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Inspection on 06/12/05 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 6th December 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 Trust Management Team is very supportive to both residents and staff and training is a high priority on their 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. The residents 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 very comfortable providing the residents with an attractive and homely place to live. Proposed developments for the future 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?

Since the last inspection internal work has been completed in the home to provide four extra rooms, three with en-suite facilities. The work was undertaken without due invasion on the present residents privacy and home life. The home continues to offer a good standard of care to the residents.

What the care home could do better:

No requirements 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 Residential & Day Care Centre Church Street Broseley Shropshire TF12 5BQ Lead Inspector Mike Highfield and Karen Powell Announced Inspection 6th December 2005 09:30 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 Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 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. Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 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 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) 01952 884539 01952 884552 Mr Roy Lane Ms Cecilia Joan Walden Care Home 7 Category(ies) of Old age, not falling within any other category registration, with number (7) of places Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th April 2005 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 an eighth room awaits registration. Six rooms are provided for permanent service users and two beds are provided for respite purposes. At the time of the inspection there were eight service users in residence. The home is situated on the outskirts of Broseley, Shropshire and set in well 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 Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of six hours it was announced 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 alterations that had been made in the internal structure of the home and the implications on additional staff recruitment and training. A further visit is scheduled for January 2006 by the Commission to formally register the “new” accommodation when building snagging work has been completed, certification by the Fire Safety Authority and furnishings are in place. What the service 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 Trust Management Team is very supportive to both residents and staff and training is a high priority on their 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. The residents 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 very comfortable providing the residents with an attractive and homely place to live. Proposed developments for the future will further enhance the facilities that will become available to the residents ie: A Purpose Built Day Centre. Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 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. Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 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 Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 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): 1 to 6. The Homes Statement of how they operate and the Residents Guide provides present and prospective users with detailed information from which they would be able to make a decision on whether or not they wish to become a resident in the home. EVIDENCE: The manager has produced a 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, which 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. 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. Through discussion with service uses it became apparent that some individuals attended the day care service at Lady Forrester Care Centre prior to moving in Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 Page 9 to the home. Therefore they already have some knowledge of the care home. This link can still be maintained when an individual has made the decision to move in to the home and was seen on the day of the inspection visit. One service user and their family told the inspector that they had spent two weeks respite in the home before making a decision about moving in on a permanent basis. Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 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 the following standard(s): 7 to 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. All service users have a plan of care in place, which were made available for the inspector to see. Three care plans were examined in close detail. Two were of individuals who had moved in to the home within the last twelve months and one was of a respite service user. All care plans were well organised and reviewed on a monthly basis. Evidence of service user involvement in the care planning process was seen on each care plan. Care plans selected for examination were all generated from assessments carried out by the homes manager or social worker responsible for arranging the placement. It was evident through examination of daily care records, discussion with the care team and service users that individual’s needs are being met. However, Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 Page 11 detail regarding the individual’s personal care needs and how these should be met lacked in specific detail. Records relating to GP, District Nurse and Chiropody visits were well recorded along with daily care records. 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 evident through discussion with service users, relatives and interviews with staff that service users are treated with great respect. Service users were complimentary with regard to the attitudes of staff and the way that intimate personal care is carried out. Privacy is maintained at all times in relation to service users being able to see relatives in their own rooms (witnessed on the inspection visit) and treatment by health care professionals being carried out in their own rooms. Service users told the inspector that their personal mail is always delivered to them unopened. All service users have a telephone point in their rooms, some service users have chosen to have a telephone installed. An additional cost for calls is paid to the home on a monthly basis. Staff were observed to treat service users in a respectful manner. Service users stated they were addressed in a way that they are happy with. Staff were seen to knock on service users bedroom doors before entering during the inspection visit. Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 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 the following standard(s): 12 to 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 local community which enriches the residents 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. All service users spoken to confirmed that they are free to come and go within the home as they wish. It was clear through discussion with service users and Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 Page 13 family that service users are treated as individuals and enabled to do what they wish to. One service user was happy to share with the inspector that they like to make their own bed and dust in their room. Another, that they chose the colour of their room and their bed linen. Two service users were using the day centre facilities during the inspection. Two other service users told the inspector that they have made a friendship together and spend a large majority of the day together. What was evident through discussion with service users is that individual choices made by service users are respected by staff. Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 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 the following standard(s): 16 to 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 inspectors 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 Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 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 the following standard(s): 19 to 26. The standard of the environment in the home is good providing the residents with an attractive and homely place to live in. Proposed future developments on site 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 may also access the day services unit during the week. Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 Page 16 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. Following registration in the new year the home will have three “new” single rooms on the ground floor with en-suite facilities. Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 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 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 to 30. Staff morale in the home is good 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 eight 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 inspectors that of the present 12 care staff employed, 9 have completed their NVQ Level 2 /3 in care. No new staff have been employed since the last inspection, staff files examined on this occasion contained all the elements that are required in the care regulations ie: a photograph, 2 references, CRB Check and the training undertaken together with staff supervision notes. Since the last inspection basic training in Fire Prevention and Manual Handling has been updated and basic training in the understanding of mental illness has been provided for the care staff. It was established through discussion with staff at the time of the inspection that they have not had any Parkinson’s Disease training and they do have a resident with Parkinsonism. Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 Page 18 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 to 38. The home regularly reviews aspects of its performance through regular visits by a member of the Trustees who consults with the residents , staff, and relatives. The Manager is well supported by the Trustees in providing clear leadership throughout the home. All the required policies and procedures for safe operation of the home are in place and are regularly reviewed. EVIDENCE: The Registered Manager holds the relevant qualifications for running the home, she is also responsible for the Day Centre 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 and are regularly forwarded to the inspectorate. Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 Page 19 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 financial affairs. 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 inspection. Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 Page 20 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 Standard No Score 16 3 17 3 18 3 4 4 4 3 4 4 3 4 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 3 3 3 3 3 Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? None 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 OP7 Regulation 15 Requirement Timescale for action 31/01/06 2. OP30 19 The home must ensure that care plans are sufficiently comprehensive ie: include personal care requirements. The Training Programme must 31/03/06 be developed to include Specialist Training for the type of resident in residence in the home ie: Training in the Management of Parkinson’s Disease. 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 Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Shrewsbury Local Office 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. Extracts may not be used or reproduced without the express permission of CSCI Lady Forester Residential & Day Care Centre DS0000020681.V257904.R01.S.doc Version 5.0 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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