Inspection on 06/03/07 for The Forbury

This inspection was carried out on 6th March 2007.

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.

Other inspections for this house

The Forbury 13/01/06

The Forbury 11/07/05

The Forbury 14/02/05

The Forbury 07/09/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Forbury The Church Street Leominster Herefordshire HR6 8NQ Lead Inspector Lorraine Briggs / Pat Scott DRAFT Unannounced Inspection 8th February 2007 10:00 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 Forbury The DS0000024735.V328047.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 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. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Forbury The Address Church Street Leominster Herefordshire HR6 8NQ 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) 01568 613877 01568 612089 Mr Christopher Anthony Lutton Mrs June Bakewell Care Home 28 Category(ies) of Dementia - over 65 years of age (28), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (28), Old age, not falling within any other category (28), Physical disability over 65 years of age (28) Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13/01/2006 Brief Description of the Service: The Forbury provides a service to older people who have care needs arising simply due to their age or because they have particular needs due to physical disabilities, a dementia illness or other mental health difficulties. The building is a large Grade 1 listed Georgian house in the market town of Leominster. It is situated in a quiet street within walking distance of the town centre and the local church and park. An extensive refurbishment project has been underway for 3 years resulting in more single rooms, ensuite facilities and communal space. The kitchen has been upgraded and a salon quality hairdressing room is nearing completion. Fess range from £350 to £395 per week. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider, staff records kept in the home, medication records, discussion with people who use the service, discussions with the staff team, discussion with the manager, tour of the premises, previous inspection reports, quality assurance process, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. What the service does well: The home provides well maintained accommodation that is in the centre of Leominster. Service users spoken with identified the activities and food provided at the home are very good. There is a strong staff team, some of whom have worked at the home for many years. Comments received from service users included: ‘The forbury is a family home. All staff are friendly, helpful and have compassion towards the service users. I would recommend it to anyone needing looking after. They are the best and the food is excellent.’ Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 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 Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. Service users have their needs assessed so that they can be assured that the service will try and provide the necessary care. This judgement has been made using available evidence including a visit to this service. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 9 EVIDENCE: Significant time and effort is spent making admissions to the home personal and well managed. There is a high value on responding to individual needs for information, reassurance and support. The service considers carefully the needs assessment for each prospective service user before agreeing admission to the home. Examples of assessments were within care plans viewed. The manager ensures that a summary of any assessment undertaken through the care management arrangements is obtained and insists on receiving a copy of the care plan. Prospective service users and their family, always have the opportunity to visit and spend time in the home prior to agreeing admission. A service user survey returned commented that: “ when I came to view the home, the staff were very welcoming and answered any questions that I had”. Staff are prepared to visit the prospective service user and their family to get to know them and answer questions. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. The health and personal care, which a service user receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 11 EVIDENCE: From discussions with the manager, the service believes in the service users’ right to be involved in the planning of care as it affects their lifestyle and quality of life. Each service user has an initial plan that has been agreed with them and where appropriate signed by them or their immediate family. This is written in plain language, is easy to understand and considers all areas of the individual’s life including health, personal and social care needs. The plan also includes a risk assessment element. Services users admitted for Dementia care have a specific risk assessment in place. Training programmes provide staff with the skills and ability to support and encourage service users to be involved in the ongoing development of their plan. Key workers are appointed who build up special relationships with service users and work on a one to one basis. they are also involved in the recording of the reviews. This aspect of the service has improved. The home ensures that each service users plan is reviewed regularly and involves the service user and where agreed their family. The plan is updated and the necessary action taken to respond to any changes. Service users have right of access to health and remedial services and the home’s policies, procedures and practice guidance strongly support this. The health care needs of those service users too frail to leave the home are managed by visits from local health care services. Service users’ personal aids are well maintained and the home provides the necessary aids and equipment to support both staff and service users in daily living. Service users have individual health care plans that give a comprehensive overview of their general health and acts as an indicator to changing health needs. Medication for service users has recently been reviewed and training provided for staff. Storage facilities are within the service user communal space in the new extension. However, storage is discreetly provided and does not detract unduly from the homely surroundings. The aims and objectives of the home reinforce the importance of treating service users with respect and dignity and these values were seen and heard. Particular attention is given to ensuring privacy and dignity when delivering personal care. Doors were closed after entering bedrooms. Induction training covers privacy and dignity. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. Service users are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet service user’s expectations. Service users receive a healthy, varied diet according to their assessed requirement and choice. This judgement has been made using available evidence including a visit to this service. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 13 EVIDENCE: Rotas showed that sufficient staff resources are provided to allow time for activities and stimulation. The home operates a key worker system, which enables closer service user/family staff relationships where likes, dislikes and needs are shared. The home has developed a system for displaying information and bringing attention to community events and activities. Service users stated in their surveys that family and friends are made welcome and know they can visit the home at any time. Staff were seen to make time to talk to service users. The design of the home provides seating areas within the communal areas of the home where service users can entertain their visitors, in addition to the privacy of their own room. Staff support those service users who need help in financial matters, they work to a clear company policies that protects the service user from financial abuse and clearly directs staff in their practice. The home is able to offer service users information and telephone numbers for contacting independent people who will act as advocates on the service users’ behalf where the service user prefers the help of an independent person. Service users have the choice to bring a limited amount of small goods with them on admission to the home and were seen to keep personal items which are important to them in their own room. Experienced cooks are responsible for providing quality nutritional meals that meet the dietary needs of the service users. The manager and staff are in the process of improving this aspect of the service. The information in the home states that breakfast is on demand. This was observed during the fieldwork visit to the home as service users were seen sitting having their breakfast as and when they had got up for the day. Tables were set attractively for breakfast with the necessary cutlery and aids to help individuals during their meal. Regular drinks are available and staff were seen to make a cup of tea at any time when asked. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. Service users have access to a robust, effective complaints procedure, are protected from abuse and have their legal rights protected. This judgement has been made using available evidence including a visit to this service. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 15 EVIDENCE: The service has a complaints procedure that is up to date, clearly written, and is easy to understand. A copy is given to each service user. Service users, when asked, were clear that they could speak to staff about any concerns they may have. The policies and procedures regarding protection of service users are in place. Training of staff in the area of protection is regularly arranged by the home. Service users surveys stated that they are very satisfied with the service provision, feel very safe and well supported by staff. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The physical design and layout of the home has improved to enable service users to live in a safe, well-maintained and comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 17 EVIDENCE: The home has a well-maintained environment, which provides aids and equipment to meet the care needs of the service users. They have the choice to bring personal items of furniture into the home as was seen in those rooms entered. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in privacy or in their own rooms. The home is well lit, clean and tidy and smells fresh. The service conducts its own reviews of the premises and intends to record any action taken to remedy defects. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of service users. This judgement has been made using available evidence including a visit to this service. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 19 EVIDENCE: Services users surveys commented that staff looked after them well and were very kind. Management encourage staff members to undertake qualifications, and recognise the benefits of a skilled, trained workforce. The service ensures that all staff within its organisation receive relevant training that is focussed on improving outcomes for service users. The service uses external providers to deliver this training if they have not got the appropriate skills within the organisation. Induction booklets for new members of staff were seen. The service has a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice as seen from the recruitment records of a new staff member. All was in place except the photograph and the criminal record bureau checks/work permits. The manager reported that the owner had these with him. NVQ training is high priority with over 50 of care staff having level 2. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by the provider. This judgement has been made using available evidence including a visit to this service. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 21 EVIDENCE: The home has policies and procedures, which the manager effectively reviews and updates, in line with current thinking and practice. Systems are in place to monitor staff adherence to policies and procedures during their practice.. Management processes ensure that staff receive feedback on their successes and failures through supervision and examples of this were seen recorded. The provider has a good record of meeting relevant health and safety requirements and legislation and conducts its own audit to ensure compliance with policies. Records are of a good standard and are routinely completed. Fire records were sampled and were in order. Business planning provides a quality assurance and monitoring process through service users satisfaction questionnaires and service user meetings. The home has all the necessary insurance cover in place to enable it to fulfil any loss or legal liabilities. If they wish and are able to, service users are helped to take responsibility for managing their own money. Where the home is responsible for service user’s money it works to a very rigorous system. It maintains very clear records that are routinely kept up to date and can be used to track individual service users finances. Money for one service user is kept at the moment whose records are regularly audited by management. Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 22 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 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement 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. Refer to Standard Good Practice Recommendations Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Forbury The DS0000024735.V328047.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!