Care Home: Forder Lane House

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What the care home does well Forder Lane House provides care of a good standard. People who live at the home and their relatives praised the care given. Comments made included: "I am very well cared for, no home is like ones own home but Forder Lane House inspires to be the next best", and "they look after mum 100%, nothing is too much trouble". People have confidence in the registered manager and the staff. A relative said, " the manager excels in every respect, she and the team are angels who really care". Health care professionals also made positive comments, which included " the home supports individuals and treats them with dignity and compassion" and "we could do with more homes like Forder Lane House". The home is attractive, comfortable, very clean and well maintained. People said how much they like their rooms and appreciate having easy, direct access to the gardens. Many people previously lived locally and are encouraged to maintain contact with family and friends. Relatives commented on the friendly, welcoming atmosphere and said they were "always offered a cup of tea". Meals are of a very good standard and provide a wholesome, varied and balanced diet. People described the food as "wonderful" and "always tasty". Forder Lane House is well managed. Staff have good access to training and work well together as a team, supporting one another, and ensuring that care is provided sensitively. What has improved since the last inspection? What the care home could do better: Care plans should be more detailed to reflect people`s needs and choices. They should give more guidance to staff to ensure person-centred care is provided. Care plans are reviewed, but those inspected had not always been reviewed monthly. The fire door at the entrance of one bedroom was wedged open. In order to prevent the risk of fire, an approved hold-open device must be fitted if the person occupying the room wishes to have the door held open. CARE HOMES FOR OLDER PEOPLE Forder Lane House Forder Lane Dartington Totnes Devon TQ9 6HT Lead Inspector Margaret Crowley Unannounced Inspection 15th October 2007 10:00 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 Forder Lane House DS0000003703.V343728.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. Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Forder Lane House Address Forder Lane Dartington Totnes Devon TQ9 6HT 01803 863532 01803 863685 careoffice@dartingtonha.co.uk 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) Dartington Housing Assoc Limited Mrs Elizabeth Jean Shinner Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th September 2006 Brief Description of the Service: Forder Lane House is a care home owned by Dartington Housing Association. It is set within a complex of sheltered bungalows, also owned by the housing association. All bedrooms, communal rooms and facilities are situated on the ground floor. People are accommodated in pleasant single rooms, which have en-suite facilities or a designated toilet nearby. The bedrooms all have an external door that opens out onto level gardens. There is an attractive central combined lounge/dining area. In addition there is a conservatory that is used by a small number of people who receive day care and those attending a luncheon club. The home provides aids and adaptations to meet people’s needs including grab rails, a mobile hoist and an adapted bath. The Registered Manager’s office is situated on the first floor, next to the Dartington Housing Association’s Chief Executive’s office and their administration. Outside there are attractive level gardens, which surround the care home. A patio area with seating is situated at the front of the building. There is an external laundry that is also shared with the bungalows. Current fees are £390 per week. Written information regarding the home and the services provided is available in the reception and is given to prospective residents. Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over seven hours on 15th October 2007. Liz Shinner, the Registered Manager was on duty and available for discussion, along with Stephen Prime, the Responsible Individual and Chief Executive of Dartington Housing Association. Prior to the inspection the management provided detailed information about how they maintain a safe environment, train and support staff and how they ensure that the views of the people who live at the home are used to improve the quality of care provided. There were thirteen people resident in the home at the time of the inspection. Many were spoken with, including five in more depth, regarding the lifestyle in the home and the care services they receive. Two people who visit the home for day care were also spoken with. Staff on duty were observed and spoken with in the course of their daily duties. A tour of the premises was made and records were inspected including care, medication and staff records. Surveys were received from seven people who live in the home, eight relatives and four staff. Feedback was also received from two general practitioners and a district nurse. What the service does well: What has improved since the last inspection? Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 6 There is an ongoing programme of redecoration, maintenance and renewal to ensure that the premises are kept at a very good standard. At the time of the inspection a programme was underway to refurbish the lounge/dining room. New furniture had been provided in the dining room and the lounge chairs were to be recovered. People living in the home were involved in the choice of the décor. The reception area has been improved and made more spacious. Care records have been co-ordinated and are now stored in a locked cupboard that is accessible for staff providing care. Staffing arrangements have been improved at night time, with one member of staff awake at night time and one who sleeps on the premises on call. 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. Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 7 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 Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 8 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 1,3,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive information to assist them in choosing to live at Forder Lane House and admission procedures ensure that their needs can be met. EVIDENCE: Two people who had come to stay at the home recently were spoken with. They said that staff were very kind and welcoming at the time they moved in. One person said a relative had visited the home on her behalf while she was in hospital, but she had felt involved and consulted in the process. She said she was receiving the level of assistance that she needed. Written information is provided for people considering moving to the home and is also available in the home’s reception. It was suggested in discussion that each person should have a copy of the service user’s guide available in his or her room. The registered manager or the deputy manager completes a pre admission assessment. The manager is clear regarding the needs that they are able to meet. Records inspected of people admitted recently showed evidence of Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 9 assessments undertaken and information provided from social services and hospital staff. However, the assessment did not always indicate where the home’s pre- admission assessment had taken place. Assessments contained sparse information regarding the person’s interests and social needs. Forder Lane House does not provide intermediate care. Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. People are cared for well in respect of their health and personal care needs and their privacy and dignity is upheld. EVIDENCE: People living at the home said that the staff were kind and caring and that they received assistance promptly. They said that their personal care needs were addressed with sensitivity. Comments were made that “ all the care staff are very good” and “couldn’t have better care”. Care staff were observed to speak to people respectfully and to have a friendly manner. The home has good working relationships with local health care professionals. who said referrals were made to them in a timely manner and that health care needs are well managed. General practitioners said “ they provide an excellent service and are well staffed” and the home is “ run very well with good supportive care staff”. An inspection of care records showed that improvements have been made in the organisation of the records and the manner in which they are stored. Each person’s records are now co-ordinated in a separate file and kept in a locked cupboard, which is accessible to care staff. At the last inspection there were discussions with the manager and deputy regarding improving the Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 11 assessments and care plans. There has been some progress, but care plans contained generalised statements regarding the person’s care needs. They had limited, specific information for care staff regarding the care to be provided and the person’s preferred routines. There is a system of reviewing care plans, but not all care plans inspected had been reviewed on a monthly basis. Improvements have been made in the method of recording monitoring records. Records are now recorded separately for each person and held in his or her care plan folder, although there was not always a daily entry for each person. Staff who responded to the survey and those spoken with felt that there is good verbal communication and information regarding people’s needs and the manager and deputy are very accessible. Medication is stored safely and there is with a photograph to identify each person receiving medication. No one currently administers his or her own medication, but people are offered this facility subject to risk assessment. Records of the administration of medication were inspected and were up to date and in good order other than on one occasion. The registered manager said that she would address this with the staff member concerned. Those staff who administer medication have received training to ensure they are aware safe medication practices. Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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 living at Forder Lane House are encouraged to make decisions and choices about their lifestyle and have activities available for them to enjoy. EVIDENCE: Routines within the home are flexible to ensure that people can choose how to spend their time. People confirmed that they were able to choose what time they got up and went to bed and that they were free to come and go as they pleased. Many people said they like to spend time in their own pleasant rooms. However, they also said that activities are available if they wish to participate. The home provides day care for a small number of people in a conservatory that adjoins the residents’ lounge/dining room. A member of staff is specifically employed for this purpose. People who live at the home can join in activities including two exercise classes, crafts and games. They can also go out on trips. The home organises themed events such as a recent Harvest festival, to which relatives and friends are invited Forder Lane House has good links with the local community. A small luncheon club is held in the conservatory for people living in the Dartington/Totnes area. There are also social events shared with the neighbouring bungalows. People said that their relatives and friends are always made welcome when they visit, which was confirmed in feedback from people surveyed. Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 13 Meals of a very good standard continue to be provided. The home offers a good range and choice of meals. People complete a preference sheet for the week and can request an alternative to the main choices. Those spoken to rated the meals very highly. Fresh produce is used where possible. One person said that she had asked for a light supper to be available in the evening, like she had in her own home home. This has been provided, including her favourite soup. Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that they are listened to and their concerns acted upon. EVIDENCE: People said that they could talk to staff or the manager about any concerns they had. The complaints procedure is displayed in the home and is also contained in the service users guide. The management recognises the importance of having robust procedures in place to address complaints in a timely manner and to protect people. The home has not received any complaints since the last inspection and neither has CSCI. Staff said that they have received training in the protection of vulnerable adults since the last inspection. They were aware of their responsibilities should they suspect a resident is at risk of abuse. Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People at Forder Lane House live in a home that is safe, attractive, comfortable and well maintained. EVIDENCE: A tour of the premises was made and most rooms were seen. People praised the quality of their rooms and their pleasant surroundings. Bedrooms are personalised to people’s taste. All have en suite facilities or a designated toilet. People also value the individual access from their rooms to the level gardens. Forder Lane House is very well maintained and furnished to a good standard. There is an ongoing programme of redecoration and renewal to ensure that the premises remain attractive and safe. At the time of the inspection plans were underway to redecorate the communal lounge/dining room and provide new dining tables and to recover the seating. Bedrooms are redecorated in rotation Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 16 or as they become vacant. One person spoken with was looking forward to the new carpet and decoration she had chosen for her room. There are two bathrooms with adapted bathing facilities, and ramps and environmental adaptations to meet people’s needs. The premises were very clean, hygienic and free from unpleasant odours throughout. There are procedures in place to control the spread of infection. The laundry is situated outside the main building in premises shared with the bungalow complex. Improvements have been made in the laundry service since the last inspection. Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Forder Lane House can be assured that staff have the skills and experience to meet their needs. EVIDENCE: People said that staff were very kind, helpful and accessible without delays. Communication seen during the inspection between staff and people living in the home was friendly and appropriate. Staff spoken with and feedback from staff questionnaires showed that staff are very positive about their work and the standard of care provided. Staff said they work together as a team and receive good support. On the day of the inspection there were 13 people resident in the home and one in hospital. Staff rotas were inspected and the registered manager said that staffing levels are maintained at an appropriate level for the needs and number of people living in the home. Bank and agency staff are employed to cover vacant posts when necessary. Since the last inspection one of the two night staff remains awake on duty and the other person is on call on the premises. There has been an increase in the hours of domestic staff employed and cover is now provided at the weekend. There is a good range of experience and training within the staff group. The organisation demonstrates good commitment to staff training, including mandatory training in safe working practices. Seven of the care staff currently hold the National Vocational Qualification in Care at level 2 or above. Two people were currently undertaking National Vocational training. New staff Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 18 receive induction training. Since the last inspection staff training has included fire safety, the protection of vulnerable adults, first aid and health and safety training. Staff records inspected provided satisfactory evidence of the recruitment and the induction processes. Criminal Record Bureau disclosures and Protection of Vulnerable Adults checks were applied for and references obtained. Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from living in a care home that is well managed and where attention is given to their health, welfare and safety. EVIDENCE: The registered manager has been in post for several years and holds the Registered Managers Award. She provides continuity and consistency for both people living in the home and staff. People living in the home and their relatives expressed their confidence in the manager’s approach. She receives support from the chief executive, and they work together with the staff team to create a homely and open environment. Quality assurance and monitoring systems are in place. Quality surveys are carried out twice a year to gain the views of people who live in the home, relatives and visiting professionals. A survey had been completed prior to the inspection. There was a high level of satisfaction expressed in most areas in Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 20 the report and suggestions and areas for improvement are acted upon where feasible. A member of the Management Committee conducts monthly visits to the home and produces a report. Most people’s relatives or their representative manage their financial affairs. There were clear records kept of the small amounts of money held in safekeeping on people’s behalf. This included records of incoming payments and receipts for outgoing payments. Routine health and safety issues were managed satisfactorily and maintenance records inspected were kept up to date and accurate. Accidents were recorded appropriately and any action taken. A fire risk assessment has been undertaken and records of tests and drills maintained. The fire door at the entrance to a person’s room was wedged open. The registered manager and responsible individual were advised that this presented a fire risk and only approved hold open devices must be used. Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(2) b, c Requirement Care plans must be reviewed a minimum of monthly and updated when the person’s needs change. This will ensure that a person’s changing needs are assessed and met. Previous timescale 25/12/06 Timescale for action 15/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to OP7 Good Practice Recommendations Each person should have a plan of care based on a comprehensive assessment of his or her needs, which sets out the specific actions to be taken by staff to meet those needs. This is to ensure that that the person receives the person-centred care required. Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Forder Lane House DS0000003703.V343728.R01.S.doc Version 5.2 Page 24 - 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. 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