Inspection on 09/08/05 for The Foxwalls

This inspection was carried out on 9th August 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.

Other inspections for this house

The Foxwalls 11/06/07

The Foxwalls 12/02/07

The Foxwalls 03/01/06

The Foxwalls 08/03/05

The Foxwalls 20/09/04

The Foxwalls 05/03/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Foxwalls Marston Road Stafford Staffordshire ST16 3BU Lead Inspector Wendy Grainger Announced 9 August 2005 9:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Foxwalls Address Marston Road Stafford Staffordshire ST16 3BU 01785 277088 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Staffordshire County Council, Social Care and Health Directorate Mrs Bridget Hill CRH 48 Category(ies) of DE 4 registration, with number DE(E) 32 of places MD(E) 12 OP 7 PD(E) 16 The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: (DE) - 3 Both sexes - Minimum age 50 years on admission. Date of last inspection 8 March 2005 Brief Description of the Service: The Foxwalls is a purpose built Local Authority home that was registered for 39 older people. The home had being extensively altered and was now registered for 48 older people. The home is owned by Staffordshire County Council and operated by Staffordshire Social Services. The home is located in a residential area of Stafford and is close to amenities and served by public transport. The home is pleasantly situated with lawns, a quadrangle and external sitting area. Adequate car parking, external roadways and pathways are provided. The accommodation is provided on one floor and comprises single bedrooms and all necessary facilities. Services and facilities including laundry, catering and hotel services have been adequately maintained, with adequate staffing levels. Activities, hobbies and entertainment all take place and transport is provided when required. Families and friends are encouraged to take part in activities and trips out. Care is provided by teams of care assistants each having a care shift leader. They are responsible to a care team leader (deputy manager) and the home manager. Health service professionals such as district nurse, community psychiatric nurse, and physiotherapist are accessed when required and local GP’s and a pharmacist service the home. The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was completed on the day of the 9 August 2005 the inspector was assisted by the Head of Home, staff, residents and visitors with the contents of the report. Documents, records, and reports were provided upon request by the management. Four comment cards were received by the Commission, two of them had additional comments “ the present staff work very hard but on some occasions incidents need more staff to deal with them” this relative also thought there should be more staff on duty. “ We are very pleased with the care my mother gets at the home, and the staff are very caring and are always happy” No relative had made a complaint to the management. Other comments provided during the day from visitors included their personal observations of the staff and management, the condition of their loved one and the standards of the home. Each person had only positive comments in respect of The Foxwalls. At the time of this inspection the home was fully occupied and a waiting list existed. Over half of the residents had a mental frailty of some degree. The majority of the residents required some form of assistance with personal daily living skills. Located in a quiet area of Stafford the home divides into three units, each with staff meeting the needs of the residents. At the commencement of the inspection breakfast had not been served, residents were wandering freely around the home. The staff assisted where necessary. The previous inspection report made one requirement, which had been addressed by the management and evidenced on this inspection. Within the entrance hall was the previous inspection report with the Statement of Purpose available for any visitor or resident. Resident’s accommodation was located on the ground floor, the home in general was exceptional in its hygiene. The resident’s personal space had been personalised to suit individuals taste. The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 6 Any person coming to the Foxwalls would have a full assessment of their needs prior to admission. Arrangements were in place for the continued care from other professional agencies, additional care required would be recorded in the persons care plan. The homes offered regular social activities; during the inspection the new activity co-ordinator commenced duty. Residents at the Foxwalls were provided with a choice of meals from the menus that displayed a well balanced diet, prepared by qualified staff. Individual dietary needs could be prepared from the information gathered during the assessment/admission process. The homes complaints process was displayed within the home and in the document the Service Users Guide. The Head of Home was to review the staff rota to provide more staff on the floor meeting residents needs at peak times. The home had robust procedures in place for the recruitment of new staff. All the staff prior to employment had Criminal Records Bureau checks carried out. This was evidenced during the inspection. Staffs at the Foxwalls were experienced and competent to care for the more vulnerable person from the community. What the service does well: The homes staff were committed to the care of the people at the Foxwalls, this was demonstrated during the inspection. Needs were met with the knowledge of the individual person. Residents were observed to be offered a choice of their life style, wandering freely around the home. Positive warm interaction was observed between the management, staff and residents. The home had a planned programme for staff to continue with their development and training needs. The home was comfortable and homely, well maintained in all areas. The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 7 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 Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,5, Standard six is not applicable to this home. The necessary information was provided in a format suitable and demonstrated what services the home offered. EVIDENCE: The Statement of Purpose, previous inspection report and Service User Guide were displayed in the front entrance; easily available to any person in the home. Pre assessments of needs were carried out to ensure the person coming to the home could be catered for. The registered care manager initially completed assessments for respite care. Residents and or relatives were informed of the outcome of the assessments in writing. It was a policy for the home to offer a visit prior to admission, the person would be invited to take lunch or just refreshments. The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10 11. Recorded information relating to the residents was detailed and provided current details for care needs. Appropriate arrangements were in place for the health and personal care, including the intervention and support from other agencies. EVIDENCE: Each of the residents including the respite people had a care plan, the modular form had been used for the respite stay; it was evidenced to be service user friendly by using the short stay format documents. Long-term care plans were seen to be detailed as to the current needs of individuals. Evaluations and clearly written risk assessments with an action plan were seen. The only comment the inspector would make is that there is a lot of duplication in the documentation especially with the risk assessment process. The management had completed risk assessments of needs where necessary. The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 11 Contacts with other health care professionals were evidenced in the sample of care plans seen during the inspection. A comment from a District Nurse visiting the home felt that the staff could liaise more with the surgery, leaving messages on the answer phone if necessary. This nurse did however praise the staff for their continued care of residents. The system for medication administration was observed and found to be satisfactory. Medication records were current and staff had received training for the safe keeping and handling of drugs. Residents spoken with confirmed that they were treated with respect and that their dignity was considered at all times. The staff were observed to interact with residents. The inspector would have preferred more verbal interaction by one staff when assisting a resident with her lunch. Staff during the inspection were pleasant and continued with the appropriate care of residents. Policies and procedures for death and dying were operational. The needs of residents where possible would be catered for at the home. Other professional agencies would be involved. The registered manager told the inspector that the home was well supported by doctors and district nurses. The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 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 standard(s) 12.13.14.15. Residents were offered a daily choice to meet their life style. Management and the staff promoted a relaxed comfortable home. Links with families, friends and community continued following the admission. A balanced diet ensured the health needs of residents were maintained. EVIDENCE: Evidenced from a notice displayed was an opportunity of joining an outing to the Chase plus refreshments, also a quiz night to raise funds arranged by the staff and inviting any relative to participate. Flexible routines were in place for the residents, this was obvious with residents choosing to participate in an activity/reminiscence session. Other residents preferred to remain in their rooms. The person on respite care confirmed this, which was evidenced in her care plan. During the inspection a new activity co-ordinator commenced duty, she spent time in one lounge, where residents joined in with reminiscence. The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 13 Contact was maintained with relatives, one relative confirmed that she came six days each week to see her husband. She felt welcome and was appreciative of the care he received. The meal of the day was a choice between battered roe or sausage, the meal was well presented and of a portion to suit the individual. The stand in cook for the day confirmed that she had the required training. The current food, fridge, freezer temperatures for the day and previous days were made available the inspector. The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 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 standard(s) 16 18 The home had a satisfactory complaints system in operation. Residents were further protected by the positive on going awareness training of abuse for the staff. EVIDENCE: The Commission had not received any form of complaint. The registered care manager told the inspector that the Foxwalls management had not received any internal complaint. The home had in place the appropriate documentation and information to enable any person to raise a complaint. Staff training was carried out to protect individuals from abuse this training was evidenced in the records. Staff spoken with confirmed that they were aware of the procedure to follow if necessary when reporting any concerns. The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 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 standard(s) 19.20.21.23.24.25.26. The Foxwalls residents were provided with a comfortable environment, the small areas/lounges provided an attractive homely place to live. Residents were supported in their life style and needs by equipment purchased following a professional assessment. Each resident had sufficient space to enable them to live a comfortable life style. EVIDENCE: Located in a quiet area of Stafford, and near to some limited facilities; the town of Stafford could be accessed via public transport. The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 16 The communal, bedroom and toilet facilities were located on the ground floor. There were a small number of en-suite facilities provided in the recently registered wing. Observations of the bedrooms evidenced that residents were encouraged to personalise their own space. Within the home were small areas off the corridors where residents were observed to relax; these areas were well furnished and comfortable as were the lounges throughout the home. Recently totally refurbished and decorated the home maintained high standards both in decoration and hygiene. It was planned following an assessment of needs to provide three specialist arm chairs, further promoting the comfort of individuals. The registered manager continued to monitor the provision of linen and towels. Staff confirmed that they had been made aware and followed the COSHH requirements for the control of infection. A digital lock protected the laundry, which was located off the main corridor. The area was tidy and well organised. Various equipment had been purchased including a Jacuzzi bath located in an attractively classically tiled bathroom. The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27.28.29.30 The staff at Foxwalls were competent and trained to care for older people. The home had robust procedures for the recruitment of any staff. At the time of the inspection staff were meeting the needs of the present resident group. EVIDENCE: The registered care manager was to re-assess the rotas to provide more staff to meet the needs of residents at peak times. From the rotas provided for the inspection it was normal for management to work as part of the team with the carers. On any one day five staff in the morning would address the needs of the residents, this reduced by one care staff for the afternoon. Three staff were on waking duty during the night shift. Catering laundry and housekeeping staff would support the shift during the daytime. Management were available at any time. Staff training continued with 54 of the present staff achieving NVQ levels II & III records confirmed training in other sectors included Blood Borne Transmissible Diseases, Moving & Handling, Blood Sugar Monitoring, First Aid, Fire Safety, Health & Safety, Visual awareness, Deaf awareness, Incontinence aids. COSHH. The registered care manger had Mental Health & Dementia The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 18 training planned for 2005. Staff on duty confirmed they were current with their mandatory training. The home had robust recruitment procedures; the required documentation was evidenced in the records provided. The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 32 33 35 36 38 The management ensured that as far as possible the home was operated to protect the health and safety of the residents. The management team were available to the residents and or families. Systems in place ensured that the home was operated to meet the Standards. EVIDENCE: The registered care manager Mrs Hill was up to date with in her mandatory and other external training. She had achieved the Registered Managers Award Level IV NVQ in Management. The Foxwalls management ensured that the home was operated to the benefit of the residents. The home had a relaxed and comfortable atmosphere. The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 20 Recently the County Council had undertaken an in-depth Quality Audit over a three day period. The report of the findings will be sent to the home. The annual review of the service provided to residents will be included as part of the quality audit. Evidenced was provided of staff and residents meetings. The staff spoken with felt supported by the management, they confirmed that they had supervision on a regular basis when their development and training needs were discussed. The home was viable to continue operating. Three of the monies saved on behalf of certain residents were checked and found satisfactory. The management provided evidence to confirm that the required records in respect of the fire regulations were accurate. Other records included namely: Health & Safety department visit 14 7 05 Environmental Health Officer 14 4 04 Gas installation 25 5 04 Approved electrical contractor 27 2 02 Fire lecture 14 7 05 Fire system check 20 8 04 The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 4 4 4 x 3 4 2 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 4 4 3 x 3 3 x 3 The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 22 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations The Foxwalls E51-E09 The Foxwells s.35821 9.08.05 v239466 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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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