Care Home: Far Fillimore Rest Home

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What the care home does well The service told us in the AQAA that they have 6 monthly Resident Meetings, which people using the service are encouraged to attend together with some family members. This was confirmed during the inspection.The service reviews the care plans annually, ensuring that they can still meet people`s needs. If the people using the service wish to express any concerns anonymously there is a `Comments and Grumbles` box. The home has a postal system in place, which comprises of an individual box in bedrooms with letters being transferred into a postal box in the hallway. A Relatives` committee takes place annually, which has enhanced and promoted communication skills between the home and family members. The home`s staff consult regularly with people who use the service about what they wish to do on a daily basis, how they like to spend their time, and individual`s views are generally acted upon. Observations were made of visitors moving freely in and out of the home and being made welcome and offered refreshments. Communication between the home and health care professionals is good. Positive working relationships were observed between the district nursing service and staff at Far Fillimore. What has improved since the last inspection? The home has continued its redecorating and refurbishment programme. Work has taken place on landscaping the gardens. Staff training remains high priority at the home. The AQAA told us that the home is constantly reviewing and are reactive to any issues or concerns raised generally. This was confirmed during the inspection. What the care home could do better: Continue the external improvements in the grounds to provide pathways for people with wheelchairs and walking frames in all areas of the gardens and car park. (We understand this is in the long-term plan). The information we obtained during this inspection indicates that the service provider continues to improve the service for the people living in the home. CARE HOMES FOR OLDER PEOPLE Far Fillimore Rest Home Wood Lane Hanbury Burton On Trent Staffordshire DE13 8TG Lead Inspector Kathryn Marks Unannounced Inspection 7th August 2008 08:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000034076.V369620.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. DS0000034076.V369620.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Far Fillimore Rest Home Address Wood Lane Hanbury Burton On Trent Staffordshire DE13 8TG 01283 812180 01283 813666 Ffchltd@aol.com 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) Mr Chander Goel Mrs Nisha Goel Nicola Jayne Yeomans Care Home 26 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (26) of places DS0000034076.V369620.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2007 Brief Description of the Service: Far Fillimore Rest Home is situated in the hamlet of Hanbury, mid-way between Uttoxeter and Burton-on-Trent, in a country setting. Road links are via Broads and lanes, with a 2 hourly bus service. The three-storey house was converted from a private dwelling to provide residential accommodation and care for twenty-six elderly persons three of whom may have dementia-type conditions. Far Fillimore has a bungalow within the grounds of the home, which provides accommodation for two staff. Far Fillimore consists of twenty-two single occupancy bedrooms, two of which are equipped with en-suite facilities; There are also two shared bedrooms. The home also provides two lounge areas and a separate dining room. Toilets are provided throughout the property and are in close proximity to bedrooms and communal areas. Ramp access and grab rails are provided at the external entrances, enabling people who use the service to access the large attractive well maintained gardens where there is seating for individuals and visitors. On entering the home, there are notice boards in the reception hall displaying information about the home and the services provided. Our last report is also displayed here. There are photographs of staff on duty, the date and weather for the day. The homes Statement of Purpose and Service Users Guide were not reviewed at this visit therefore, readers of this report may wish to contact the home for up to date information regarding fees. DS0000034076.V369620.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Overall quality rating for this service is 2 Star. This means that the people using the service experience good quality outcomes. This key inspection was carried out on Thursday 7th August 2008 from 9am to 4pm. During this unannounced Key Inspection, the Deputy Manager was on duty with three care staff, cook, kitchen assistant, housekeeper and two gardener maintenance persons. The proprietor also arrived on site shortly after we arrived. The Annual Quality Assurance Assessment had been returned to us by the service. Completion of the AQAA is a legal requirement and it enables the service to under-take a self-assessment, which focuses on how well outcomes are met for people using the service. It was completed to a good standard and gave detailed information about the services offered. The Care Manager also provided written information regarding staffing, staff training, menu and dietary provision that was observed by the inspector to be in place at the home. On arrival at Far Fillimore people who use the service were having breakfast chatting to staff and planning their day. The district nurse arrived to see one person using the service. We talked to people who use the service, the district nurse and seven relatives, some of which had returned surveys to us. All spoke positively about Far Fillimore and the service offered. Information in the surveys we received could be summarised as follows: Seven people using the service told us they ‘always’ received the support and care they needed and two people told us they ‘usually’ did. Six people told us that staff are ‘always’ available when they need them and three said usually. Ten people told us staff listen to them and act on what they say. What the service does well: The service told us in the AQAA that they have 6 monthly Resident Meetings, which people using the service are encouraged to attend together with some family members. This was confirmed during the inspection. DS0000034076.V369620.R01.S.doc Version 5.2 Page 6 The service reviews the care plans annually, ensuring that they can still meet people’s needs. If the people using the service wish to express any concerns anonymously there is a ‘Comments and Grumbles’ box. The home has a postal system in place, which comprises of an individual box in bedrooms with letters being transferred into a postal box in the hallway. A Relatives’ committee takes place annually, which has enhanced and promoted communication skills between the home and family members. The home’s staff consult regularly with people who use the service about what they wish to do on a daily basis, how they like to spend their time, and individual’s views are generally acted upon. Observations were made of visitors moving freely in and out of the home and being made welcome and offered refreshments. Communication between the home and health care professionals is good. Positive working relationships were observed between the district nursing service and staff at Far Fillimore. What has improved since the last inspection? What they could do better: Continue the external improvements in the grounds to provide pathways for people with wheelchairs and walking frames in all areas of the gardens and car park. (We understand this is in the long-term plan). The information we obtained during this inspection indicates that the service provider continues to improve the service for the people living in the home. DS0000034076.V369620.R01.S.doc Version 5.2 Page 7 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. DS0000034076.V369620.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection DS0000034076.V369620.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6 were reviewed at this visit. Quality in this outcome area is good. People who wish to move into Far Fillimore receive all the information they require and they are assessed so that they can be assured the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA we received before this unannounced inspection told us that people wishing to move into the home receive a thorough assessment before they move in. DS0000034076.V369620.R01.S.doc Version 5.2 Page 10 We saw the assessments of the last three people admitted to the home. Care records were also reviewed. These assessments ensure that Far Fillimore and its staff are able to meet the assessed needs of individuals. The district nurses assessments were also seen. From this initial pre-admission information a decision is made as to whether the home can meet the needs of prospective person wanting to use the service. We talked to two of the newest residents, who confirmed that they and their relatives had received information prior to coming to the home. We also spoke to relatives who were visiting and they confirmed that they had received enough information to make a decision about the home. We received surveys from seven people using the service, which told us they had received enough information about the home prior to moving in. The home does not provide intermediate care. DS0000034076.V369620.R01.S.doc Version 5.2 Page 11 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): Standards 7, 8, 9, and 10 were reviewed at this visit. Quality in this outcome area is good. The home meets the personal, health and social needs of people using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA told us that the home is able to demonstrate that it meets the health and personal care needs of the people using the service within individual care plans and risk assessments. The AQAA also says that the home’s policy for the administration of medication, people’s medication reviews and medication training for staff, also meet people’s needs. DS0000034076.V369620.R01.S.doc Version 5.2 Page 12 We saw the care plans of three people using the service. The plans were up to date and identified personal preferences. We talked to two of the people whose records we had reviewed and they confirmed this. Care plans are in a modular format and detail how the needs of people using the service are to be met. Monthly reviews are carried out with regular on going reviews to ensure that all identified actions have been followed up. Risk assessments are also carried out and detailed on care plans. This means that the staff know how to support people safely. Individuals are now signing care plans following discussions with them about their care. All staff administering medication are trained in the administration of medication and a recent update took place in June 2008. People using the service are given information about what medications are for. In the surveys returned to us nine of the people using the service told us they always receive the medical support they need and one person said they usually do. Observations were made of privacy and dignity being promoted. People who use the service are consulted and given information about what is happening in the home. Each person now has a Health File that records all health related information. Where people are able to make decisions about healthcare issues they do so; otherwise staff assist individuals to make informed choices. In the surveys returned to us, five people using the service told us they ‘always’ receive the support and care they need and two people told us they ‘usually’ do. Six people told us staff are always available when they need them and three said usually. Ten people told us staff listen to them and act on what they say. We talked to people who use the service who confirmed the information in surveys. DS0000034076.V369620.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 were reviewed at this visit. Quality in this outcome area is Excellent. The people using the service are given opportunities to enjoy fulfilling lifestyles and maintain relationships. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home operates an open visiting policy and this was observed during this unannounced visit to the home. Seven visitors came to the home, plus the visiting district nurse and the proprietor also arrived from London. One person using the service received two visitors on horseback, her daughter and Grandaughter whom she was able to communicate with from her bedroom window. DS0000034076.V369620.R01.S.doc Version 5.2 Page 14 In surveys, one person told us that the home always helps them to keep in touch with friends and relatives and two told us they usually do. All of the relatives surveyed told us they are kept up to date with important issues. One person is being visited by an advocacy service to support them to make decisions. There are daily activities organised and promoted by staff on duty. On the day of this visit, one person was playing a game of ‘Connect Four’ with a member of staff and a quiz took place for everyone. Events that have taken place in the home include a Mothers Day cream tea; National Apple Day, along with other various special events and birthdays being celebrated. All activities are displayed on the notice board in the main hallway along with pictures of the staff on duty, the days date and weather. Seven people told us in surveys there are always activities arranged and one person told us there usually are. Eight people using the service went out to play Bingo but told us they did not really enjoy this, however they like being provided with the Hanbury Newsletter, which gives them information about the local area. A regular visitor to the home from the village is welcomed by the people using the service. Where able to do so people using the service make their own decision about their daily routines. The home provides all home-cooked food using local fresh produce and homemade cakes and puddings. People spoken to after lunch told us they enjoyed their food and always had enough to eat. There are four-weekly menus with choices and flexibility at mealtimes. Eight people told us in surveys that they always like the meals at the home and two said they usually do. An Environmental Health Inspection took place in February 2008 and the home was given a 4 star rating. DS0000034076.V369620.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 16 were reviewed at this visit. Quality in this outcome area is good. People who use the service are able to make complaints and are safeguarded by the home’s procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes complaints procedure is displayed in the bedrooms of people using the service and in the main hallway, together with the Statement of Purpose. People using the service and their relatives told us during conversations that they know who to make a complaint to. Ten people using the service returned surveys to us and told us that they knew who to speak to if not happy and all said they knew how to make a complaint. Five relatives returned surveys to us and told us they knew how to make a complaint and that the service responds appropriately. DS0000034076.V369620.R01.S.doc Version 5.2 Page 16 There is a comments box in the hallway for people who prefer to use this. People using the service are protected from abuse by robust staff recruitment and selection processes. All staff under-go Criminal Records Bureau and Protection of Vulnerable Adults checks prior to employment. This makes sure that suitable staff support the people using the service. Staff receive Abuse Awareness and whistle blowing training in their induction, which is followed up during personal supervision. We received eight surveys from staff, in which they confirmed that they had received CRB and PoVA checks prior to employment and that references had been obtained. The home has a complaints, grumbles and compliments book in which they record any issues. We have received no complaints about the service since the last inspection. There have been no safeguarding referrals. DS0000034076.V369620.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 were reviewed at this visit. Quality in this outcome area is good. Far Filliemore offers a good standard of accommodation to people who use the service in a homely setting. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA told us that the service ensures the living environment is clean and odour free. On-going maintenance to the internal and external of the home takes place. DS0000034076.V369620.R01.S.doc Version 5.2 Page 18 Since April 2008, work has been carried out to further improve the environment for the people using the service, which includes landscaping the gardens, redecorating bedrooms and the dining room and the provision of some new furniture. A new boiler has been fitted, electrics have been rewired and some light fittings replaced. The dining room, landing and hallway are being fitted with new carpets. Three emergency lights have been fitted in the cellar. A new dishwasher has been purchased and the water tank has been replaced. During this inspection, relatives and friends were visiting individuals in their bedrooms. Conversation was cheerful and friendly with people using the service commenting on the comfort of the home and how they enjoyed the rural aspect. Attractive visual images are provided on the doors of bathrooms, toilets and the shower room to let people with short-term memory problems know what the rooms are. In the surveys returned to us, eight people told us that the home is always clean and fresh and two people said that it usually is. We observed a friendly relaxed atmosphere with people using the service being comfortable in their surroundings. DS0000034076.V369620.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29, and 30 were reviewed at this visit. Quality in this outcome area is good. A well trained long standing team of staff support the people using the service and keeps them safe This judgement has been made using available evidence including a visit to this service. EVIDENCE: During this inspection the following staff were on duty: Deputy Manager Three Care Assistants One Cook One Kitchen Assistant One Housekeeper Two Gardener/Maintenance persons. We were satisfied that sufficient staff are available to meet the needs of the people using the service. DS0000034076.V369620.R01.S.doc Version 5.2 Page 20 We spoke to six members of staff all of whom told us they were happy working at the home and were supported by management to complete their roles in the home. This had also been confirmed in survey responses. All told us they received induction and on going training relevant to their role, and that they received support and supervision. Surveys returned to us by staff told us that the individual needs of the people using the service change on a daily basis and that the staff are given this information during handover, which takes place before every shift. All staff surveys confirmed that they had received CRB and PoVA checks prior to employment and that references had been obtained. We reviewed two staff files and were able to confirm that staff are recruited appropriately, with all pre-employment checks being undertaken. We also saw the training records, which confirmed that mandatory training had been completed. This means that the staff have the skills to meet the needs of people using the service safely. The service displays an equal opportunities policy, which tells us how they meet diverse needs. DS0000034076.V369620.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, and 38 were reviewed at this visit. Quality in this outcome area is good. The people using the service are safeguarded by competent management systems. This judgement has been made using available evidence including a visit to this service. EVIDENCE: DS0000034076.V369620.R01.S.doc Version 5.2 Page 22 The Care Manager and Deputy Manager have completed the Registered Managers Award and are experienced and competent to run the home and care for older people. Resident’s financial interests are safeguarded by the involvement of individuals themselves, their relatives/solicitors and staff at the home. We checked the financial systems used for three people using the service and cash is balanced with receipts and records maintained. The home has a quality assurance system that they use to monitor standards for people using the service. Internal surveys are analysed and used for monitoring quality assurance. The AQAA tells us that equipment is serviced in line with Health and Safety regulations. Health and Safety awareness training is high priority and daily health and safety checks are carried out. Safe working practices are in place and staff have received training in moving and handling, fire safety, first aid, food hygiene and infection control. Updates for this training are all planned. Hazardous substances are stored safely. Servicing of equipment is up to date and we saw the records. We were told that the electrical systems have been bought up to date to meet new legislation. DS0000034076.V369620.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 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 4 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 DS0000034076.V369620.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. 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 DS0000034076.V369620.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 DS0000034076.V369620.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. 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