coming back. All hoped he would be able to return, make a good recovery, and be able to remain at the home far beyond the three months. Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents are supported to make decisions about their lives, and the home works hard to ensure that needs are met, even when these change rapidly. EVIDENCE: Residents all have individual care files. These include personal care books which detail all care needs and how they are met. Daily records are kept, and where, relevant, details of behaviours. One person’s needs are changing rapidly, because of a rapidly developing dementia. Daily recordings, staff handovers and meetings assist in ensuring all those providing her care are aware of changes. Specialist and advice support is available, and waking night staff have just been introduced to try and ensure safety and minimal disturbance to others during the night. Staff spoken to were aware of her changing needs and were striving to meet them. The manager acknowledged that the physical design of the building and the needs of the other residents was making increasingly difficult to meet this person’s needs, and that alternative care had to be sought. Person-centred plans included a variety of goals and wishes. Staff were able to discuss how the progress in meeting these. Staff acknowledged the difficulty in Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 10 making residents aware of future possibilities, so that they might be aware, for example, of the possibility of living in a more individual setting, rather than sharing with seven other people. Residents had free access to the home, and were observed enjoying their particular activities, or being supported by staff in particular activities. Risk assessments were seen, and these, along with personal guidelines, supported residents in taking risks as part of establishing independence. Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16, 17 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Service users are supported and encouraged in activities both within the home and in the wider community. Family and social contact is supported and encouraged, as is the exercising of rights and responsibilities. Residents enjoy a healthy diet, in which they have a say. EVIDENCE: Residents are able to take part in a variety of activities they enjoy, inside and outside the home. One resident, when asked what enjoyed most about the home, said ‘going out’. He particularly enjoyed going to Stratford, and to discos. Several residents said that they enjoyed going to the ‘Mirage’ nightclub in Leamington, and attending the local ‘Gateway’ club. Residents attend day services on various days of the week. Of those residents at home during the inspection, some occupied themselves with activities such as drawing, others were supported in finding and persevering with activities. One resident was enjoying an ‘Early Learning Centre’ puzzle. There was a discussion with the manager concerning the availability of similar puzzles, but with a more ‘adult’ orientation. One resident showed me her ‘Lego’ bricks, from Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 12 which she obviously obtained a great deal of enjoyment. One person was enjoying drawing, and took pleasure in giving me some drawings of aeroplanes that he had done. Residents are encouraged to help with basic self-help and communal chores, according to their wishes and current abilities. Regular contact with relatives was evident in discussion and records, as was contact with friends in the neighbouring area, principally from the day service and other Home Farm Trust services. Menus showed a good variety of healthy food. There are no special diets at present, but staff are aware of the frequently changing wishes and needs of the resident with dementia. Residents who were able to said that they enjoyed the food, and all were waiting patiently but eagerly whilst the evening meal was being prepared. One resident had assisted with the preparation in a minor but significant way. Staff had also spent time that afternoon with that person discussing future meal options and preferences. Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents can generally be confident that their needs can be met, and that where these needs rapidly escalate, that the home will seek to take appropriate action. EVIDENCE: Individual guidelines are in place, showing the personal support needed and the preferred ways of providing it. Staff were observed giving support according to the guidelines and through their extensive knowledge of the residents. Staff were observed helping the person with rapidly accelerating dementia in a sensitive and careful manner. The difference now in her needs to those of others in the home was very noticeable, as a member of staff had to spend a considerable amount of time helping/encouraging her to walk through a doorway, whilst another resident waited, with diminishing patience, behind. Appointments with health professionals are recorded for all residents; at present, there is much consultation with appropriate health professionals regarding the needs of two residents. Medicines were dispensed appropriately, records were accurate, and good stock control was evident. Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents can feel confident that they are protected from abuse, neglect and self-harm, but might benefit from the service being more pro-active in recognising and supporting residents where they have concerns regarding other residents. EVIDENCE: The complaints policy and procedure was seen, alongside with the complaints log, that contained no entries. Residents spoken to indicated that they were content within the home. However, ‘behavioural’ records for one resident indicated that he had been unhappy at being disturbed in the night by another resident. This night disturbance had been a recent, and major, disruption for residents and staff alike, and the manager agreed that whilst residents should not be coached into complaining, they may need support in articulating something that made them unhappy into a complaint. An allegation in previous months had been dealt with appropriately, with all necessary bodies involved and suitable action taken. The service acknowledged that some useful lessons had been learned and is working on new ways to help residents with ‘whistle blowing’. The manager advised that an outside audit had recently been completed of residents’ finances, and, although she had not seen the report, she had received feedback on the relevant parts of it, and a new cash recording system had been implemented. Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The building provides a homely, ‘domestic’ type environment suitable for the majority of the residents, but is not suitable for those with additional long-term support needs, as with, for example, rapidly accelerating dementia. EVIDENCE: The home is well maintained, and requirements from the previous inspection have been dealt with. The home was clean, hygienic, and free from unpleasant odours. There is an alternative access to the laundry, which is used as necessary, to avoid going through the kitchen with soiled or other items that might compromise cleanliness and good hygiene. The home is suitable for able-bodied people, but with most of the bedrooms upstairs, and relatively narrow, ‘domestic’ corridors, was seen to pose problems when one person required staff support to walk down a hallway very slowly. Bedrooms are roomy and reflect individual needs and wishes. There are two bedrooms downstairs, plus a room that was formerly a bedroom but has been used more recently as an additional lounge; it is planned to use this as a bedroom again for a three month period to enable a resident to return and hopefully be rehabilitated sufficiently to be able to come back permanently and re-occupy his old, upstairs room. Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents benefit from welltrained and experienced staff who are familiar with and are able to meet their needs. For the additional needs of two residents, extra staffing is needed. EVIDENCE: All staff spoken to had worked for the service for several years, and were able to demonstrate a good knowledge of the residents and their needs and wishes. They were seen to support, encourage, and reassure residents in a positive manner at all times. The manager advised that the escalating needs of one resident has required additional night staffing as an emergency measure, and the successful return of another resident on a temporary, trial basis will require additional staffing to ensure his needs are able to be met. A sample of staff files were looked at and showed recruitment procedures to be satisfactory, other than details of satisfactory Criminal Bureau Records checks for some relief staff not being available on the premises. The manager advised that these were held in head office, but would request that verifications of them be forwarded for the home to have on record. Discussion with staff, examination of training programmes, and sampling of records showed that training continues to be provided to meet mandatory requirements and the needs of residents. Staff spoken to felt that the Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 17 organisation provides a good level of training. They spoke of dementia training recently attended, and were seen putting their understanding into practice. Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The home works to safeguard the health, safety and well-being of residents, and is working to ensure that their views, and the views of significant others, are taken into account in the running of the home. EVIDENCE: The home was seen to be running effectively, and busily, with staff being aware of roles and expectations, and ensuring that the immediate and differing needs of service users were being met. The manager advised that, following a requirement from the previous inspection, a quality monitoring exercise had been undertaken, and that she was awaiting the compilation of a report by the organisation based on the information gathered. Pre-inspection information showed that health and safety checks take place satisfactorily. A recently revised fire risk assessment was seen, as was evidence of an up-to-date electrical wiring check. Control Of Substances Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 19 Hazardous to Health sheets are available, and hazardous substances kept safely. Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 2 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 2 3 X 3 X X 3 x Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 21 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. 1. Standard YA3 Regulation 14 Requirement The service must be clear that it is only re-admitting a resident on a three month basis, and that any stay beyond that point is conditional on his rehabilitation being such that he can once more use the permanent upstairs bedroom. Timescale for action 29/10/06 2. YA21 14,12,23 Alternative care 29/10/06 arrangements must be made for any resident whose needs the service can no longer meet. Evidence must be available 29/10/06 in the home that satisfactory Criminal Record Bureau checks have been undertaken for all those who work in the home with vulnerable adults. 3. YA34 19 Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA22 YA14 Good Practice Recommendations The service is recommended to look at new ways of supporting residents in the making of complaints. It is recommended that the service considers the desirability of purchasing and encouraging more age appropriate ‘puzzles’ for residents. Hft - Falstaff House DS0000004243.V360153.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Hft - Falstaff House DS0000004243.V360153.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. 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