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Care Home: Fauld House Care Home

  • Fauld House Care Home Fauld Burton On Trent Staffordshire DE13 9HS
  • Tel: 01283813642
  • Fax: 01283815672

Fauld House Care Home provides personal and nursing care to a maximum of 30 people. The service is situated in a rural hamlet close to the village of Tutbury it has views to open countryside. Ground, first and second floor accommodation is provided for people, with a mixture of single, double and en-suite bedrooms. The service offers adequate lounge and dining facilities. A designated smoking area and a hairdressing facility are provided. The registered care manager who is qualified as a Registered General Nurse (RGN) and Registered Mental Nurse (RMN) supported by nursing staff and teams of care assistants provide nursing and personal care. Readers may wish to contact the service to obtain up to date information about fees and charges that apply.

Residents Needs:
Dementia, Old age, not falling within any other category, Physical disability

Latest Inspection

This is the latest available inspection report for this service, carried out on 7th August 2008. CSCI found this care home to be providing an Good service.

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.

For extracts, read the latest CQC inspection for Fauld House Care Home.

What the care home does well The management and staff make the people who use the service and their visitors welcome. There are frequent visitors to the service. Staff demonstrated great respect for the people who use the service, and people were addressed in an appropriate manner. Discussions with staff were positive, and showed a clear determination that they belong to a committed team. People spoken with were very positive about the care that they were receiving.We observed people who were unable to communicate. Our observations showed that these people were well cared for, and were happy in their surroundings. Services and facilities including laundry, catering and hotel services are good The premises are clean, warm and comfortable. The service provides a `homely and warm` atmosphere. Care plans we saw evidenced that people`s health needs were being met What has improved since the last inspection? There were no requirements and recommendations made at the previous inspection. The Annual Quality Assurance Assessment (AQAA) completed by the care manager confirmed the following improvements: "We have converted a bathroom to a wet room, which includes a shower which can be easily used by our Service Users. Our Admission documentation has been updated. A greenhouse has been erected, for our Service Users, some of whom have shown great interest in all aspects of the greenhouse. Tomatoes and cucumbers have been planted and we are already gathering strawberries. Poetry sessions have been held by `Poetic Therapy`.` Zoo Lab` have held educational displays, bringing small animals and reptiles for Service Users and their relatives to see and touch. We have purchased a digital camera and printer specifically for the use of our Service Users to take and print their own photographs. Service Users have been assisted in booking meals at a local restaurant for their personal celebrations, with transport and other assistance provided by our Activities Co-ordinator. A Heated Food Trolley has been purchased, which promotes ease of choice at mealtimes." What the care home could do better: Risk assessments should be clearly recorded, kept under review, and updated to reflect any changes in the individual`s condition. Assessments for people on respite care should be more comprehensive and should contain all of the information necessary to meet their needs. Menus should be clear and should be available in large print. People using the service should be offered a choice of main meal each day. Those options should be clearly written on the chalkboard in the dining room and on the menu for people to see.Care plans would benefit from the recording of the person`s social history, for example lifestyle, hobbies and interests prior to moving into the home. This would enable a care plan that is more tailored to the person`s needs. Staffing numbers should be regularly reviewed, and should be appropriate to the assessed level of needs of people who use the service. The staff rota should include the names and the hours worked by bank staff when covering for staff sickness and or absence. Staff should receive regular update and refresher training in regard to Safeguarding and Abuse of Vulnerable Adults. Staff handling food should receive update refresher training in regard to Food Hygiene. Staff should receive training in Dementia Care. The staff training matrix should include all members of staff working at the service. The standard of hygiene and cleanliness in the kitchen and sluices should be monitored and improved. CARE HOMES FOR OLDER PEOPLE Fauld House Care Home Fauld Burton On Trent Staffordshire DE13 9HS Lead Inspector Pam Grace Unannounced Inspection 7th August 2008 11:45a 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 DS0000067065.V371230.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. DS0000067065.V371230.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fauld House Care Home Address Fauld Burton On Trent Staffordshire DE13 9HS 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) 01283 813642 01283 815672 faulddoreen@aol.com Sudera Care Associates Limited Doreen Ashmore Care Home 30 Category(ies) of Dementia - over 65 years of age (10), Learning registration, with number disability (1), Old age, not falling within any of places other category (10), Physical disability (10), Physical disability over 65 years of age (30), Terminally ill (4) DS0000067065.V371230.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Minimum age PD category 45 years of age One named person in LD category Date of last inspection 1st August 2006 Brief Description of the Service: Fauld House Care Home provides personal and nursing care to a maximum of 30 people. The service is situated in a rural hamlet close to the village of Tutbury it has views to open countryside. Ground, first and second floor accommodation is provided for people, with a mixture of single, double and en-suite bedrooms. The service offers adequate lounge and dining facilities. A designated smoking area and a hairdressing facility are provided. The registered care manager who is qualified as a Registered General Nurse (RGN) and Registered Mental Nurse (RMN) supported by nursing staff and teams of care assistants provide nursing and personal care. Readers may wish to contact the service to obtain up to date information about fees and charges that apply. DS0000067065.V371230.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 stars This means the people who use this service experience good quality outcomes. This key unannounced inspection was carried out over one day, by one inspector. The inspection was planned using information gathered from the Commission for Social Care (CSCI) database, the Annual Quality Assurance Assessment (AQAA) document that had been completed by the care manager, and comments received from people who use the service and their relatives. The key National Minimum Standards for Older People were identified for this inspection and the methods in which the information was gained for this report included case tracking, general observations, document reading, speaking with staff, people who use the service and their visiting relatives. We looked around the premises during our day at the service. We observed people who were unable to communicate. Three complaints have been received by the service and one Safeguarding referral had been made by the service to Social Services since our previous inspection. There was a poor response to our request for the completion of “Have Your Say” surveys by the people who use the service. No surveys were returned to us. However, verbal comments were received about the service during our visit. These were generally positive, and are included in this report There were no requirements but 11 recommendations made as a result of this unannounced inspection. What the service does well: The management and staff make the people who use the service and their visitors welcome. There are frequent visitors to the service. Staff demonstrated great respect for the people who use the service, and people were addressed in an appropriate manner. Discussions with staff were positive, and showed a clear determination that they belong to a committed team. People spoken with were very positive about the care that they were receiving. DS0000067065.V371230.R01.S.doc Version 5.2 Page 6 We observed people who were unable to communicate. Our observations showed that these people were well cared for, and were happy in their surroundings. Services and facilities including laundry, catering and hotel services are good The premises are clean, warm and comfortable. The service provides a ‘homely and warm’ atmosphere. Care plans we saw evidenced that people’s health needs were being met What has improved since the last inspection? What they could do better: Risk assessments should be clearly recorded, kept under review, and updated to reflect any changes in the individual’s condition. Assessments for people on respite care should be more comprehensive and should contain all of the information necessary to meet their needs. Menus should be clear and should be available in large print. People using the service should be offered a choice of main meal each day. Those options should be clearly written on the chalkboard in the dining room and on the menu for people to see. DS0000067065.V371230.R01.S.doc Version 5.2 Page 7 Care plans would benefit from the recording of the person’s social history, for example lifestyle, hobbies and interests prior to moving into the home. This would enable a care plan that is more tailored to the person’s needs. Staffing numbers should be regularly reviewed, and should be appropriate to the assessed level of needs of people who use the service. The staff rota should include the names and the hours worked by bank staff when covering for staff sickness and or absence. Staff should receive regular update and refresher training in regard to Safeguarding and Abuse of Vulnerable Adults. Staff handling food should receive update refresher training in regard to Food Hygiene. Staff should receive training in Dementia Care. The staff training matrix should include all members of staff working at the service. The standard of hygiene and cleanliness in the kitchen and sluices should be monitored and improved. 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. DS0000067065.V371230.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 DS0000067065.V371230.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): 1,2,3 and 6. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who may use the service and their representatives have the information needed to choose a service that will meet their needs. Assessments undertaken for people on respite care need further development and improvement to ensure that needs can be met. EVIDENCE: The service’s Annual Quality Assurance Assessment document (AQAA), which was completed by the care manager, told us: “Policies and Procedures which are reviewed and updated regularly. Fauld House Brochure. All staff complete mandatory annual training applicable to their position. Individual Pre-Admission Assessments to ascertain that we are able to meet Service Users needs. If possible, Service Users are able to visit Fauld House before admission. DS0000067065.V371230.R01.S.doc Version 5.2 Page 10 Eight week trial period for all admissions. Ensure privacy of Service Users is respected.Refreshments/meals are offered to visitors on arrival and at other appropriate times. Ensure all Service Users and their relatives are aware of the Complaints Procedure. All new Service Users receive a Statement of Purpose and Service User Guide. Ensure Service Users are assessed/re-assessed for Registered Nursing Care Contribution. Fauld House gives advance notice of any changes regarding payment.” We saw that our previous inspection report was available to read in the main entrance hallway. The Statement of Purpose and Service User Guide were available for us to view. We looked at the Statement of Purpose and Service User Guide. We saw that these documents had been reviewed and meet the required standards. People spoken with confirmed that they had received appropriate information prior to admission, which had included the Statement of Purpose. That they had been able to visit the home, and spend time talking with people who use the service to help them decide if the service would be suitable for them. People also confirmed that they had been provided with a contract; terms and conditions document. We looked at three care plans. These showed that an assessment of needs had been undertaken for those individuals on admission. The assessments gave adequate and basic information about the person’s needs across all activities of daily living examples being; cognitive awareness, confusion, risk assessment including falls, bathing, moving and handling. However in one instance a person on respite had sensory needs, and this was not identified during the assessment process, which was reportedly undertaken very quickly. Five days later, we looked at the assessment during our inspection visit, and highlighted the shortfall. Assessments undertaken should be comprehensive and thorough, in order to meet the needs of the people who use the service. Intermediate care is not provided by this service. DS0000067065.V371230.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): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Risk assessments need to be further developed to help keep people safe. EVIDENCE: The service’s Annual Quality Assurance Assessment document (AQAA), which was completed by the care manager, confirmed the following: “With the agreement of the Service User, we work with the Service User, relatives, carers and other professionals, in order to provide the best support for the individual. Carers are trained in giving choice to Service Users and in ways which facilitate Service Users to make their own decisions (i.e. what to wear, choice of food, activities, etc). Fauld House a policy of always knocking on the door of a Service Users room before entering the room, ensuring privacy and respect. DS0000067065.V371230.R01.S.doc Version 5.2 Page 12 Care Plans / Risk Assessments to identify those at risk in the following areas: Pressure Damage Falls Malnutrition, etc. Policy for receipt/storage/handling/administration and disposal of medication. Individual Service Users documentation records formal decisions regarding resuscitation, end of life care, etc.” We examined three care plans. We spoke with staff, people who use the service, and their visiting relatives. Staff spoken with could tell us exactly how each of these people were to be cared for, what these staff told us reflected what was written in individuals care plans. People we spoke to told us they had been involved in their care planning processes and their review. All three care plans contained evidence of a pre-admission assessment, which had informed the care plan. There was also evidence of health professional’s involvement, for example the General Practitioner and dietician. Health service professionals such as the district nurse, community psychiatric nurse, and physiotherapist are accessed when required. The care manager confirmed that the tissue viability specialist nurse would be consulted where necessary in relation to a person requiring more complex treatment. People spoken with during our visit said that they were very satisfied with the care they receive, and that they were “only to ask for help, and staff gave them help.” One person confirmed her satisfaction with the care she was receiving. She said the staff were “lovely”. She said she was “happy with her room”, and realised that she “was a bit forgetful sometimes”, but said she “was getting the support she needed from staff. Another person said he “sometimes had to wait for staff to come, but realised he was not the only person needing help”. Some assessments were incomplete, and undated, and it wasn’t clear when they were last reviewed. This was highlighted and discussed at the time with the care manager. Risk assessments contained within two care plans were not comprehensive, were out of date, and did not reflect the changing needs of the individuals concerned. We undertook a spot check of the home’s Medication Administration system. Administration Sheets were all in order, and there is a policy and procedure in place. Returns and disposal of medication are recorded, signed for and checked by two nurses, leaving an auditable trail. An item of prescribed medication was discovered on the window ledge of a bathroom, when we were looking around the premises. This was considered to be an oversight, and was removed straight away. This shortfall was highlighted and discussed with the care manager during our inspection. DS0000067065.V371230.R01.S.doc Version 5.2 Page 13 DS0000067065.V371230.R01.S.doc Version 5.2 Page 14 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): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to make choices about their life style and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations. EVIDENCE: The service’s Annual Quality Assurance Assessment (AQAA) document, which was completed by the care manager, confirmed the following: “Maintain strong links with the community, including the local churches. A monthly interdenominational Service and Communion is also held at Fauld House. A Roman Catholic representative visits weekly. Mobile Library visits every two months, with large print and audio books. Musical Movement is held three-weekly, with a qualified instructor. Professional Entertainers visit Fauld House regularly. Garden Fete, Autumn Fayre, Christmas Carol Service and Entertainment. Contact is maintained with the local Arts Council. We were recently one of the Homes joining in the Storytelling Week. Special interest days are held (i.e. St Georges Day, American Independence Day). DS0000067065.V371230.R01.S.doc Version 5.2 Page 15 Newspapers, Jigsaws and Board Games are always available, together with one-to-one conversations with individual Service Users. Regular Service User/Relatives Meetings, where ideas and suggestions are discussed and taken on board and where Service Users are able to make decisions on menus, activities, outings, etc. Service Users are encouraged to participate in activities and outings, but should they not wish to do so, this decision is respected. Whenever possible, transport is provided for those residents who wish to join in community activities. Raised Bed in the garden, for those residents who enjoy gardening. As far as possible, Fauld House will accommodate as many of the Service Users own personal possessions which they wish to bring with them from their own home. Service Users are able to have their own private telephone line into their room, if they so wish. We serve three meals daily, plus snacks and drinks, which are also available during the night. We serve a colourful, well-balanced nutritional diet, with attention paid to ensuring the five a day fruit and vegetables are available. Special diets are available for those who require them.” The service employs an activities co-ordinator for 15 to 20 hours weekly. There are library books available for people to read, some of these were in large print versions. There are often ad hoc activities undertaken, for example reading the news, telling stories, group discussion, reminiscence groups and one to one conversations. There were quizzes and bingo available. Transport for trips is provided when required. Families and friends are encouraged to take part in activities and trips out. The garden is well used. People can sit out, and are protected from the weather with a covered area to sit in. Some people spoken with said, “I like to sit here, to watch what’s going on, and I see people coming and going.” The service has a hairdressing room, with a visiting hairdresser every week. People spoken with said, “there is plenty going on at the home”. On the day of our visit the visiting minister undertook a service, which was very well attended by people using the service. Four weekly rotational and seasonal menus were in place. We discussed the need for people to have a choice of main meal each day, and to clearly record the choices of meals at each mealtime, so that people can see what options are on offer on the daily menu. Menus available were in small print, and not easy to read. People using the service are given plastic beakers to drink from. We discussed this with the manager and suggested to increase choice it would be better if staff ask people what type of beaker they would prefer to use. If risk was a DS0000067065.V371230.R01.S.doc Version 5.2 Page 16 concern then working within a risk assessment framework may help identify any risk. Decisions taken could be recorded and included into the individual’s care plan. DS0000067065.V371230.R01.S.doc Version 5.2 Page 17 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. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. People are protected from abuse, and have their rights protected. EVIDENCE: The service’s Annual Quality Assurance Assessment document completed by the care manager confirmed the following: “Fauld House has a clear and accessable Complaints Procedure, stating timetables and how complaints are dealt with. Any Service User or their Relative is fully supported by staff in making a complaint. Service Users and Relatives can be provided with Advocacy information. All staff receive POVA training and work to these regulations. Procedures are in place to respond to evidence or suspicion of neglect. We assist Service Users to be as politically active as they choose. Many Service Users use the Postal Vote system.” We saw that the complaints procedure was displayed in the main entrance hall. However, our address had not been updated, and the size of print was too small, making it difficult for people to see it clearly. This was highlighted and discussed with the care manager at the time of our inspection. DS0000067065.V371230.R01.S.doc Version 5.2 Page 18 The care manager confirmed that people who use the service and or their representatives are provided with a copy of the complaints procedure during the admission process. People spoken with during our inspection visit confirmed that they had been given a copy of the complaints procedure, and knew who to complain to. They said that their ‘grumbles are listened to and acted upon by staff’. We discussed the use of a “Grumbles” book for minor every day grumbles to be recorded and acted upon. We have received notification of one Safeguarding referral made to Social Services, since our previous inspection. This was discussed during our visit, and had been dealt with at the time by the care manager. There have been three complaints received by the service since our previous inspection. One complaint had been upheld, one complaint had not been upheld, and one complaint had been partially upheld. There had been no complaints received by us - the Commission for Social Care Inspection (CSCI) since the previous inspection. We examined three staff recruitment files. There was no evidence to confirm that Criminal Records Bureau (CRB) or Protection of Vulnerable Adults (POVA) list checks had been undertaken for these staff. This was highlighted and discussed with the care manager at the time. The care manager confirmed that checks are always undertaken, however, the administrator for the service was on leave, and she was unable to access the information on the day. We asked that this information be forwarded to us as soon as possible. This information was subsequently forwarded to us. We spoke with staff, they were unable to remember or confirm whether they had received update or refresher training with regard to issues of abuse, its identification and types of exploitation. We recommended that safeguarding and or abuse training, is undertaken by care staff to help protect the people who use the service. DS0000067065.V371230.R01.S.doc Version 5.2 Page 19 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): 19,20,21,22,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the premises enables people who use the service to live in a well-maintained and comfortable environment, which encourages independence. EVIDENCE: The service’s Annual Quality Assurance Assessment (AQAA) document, completed by the care manager, confirmed that all health and safety checks on equipment and fire systems had been undertaken, and confirmed the following: “The house and gardens are well-maintained, giving Service Users a homely place to live, whilst ensuring the risk of infection and cross-contamination is reduced. Staff receive infection control and COSHH training, so that they are aware of prevention of infection. DS0000067065.V371230.R01.S.doc Version 5.2 Page 20 Fauld House complies with the requirements of the local Fire Service. Specialised toilet and bathing facilities are available to meet the needs of our Service Users, together with other adapted equipment for those with limited mobility. Fauld House has a Nurse Call System, with an accessable alarm call in every room. Fauld House is centrally heated and furnished to a comfortable standard. Regular equipment and water temperature checks are made. All statutory inspections are undertaken by outside professionals. A full decorating programme is in place.” People spoken with during our inspection visit expressed their satisfaction with the general environment, their room, and the equipment provided within the home. People spoken with said “it’s always nice and clean here”, and “the staff try very hard to keep it all clean”. “I’ve never seen it in a mess”. “I like my room.” We looked at parts of the premises. One of the rooms we looked at had a malodour, which we reported to the care manager. There were some areas highlighted and noted in regard to replacement of carpets, and refurbishment, however, these were already known to the care manager, and were in hand. We looked at the kitchen, which was tidy, but the floor was sticky and needed thorough cleaning. Some worktop surfaces also needed thorough cleaning. The laundry was clean and tidy, with evidence that measures had been taken to prevent cross infection – for example the separation of areas for clean and or soiled linen was established. The upstairs sluice room was dirty and needed a thorough clean. This was highlighted and discussed with the care manager. The maintenance folder evidenced that maintenance tasks are being requested by staff and signed off by the maintenance person when they are completed. However, monthly health and safety audits checks, and wheelchair audits had not been completed for some time, and need to be resurrected – these are considered to be good practice, ensuring the safety of the people using the service. Fire alarm checks and emergency lighting records were seen for 6/8/08 and 31/07/08 checks had been completed and recorded. Fire Training for staff had been undertaken – records were seen for 18/04/08 and 2/4/08 when staff had last had fire training. Accommodation is personalised to suit individuals. Communal areas are comfortable and homely. Bathrooms and toilets are conveniently sited around the home. DS0000067065.V371230.R01.S.doc Version 5.2 Page 21 We noted that equipment and adaptations were provided as necessary to maximise independence. For example, wheelchairs, raised toilet seat, bed rails, pressure mattress, handrails, and assisted baths. Outstanding issues in regard to Fire Safety Compliance were discussed with the operations manager. A copy of the home’s Fire Safety Compliance Certificate was requested. DS0000067065.V371230.R01.S.doc Version 5.2 Page 22 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 adequate. This judgement has been made using available evidence including a visit to this service. Staff are not always trained, skilled or provided in sufficient numbers to support the people who use the service. EVIDENCE: The service’s Annual Quality Assurance Assessment (AQAA) document, completed by the acting care manager, confirmed the following: “All Registered Nurses are suitably registered with appropriate professional body. All staff operate in a manner which enables Service Users to feel safe and secure, whilst promoting independence. All staff have undergone appropriate employment checks. Candidate selection for employment is always carefully considered, with a three-month probationary period. All staff receive an Employment Contract, including Terms & Conditions, a Staff Handbook and a Job Description. We have an appropriately qualified workforce, with 74 of the staff who deliver personal care holding NVQ2 or above. A Staff Rota is displayed, showing what staff are on duty at specific times. All staff receive Induction training, mandatory and other training, including regular updates. DS0000067065.V371230.R01.S.doc Version 5.2 Page 23 Staff Supervision and Appraisals highlight personal development and training needs, Fauld House ensures staff have the required skills to meet Service Users needs. Staffing levels are maintained, with the correct numbers and skill mix, as recorded on the staff rotas.” The service has a qualified nurse RGN care manager on duty five days a week supported by a full time Deputy Care Manager who is also a qualified nurse RGN. Staff rotas for June 6th and 29th, and July 13th and 27th (all 2008) were examined. These evidenced that there had been staff absences and sickness during this period, and staffing levels had not been maintained. This was subsequently highlighted and discussed with the care manager. The reasons given were staff sickness, and two staff leaving during that time. The agency had been unable to provide staff at such short notice, and bank staff had covered on some occasions. Staff recruitment has since taken place, and the situation has improved. We also discussed the need for the staffing levels to be regularly reviewed in line with the needs of the people who use the service. We noted from the AQAA document provided by the care manager, that 18 people living at the home have mental health needs, and 22 people are having assistance due to continence management. This would clearly indicate a need to keep staffing levels under review. Current staffing levels were confirmed to be as follows: a.m. one qualified nurse plus five care assistants plus the care manager RGN for five days, p.m. one qualified nurse plus four care assistants, nights one qualified nurse plus one care assistant (waking nights) plus a qualified nurse on-call. We looked at the staff ‘training matrix’. The care manager confirmed that not all staff members were included in the training matrix provided to us. This was discussed at the time with the care manager. Training in regard to Dementia Care, Updates in Food Hygiene, Abuse of Vulnerable Adults, and Infection Control were highlighted and recommended to the care manager to be arranged this is to make sure that all staff are fully trained to look after the people in their care. Recruitment records were examined and staff spoken with. Staff confirmed that they attend regular supervision and staff meetings. They also confirmed the training that they had undertaken. Records seen did not evidence that CRB/POVA checks had been undertaken. This was highlighted and discussed with the care manager at the time. This was thought to be because the DS0000067065.V371230.R01.S.doc Version 5.2 Page 24 administrator was on leave, and the care manager was unable to access the information. The care manager was asked to forward the information to us as soon as possible. This information was subsequently forwarded to us. DS0000067065.V371230.R01.S.doc Version 5.2 Page 25 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): 31,33,35,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the service is based on openness and respect. Effective quality assurance systems developed by a qualified, competent manager help to make sure that the service is run in the best interests of the people who use it. EVIDENCE: The service’s Annual Quality Assurance Assessment (AQAA) document, which was completed by the care manager, was returned to us on time, and was completed to an adequate standard. DS0000067065.V371230.R01.S.doc Version 5.2 Page 26 The Annual Quality Assurance Assessment document completed by the care manager confirmed the following: “The Care Manager has 20 years experience in an elderly care setting and holds the NVQ Registered Managers Award. Fauld House has a clear and accountable Management structure. All staff receive Induction Training and annual appraisals to identify any training needs. Essential Records are kept for a minimum of 7 years. Fauld House has up to date Policies and Procedures, available at all times. Regular Service Users Questionnaires are distributed. Service Users are able to see their own Records, if they wish. We provide a safe place for Service Users to keep their money. Appointed Health & Safety Officers ensure that Fauld House complies with all relevant issues, laws and regulations.” Personal monies held by the home for people who use the service were not spot checked on this occasion, and will be monitored during our next inspection. The care manager confirmed that quality assurance surveys were sent out this year to the people who use the service and their relatives and representatives. The feedback from these survey’s was in the process of being collated at the time of our inspection visit. People we spoke to confirmed that they generally receive a good service. Staff we spoke to were all committed to looking after the people in their care to a good standard. At the end of our inspection, feedback was given to the care manager, outlining the overall findings of the inspection, and giving information about the recommendations that we would make for example, more work is needed in relation to Health and Safety monitoring of the environment, and the quality and consistency of pre-admission assessments and risk assessments undertaken for people using the service. Staffing levels should be monitored and reviewed in line with the needs of the people who use the service. DS0000067065.V371230.R01.S.doc Version 5.2 Page 27 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 3 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 X 3 x x 2 DS0000067065.V371230.R01.S.doc Version 5.2 Page 28 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. 1. 2. 3. Refer to Standard OP3 Good Practice Recommendations Assessments for people on respite care should be more comprehensive and should contain all the information necessary to meet their needs. Risk assessments should be clearly recorded, kept under review, and updated to reflect any changes in the individual’s condition. Care plans would benefit from the recording of the person’s social history, for example, lifestyle, hobbies and interests prior to moving into the home. This would enable a care plan that is more tailored to the person’s needs. Menus should be clear and should be available in large print. People using the service should have a choice of main meal each day, and this should be clearly written on the menu, and on the chalkboard in the dining area. Staffing numbers should be regularly reviewed, and should be appropriate to the assessed level of needs of people DS0000067065.V371230.R01.S.doc Version 5.2 Page 29 OP7 OP7 4. 5. 6. OP15 OP15 OP27 7. 8. 9. 10. 11. OP27 OP30 OP30 OP30 OP30 who use the service. The staff rota should include the names and the hours worked by bank staff when covering for staff sickness and or absence. Staff should receive regular update and refresher training in regard to Safeguarding and Abuse of Vulnerable Adults. Staff handling food should receive update refresher training in regard to Food Hygiene. Staff should receive training in Dementia Care. The staff training matrix should include all members of staff working at the service. DS0000067065.V371230.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection West Midlands Office 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 DS0000067065.V371230.R01.S.doc Version 5.2 Page 31 - 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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Fauld House Care Home 01/08/06

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