Care Home: Forde Park Residential Home

Similar services:

• The Vicarage
• Fairfields Country Rest Home
• 7 Hyde Road
• 5 Seafield Road
• Poldhu
• Queensmount
• Trevaylor Manor
• Didsbury Court Rest Home

What the care home does well Forde Park Residential Care Home is well managed and provides a safe, comfortable and homely place in which individuals can live their lives. Everyone looked clean and well cared for. Everyone living at the home has a care plan that sets out their needs. Staffing levels, though variable are sufficient to meet the needs of people currently living at the home and staff are well trained. People living at the home said that staff were helpful and friendly. One person commented via a survey form that `The home has an air of tranquility, homeliness and care`. Staff said that they felt well supported by management and each other. Staff said via survey forms, that the home `genuinely cares for the physical and emotional needs of the residents in their care` and `The clients are happy and that`s what`s important, they get the care they need and deserve`. Another said when asked what the home does well `interact and reminisces with residents`. There was evidence of good multi-disciplinary working with other professionals and records, including those relating to medication administration were generally well maintained. People felt that meals were very good and there was a good variety of food available, also that there was always an alternative if they didn`t want what was on the menu. What has improved since the last inspection? All staff have now received training in POVA (Protection of Vulnerable Adults) issues. The home is now aware of its duty to report to the Commission any accidents to individuals that require professional medical attention. The manager now assess people prior to them moving into the home, wherever possible. Staff now record on the MAR (Medication Administration Record) sheet when they have applied topical creams to individuals. Staff meetings are held more regularly and staff now read (and sign to say they have read) all the policies and procedures for the home. What the care home could do better: More detailed assessments need to be completed before people are admitted to the home in order to ensure their needs can be met. Care plans should be more organised and give clear directions to staff on meeting people`s needs and all recordings made about people should be recorded individually. Risk assessments for everyone need to be more detailed, covering all areas of risk and should show any measures in place to minimise the risks. Medication arriving at the home should be counted and the quantity entered onto the MAR (Medication Administration Record) sheet and signed for, so that there is a record of the medication received into the home. All handwritten entries on MAR sheets should be double signed to ensure the entry is correct.The doors to the laundry and the back stairs (from the first floor) should be fitted with suitable locks to prevent people living in the home having access to the steep stairs. The vinyl floor covering in the first floor bathroom should be made safe to prevent people tripping on the uneven surface and the hot water system needs attention to improve the consistency of the temperature of the hot water to ensure that it is hot enough to wash with. Consideration should be given to finding an alternative location for the laundry to prevent it flooding and minimise the risk of contamination. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Forde Park Residential Home 18 Keyberry Park Newton Abbot Devon TQ12 1BZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sue Dewis     Date: 1 2 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Forde Park Residential Home 18 Keyberry Park Newton Abbot Devon TQ12 1BZ 01626352904 01626356847 r.underhill@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Wilson Crawford Partnership care home 15 Number of places (if applicable): Under 65 Over 65 0 15 15 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home 15 0 0 Forde Park Residential Home is registered to provide accommodation and care for a maximum of fifteen people in the registration categories of Old Age, Physical Disabilities (over 65) and Dementia (over 65). The home is situated in a residential area of Newton Abbott and is approximately one mile from the town centre, which has a wide range of facilities including shops, restaurants and a main line railway centre. There is an hourly bus service between the home and the town centre. Information about the home is available in the form of a Statement of Purpose and a Service Users Guide. Copies of inspection reports are placed in the entrance hall and kept available for residents and visitors to read. Care Homes for Older People Page 4 of 29 Brief description of the care home The current fees are between 420 and 450 pounds a week and cover the costs of care, accommodation, food and some toiletries. Additional charges are made for optional extras including private hairdressing and chiropody, newspapers, transport for trips, telephone calls and some escort duties. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced visit took place over 13 hours, on 2 days in the middle of May 2009. The first day of the visit was spent talking with staff and residents and looking at staff files. The second day was spent speaking with the manager and looking at care plans. The home had been notified that a review of the home was due and had been asked to complete and return an AQAA (Annual Quality Assurance Assessment). This shows us how the home has managed the quality of the service provided over the previous year. It also confirms the dates of maintenance of equipment and what policies and procedures are in place. Information from this document was used to write this report. Care Homes for Older People Page 6 of 29 Although only one inspector undertook this inspection, throughout the report there will be reference to what we found and what we were told. This is because the report is written on behalf of the Care Quality Commission (CQC). During the inspection 3 people were case tracked. This involves looking at peoples individual plans of care, and, where possible speaking with the person and staff who care for them. This enables the Commission to better understand the experience of everyone living at the home. As part of the inspection process CQC likes to ask as many people as possible for their opinion on how the home is run. We sent questionnaires out to some people living at the home, and some staff. At the time of writing the report, responses had been received from 7 people living at the home and 5 staff. Their comments and views have been included in this report and helped us to make a judgement about the service provided. During the inspection 2 people living at the home were spoken with individually and 3 in a group setting, as well as observing staff and people living at the home throughout the day. We also spoke with 2 representatives, 2 staff, a District Nurse and the manager. A full tour of the communal areas of the building was made and a sample of records was looked at, including medications, care plans and staff files. All key standards were inspected. One complaint has been received by the Commission since the last inspection. This related to the security of the building, access to the building and the siting of the laundry. The complaint was passed to the Responsible Individual for the company to investigate through their own complaints procedure. The complaint was dealt with appropriately. What the care home does well: What has improved since the last inspection? What they could do better: More detailed assessments need to be completed before people are admitted to the home in order to ensure their needs can be met. Care plans should be more organised and give clear directions to staff on meeting peoples needs and all recordings made about people should be recorded individually. Risk assessments for everyone need to be more detailed, covering all areas of risk and should show any measures in place to minimise the risks. Medication arriving at the home should be counted and the quantity entered onto the MAR (Medication Administration Record) sheet and signed for, so that there is a record of the medication received into the home. All handwritten entries on MAR sheets should be double signed to ensure the entry is correct. Care Homes for Older People Page 8 of 29 The doors to the laundry and the back stairs (from the first floor) should be fitted with suitable locks to prevent people living in the home having access to the steep stairs. The vinyl floor covering in the first floor bathroom should be made safe to prevent people tripping on the uneven surface and the hot water system needs attention to improve the consistency of the temperature of the hot water to ensure that it is hot enough to wash with. Consideration should be given to finding an alternative location for the laundry to prevent it flooding and minimise the risk of contamination. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission procedure does not always ensure that there is a proper assessment prior to people moving into the home, and therefore they cannot always be assured that their care needs can be met. Evidence: There is a Statement of Purpose, Service User Guide and Brochure available to people thinking of moving into the home. The manager told us that she is generally the person that now completes the preadmission assessments, unless she is unavailable, and she explained the admission process from when she first receives a referral. She said that she will go to see the individual in their own home or hospital and complete an assessment form, she also collects as much other information from as many people as possible. However, of the three files that were looked at two contained limited information and one had no Care Homes for Older People Page 11 of 29 Evidence: assessment at all. People must be fully and appropriately assessed prior to being admitted to the home in order to ensure that their needs can be met. People that we spoke with were unable to tell us if they had received enough information about the home before they moved in. However, one person commented via their survey form that they felt they didnt have enough information about fees prior to them moving into the home. We were told that people are always invited to look around the home, but many rely on their relatives to do this on their behalf. The home does not provide intermediate care. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are detailed, but do not always provide staff with clear information on meeting the needs of the individual. The management of medication needs to be improved. Evidence: Three care plans were looked at and each contained comprehensive information about the person, including Personal Hygiene, Sleeping Assessment and Social Interaction and Emotional Support. However, the plans were very confusing, old care plans were kept in the same folder as new ones and it was difficult to tell which was the current one. There was little direction to staff on how peoples needs were to be met. For example, one plan stated that X can be aggressive towards staff - will throw things when annoyed, but there were no instructions to staff on how to deal with the situation. Although it was clear through discussions with staff that they knew the people they Care Homes for Older People Page 13 of 29 Evidence: care for very well and knew how best to meet to meet their needs, this lack of instruction to staff could lead to inconsistent care being given, especially with staff being rotated between the residential and nursing homes (see Staffing). There was no evidence that people had been involved in completing their care plans. One care plan that was seen was excellent and contained detailed information for staff on how they were to manage behaviour. The individual had been receiving 1:1 care and their specialist worker had written the care plan. The manager told us that she and the staff were working on new care plans that would be more organised and give good directions to staff on meeting peoples needs. There were some risk assessments completed that included Waterlow (for pressure areas) and Moving and handling. However, not all of the risk assessments had been reviewed. For example, one Moving and Handling plan had not been reviewed since June 2008. This plan stated that the person was a capable independent person - can get out of bed on their own, but we were told by staff that this person was now bed bound. There were no full risk assessments for the individual relating to their personal safety. Part of the complaint received by the Commission related to an individual wandering away from the home without staff being aware they were missing. The manager told us that this matter has been addressed and has not happened since. The daily records for people contained some good observations but they did not always evidence how the persons needs had been met. A communication book is also kept for staff to pass on information. A lot of personal information about everyone is recorded here. Any personal information about individuals should be made separately so that people wishing to see information about themselves cannot see information about other people. Information about visits from health care professionals had been recorded in individual care plans, showing clear evidence that people are supported to maintain access to specialist medical services. These included GPs and District Nurses. One visiting District Nurse was spoken with during the visit, they told us that they always found the staff to be polite and friendly and that any problems the staff identified were quickly reported to the District Nursing service. They also said that although they didnt visit very often they found the care to be good and had never seen anyone receiving poor care. There is a policy and procedure for the administration of medicines. All medicines were Care Homes for Older People Page 14 of 29 Evidence: seen to be stored correctly and staff were seen administering them appropriately and signing the MAR (Medication Administration Record) as needed. We were told that all staff who administer medication have received appropriate training and that no-one administers medication until they feel confident to do so. However, medication is not counted and the MAR sheet signed when it is received at the home. This means that any inaccuracies by the chemist would not be picked up by the home and the home does not have an accurate record of the quantity of medication in the home. Handwritten entries recorded on the MAR sheet, for example when antibiotics had been prescribed, had not been double signed to confirm the accuracy of the entry. Noone at the home currently looks after their own medication and the home does not have a homely remedies policy as it only administers medication that has been prescribed for the individual by their GP. All individuals we saw during this visit looked well cared for, were treated with respect by the staff and their right to privacy was upheld. Personal care was seen to be offered in a discreet manner. Staff told us how they respect peoples privacy when helping them with personal care and we heard staff speaking with people in a kindly, friendly way and there was an obvious affection between staff and the people they care for. The representatives that we spoke with were happy with the care their relative received, who, they said was very happy at the home and always looked well cared for. They also said that they were always kept well informed about their relatives health and that they were always told when a GP had visited. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social interaction and activities are available, and there is good daily variation for people living in the home. Evidence: People told us that they can choose how and where they spend their time and routines within the home are flexible. Staff told us that they are always asking people what they would like to do in the way of activities or outings. We were told that there is a wide range of activities available for people, including board games, videos, gentle exercises, walks, shopping and trips out on the mini bus. We were told that 2 people go out regularly to a local day centre and to church. We saw people taking part in a quiz and they said that they enjoyed sessions like that. Staff told us that they have time to spend with people on an individual basis either sitting and chatting or taking them out shopping or for a walk. We were told that although meetings had been held with individuals and their representatives for them to discuss issues about the home, a meeting had not been held recently. Care Homes for Older People Page 16 of 29 Evidence: People living at the home told us that their family and friends can visit them at anytime and that they are always made welcome. Representatives told us that they were encouraged by staff to visit at anytime. The menu plans that were seen show that a set meal is offered at lunch time but that alternatives, including a vegetarian option are made available on request. Lunch is cooked at Forde Park Nursing Home, which is a part of the same company and is situated a few yards down the road. Food is transported in heated trolleys and temperatures are checked on arrival to ensure the food is hot when it arrives at the home. Breakfast and tea are prepared at the home and people are asked what they would like for these meals. We saw that the kitchen is well stocked so that people can have a snack or drink at anytime they wish. Although there is a spacious dining room at the home, some people prefer to eat their meals in their bedrooms and their wishes are respected. We ate lunch with the people in the dining room. The meal was tasty, well presented and nutritious and people said that they enjoyed it. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a simple complaints procedure and adequate procedures are in place to ensure that people are protected from abuse. Evidence: There is a clear and simple complaints procedure in place to help people who may wish to raise concerns and a copy is displayed in the entrance hall. Some people living at the home who were spoken with during this visit were unsure about about the homes formal complaints procedure. However, those who were spoken with were able to tell us who they would speak with if they were unhappy about anything and this was generally the manager. Mixed responses were received from people who had completed surveys. Some people did not know who to speak with if they had concerns while others did. One person felt that they had raised concerns that had not been addressed. Details of all complaints are kept separately at the companys main office located at the nursing home and all complaints had been dealt with appropriately, with outcomes recorded. One complaint has been received by the Commission since the last inspection which related to the security of the building, access to the building and the siting of the laundry. The complainant said that their relative has left the home on several occasions and this had not been noticed by the staff. They also said that their relative was not able to access the front of the home due to the steps. Concern was Care Homes for Older People Page 18 of 29 Evidence: also raised over the siting of the laundry in the basement of the home. The complaint was passed to the Responsible Individual for the company to investigate through their own complaints procedure and the complaint was dealt with appropriately. Records show, and staff told us that they had received training in Protection Of Vulnerable Adults (POVA) issues. Both staff that we spoke with were able to discuss different forms of abuse and said that they would report any suspicions they had to the manager. They were also able to tell us who they would report any concerns to, outside of the home. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a pleasant, comfortable and generally `safe environment for those living in, working at and visiting the home. Evidence: The home is located in a quiet residential area on the outskirts of Newton Abbot and is approximately one mile from the town centre. There is an hourly bus service to and from the town centre and a large supermarket is within easy walking distance of the home. The home is detached and set in large, well-maintained gardens, which are accessible to people living there and there is a large decked patio to the rear of the home with tables and chairs. A full tour of the communal areas of the home was made and some individual bedrooms were looked at. Peoples bedrooms contained many individual items and reflected the personality of the occupant. People told us that they had been able to bring things from their home when they had first moved in. Communal areas consist of a comfortable lounge, small conservatory and separate dining room. All areas are nicely decorated and furnished and have a light, airy, Care Homes for Older People Page 20 of 29 Evidence: comfortable and homely feel. Everywhere was clean, well ventilated and there were no unpleasant odours. One person commented via a survey form that The home is always clean and pleasant. The home has a range of mobility equipment including grab rails, handrails, a mobile hoist, stairlift, mobile ramp to the front door and moving and handling equipment. The complaint received by the Commission also referred to the fact that the front door was only accessible by steps. We were told that there has always been a mobile ramp available to be put at the front door should it be needed. During the visit the temperature of the hot water to several hand basins was tested. Again it was found that the supply was inconsistent and sometimes was running cold or tepid. This was highlighted at the previous visit and needs attention so that individuals are able to wash or be washed in water of a suitable temperature. The vinyl flooring in the first floor bathroom was ripped and presented a trip hazard. The flooring needs to be made secure to prevent the risk of people falling. Staff told us and records confirmed that they had received training in Infection Control. Disposable gloves and aprons were available to staff around the home and staff were seen using them as required. Another area of the complaint that was received by the Commission was the siting of the laundry. The laundry is sited in the basement and is accessed via a steep flight of stairs. We were told by staff that during heavy downfalls of rain the area floods. There is a pump in the corner that will start to pump when water reaches a certain depth. However, if this depth is not reached staff have to put on wellingtons and wade to the pump to turn it on. Staff told us that these problems mean that sometimes soiled washing is not put into the machines for some time as the machines cannot be accessed. The pump is located in the corner of the room and has standing water around it. Serious consideration must be given to re-siting of this area as there is the potential for cross infection. The door to the laundry area and a door to back stairs on the first floor open directly onto very steep stairs. These doors should have suitable locks fitted to them to ensure people living at the home cannot access them accidentally. The fire service will need to be consulted over the suitability of the locks to be fitted. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A wide range of training is provided and the numbers and skill mix of staff on duty are generally sufficient to meet the needs of people currently living at the home. People are protected by recruitment procedures that ensure people who may be unsuitable to work with vulnerable people are not employed at the home. Evidence: On the day of the visit there were 11 people living at the home. There were 3 care staff, the manager and a housekeeper on duty during the morning, this dropped to 2 care staff and the manager during mid afternoon, then in the evening there were to be 3 care staff. At night there is one staff awake and one asleep. One persons representative commented via a survey form that The staff are friendly and caring and have tried to make X comfortable and happy. Staff and people living at the home said that there was generally enough staff to enable peoples needs to be met. However, the company has introduced a system where staff from the residential home and the nursing home are rotated. This means that staff from the nursing home come to work at the residential home who have often not been there before. These staff have to be supervised and helped to learn about the needs of the people living at the home which means that staff have less time to meet Care Homes for Older People Page 22 of 29 Evidence: the needs of individuals. Staff said that it was very frustrating having to spend time with staff that should be spent with people living at the home. They also said that they found it difficult having to leave the home and individuals that they know well and work in the nursing home with different people and needs. Staff that completed surveys indicated that they felt there was rarely enough staff on duty to be able to fully meet the needs of people living at the home. The manager told us that it is difficult to supervise a changing staff group, and that much more time was being spent on inductions for staff. She said that although there was a core of staff who had worked at the home for some time there were times when there were only staff at the home who did not know the people living there well. This is concerning as it can have an impact on the consistency of the care provided. Three staff files were looked at. Two files contained all the required information including satisfactory CRB (Criminal Records Bureau) checks, two written references and proof of identity. The file of the other staff member was incomplete and did not contain two references. We were assured that no-one is allowed to work in the home until all the required checks are complete. Training has a high priority at the home. Staff told us that there was plenty of training available to them. Records show and staff confirmed that they receive a wide variety of training, including Fire procedures, Moving and Handling, Food Hygiene, First Aid and Infection Control. Staff are also encouraged to work for NVQs (National Vocational Qualifications) and 6 staff currently have NVQ level 2 or above. All staff have received training in POVA (Protection Of Vulnerable Adults) issues and training for staff working with people with Dementia has also been provided. All new staff receive a full induction in line with Skills for Care recommendations and are expected to start NVQ training as soon as they have finished their induction. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed resulting in practices that promote and safeguard the health, safety and welfare of people who live and work in the home. Evidence: The registered manager, Barbara Underhill has been in post for many years and has completed the Registered Managers Award, a City and Guilds course in the Management of Care and a Certificate in Management course with the Institute of Management. She is also a qualified NVQ Assessor and has kept up to date with relevant health and safety topics and with training related to the specific needs of individuals, such as dementia care and person centred planning. Staff told us that they felt supported by the manager to do a good job, and one staff member commented via a survey form that Mrs Underhill has always shown kindness and gives that extra bit. Care Homes for Older People Page 24 of 29 Evidence: The manager told us that there was no-one living at the home that is subject to a deprivation of liberty authorisation. We saw no evidence to show that anyone living at the home is having their liberty deprived without an authorisation. The home has a quality assurance system in place to monitor the quality of care provided at the home. The Quality Management System sets the standards to be met at the home and as part of this the manager audits 6 care plans each month. As part of the Dynamic Standard Setting System surveys are sent to representatives twice a year and to people living at the home each year. A report is produced when the returns have been collated showing where any changes have been made. The home now is aware of its duty to report any accidents to individuals that require professional medical attention. No money is managed on behalf of anyone living at the home. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit, provided evidence that Forde Park Residential Care Home complies with health and safety legislation in relation to maintenance of equipment, storage of hazardous substances, fire precautions, health and safety checks and risk assessments. Policies and procedures are not always inspected during the visit but the information provided on the AQAA helps us form a judgement as to whether the home has the correct policies to keep people living and working at the home safe. Information provided by the home, evidenced that policies and procedures are in place and along with risk assessments are reviewed regularly and updated where necessary, to ensure they remain appropriate and reduce risks to people living and working at the home. So that the risk of burning from hot surfaces is minimised, radiators within the home have been covered. Restrictors are fitted to windows above ground floor level to minimise the risk of anyone falling from these windows. Individual temperature valves have been fitted to taps in order to minimise the risk of scalding from hot water. It was noticed during the visit that some forms and information are titled Forde Park Residential Care Home and some are titled Tremadoc (the previous name of the home). This was very confusing and it is suggested that all paperwork shows the correct name of the home. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 Everyone should be fully 17/08/2009 assessed prior to them being admitted to the home. To ensure peoples needs can be met by the home. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 7 7 9 Care plans should be more organised and provide staff with clear directions on meeting peoples needs. All personal recordings should be made individually and evidence where identified needs have been met. All medication should be counted when received at the home. Staff should record quantities on the MAR (Medication Administration Record) sheet and sign the sheet. Suitable locks should be fitted to the laundry door and the door from the first floor to the back stairs to prevent individuals accidentally accessing the steep stairs. The flooring in the first floor bathroom needs to be made safe to prevent people from tripping. The hot water from all taps should be a suitable Page 27 of 29 4 19 5 6 19 21 Care Homes for Older People temperature for washing in. 7 26 Consideration should be given to re-siting the laundry to minimise the risk of cross contamination. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!