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Inspection on 12/04/05 for Lady Forester Residential & Day Care Centre

Also see our care home review for Lady Forester Residential & Day Care Centre for more information

This inspection was carried out on 12th April 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a group of staff who have worked in the home for some considerable time, they are keen to maintain the good name the home has in the local community. The management team in the home is very supportive to both residents and staff and training is a high priority on the managements agenda. The residents spoken to felt that the staff have built a good relationship with them and they work hard to improve their quality of life. They also stated that there was good choice and quality in the meals offered to them and they were able to join in the daily activities that were provided for them both inside and outside the home. The standard of the environment in the home is good providing the residents with an attractive and homely place to live. Proposed developments will further enhance the facilities that will become available to the residents ie: A Purpose Built Day Centre.

What has improved since the last inspection?

There have been no developments or changes in the home since the last inspection the good standard of care provided by the home has been maintained.

What the care home could do better:

No requirements or recommendations for improvement in improving standards in the home were made during this inspection. This being due to the good standard of care provided in the home being maintained.

CARE HOMES FOR OLDER PEOPLE Lady Forester Res. & Day Care Church Street Broseley Shropshire TF12 5BQ Lead Inspector Michael Highfield Unannounced 12th April 2005 10:00 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. Lady Forester Res. & Day Care Version 1.10 Page 3 SERVICE INFORMATION Name of service Lady Forester Residential & Day Care Centre Address Church Street, Broseley, Shropshire, TF12 5BQ 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) 01952 884539 01952 884552 Lady Forester Trust Limited Cecilia Joan Walden Care Home 7 Category(ies) of Old Age (7) registration, with number of places Lady Forester Res. & Day Care Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: No conditions. Date of last inspection 7th December 2004 Brief Description of the Service: Lady Forester Residential and Day Care Centre is registered with the Commission for Social Care Inspection to provide accommodation and personal care to a maximum of seven elderly people. Five rooms are provided for permanent service users and two beds are provided for respite purposes. At the time of the inspection there were six service users in residence. The home is situated on the outskirts of Broseley, Shropshire and set in beautifully maintained grounds. The building was formerly the Cottage Hospital. The centre is a charitable organisation and managed by a board of Trustees. The home is situated on the first floor of the centre, which is accessible via a passenger lift. A small lounge is provided on the first floor and a lounge dining area on the ground floor. All bedrooms are single.Day Care is provided Monday to Friday on the ground floor and the service users of the home are able to participate in activities arranged by day care staff if they wish to do so. Lady Forester Res. & Day Care Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of four hours it was unannounced and formed part of the two routine inspections per year under taken by the Commission for Social Care Inspection. During the inspection a tour of the premises took place, discussions with management, residents, and staff occurred and care records of the residents were perused together with medicine administration. Discussions with the management occurred concerning the starting time of alterations that were going to be made in the internal structure of the home and the implications on additional staff recruitment and training. What the service does well: What has improved since the last inspection? There have been no developments or changes in the home since the last inspection the good standard of care provided by the home has been maintained. Lady Forester Res. & Day Care Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lady Forester Res. & Day Care Version 1.10 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 Lady Forester Res. & Day Care Version 1.10 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) 1-6 The homes Statement of how they operate and the Residents Guide provide present and prospective users with detailed information which would assist them in making a decision on whether or not they wish to become a resident in the home. EVIDENCE: The manager has produced a very comprehensive Statement of Purpose which contains all the relevant information required under Schedule 1 of the Care Homes Act. Each resident has their own personal copy of the residents guide and their contract with the home states the room number they occupy. Contracts Terms and Conditions have not changed since the last inspection. The Residents assessment tool contained elements of shared care with community staff and the staff on duty had a very detailed knowledge of each residents needs and appeared very confident in meeting them. Residents can spend a week in the Lady Forrester Home before making up their mind whether on not they wish to become a permanent resident or not. Many of the residents had been in the home for some considerable time, they were well settled and had the support of their family members. Lady Forester Res. & Day Care Version 1.10 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 standard(s) 7-11 The health needs are well met with evidence of good multi disciplinary working. The system of medicine administration is well managed and safe. EVIDENCE: The home has a policy on care planning which clearly states that care plans must be reviewed and updated monthly. Records seen evidenced this. Care plans developed are discussed with the resident then signed whenever they are capable to do so. Each resident has a personal care check list in their care file, and their likes and dislikes in diet are documented in their care plan. Appropriate procedures are in place for the safe administration of medicines, and several staff members have completed a self assessment work book for the safe handling of medicines. Medication sheets are now printed by the local pharmacy and blister pack dispensing is renewed weekly. It was observed that the residents are treated with the utmost dignity and respect. There was a homely atmosphere in the home and the residents spoken to substantiated this. Lady Forester Res. & Day Care Version 1.10 Page 10 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) 12-15 The systems for resident consultation are good with a variety of evidence that they are sought and acted upon. The home has good links with the community which enriches their social opportunities. EVIDENCE: Through discussions held with the residents it was evident that individuals have the opportunity to exercise choice, meal times are flexible and people can choose how they wish to fulfil their day. The residents can attend the day care facility on the ground floor of the home to participate in structural activities, the majority however prefer to stay in the residential part of the home. Each residents interests are recorded in their care plans. The residents stated that their visitors are always made welcome when visiting the home and offered refreshments, this fact was observed during the inspection. Discussions held with the residents on the day of the inspection confirmed that they are were happy with the choice of meals that are provided and that drinks are readily available at all times. Lady Forester Res. & Day Care Version 1.10 Page 11 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 The home has an effective complaints system which was evidenced by comments made by residents that they felt that their views are listened to and acted upon. EVIDENCE: No complaints had been received by the home concerning the service they offer or by the CSCI since the last inspection. Residents are aware of the complaints procedure, comments received by the inspector were complimentary of the home and the service it offers. None of the residents currently access advocacy services as their families act for them and they are registered to vote with the local council. Lady Forester Res. & Day Care Version 1.10 Page 12 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 standard of the environment in the home is good providing the residents with an attractive and homely place to live in. Proposed developments will further enhance the facilities that will become available to the residents ie: A Purpose Built Day Centre. EVIDENCE: It was established through inspection of the lounges, dining areas, kitchen, bathroom and bedrooms that the service users live in a homely, comfortable and safe environment which is tastefully decorated. The atmosphere in the home was very welcoming. The bedrooms of the residents are personalised with many family photographs and momento,s. In addition to the lounge/dining area on the ground floor, residents also have provision of a small lounge on the first floor and may also access day services during the week. The home has an assisted Parker Type bath on the ground floor and walk in shower on the first. Toilets are provided in close proximity of the lounge and dining areas in the home. Lady Forester Res. & Day Care Version 1.10 Page 13 In the summer of 2005 an extension of five extra beds with en-suite facilities is to be provided and a purpose built Day Centre. Lady Forester Res. & Day Care Version 1.10 Page 14 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) 27-30 Staff morale in the home is high resulting in an enthusiastic work force that work positively with the residents to improve their quality of life. The home is very committed in training their staff to provide a quality service. EVIDENCE: The home is registered for seven people, the staff on duty stated that there are always two members of staff on duty, this fact was substantiated by the off duty perused. The present staffing levels met the assessed needs of the present residents living in the home. It was reported to the inspector that presently 12 staff have completed their NVQ Level 2 in care, and 5 staff have achieved Level3. No new staff have been employed since the last inspection files examined at that time contained all the elements that are required in the care regulations ie: a photograph, 2 references, CRB Check and the training undertaken. Since the last inspection basic training in Fire Prevention and Manual Handling has been updated and with future developments in the home basic training in the understanding of mental illness is to be undertaken. Lady Forester Res. & Day Care Version 1.10 Page 15 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) 31-33, and 35 The home regularly reviews aspects of its performance through self review and consultation with the residents , staff, and relatives. The Manager is well supported by the Trustees in providing clear leadership throughout the home and the staff demonstrating an understanding and awareness of their responsibilities. EVIDENCE: The Registered Manager holds the relevant qualifications for running the home, she is also responsible for the Day Centre and Domiciliary Care. There is a management structure and accountability process in the home, regular Regulation 26 visits as part of the care management of the home by the Trustees are regularly forwarded to the inspectorate. Through discussions held and observations it was evident that staff are well motivated and committed to their work. The residents or their families have control of their own financial affairs. Lady Forester Res. & Day Care Version 1.10 Page 16 Lockable storage is available to the residents for privacy and the residents room has a suited lock. Risk assessments are undertaken of each resident as to whether or not they are capable of holding their own key. Staff reported that they had received all their mandatory training and a first aider is always on duty. Health and Safety Records were in correct order at the last inspection. Lady Forester Res. & Day Care Version 1.10 Page 17 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 4 4 4 3 4 4 3 4 STAFFING Standard No Score 27 3 28 4 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 3 3 3 3 4 N/A 3 N/A N/A N/A Lady Forester Res. & Day Care Version 1.10 Page 18 None 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. Standard Regulation Requirement None Made 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. 1. Refer to Standard None Made Good Practice Recommendations Lady Forester Res. & Day Care Version 1.10 Page 19 Commission for Social Care Inspection 1st Floor, Chapter House South Abbey Lawn, Abbey Foregate Shrewsbury SY2 5DE 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. 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