Inspection on 23/02/06 for Low Furlong

This inspection was carried out on 23rd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

Low Furlong 20/03/07

Low Furlong 21/06/05

Low Furlong 16/02/05

Low Furlong 17/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Low Furlong Darlingscote Road Shipston on Stour Warwickshire CV36 4DY Lead Inspector Patricia Flanaghan Unannounced Inspection 23rd February 2006 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Low Furlong Address Darlingscote Road Shipston on Stour Warwickshire CV36 4DY 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) 01608 662005 01608 664090 Warwickshire County Council, Social Services Department Ruth Carter Care Home 35 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (35) of places Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of residents accommodated will be 35 to include up to 11 service users assessed as requiring dementia care. The entrance and exit doors to the dementia unit must have a discreet alarm system fitted so that staff are aware when service users leave the unit. (1st January 2006) Service users assessed as requiring dementia care to be admitted only to the dedicated unit identified as `Stanbury` The garden to be used for service users admitted to the dementia unit should be made safely accessible and stimulating for service users with dementia. (31st July 2006) 21st June 2005 3. 4. Date of last inspection Brief Description of the Service: Low Furlong is a home for thirty-five older people, owned and managed by Warwickshire County Council. It is about half a mile from Shipston town centre, where all community and health facilities offered in the town are sited. There is no bus service up to the home from the town centre. There is parking to the front and side of the building. Low Furlong was refurbished in 1996. The home provides long stay care, short stay and day care. All thirty-five bedrooms have en-suite facilities. One unit on the ground floor now provides care for eleven older people with either a dementia or other cognitive illness. Within this area there are two lounges, one of which has a dining area and a conservatory. The other unit on the ground floor provides two long stay bedrooms, while the rest are used for short stays or respite care. All the first floor accommodation is for long stay residents. There are two units, each with a lounge/diner. The home has a shaft lift. Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection, the second visit of this inspection year, took place between 12 noon and 4.30pm. The registered manager was not available at this inspection as she was on sick leave. The deputy manager was available throughout the duration of the inspection. A manager from another local authority home provides management support to the home. During the inspection records were examined in relation to care provision for the residents, staff records and those concerning health & safety and management of equipment in the home. A tour of the building was carried out. Eight residents, two visitors and three staff members were spoken with. A service questionnaire was completed by the home and returned to the Commission for Social Care Inspection (CSCI) prior to this inspection. The manager was asked to distribute other questionnaires regarding the service to residents, relatives and health care professionals. The completion of these is voluntary but proves useful in assessing the various views that are held. Five responses from residents and sixteen responses from visitors/relatives had been received by the CSCI at the time of writing this report. The responses were mostly positive. Comments from residents include • “I love it here and feel extremely well cared for.” Comments from relatives include • “…my relative couldn’t be in a better place” • “A very friendly home and staff” • “If I mention anything it is always done” • “I knew from the moment I walked into the home I would have peace of mind” • “Staff are wonderful. They are kind, caring and humorous” • “If I can’t have my relative at home there is nowhere I would rather her be” • “I cannot speak highly enough of the all round care my relative receives” • “I would like to see more care taken with laundry arrangements, too many items missing” • The building is in need of refurbishment and rooms look a little tatty, but otherwise no complaints” A visitor also told the inspector “the kindness of the staff is outstanding”. Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 Page 6 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. Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected at this visit. Standards 3 and 5 were reviewed at the inspection of 21/06/05 and assessed as met. EVIDENCE: Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Medicines are generally safely managed within the home. The inspection showed that some more attention to detail is needed to demonstrate that all the medicines are administered as prescribed. EVIDENCE: Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 Page 10 The home operates a monitored dosage system (MDS) for drugs. Each resident has their own medication stored within their bedroom in a separate locked drawer to which staff members administering the medication have access. Appropriate procedures are in place for storage of the keys. A small sample of medication administration record (MAR) sheets were seen. A number of gaps, where a signature to confirm administration or an abbreviation for non-administration should have been, were observed. It also appeared that staff members were signing some of the MAR charts before the administration process had taken place, as the medication was still in the box. The signing of the MAR charts is a confirmation that the medication has been taken properly and therefore must be signed after the administration process has been completed. Controlled drugs were stored appropriately. An examination of medication and records were found to be accurate. The deputy manager advised that the present system of medication administration is under review. Staff administering medication undertake an ASET distance learning course with a local college, The Safe Handling of Medication, as well as a Boots the Chemist short course. Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected at this visit. Standards 12, 13, 14 and 15 were reviewed at the inspection of 21/06/05 and assessed as met. EVIDENCE: Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 Page 12 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 and 18 Systems for the management of complaints are satisfactory. Residents can be confident that their concerns are listened to, taken seriously and acted upon. There is a clear Adult Protection policy in place, to make staff aware of their responsibilities to provide a proper response to any suspicion or allegation of abuse. EVIDENCE: A complaints procedure is available and accessible to residents, staff and visitors in the home. A relative spoken with advised that they would speak to the manager or a member of staff if they had any concerns. The Commission for Social Care Inspection have not received any complaints since the last inspection no recent complaints have been received by the home. Written details of complaints received are maintained with details of any investigation carried out and action taken to address the findings. No incidents of neglect or abuse of any kind has been reported. The policy documentation seen, and a discussion with staff confirmed that residents are protected from all forms of abuse. Documentation seen and discussions with staff evidenced vulnerable adult protection had been discussed at length during staff induction, training and on-going supervision. Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 Page 13 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 and 26 The home is clean and comfortable. Generally the premises are maintained to a satisfactory standard resulting in a suitable living environment for residents. EVIDENCE: The home remains in need of maintenance. Areas such as dining rooms, lounges, corridors and bedrooms all require re-decoration. Doors and skirting boards were also marked and scuffed. A comment was received from one resident’s relative stating that “the building is in need of refurbishment and rooms look a little tatty.” The home has ample laundry facilities. There is one large laundry on the ground floor with smaller laundry rooms in three units. All washing machines have the specified programming ability to meet disinfection standards. COSHH information is kept in the small offices within each unit. Individual laundry is washed on each unit by the care staff. A sluice is also provided. The main laundry in the Stanbury Unit was noted to be cluttered and untidy with 2 carpet cleaners and numerous metal bed rails being stored here. Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 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 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): 29, 29 and 30 The recruitment procedure ensures that suitable people are employed to safely provide care for the residents. A strong commitment to training ensures staff have the knowledge and skills to undertake their duties. EVIDENCE: The home had a strong recruitment procedure and the records indicated that it was implemented. The files of newly appointed staff were seen at the inspection. The files were in very good order and contained the required documentation, including two written references. Criminal Records Bureau checks and POVA checks are maintained at Central Office. The home receives written verification from their Human Resources department that satisfactory checks have been obtained and this documentation is retained on individual staff files. There is a staff training plan in place and all new staff receive induction training. As well as the mandatory health and safety training, staff take part in other appropriate training, including Dementia Care, Adult Protection, Recording Skills, Blood Borne Virus, Safe Handling of Medication, Bereavement and Loss and Infection Control. Training records provided by the home indicate that 14 staff have an NVQ Level 2 or Level 3 in Care. NVQ training remains ongoing for staff. Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 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 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): 33, 35 and 38 Systems are in place to monitor the quality of the service provided and identify areas in need of improvement. Residents financial interests are safeguarded. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The registered manager is on sick leave and a manager from another local authority home is currently providing support to the deputy manager. This standard could therefore not be assessed. A formal quality system was evidenced. The annual quality assurance survey has recently been completed and the home are awaiting the results. The Local Authority have addressed the need for the registered provider or delegated person to visit the home monthly and write a report, which is also forwarded to the CSCI, on the conduct of the care home. A large number of ‘thank you’ letters and cards were also seen during the inspection. Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 Page 16 One visitor commented that “the kindness of the staff is outstanding.” Monies held at the home on behalf of residents are handled in line with the homes policy of handling resident’s money, ensuring their financial interests are safeguarded. Monies on behalf of residents are held in a central residents bank account by the home. Cash is pooled together in one amount at the home, therefore residents individual cash balances could not be checked. A separate record is maintained for each resident which details their individual balance. The total amount tallied with what had been recorded on the central account. Secure facilities are provided for the safe keeping of monies. Evidence was seen to confirm that staff receive regular training in moving and handling, fire safety, first aid, food hygiene and infection control. Fire alarm tests, emergency lighting tests and fire drills have been carried out at the required intervals. Certificates were seen during the inspection for the maintenance and service of major systems. No health and safety hazards were observed at this inspection. Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 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. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Yes Version 5.1 Page 18 Are there any outstanding requirements from the last Low Furlong DS0000036324.V285053.R01.S.doc 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 OP9 Regulation 13(2) Requirement Staff must refer to the Medicines Administration Record (MAR) chart before the administration of medicines and directly sign following the transaction or record the reasons for nonadministration. The MAR chart must accurately reflect what has been administered within the home. The registered provider must ensure that the home is kept in good decorative repair. (Original timescale of 30/09/05 part met.) The manager must ensure that the laundry area is kept clean and tidy and is suitably organised Timescale for action 31/03/06 2 OP19 23 31/05/06 3 OP26 23(2) 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Low Furlong DS0000036324.V285053.R01.S.doc Version 5.1 Page 19 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. 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