Care Home: Forest Brow Care Home

Similar services:

• St Vincents
• The Cotswold Home
• Winton House
• Rush Court
• Hillyfield Rest Home
• The Maypole Nursing Centre
• The Briars

What the care home does well Forest Brow does well to ensure it provides prospective residents and their representatives with information about the home, it assesses if it can meet their needs and supports them to become familiar with their new surroundings and others living in the home by supporting visits to the home prior to moving in. The majority of residents at Forest Brow have varying degrees of dementia, however it does provide for people who are elderly and frail. Despite this mix of cliental the home shows us that it can meet the diverse needs of the people well, whilst taking into account their strengths, needs, compatibility and the skills of the staff. The home does well to support the residents using a person centred approach, respecting their wishes, decisions and aspirations. It encourages the residents Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 6to develop and maintain their independence, access their local community and maintain contact with family and friends. The staff do well to ensure the physical and psychological needs of the residents are being met, providing the residents with support to access health care professionals such as GP`s, dentists, district nurses and other specialist health care professionals if required. The home supports residents with their medication but where possible promotes independence in this area. The home listens to the resident`s needs, wishes and concerns and acts promptly to deal with any concerns or complaints the residents or their representatives may have. Staff are trained to protect the residents and to inform someone immediately if they are concerned that they are at risk of harm. Comments received from residents, relatives and staff: Relative: " This is an exceptional home, the manager and her staff are open and honest and deal with concerns immediately" Resident: "The staff here are wonderful, kind and patient". Relative: "If I had to move into a home this is the one I would choose". Resident: "I`ve no complaints I am very well looked after and the staff are very kind". Staff: "I really enjoy working here, it is a happy home". Staff: "I haven`t worked here long but I already feel part of the team, we work well together". Forest Brow offers a homely, safe and welcoming environment, which is spacious, tastefully decorated and furnished and offers individual bedrooms and a small number of shared rooms that are personalised and decorated to the residents liking. The manager and her staff are skilled and competent to meet the needs of the residents, the staff go through a thorough interview and induction process followed by mandatory training such as moving and handling and fire safety and specific training such as abuse awareness, dementia and safe administration of medication. The manager and her staff go about their day-to-day responsibilities in a calm and relaxed manner, showing kindness and respect to the residents and their visitors. What has improved since the last inspection? The home has made a number of significant changes to the environment since the last visit to the service. The newly eight-bedded extension has been built to a very high standard and has taken into account the psychical needs of the residents including installing en suite facilities. In addition the new build includes a large training/staff room, and has an en suite visitors room where relatives can stay if they wish, especially at a time when their relative is very poorly or coming to the end of their life. CARE HOMES FOR OLDER PEOPLE Forest Brow Care Home 63 Forest Road Liss Hampshire GU33 7BL Lead Inspector Christine Walsh Unannounced Inspection 27th March 2008 10:20 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 Forest Brow Care Home DS0000057070.V359332.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. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Forest Brow Care Home Address 63 Forest Road Liss Hampshire GU33 7BL 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) 01730 893342 forestbrow@keme.co.uk BRIJ Care Ltd Mrs Susan Makhzangi Care Home 32 Category(ies) of Dementia (30), Old age, not falling within any registration, with number other category (32) of places Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either M/F Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 2. Dementia (DE) The maximum number of service users to be accommodated is thirtytwo (32). 12th June 2006 Date of last inspection Brief Description of the Service: Forest Brow is a residential care home that provides support and accommodation for older persons. The home is registered to admit up to thirty-two residents in the categories of old age [OP] and dementia [DE(E)]. Forest Brow is a large Victorian house that has been extended but has retained many of its period features; accommodation is set out over three floors, which can be accessed by a passenger lift. There are two sitting rooms, which are light and airy and two separate dining rooms. The home has a one and a half acre garden, which is accessible to the residents. The home is located in a semi rural area in the small village of Liss, between Petersfield and Liphook, and is within access of local shops and larger towns in the area. The current level of fees is: £404. 00 Shared room. £415. 03 Social services placements. £686 per week Single room with en suite. } Per week } Per week } Per week There are additional charges for chiropody, hairdressing and the purchase of newspapers and/or magazines. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This site visit formed part of the key inspection process and was carried out over one day by Mrs C Walsh, regulatory inspector, the registered responsible manager Mrs Susan Makhzangi assisted with the inspection visit. The manager completed an Annual Quality Assurance Assessment (AQAA) document, which was returned to the Commission for Social Care Inspection prior to the visit to the service. The AQAA informed us that the service undertakes to treat all, be they residents or staff, with respect and kindness. “Everyone here is seen, first and foremost as a human being, regardless of his or her race, creed, colour, sexual orientation, gender political leanings, age, culture, size or appearance”. The information obtained to inform this report was based on viewing the records of the people who use and work for the service, of which four service user records were looked at in depth. The day-to-day management of the home was observed, and discussions with residents, staff and visitors took place. The people who use this service are referred to as residents. What the service does well: Forest Brow does well to ensure it provides prospective residents and their representatives with information about the home, it assesses if it can meet their needs and supports them to become familiar with their new surroundings and others living in the home by supporting visits to the home prior to moving in. The majority of residents at Forest Brow have varying degrees of dementia, however it does provide for people who are elderly and frail. Despite this mix of cliental the home shows us that it can meet the diverse needs of the people well, whilst taking into account their strengths, needs, compatibility and the skills of the staff. The home does well to support the residents using a person centred approach, respecting their wishes, decisions and aspirations. It encourages the residents Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 6 to develop and maintain their independence, access their local community and maintain contact with family and friends. The staff do well to ensure the physical and psychological needs of the residents are being met, providing the residents with support to access health care professionals such as GP’s, dentists, district nurses and other specialist health care professionals if required. The home supports residents with their medication but where possible promotes independence in this area. The home listens to the resident’s needs, wishes and concerns and acts promptly to deal with any concerns or complaints the residents or their representatives may have. Staff are trained to protect the residents and to inform someone immediately if they are concerned that they are at risk of harm. Comments received from residents, relatives and staff: Relative: “ This is an exceptional home, the manager and her staff are open and honest and deal with concerns immediately” Resident: “The staff here are wonderful, kind and patient”. Relative: “If I had to move into a home this is the one I would choose”. Resident: “I’ve no complaints I am very well looked after and the staff are very kind”. Staff: “I really enjoy working here, it is a happy home”. Staff: “I haven’t worked here long but I already feel part of the team, we work well together”. Forest Brow offers a homely, safe and welcoming environment, which is spacious, tastefully decorated and furnished and offers individual bedrooms and a small number of shared rooms that are personalised and decorated to the residents liking. The manager and her staff are skilled and competent to meet the needs of the residents, the staff go through a thorough interview and induction process followed by mandatory training such as moving and handling and fire safety and specific training such as abuse awareness, dementia and safe administration of medication. The manager and her staff go about their day-to-day responsibilities in a calm and relaxed manner, showing kindness and respect to the residents and their visitors. Forest Brow Care Home DS0000057070.V359332.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. Forest Brow Care Home DS0000057070.V359332.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 Forest Brow Care Home DS0000057070.V359332.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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures the people who wish to move into the home have their needs assessed prior to admission to make sure they can meet their needs. The home does not provide intermediate care. EVIDENCE: The AQAA (Annual Quality Assurance Assessment) informed us that it has a comprehensive induction and assessment process before a potential resident moves in, from taking an initial enquiry, inviting the potential resident and family to the home to look around, meeting them in their own home to carry out a full assessment and further visits to the home are arranged if required. This was tested by viewing the assessment papers of four residents, speaking with three residents, a family member and the manager. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 10 A resident who was spoken with at the time of the visit and who lived out of the area said she had been visited by the manager who asked her a number of questions about her health, what she can do for herself and what she needs help with. She went onto say that she didn’t visit the home before moving in but family members had and she was provided with information about what the home has to offer and she knew she would have a room of her own. Assessment documents were viewed for four residents one of which had recently moved in, the assessment information is comprehensive and as stated by the resident requests information about the person’s health, strengths and needs and other information relating the resident’s wellbeing, social interests, likes and dislikes and cultural and religious beliefs. The manager said that she in addition to meeting with the prospective resident she will meet with and obtain information from family members, and social services and health care professionals if applicable. If the prospective resident is able they are invited to visit the home prior to moving in, where they are shown the room they will occupy, meet informally with other residents over tea and cakes and meet with the staff. The manager went onto say if the prospective resident requires further assessments such as moving and handling referrals will be made to the appropriate professional, where possible requesting that these take place prior to the person moving in. Following admission to the home it continues to assess the strengths and needs of the residents on a monthly basis and care plans are changed to reflect any changes to the residents health and wellbeing. The home is not registered to provide intermediate care, but it does offer respite care where residents are welcome to stay for short breaks, be it to support main carers or to support the resident to get back to good health following an illness. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures the people who use the service have their personal, and health care needs met using a person centred approach and are supported to have a say about how they wish to receive their care and feel they are treated with dignity and privacy. The home ensures the people who use the service receive their medication as prescribed by their general practitioner, however the home must be mindful to ensure mistakes are minimised by following correct procedures. The end of life arrangements for people who use the service are carried out in a sensitive and respectful manner. EVIDENCE: The AQAA (Annual Quality Assurance Assessment) informed us that it ensures residents receive assistance where necessary with their personal care needs in Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 12 a dignified, sensitive and respectful manner. The AQAA also informed us that the home has adaptations to meet the physical and medical needs of the residents such as pressure reliving mattresses and cushions. Residents are registered with a GP of their choice and have access to other health care professionals such as opticians. Medication is administered by the home where necessary and medications are safely stored and administered. The above was tested by viewing the personal plans, daily notes and medication records of four residents. Speaking with residents, relatives, staff and the manager and observing day-to-day practice in the home. Each resident has a personal plan of their own which provides information on their daily personal, physical and mental health care needs, social support and areas of where the residents maybe at risk. Care plans provide detail on how the resident requires assistance allowing for a consistency of care. This includes informing staff of the aim of care, which involves prompting staff to consider the residents level of independence and promoting it, offering choices such as clothing and the plans describe the residents preferred routine of care, and wishes. “Mrs X likes to have her breakfast in her bedroom and lunch and supper in the dining room”. Some of the residents have a life history in their personal file providing staff with background knowledge about the person, their occupation, their family, their likes and dislikes and their social hobbies and interests. A member of staff said that she had found the information very helpful and it had enabled her to interact meaningfully with the resident. She went onto say that the care plans are read, reviewed and updated on a regular basis, this is carried out with the residents if they wish to be involved. There was evidence that some residents had been involved in the development of their personal plans. The members of staff spoken with confirmed that they had received training in the principles of care and understood the importance of providing residents with care that meets their individual needs and preferences. A resident said she was aware she had a personal file and will sometimes look at it with a member of staff. Care plans are linked to risk assessments and provide detail of the risk and action required by staff to minimise the risks. The information was written in plain English and easy to follow. There was evidence that the home regularly reviews residents weight, skin condition and mobility to minimise the risk of residents getting pressure sores, those residents identified as at risk were provided with pressure relieving equipment such as mattresses and cushions. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 13 Residents and relatives who were spoken with at the time of the visit were very complimentary of the care and support the staff and manager provide. A resident said: “The staff are wonderful, kind, respectful and I couldn’t wish for more”. A relative said: “I must commend the staff they do a wonderful job supporting the people who live here, some of who have very demanding needs”. Another relative said: “The staff are always smiling, it is a lovely place to come, I know my mum is very well cared for, she always looks clean and tidy and they do everything they can for her”. It was noted that all the residents were smartly dressed, clean and attention had been given to the resident’s hair and personal grooming such as teeth, glasses and facial hair. Each resident is registered with a GP and information in resident’s personal plans tells us that a record is kept of the resident’s personal health care needs and the support they require to get better. In addition residents have access to other health care professionals such as dentists, opticians, chiropodists and community health care teams such as district nurses and psychiatrists. The home has systems in place for the administration of medication. The home uses a monitored dossett system which is supplied by a well-known high street pharmacy and who provide training for staff. Residents who are assessed as able to administer their own medication are encouraged to do so and a safe place is provided for them to store their medication. Medications are received, stored, recorded and disposed of using systems as stipulated in the Royal Pharmaceutical Guidelines. Observation of the medication round showed us that home has adopted safe procedures for the administration of medication including using two staff to check and sign for the medication once it has been given, but recent medication errors have forced the home to review their polices and procedures and where necessary provide additional training for staff. Medication errors have been reported to the Commission for Social Care Inspection and the manager was able to show us records and action taken to address the initial error and future actions to minimise the risks. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 14 At the time of the visit the inspector was made aware that some of the managers time would be spent caring for a dying resident and supporting the relatives of the resident. This was done in a sensitive, respectful and kind manner. Each resident has in their personal plan information relating to the residents end of life arrangements and wishes. The home offers a place for relatives to stay overnight, which has en suite facilities, and facilities where they can make themselves drinks and snacks. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures the service supports the people who use the service to participate and engage in activites of their choice and choosing, maintain contact with family and friends and provide them with meals that meets their dietary needs and preferences. EVIDENCE: The AQAA (Annual Quality Assurance Assessment) informed us that the home has a good understanding of the individual needs and capabilities of the residents, including those with dementia. The AQAA informed us that the home considers the diverse needs of residents when organising activities, social and religious events. The home encourages and welcomes friends and family to visit and it provides regular healthy meals and drinks whilst considering the individual likes, dislikes and physical health care needs of the residents. This was tested through observation on the day of the visit, viewing menu plans, the lunchtime meal, and speaking with residents, staff, cook and visitors. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 16 The residents personal files provide information on the resident’s social interests, hobbies and likes and dislikes and of the four personal plans viewed one resident had a personal history that provides staff with information of the resident’s occupation and family history. The personal information describes how the residents like to spend their day including for one resident who prefers to rest on her bed listening to classical music in the morning and then taking tea with a friend and spending the rest of the day in the company of others. The majority of the residents living at Forest Brow have dementia some of whose dementia is very advanced, despite being busy it was observed on the day of the visit that staff spend time with the residents engaging in general conversation, have a laugh and joke with the residents and provide stimulation through music and games. The home provides a number of planned activities through out the year which are both seasonal and at the request of the residents such as the church choir visiting to sing Christmas carols, and enjoy mince pies and mauled wine, and garden parties in the summer. Pictures were seen of residents taking a meal out and the manager said that she regularly organises trips to the theatre. Reminiscence therapy and watching old musicals and comedy films is a regular occurrence. A resident said: “I like my own company but I do enjoy listening to the harpist who visits fortnightly, the music is beautiful and restful”. She went on to say that she has access to books and on occasions likes to go out. The manager said that the home has a number of very independent residents who like to go out during the day using their own transport or that of friends and relatives. The AQAA informed us that the home recognises it could provide greater and varied stimulation and plans within the next twelve months to employ someone to coordinate and arrange activities such as arts and crafts, knitting and sewing circle, gardening and gentle housework to name but a few. The home was busy with visitors some spending time in the home and others taking their relative/friend out for the day. All visitors spoken with said they were always made to feel welcome, that staff are very kind and approachable and the manager or senior staff on duty will always provide them with an update on the wellbeing and care of their next of kin. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 17 All visitors are asked to sign in and sign out of the home and a notice in the entrance of the home informs visitor of their rights and advises them of what to do in case of a fire. At the time of the visit it was noted throughout the day that residents were provided with regular fluids and snacks and a wholesome two-course meal was provided at lunchtime. The cook informed us that she uses only fresh produce and is provided with information about residents’ specific likes and dislikes and dietary needs. The home has two dining rooms, which allows the home to support residents who require support and those who are independent separately. The manager said this is to preserve all residents dignity and encourage independence. For residents requiring specific support meals are presented in manageable consistencies to assist with the mechanics of eating and swallowing. Where required the home will refer to dieticians and occupational therapists. A personal plan viewed as part of the tracking process described in detail the residents specific likes and dislikes, when and how the resident wishes to take her meals and the support she requires to eat her meals. All residents who were spoken with said they like the meals and could have something different if they didn’t like what was on the menu. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that the people who use the service are listened and concerns raised by them are acted upon. The home ensures that the people who use the service are safeguarded from the potential risk of harm. EVIDENCE: The AQAA (Annual Quality Assurance Assessment) informed us that the home welcomes complaints, suggestions and ideas about the service, which is backed up by comprehensive policies and procedures in complaints and safeguarding the residents. The home recognises the importance of protecting the residents and provides staff with training which includes recognising when someone may have been abused, how to safeguard against it and what to do if they suspect abuse. This was tested by viewing the complaints procedures and logbook, testing if the home had procedures for safeguarding the residents, speaking with the residents, staff and relatives. The complaints procedure details how the people who use the service can make a complaint and what action must be taken to resolve their complaint. The home encourages open dialogue with residents and relatives on a day-today basis. The manager said she welcomes suggestions and complaints as Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 19 this enables the home to continue to monitor and improve the quality of care they provide. A resident confirmed that she knows how to make a complaint or raise concerns with the manager or a member of staff. Stating that all the staff and the manager are approachable and listen to what she says. A member of staff was clear about the procedure in responding to complaints and a relative said: “I know how to make a complaint but so far I haven’t needed to”. The majority of the residents who live at Forest Brow have varying degrees of dementia, the manager showed us that she has a good understanding of the physical, sensory and cognitive needs of people with dementia and is aware that the home could do better to develop ways of assisting those residents to make complaints including producing an accessible complaints procedure. The AQAA stated that this will carried out in the next twelve months. The staff are provided with safeguarding of vulnerable adults training, which provides them with the knowledge to identify various types of abuse and how to report these. The staff spoken with at the time of visit confirmed that they had received training and were aware of their roles and responsibilities in maintaining the residents’ health and wellbeing and reporting incidents of concern. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20,21,22, 23, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures the people who use the service live in a welcoming, comfortable and clean environment. EVIDENCE: The AQAA (Annual Quality Assurance Assessment) informed us that Forest Brow is a beautiful spacious house, which is over a hundred years old, retaining a number of its original features and is surrounded by 1.5 acres of well tended and secure garden. The AQAA also informs us that the home has an ongoing maintenance, redecoration and refurbishment programme and care is taken to minimise the risk of cross infection. This was tested by touring the home, speaking with residents about their personal rooms and the homes environment, speaking with domestic and care staff and visitors. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 21 An extensive tour of the home provided us with evidence that the home takes considerable pride in its facilities it has to offer, including a new extension of eight en suite single rooms, additional toilet and bathing facilities and upstairs accommodation for relatives and if needs be staff and a combined rest and training room fro staff which includes a small kitchenette. The manager identified areas of improvements made and areas of the home requiring improvement, plans are in place to make changes and the manager is aware that when making improvements especially redecoration consideration must be given to those residents with dementia where their cognitive and sensory function has been affected. The home has suffient numbers of toilet and bathing facilities to meet the number and needs of the residents. Where required these facilities are equipped with moving and handling equipment such as hoists and handrails. The home is a three-storey building with level access to the ground floor and a lift to the first floor. The home has a large lounge, separate conservatory and two dining rooms; all have been tastefully decorated and furnished. In addition the home has a separate hairdressing room. The garden is landscaped, surrounded by a variety of trees and shrubs and has a levelled patio area, which residents can access during the warmer months of the year. Large windows allow a good view into the garden. External doors are not locked but are alarmed to alert staff to residents who are wishing to leave the building. The majority of the residents are at risk from leaving the building unattended, however the home does not insist they come back into the home but will either escort or follow them for a short distance before they are encouraged to return to the home. This was observed at the time of the visit and appeared to suit the needs of the resident who had left the home. Several residents were met with in their bedrooms; all rooms seen were homely, furnished with personal items and in some cases furniture brought from their previous home. The rooms were individualised and reflected the person’s hobbies, interests and personality. The residents with whom were spoken with appeared pleased with their rooms and their cleanliness. A resident said: “The staff are very good they clean and help me tidy my room everyday, my sheets on my bed are changed regularly”. The home has staff appointed to clean the home who are responsible for maintaining a good standard of hygiene throughout the home. The home was noted to be clean and the staff were observed to be hard at work throughout Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 22 the day. The home was observed to be very clean and free from offensive odours. Both cleaning staff who were spoken with confirmed they had received training relevant to their roles and responsibilities including health and safety, The Control of Substances Hazardous to Health (COSHH) and infection control. They went on to say that they have been involved in other training relating to care issues and this assisted them to have a better understanding of the needs of the residents. Two care staff spoken with also confirmed that they had received training in infection control and are provided with equipment such as hand gels, and protective clothing to assist in minimising the risk of cross infection. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home ensures the people who use the service are supported by adequate numbers of skilled, competent and appropriately recruited staff. EVIDENCE: The AQAA (Annual Quality Assurance Assessment) informed us that the home has built an effective staff team who are able to work on their own initiative, deliver care to a high standard, committed to training including doing a National Vocation Qualification (NVQ) in care and who are recruited based on their strengths and following good recruitment procedures. The AQAA also informed us that the manager intends to attend seminars on dementia and undertake a train the trainer course in dementia care in the next twelve months so she can help her staff to improve their knowledge and understanding of caring for people with dementia. This was tested by observing practice on the day of the visit, seeking the views of residents and visitors, and viewing staff recruitment and training files. On entering the home midmorning it was soon established that the home was busy with staff supporting residents with personal care needs, providing refreshments and greeting visitors. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 24 The duty rota confirmed that the home has five staff on duty in the morning plus ancillary staff, four staff in the afternoon/evening and two staff at night. The manager said she will often come in early in the morning to assist with getting the residents up and her deputy manager works across the day, which ensures there is always a senior member of staff on duty and there is a senior on call at night. A member of staff said that residents are got up at their leisure and no one is rushed or expected to do anything they don’t want to. This was supported by what was observed as a relaxed and organised approach to the day-to-day needs of the residents. Call bells were answered promptly and staff were very quick to react when a resident left the home unescorted. The staff were observed to be happy, involved in cheerful banter with the residents and one another. A member of staff said: “Forest Brow is a happy home and a really nice place to work. We work as a team and will support one another when it is busy and when duties need covering”. A newly appointed staff member said: “Everyone works well together, I’ve been made to feel very welcome and I am comfortable working here”. The newly appointed member of staff also commented on how nice the home was and how good the staff and the manager have been in supporting her through her induction period. The manager said that the home rarely uses agency, as staff are very good at covering one another. She went onto say that the home has a number of vacancies including domestic staff, which she hoped to appoint to very soon. Four staff personal records were viewed including newly appointed staff, recruitment records indicated that appropriate checks are carried out on staff prior to them starting in the home, including two references, criminal record bureau (CRB’s) and protection of vulnerable adult (POVA) checks. Two staff were met with as part of the tracking process and both confirmed that they had completed an application, attended an interview and were fully inducted with support whilst getting to know and work with the residents. Evidence of these documents were found on the staff personal records. A member of staff spoken with at length spoke of the process of her induction and training which she felt was very good and comprehensive and how the home has encouraged and supported her to achieve a NVQ. She went onto Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 25 say that the home has a very good internal assessor, which has helped with getting answers to queries quickly. She also said the new training facilities will be a big advantage to home and the staff, in making sure as many staff as possible with receive the training they need. The member of staff showed us that she has a good understanding of her roles and responsible and showed good values when she said: “The aim of care in this home is about putting the person first, listening to their wishes, providing care that meets and suits their needs, not ours! and keeping them safe”. The evidence of staff training is extensive and diverse including mandatory training such as health and safety, food hygiene, fire safety and specific training such as abuse awareness, safe handling of medication and dementia care. The dementia care awareness course is eight weeks long, is workbook based and teaches the staff to see the person first and not their condition. Medication training is six weeks long and is carried out through a local college, this includes storing, ordering, administration and disposal, and checking instructions on medication records against information on the labels of residents medication. Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 26 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a competent registered manager and a skilled staff team who ensure it is run in the best interest of the people who use it and who provide a safe place of them to live. EVIDENCE: The AQAA (Annual Quality Assurance Assessment) informed us that the manager is a first level nurse and has achieved her registered managers award as well as other qualifications in business and finance. The AQAA tells us that the manager is proud of her workforce and has seen a number of significant changes for the best over the last couple of years in terms of the environment and the standard of care provided by the staff. The manager say’s she has an Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 27 open door policy and regularly seeks the views of residents, staff and visitors. The home complies with all health and safety regulations. This was tested by spending time with the manager, observing her practice and running of the home, observing her interactions with staff, residents and relatives. Viewing health and safety documents including fire safety records, quality monitoring records including regulation 26 reports and speaking with residents, staff and visitors. The manager showed us through the course of the visit that she has a professional approach to her work and takes her role as the registered manager seriously. She showed an open and calm approach to her work and engaged with residents, staff and visitors respectfully. The manager was aware of the needs of the residents and requested updates about individual residents health from staff when moving around the home. Staff, residents and visitors were complimentary of the manager and her management team, speaking of their kindness, thoughtfulness and going that extra mile when the need arises. A relative said: “This is an exceptional home, they are open and honest and deal immediately with any concerns” A member of staff said: “The manager is open and friendly, I have only been here a short while but I have been made to feel part of the team already”. A resident said: “The manager and her staff are lovely, they have always got time to listen to me.” The manager was observed to seek how the residents, staff and visitors were when she was walking around the home. A visitor said she visited several times a week and the manager will always ask her how she is and if everything is okay. The home holds regular residents and staff meetings, but recognises there are a number of residents who are unable to fully take part due the level of their cognitive and sensory function, but plans to look at how this area of quality monitoring can be improved. The home is visited monthly by a business partner to undertake a regulation 26 visit. The visit involves looking at all areas of care and administration Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 28 practice and includes seeking the views of residents, staff, relatives and any visiting health care professionals. There was evidence that these visits had been undertaken although a report for one month was missing, the manger said that the visit had taken place but it appeared the report was delayed. The manager provided evidence that the home undertakes quality questionnaires but admitted to not formalising the information into a report and development plan. The manager agreed that this would be completed soon. The manager said the home does not deal with resident’s monies in terms of dealing with benefits and personal financial affairs, although the home will assist residents to access the bank or post office if they require the support. The home does not hold personal money on behalf of residents but will pay for such things as chiropody and hairdressing, claiming the money back by invoicing the next of kin or whoever is responsible for the residents monies, records and receipts are kept for this type pf expenditure. There are safe systems in place for fire safety. Staff receive regular training and regular checks are made on fire safety equipment. Control of Substances Hazardous to Health (COSHH) are securely locked away, there are notices discreetly displayed around the home reminding people of good hygiene practices, and all serviceable utilities including small electrical appliances are regularly checked to ensure they are in goods working order. The home can demonstrate that it regularly carries out environmental assessments, which are comprehensive. Individual assessments on residents’ and staff are kept in their personal files Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 29 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 30 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 31 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 Forest Brow Care Home DS0000057070.V359332.R01.S.doc Version 5.2 Page 32 - 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!