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Care Home: Firs (Firwood Intermediate Rehabilitation Service)

  • Brassey Avenue Firwood House Hampden Park Eastbourne East Sussex BN22 9QJ
  • Tel: 01323503758
  • Fax: 01323509741

Firwood House is run by East Sussex County Council (ESCC) the Registered Provider, working in partnership with the Eastbourne Downs and Weald NHS Primary Care Trust (PCT) and is the base for a range of services and facilities. Firwood House is purpose built on two floors, set in its own grounds in Hampden Park, which is located approximately three miles from Eastbourne town centre. There is a twenty-two bedded intermediate care unit on the first floor called Firs, which provides service users resident on the unit with a period of rehabilitation for up to six weeks. There are twenty single bedrooms and one further bedroom, which is a bedroom/sitting room and available for double occupancy. All the bedrooms have en-suite facilities of a toilet, wash-handbasin and shower. There are further assisted bathing facilities on the unit. Telephone facilities are in all the bedrooms. A dining area on the ground floor is for all service users accessing the building, a lounge and seating area with a kitchen facility is situated on the unit for the use of the service users resident on this unit. Level access is facilitated with the provision of a passenger lift in the building. An attractive garden is situated at the rear of the building. Downstairs is the Firwood Rehabilitation Unit open Monday to Friday, a day therapy service, the facilities of which are used by service users on the Firs unit. The Community Rehabilitation Service, Community Stroke Rehabilitation Service, Speech and Language Team and a Dietician are based at Firwood House and can also offer support and guidance. The service is free for up to the six weeks that intermediate care is provided. Following this fees charged are in accordance with ESCC policy and proceduresFirs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 5and at the time of the inspection the charges are £102.90per week to 545.00 per week with daily charges from £14.70 per night to £77.65 per night. The level of fees charged will depend on the outcome of a financial assessment. Charges are made for hairdressing, chiropody, outgoing telephone calls, newspapers/magazines and toiletries. The Statement of Purpose and a copy of the last Inspection report are available to view on the unit. A copy of the Service Users Guide is available to read in each of the service users bedrooms.

  • Latitude: 50.798000335693
    Longitude: 0.26899999380112
  • Manager: Mrs Helen Hewson
  • Price p/w: £103
  • UK
  • Total Capacity: 22
  • Type: Care home with nursing
  • Provider: East Sussex County Council
  • Ownership: Local Authority
  • Care Home ID: 6503
Residents Needs:
Old age, not falling within any other category

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Firs (Firwood Intermediate Rehabilitation Service).

CARE HOMES FOR OLDER PEOPLE Firs (Firwood Intermediate Rehabilitation Service) Firwood House Brassey Avenue Hampden Park Eastbourne East Sussex BN22 9QJ Lead Inspector June Davies Unannounced Inspection 26th June 2008 09:15 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 Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.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. Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Firs (Firwood Intermediate Rehabilitation Service) Firwood House Brassey Avenue Hampden Park Eastbourne East Sussex BN22 9QJ 01323 503758 01323 509741 caroline.piper@eastsussex.gov.uk www.eastsussex.gov.uk/socialcare East Sussex County Council Address 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) Vacant Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. A maximum of twenty-two (22) service users to be accommodated on the first floor. That service users are over the age of sixty-five (65) years or over on admission. That nursing care be provided. That three (3) places will be available for service users between the age of fifty-five (55) and sixty-four (64). That only bedroom number 20 can be used as a twin room if requested by the service users. 29th June 2007 Date of last inspection Brief Description of the Service: Firwood House is run by East Sussex County Council (ESCC) the Registered Provider, working in partnership with the Eastbourne Downs and Weald NHS Primary Care Trust (PCT) and is the base for a range of services and facilities. Firwood House is purpose built on two floors, set in its own grounds in Hampden Park, which is located approximately three miles from Eastbourne town centre. There is a twenty-two bedded intermediate care unit on the first floor called Firs, which provides service users resident on the unit with a period of rehabilitation for up to six weeks. There are twenty single bedrooms and one further bedroom, which is a bedroom/sitting room and available for double occupancy. All the bedrooms have en-suite facilities of a toilet, wash-handbasin and shower. There are further assisted bathing facilities on the unit. Telephone facilities are in all the bedrooms. A dining area on the ground floor is for all service users accessing the building, a lounge and seating area with a kitchen facility is situated on the unit for the use of the service users resident on this unit. Level access is facilitated with the provision of a passenger lift in the building. An attractive garden is situated at the rear of the building. Downstairs is the Firwood Rehabilitation Unit open Monday to Friday, a day therapy service, the facilities of which are used by service users on the Firs unit. The Community Rehabilitation Service, Community Stroke Rehabilitation Service, Speech and Language Team and a Dietician are based at Firwood House and can also offer support and guidance. The service is free for up to the six weeks that intermediate care is provided. Following this fees charged are in accordance with ESCC policy and procedures Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 5 and at the time of the inspection the charges are £102.90per week to 545.00 per week with daily charges from £14.70 per night to £77.65 per night. The level of fees charged will depend on the outcome of a financial assessment. Charges are made for hairdressing, chiropody, outgoing telephone calls, newspapers/magazines and toiletries. The Statement of Purpose and a copy of the last Inspection report are available to view on the unit. A copy of the Service Users Guide is available to read in each of the service users bedrooms. Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. This key unannounced inspection took place on the 26th June 2008 over a period of six hours. The inspector spoke with the appointed manager, four members of staff and nine residents. A tour of the home was carried out, together with observation of a medication round, client activities and a lunchtime meal. During this inspection the inspector looked at documentation relevant to the standards inspected. Information contained within the Annual Quality Assurance Assessment was also taken into account when writing this report. What the service does well: This home provides a good quality Intermediate and Rehabilitation Service to clients that require to regain skills to enable them to move back into their own homes. Pre-admission assessments are gained prior to a client moving into the home for rehabilitation, from members of the multi disciplinary team. These assessments are used to initiate the client’s care plan. The multi disciplinary team based in the home carry out further assessments once the client has arrived at the home to ascertain what daily input needs to take place for rehabilitation. The activities programme, which consists mainly of rehabilitation work, is excellent, with clients using the gym on a daily basis, being involved in cooking, both in the activities programme and as part of occupational therapy. The home provides excellent facilities for the clients to use during their stay to ensure that intensive work is put into their rehabilitation and to enable the clients to quickly move back into their own homes. Staffing levels are good and a trained nurse leads day shifts, to ensure that there is always medical assistance available if required. The staff in the home have the appropriate skills and knowledge to meet the clients needs. The appointed manager has a wealth of experience in management, and ensures that the staff team work together for the benefit of the clients. Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.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 Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.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 2, 3, and 6 People using this service experience Good quality outcomes in this area. Comprehensive information about the home is available to prospective clients and to new clients who move into the home for rehabilitation. All clients are given contracts on the day of admission, which clients and or their relative/representative sign. Detailed pre-admission assessments are gained prior to a client moving into the home to ensure that the home can meet the client’s needs. The home is dedicated to providing a rehabilitation service to its clients, and this includes good specialist care as well as a dedicated staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 10 Firwood has a comprehensive Statement of Purpose and Service User Guide, it is not always possible for potential clients to be given this information prior to them coming into the home, due to the fact that some clients are admitted to the home quickly either by the clients own general practitioner or by the hospital social worker. Each bedroom has a copy of the Service User Guide and staff are available to explain the contents of this document to clients if necessary. The inspector spoke with nine clients all said that while they were not given information prior to being admitted to Firwood, they are aware that information is available in their bedroom and is there for them to refer to if they wish to. The manager stated that she does all she can to ensure that clients are given information prior to moving into the home, and while she does give pre-admission information to general practitioners and hospital social workers the information is not given to the clients. Each client is given a contract of residence; this states the room number that the client will occupy while undergoing rehabilitation. The service is free for the six weeks of their rehabilitation stay, and will remain free if there is an ongoing health problem. Where there is not an ongoing health problem clients are then assessed on the financial status, and a fee is charged accordingly. From the three contracts seen the inspector verified that clients are required to sign the contract. One contract did not state the number of the room that the client would occupy. When the home receives a call from either the hospital for a step down bed, or the general practitioner via STAN (single telephone access number) for a step up bed, the home completes a Rapid Single Assessment, this requires detailed information on which the home can assess if it is able to meet the rehabilitation needs of the client, through the resources it has available within the home. Other pre-admission assessments are also obtained from the external multi disciplinary team who have knowledge of the client. Firwood only provides intermediate rehabilitation care for clients admitted to the home from the hospital or the community. The staff in the home have all been trained by the multi disciplinary team to rehabilitate the clients in the home. The clients also have daily access to a variety of specialties, including a physiotherapist, occupational therapist, speech and language therapist and the falls prevention team. Part of the ground floor is dedicated to the specialist teams offices, as well as an excellently equipped gym, and occupational therapy kitchen. None of clients are expected to stay beyond their six week contract for rehabilitation unless other health care needs that can be met by the home requires them to do so. Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.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 People who use this service experience Good quality outcomes in this area. The care planning system is consistent and provides staff with the information they need to ensure they meet the client’s needs. The health needs of the clients are well met withy evidence of good multi disciplinary working taking place on a regular basis The systems for medication administration are good with clear and comprehensive arrangements in place to ensure client’s medication needs are met. Personnel care is offered in a way to protect clients’ privacy and dignity and promote independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 12 Care plans are generated via the pre admission assessments gained prior, and immediately a client moves into the home. The inspector viewed three care plans and found them to be detailed and comprehensive as to the physical, personal hygiene and social needs of the client the care plan also contains a variety of risk assessments e.g. falls, malnutrition, tissue viability etc. The care plans details likes and dislikes of the client, as well as listing medication, and how staff will assist with personal hygiene. Behind the initial care plan there are sections with each section relating to notes of each speciality team assisting the client with his or her rehabilitation. In each clients bedroom there is a small white board that outlines the clients personal goals, physiotherapy assistance, occupational health assistance and what nursing assistance the client needs so that staff can see at a glance what they are meant to be doing for each client. The staff nurse on duty also has a handover sheet that is up dated and printed out on a daily basis, this explains in detail small issues that have some impact on the clients care this information is then given to staff at each change over. Clients have access to a whole range of health care professionals who are dedicated in rehabilitating the client to return to the community as soon as possible. Care plans are regularly reviewed to ensure that the client’s goals are being met, and care plans are updated accordingly. The inspector observed a lunchtime medication round carried out by the Staff nurse on duty. Mediation is obtained primarily from the hospital pharmacy and as a last resort from a local pharmacy. Each client has a box, which holds all their medication, with exception of external treatments and liquid medications. The inspector noted that medication records are signed off after the client has taken their medication. There were no gaps in the medication records. The medication room and trolley were all hygienically clean. There is an up to date and comprehensive medication policy and procedure. All staff administering medication have received medication training. At the present time none of the clients in the home are prescribed controlled drugs, but the staff nurse was able to tell the inspector the procedure for dealing with controlled drugs. Staff were observed talking to clients in a kindly and professional way, while at the same time respecting their privacy and dignity. Nine clients said, ‘I cannot praise too highly the care I have received while I have been here.’ ‘I have received so much help and kindness here it is going to be difficult to leave.’ ‘This place has done so much for me, I am nearly ready to go home, and I have been taken on three occasions to visit my home to make sure I can manage.’ ‘This home has been a godsend for me; I would not have received the same kind of care in hospital. All the staff here are so kind.’ ‘What a wonderful place this is, and what wonderful staff.’ ‘Everybody has been so kind, and the time goes so quickly, I forget what day it is.’ ‘Everything Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 13 about being here has been good, the staff are so kind, and I have received so much help.’ ‘I am so much better now, I feel a bit worried about going home.’ ‘We are all kept so busy, we do not have time to worry about anything, the staff here are wonderful.’ Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.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): Standards 12, 13, 14 and 15 People who use this service experience Excellent quality outcomes in this area. Activities are offered that support the clients in their rehabilitation. Contact with the community is good and there is no restriction on visiting times. The meals in this home are good offering both choice and variety and catering for special diets. This judgement has been made using available evidence including a visit to this service. EVIDENCE: While clients are in the home they are able to make choices in regard to their daily lives. On the day of this inspection one client was not feeling too well and had been allowed to stay in bed. Mealtimes are extended to ensure that clients have choice as to when they wish to take their meal. There are a Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 15 variety of activities in the day lounge, which the clients can participate in if they wish to. For most clients they have a very busy day. Clients visit the gym after breakfast on a daily basis, here they have a variety of equipment, which they are able to use under supervision of the physiotherapist, and some activities they take part in as a group. Following the visit to the gym clients’ return to the first floor where they have a drink of their choice and biscuits, and take part in baking or cooking activity, there is also a gardening club, and a curry club. All activities are based around daily life, to ensure that clients have the skills to be able to live back at their own home. There are also occupational therapy assessments carried out in the occupational therapy kitchen. Occupational therapists take a client nearing the end of their stay, back to their own home on a gradual basis, with the client spending longer periods of time in their own home before discharge. A daily log is kept of the activities that clients take part in. On the day of the inspection the inspector observed nine clients preparing to bake a banoffie pie. Where it is noticed that a client declines activities this is also recorded and taken to review, and discussed with the multi disciplinary team. The discharge co-ordinator will then discuss rehabilitation with the client. The ethos of the home is to ensure clients have the mobility and skills to return to their own home within six weeks of them coming into Firwood. Outside entertainers are brought into the home from time to time, the most recent one being age concern who carried out a session on entertainment. Clients are able to maintain there religious beliefs while they stay at Firwood and the service user guide outlines what religious beliefs can be met by the home and how clients can contact the denomination of their choice. The home does not get involved with clients’ personal finances, and it is up to the client to say if they require help, the manager will then make arrangements for them to receive help via a social worker. The inspector viewed the four-week rotating menu, which is changed twice a year. All food provided on this menu is cooked using fresh ingredients. Menus showed that clients are offered a variety of nutritious meals. On the day of the inspection clients were enjoying a roast dinner that had been served in an appealing manner after the main course the cook then went to each client with a sweet trolley and clients were able to make a choice of the sweet they would like. Generally for breakfast clients are offered a choice of cereals, toast, bread and hot drink, cooked breakfast can be catered for on request. There is also a breakfast club where clients working towards independence and going home get their own breakfasts. At teatime clients are offered a choice of cooked food, sandwiches, cakes and drinks. A record is taken of all food the client eats to ensure that nutritional needs are being met. The cook confirmed that she is able to cater for specialised diets as and when required. Where clients need assistance with eating their food this is carried out discreetly by the staff. Clients told the inspector that they really enjoyed the food they were given; all clients said that they were given choice and could Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 16 pick the food they liked. None of the clients had anything detrimental to say about the food they had received in the home during their stay. Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.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): Standards 16 and 18 People who use this service experience Good quality outcomes in this area. Clients know their complaints will be listened to and acted on. Staff have a good knowledge and understanding of Safeguarding Vulnerable Adults, which protects the clients from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy and procedure is reviewed regularly. The complaints procedure is included within the service user guide as well as being displayed in pamphlet form. The home has received one complaint since the last inspection. All documentation relating to this complaint is kept within the complaints file in the manager’s office together with an outcome of complaint. This complaint was dealt with appropriately and within the timescale set out in the complaints policy and procedure. Four clients said they would know how to complain and that initially they would make the complaint to the nurse of duty, who they would expect to pass on to the manager. The home uses the Sussex Multi Agency Policy and Procedures for Safeguarding Vulnerable Adults. There have been no adult protection issues Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 18 since the last key inspection. Where it is necessary to remove a clients Zimmer frame from the dining room a prescriptive intervention form is completed. Zimmer frames are removed from the dining room tables to prevent accidents to other clients in the home. With exception of two staff all the East Sussex County Council Staff have received Safeguarding Vulnerable Adults training, two staff are due to receive this training. Where nurses are employed in the home, the NHS employs them and the NHS provides training. Two staff stated that they had received training and would know what to do if they suspected an act of abuse had occurred. Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.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): Standards 19 and 26 People who use this service experience Excellent quality outcomes in this area. Clients live in a safe, clean and comfortable environment that provides them with all the facilities to aid their rehabilitation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Firwood provides a pleasant, light and airy environment for its clients. The home is well decorated and furniture is of a good quality. There is a passenger lift between the two floors. The dining room is based on the ground floor, with domestic style tables and chairs. There is a communal dining room on the first floor, with kitchen facilities, which clients are able to use for the cookery Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 20 clubs and group activities. The 21 bedrooms with en suite facilities are situated on the first floor, all are well decorated and furnished. The bedrooms are spacious light and airy. One bedroom is registered as a double room, but is used mainly as a single room. There are two communal bathrooms, one is fully fitted with bath hoist and appropriate handrails and mobility aids, the other bathroom is presently used as a storage room for specialist equipment that are not presently being used by the clients in the home. There is a back garden that is safe and secure for the clients to use. The clients gardening club also takes place in this garden. The clients were all full of praise for the facilities in the home. There is an under floor heating system in the home; all hot water outlets provide hot water close to 43ºC and this is checked on a regular basis. All windows are fitted with window opening restrictors. All rooms in the home have a call bell facility. The laundry room is situated on the ground floor and is clean and fitted with appropriate industrial washing machines with sluicing and disinfecting programmes. The home is clean and free from offensive odours, and the domestic staff take pride in keeping the home clean. One member of domestic staff spoken to by the inspector was able to verify that she has received all the appropriate training such as infection control, COSHH etc. As part of the quality assurance system used in the home the manager regularly carries out checks on cleanliness, infection control, health and safety and fire risk assessments. The home meets the requirements of the fire safety officer. The PCT infection control nurse inspects the home on a regular basis and any recommendations are acted upon. Clients were full of praise for the laundry system in the home, saying that laundry placed out for washing in the morning is received back in the afternoon, and that they always receive their own laundry back. Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 21 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 People who use this service experience Good quality outcomes in this area. Staff are employed in sufficient numbers to meet the assessed needs of the clients. Staff morale, is high resulting in an enthusiastic workforce that works positively with clients to improve their whole quality of life. Staff are multi skilled to ensure good quality care and support. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Nursing, physiotherapy, occupational therapy and other health speciality staff are funded via the PCT, with the manager, team leaders rehabilitation support workers and ancillary staff being funded by East Sussex Social Services. The inspector viewed the staffing rota and spoke with staff on duty that were able to confirm that there are always sufficient staff on duty to meet the clients needs. Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 22 At the present time 53 of rehabilitation support workers have obtained their NVQ level 2 or above with one member of staff working towards this qualification. 30 of pool/bank workers have achieved their NVQ qualification. Where staff are employed by the PCT they are recruited via the Human Resources Department of the local hospital. Rehabilitation Support Workers and ancillary staff are employed following East Sussex County Council recruitment practices. The files for three members of staff were viewed and showed that stringent recruitment practises take place with all staff being appropriately checked prior to taking up employment. All staff have received their mandatory training in Moving and Handling, Food hygiene, Medication, Adult Protection, Infection Control and Fire Safety, this was confirmed via the training matrix and staff spoken to during the inspection. New staff receive initial induction as well as ‘Skills for Care’ induction. Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 23 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 People who use this service experience Good quality outcomes in this area. The Manager has a good understanding of the areas in which the home needs to improve. The quality assurance system that has been developed ensures that clients receive the best quality of care. Clients know where they have requested the home to look after money and valuables; the procedure for this ensures safety and peace of mind for the clients. There are good procedures for health and safety within the home to ensure that clients and staff live and work in a safe environment. This judgement has been made using available evidence including a visit to this service. Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 24 EVIDENCE: The appointed manager has worked for East Sussex County Council for many years at management level. Her qualifications include a Certificate in Management, NVQ level 4, Registered Managers Award and she is an Internal Verifier for NVQ. She is in the process of applying to The Commission for Social Inspection to be the registered manager. While most of her working day requires her to administratively manage the home, she ensures that she visits the clients on a daily basis to see that the clients are receiving the best quality of care. There are clear lines of accountability within the organisation. Staff were very clear as to what their roles are and who they would approach if they needed to. From viewing the quality assurance system in the home, the inspector was able to confirm that quality questionnaires are received from clients, relatives and other interested parties. It was noted that professional stakeholder questionnaires are rather lengthy and complicated, and need to be reviewed to ensure that visiting professionals can complete them quickly and in the minimum of time. Quality monitoring of systems used in the home regularly take place and are recorded. There is a regular check of fire safety and health and safety in the home. From the questionnaires and monitoring checks an annual report is published which shows what the home is doing well, the improvement planned for the coming year and other issues that the manager and staff need to work on to ensure that the home is offering the best quality of care for its clients. While the home does not manage the personal allowances for the clients on occasions some clients request that the Manager looks after their money and valuable items that they bring into the home with them. For this purpose the home has a finance and personal items sheet. Where clients request this service all monies and personal items are recorded onto the sheet and signed by the client and two members of staff and a receipt is given to the client. Where clients request some money this is entered onto the finance sheet and signed by the client or two members of staff. The finance/personal valuables sheet and money/valuables are kept securely in the home until the client is discharged. Health and safety procedures in the home are good, with all staff having received their mandatory training in health and safety issues. All cleaning materials are locked in the COSHH cupboard. All equipment used in the home has up to date maintenance certificates. There are policies and procedures in place for health and safety issues, but it is noted that some of these have not been reviewed since 2005. As reported earlier all windows are fitted with window opening restrictors, hot water is delivered close to 43ºC. The Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 25 premises are secure and provide a safe environment for the clients and visitors to the home. The manager ensures that risk assessments are in place for fire risk and health and safety. Accidents are appropriately recorded in an accident book and reported to the relevant authorities as required. Client falls are monitored and the mobility risk assessment reviewed, discussion takes place at staff handover, and where necessary the client is referred to the Falls team. All new staff are required to complete ‘Skills for Care’ induction. Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 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 Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 27 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. Refer to Standard OP2 OP33 Good Practice Recommendations The manager must ensure that client’s contracts always contain the number of the room they will occupy during their rehabilitation. The professional stakeholder questionnaire should be reviewed to ensure that it is not too complicated and does not take too much time to complete. Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Firs (Firwood Intermediate Rehabilitation Service) DS0000059634.V363600.R01.S.doc Version 5.2 Page 29 - 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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