Inspection on 10/10/06 for The Fountains Care Centre

This inspection was carried out on 10th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 Fountains Care Centre 07/02/06

The Fountains Care Centre 23/05/05

The Fountains Care Centre 02/03/05

Similar services:

Innova House Care Home

Portland College

Byars Care Home

Byars Care Home

St Marys Nursing Home

St Marys Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Fountains Care Centre Church Lane Tetney Lincs DN36 5JX Lead Inspector Mr Doug Tunmore Unannounced Inspection 10th October 2006 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 The Fountains Care Centre DS0000062766.V315420.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. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Fountains Care Centre Address Church Lane Tetney Lincs DN36 5JX 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) 01472 210456 01472 816456 fountainscare@aol.com Halcyon Care Limited Mrs Paula Teal Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (42), Physical disability (6) of places The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for one person in the Category PD as named in the Notice of Proposal to Register dated 20 October 2004. This is not included in the 5 PD beds 8 February 2006 Date of last inspection Brief Description of the Service: The Fountains Care Home is registered with the Commission for Social Care Inspection to provide nursing care and personal care to people over the age of 65 years and an individual with physical disabilities. The property is located in the village of Tetney in North East Lincolnshire, lying between Louth and Grimsby. It is a large detached building, standing in its own grounds and gardens. Car parking is to the side of the house. Accommodation is provided in mainly single rooms on the ground and first floor. Although there are two double rooms, these are kept for married couples or service users who specifically wish to share. There is a passenger lift to access the first floor. he homes brochure states that we are dedicated to providing you with the best care along with courteous, understanding and friendly attention to enable you to enjoy a high quality of life. The current scale of charges at this home is from £329.00 to £560.00. The homes registered manager is Mrs Paula Teal. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took into account any previous information held by The Commission for Social Care Inspection (commission) including the homes previous inspection reports, their service history, the homes pre-inspection questionnaire and residents questionnaires sent to the home by the Commission prior to this inspection. The site inspection consisted of case tracking a sample of two residents records and assessing their care, discussion with them, the care staff and observation of care practices. The inspector spoke with three residents in the privacy of their rooms two of, whom were residents who were being case tracked and joined three other residents for lunch. The inspector also spent time with the manager, the administrator and two members of staff. Two visitors were also spoken to. A partial tour of the home and a review of a sample of the records were also included. What the service does well: What has improved since the last inspection? The manager stated that requirements made at the last inspection relating to; all staff needing to receive training in safeguarding vulnerable adults, keeping records concerning the progress of residents and the care they receive and residents admitted to the home out of category, have been addressed. The manager also said that a record all the food provided is kept, which provides a clear record of the dietary intake of each resident to ensure that their nutritional needs are being met. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 6 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 Fountains Care Centre DS0000062766.V315420.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 The Fountains Care Centre DS0000062766.V315420.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 & 6 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Residents will be assessed regarding their care needs by the provider or by health care professionals charged with this task. EVIDENCE: A review of all information available prior to this inspection, including a previous inspection report dated 08/02/06 and evidence seen at this inspection in residents files and care plans, showed that the home does not admit residents without a care needs assessment being undertaken. Prospective residents are also written to by the home confirming whether they can meet the residents care needs or not. Residents can have a trial visit lasting up to 4 weeks to see whether or not they like the home. Intermediate care is not provided in this home. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 9 The manager stated that residents are not admitted outside the homes categories of registration and that the homes registration certificate reflects those residents admitted to this home. The commission sent resident questionnaire forms (Have Your Say About…) to the home prior to this inspection and twelve were returned. Relatives of residents completed the majority of questionnaires. All questionnaires except one confirmed that residents had information about the home prior to admission and the same number also agreed that they had received a contract. Written comments made in questionnaires were; ‘the matron showed my daughter around the home and talked about the home’. ‘A nursing sister came from the home and visited me in hospital’. A sample of a contract and terms of conditions of a residents stay was sent to the commission of one resident being case tracked and one other resident who was also being case tracked had a contract and terms of condition of her stay. The Fountains Care Centre DS0000062766.V315420.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Care plans are in place and provide information to enable residents to develop their lifestyles as they may wish. The providers do not ensure that residents are empowered by holding annual reviews and seeking residents views about their care package. EVIDENCE: Information provided by the manager prior to this inspection showed that residents had detailed care plans, which described their health and welfare needs. Care records included admission details, assessments of daily living activities, personal history and moving handling assessments, risk assessments, care plans and daily reports’. However, those files of residents who were being case tracked were found not to have empowered residents in respect to ensuring that annual reviews are The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 11 held in which they and their representatives if appropriate attend and discuss the package of care available. Care plans were seen to have been updated regularly and had been signed by residents or their families acting on their behalf. Individual care plans evidenced that accidents are recorded in the homes’ accident book and in the residents daily notes. Accidents resulting in bruises or abrasions are not recorded on the residents body map, which could be used for the mapping of any cuts or abrasions over a period of time. This inspection showed that GPs, community nurses and chiropodists visit the home on a regular basis to attend to the health care needs of residents. The questionnaires returned by residents showed that ten felt that they always receive the medical support that they need and two felt that they usually received the medical support that they need. One relative wrote that ‘my mother is well care for in her medical needs. Impressed by staff and that there is a weekly visit of a GP’. Four residents commented that they felt that staff were always available when they need them and seven felt that staff are usually available when they need them. One resident stated staffs are sometimes available when needed. Written comments made by relatives were, ‘staff are not always available, we have found that they do not look in on patients on a regular basis’. Another wrote ‘staff try their hardest, sometimes slight delays due to staff shortages. I believe current shortages are being addressed’. Two visitors seen on the day of the inspection stated that they are regular visitors and felt that their relatives needs were met at this home. One stated that her mother has been admitted to hospital and that the hospital staff commented that ‘she has been so well cared for by the home she will recover and praised the home for getting an ambulance on time’. There was no record available to show when the pharmacist last inspected the administration of medication at this home. Residents medication sheets were seen and it was found that; appropriate records are kept. The provider should arrange with the surgery for regular pharmacists inspections to ensure that the administration of medication is undertaken. The homes pre-inspection questionnaire evidenced that all nurses on the 18/05/06 had undertaken medication management training. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 12 All those residents seen stated that they are treated with respect at this home by the carers; comments made were that ‘The staff are very kind, if I press my buzzer they come very quickly’. ‘Can’t grumble, treat them (staff) with respect they treat us with respect’. One written comment was that ‘my mother lost her dentures and hearing aid, staff are friendly and treat my mother with respect. Management have communicated intentions to sort problems’. The manager was made aware of the response made in questionnaires at the time of the inspection. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 13 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): 12,13,14 &15 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a variety of activities and are enabled to exercise choice and control over their lives and receive a wholesome, appealing, balanced diet. EVIDENCE: A previous inspection dated 23/05/05 found that the home has an activities programme. The provider’s pre-inspection questionnaire evidenced that activities take place in the home and outings are also undertaken. A previous inspection dated 23/05/05 found that the home has an activities coordinator, who provides a variety of activities for residents; sing-alongs, carpet bowls, outings to the Winter Gardens. Clergy visit the home and offer services to those who wish to attend. The activities programme is depicted in pictorial form on the notice board, to ensure that all residents are kept informed. Five residents questionnaire showed that there are activities and they are available to them always, six residents commented that activities are usually available, with one stating that activities and sometimes available. Written The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 14 comments were that ‘there is a very good activities programme’. ‘I do not like communal entertainment’. Residents seen stated that ‘there are all sorts of activities ‘, and ‘quite a few things something every day, you can take part pr not as you wish’. The inspector joined three residents for lunch and was informed that the food is always fresh and choices are available. Care staff were seen to be supporting residents to eat during lunch. They were sensitive to the residents needs and coaxed them to eat as much as they required. Two residents commented that ‘nothing better for food, company and freedom to express your opinion’. Care plans seen did not evidence residents likes and dislikes relating to their preferences to their daily diet. Residents questionnaires showed that five always liked the meals and six usually liked the meals provided, with one sometimes enjoying the meals. One relative wrote that ‘ my father has now been in the Fountains for a year and during that time he appears to have flourished and is happy’. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 15 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): 16,18 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home provides training for staff in maintaining a safe environment free from abuse of residents. EVIDENCE: Previous inspections of this home have shown that a detailed complaints procedure is in place. The homes complaints pre-inspection questionnaire recorded that that one complaint had been made since the last inspection, which was substantiated. Resident’s questionnaires showed that ten residents were aware of how to make a complaint and nine knew who to speak to if they were unhappy. Written comments made were that, ‘nursing staff are always willing to listen to me’. ‘Any concerns have been handled in a prompt manner’. Residents commented that they feel safe and that ‘there is always somebody there’. Those residents seen at lunch expressed no concerns about the provider and felt they could discuss any concerns with staff or the manager. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 16 One member of staff demonstrated that she was aware of the action to take if she became aware of a safeguarding vulnerable adults issue. The homes pre-inspection questionnaire showed that the home has had one safeguarding adults investigation and the provider and the Social Services Department took appropriate action. The homes training profile shows that safeguarding vulnerable adults training has been undertaken by all care workers in March, April and May 06. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 17 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): 19,26 The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well maintained and is clean and tidy, with a pleasant smell throughout. EVIDENCE: A previous inspection undertaken on the 08/02/06 found the premises to be clean and tidy with no adverse odours noted. Pathways outside the home and corridors inside were clear of potential hazards and there was room for residents to move freely. Equipment such as hoists and wheelchairs were stored in a safe manner. Hazard signs were on display for wet floors. Fire safety equipment was in place. This inspection found that the home was clean and well-aired and no unpleasant odours evident. Gloves and aprons are available and the home has an infection control policy. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 18 Residents who gave permission for their rooms to be viewed were satisfied with the décor and cleanliness. The home employs separate staff for domestic and laundry services. The residents survey overwhelming confirmed that the home always smells nice and is clean and tidy. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 19 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): 27,28,29 & 30 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home maintains appropriate staffing levels and has a robust recruitment and training practices. EVIDENCE: Previous inspections and information received prior to this inspection show that this establishment undertakes robust recruitment procedures to help ensure the safety of those people who live in this home. The manager stated that she had given The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults, to all carers as part of their induction training. The home pre-inspection questionnaire evidenced five care workers had obtained a national qualification in caring for older people and six staff were currently undertaking this training in caring for older people. When these six workers complete their training the home will meet the ratio of 50 of care staff with a vocational care training qualification. The homes training profile and pre-inspection questionnaire evidenced that mandatory training is undertaking by staff in this home. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 20 The homes duty rota was seen and it was found to be an accurate record and showed that adequate staffing levels are maintained to meet the needs of residents. There is one night nurse and three waking carers. Resident’s questionnaires also showed that six felt that they received the support that they need and five said that they usually receive the support that they need, with one stating that she sometimes receives the support she needs. Questionnaires received also made comment that there are staffing shortages within the home but the provider has evidenced through information supplied in the homes pre-inspection questionnaire and the homes rota that there are adequate staffing levels in the home. A senior nurse stated that the home has recently increased its staffing level so that there are two nurses and five care workers in the morning, with one nurse and five carers in the afternoon. This she said was an increase in one carer in the afternoon. During the day of the inspection staff were observed carrying out their duties in a sensitive and caring manner. One visitor stated that ‘there always seems to be enough staff on duty’. One resident commented that ‘when I need attention I get it but sometimes they can’t come when you ask for it’. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 21 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): 31,33, 35, & 38 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in a manner that promotes residents health and safety needs. Records are well maintained with policies and procedures regularly updated. EVIDENCE: The registered manager is qualified and experienced in running this home for older people. She has a degree in Health and Care Management and is a qualified nurse. Residents and care staff alike made positive comments about the way in which the manager runs this home, finding her approachable, supportive and able to keep confidential information to herself. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 22 The home conducts an in house quality assurance (QA) report. The quality assurance report has not been completed as questionnaires have only started to be returned. These questionnaires were seen and showed that comments were positive in respect to the care provided to residents. The home undertakes residents meetings with the minutes of the last meeting held on the 02/02/06, evidencing that residents have a voice and feel free to express opinions. However, the manager should consider holding regular meetings to ensure that any issues are raised and addressed appropriately. A sample of residents financial records were examined and it was found that there was one small inaccuracy, which was addressed at the time of the inspection. Residents finances are kept in a safe place and there is a robust system of accounting in place. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. The homes pre-inspection questionnaire evidenced that fire alarm, fire drills and emergency lighting checks have been undertaken. A check of the fire log was undertaken and it was found to be up to date. Care staff also receive fire training as part of the homes initial training and as a regular training event. The homes pre-inspection questionnaire has evidenced that maintenance and service histories of all aids and adaptations are carried out as required by law. The commission holds information about the home in their service history and it was found that the commission had not been informed of one resident who was being case tracked and had been admitted to hospital on the 03/09/06 for treatment. The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 23 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 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP38 Regulation 37 Requirement The provider must give notice to the commission without delay of and serious injury or illness of a resident. Timescale for action 25/11/06 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 The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 The Fountains Care Centre DS0000062766.V315420.R01.S.doc Version 5.2 Page 26 - 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!