Care Home: Forge House

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What the care home does well The people living at Forge Lodge are supported to have a full life. They are encouraged to make choices and decisions. They are treated as individuals. What has improved since the last inspection? There were no requirements from the previous inspection. What the care home could do better: The manager has identified for herself the following things for improvement:changing the assessment form to make it easier to complete by hand; expanding the care plans; providing risk assessment training for staff; building on the current quality assurance procedures and completing the registered manager`s award. Although the responsible individual visits the home regularly, a report is not always completed in keeping with Regulation 26. CARE HOME ADULTS 18-65 Forge House 2 Podkin Wood Chatham Kent ME5 9LY Lead Inspector Christine Lawrence Key Unannounced Inspection 7th November 2007 11.30 Forge House DS0000023831.V352419.R01.S.doc Version 5.2 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 Forge House DS0000023831.V352419.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 Adults 18-65. 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. Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Forge House Address 2 Podkin Wood Chatham Kent ME5 9LY 01634-671404 01634 671989 kentebony@yahoo.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) Placesuper Limited trading as Forge House Post Vacant Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10 August 2006 Brief Description of the Service: Forge House is situated in a quiet cul-de-sac with easy access to local shops and amenities. The home also has easy access to the M2 motorway. It is registered for five service users. It provides facilities for adults with learning disabilities that present some challenging behaviours. The home presents as homely, warm and comfortable and is decorated to a very high standard. There is some parking to the front of the property and the rear garden provides a space for outside activities. The current weekly fees for this service range from £1514.38 to £1665.81 per week dependant on individuals needs. Information about the service, including a copy of the latest inspection report will be provided on request to the home. Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and started at 11.30 and finished at 14.00. I looked at various records in the home and also used information sent to the commission by the manager shortly after the visit. Information from the previous inspection was also referred to. I spoke with several of the residents and was invited to see some bedrooms. A tour of the rest of the building was undertaken. I made observations of staff interacting with and supporting residents. Staff chatted informally with me during the course of my visit. The manager provided written information by completing an Annual Quality Assurance Assessment. What the service does well: 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. Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents’ individual aspirations and needs will be assessed. EVIDENCE: No new person has been admitted to Forge House for some time. The information provided by the manager indicates that any admission would be carefully planned and a thorough assessment would be undertaken. She is confident that the assessment format is comprehensive enough to identify the needs and aspirations of any new admission. Information from any preadmission assessment is used to compile an individual care plan (see standard 6). Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their changing needs will be noted in their individual plans and that they will be supported to make decisions and take risks to enable as independent lifestyle as possible. EVIDENCE: The staff at Forge House involve individuals in the planning of care that affects their lifestyle and quality of life. They understand the importance of residents being supported to take some control of their own lives. Individuals are encouraged to make decisions and choices wherever possible. The care plans are person centred and are agreed with the individual as much as possible. The plan is written in plain language, is easy to understand and looks at a range of areas of the individual’s life. The manager has identified that she would like to expand on this. A key worker system allows staff to work on a one to one basis and to contribute to the care plan for the individual. The one to one sessions have a formal basis and are recorded. The care plan is a working document reviewed regularly involving the person and their Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 9 representatives if appropriate. It is kept up to date. The daily records are particularly informative with plenty of space to encourage sufficient detail and to record particular things like incidents, medication changes, medical appointments etc. It is clear that residents have opportunities to take managed risks as part of having a lifestyle which focuses as much as possible on independence. The manager intends to improve some of the risk management strategies and this includes planning for staff to receive appropriate training. Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities and involvement in the local community, as well as support for personal relationships will be provided for residents. They will benefit from being offered a healthy diet and a sociable setting for mealtimes. EVIDENCE: People who live at Forge House are involved in meaningful activities of their own choice and according to their individual interests and capability. They are involved in the planning of these activities through the one to one sessions they have with their key worker. Occupation opportunities have been encouraged, especially through a local volunteer agency. People who live at Forge House access and enjoy opportunities available in their local community, e.g. local leisure facilities etc and they also go away for holidays. This past year this included two people going abroad to Corfu and two people choosing to go to Butlin’s in Bognor Regis. Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 11 People who live at Forge House are involved in the domestic routines of the home and they take responsibility for their own room and their personal laundry. A housekeeper is employed who is responsible for cooking most of the lunches and evening meals to ensure that the food provided is nutritious and well balanced. There are no particular cultural needs relating to food. Examples were noted of people being supported to maintain relationships with their family. Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s policies and procedures regarding medication and their physical and emotional needs will be responded to. Their preferences and requirements for support are respected. EVIDENCE: The records seen showed that the people living at Forge House have their health care needs identified and responded to. There were examples of routine appointments with various healthcare professionals as well as particular, more specialized services. There are two male members of staff which allows for same gender care to be provided. Staff gave examples of flexibility in daily routines and they confirmed that they work with people in a way which reflects and values individuality. The medication records and storage was satisfactory. Staff who administer medication have received training and the manager has arranged for two people to have training in respect of auditing the ongoing competency of staff who deal with medication. Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse and their views are listened to and acted on. EVIDENCE: There are appropriate policies and procedures in place covering the following:concerns and complaints; aggression towards staff; dealing with violence and aggression; disclosure of abuse and bad practice; physical intervention and safeguarding adults. The manager confirmed that these policies are reviewed and amended regularly. There have been no complaints about the home either to the commission or to the home itself. There was a safeguarding adult alert out of which the home produced an action plan. The new manager has further identified some areas which she wishes to build on. Staff have received appropriate training. Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27 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 is clean, comfortable and safe for the residents. The décor is attractive and stylish. EVIDENCE: Forge House is situated in a cul-de-sac of similar large detached houses. The home is very well decorated and furnished. The bedrooms are spacious; two have en suite facilities; two share a bathroom and the fifth bedroom has exclusive use of a bathroom. The bedrooms seen were very individual and reflected the different personalities and interests of the people living at Forge House. There is a policy on infection control and the manager confirmed that appropriate protective equipment is available to staff. The manager is going to use the Department of Health’s self-assessment tool ‘Essential Steps’ to identify if any improvements are needed. The laundry facilities are satisfactory and there are appropriate and relevant policies in place. Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sound recruitment procedures and training provided to staff will have a beneficial impact on residents. EVIDENCE: The staff group are a mixture of experiences; both work related and personal, and provide the people living at Forge House with a variety of choices for support and activities, as well as personal care. Two members of staff are working towards their national vocational qualifications at Level 3 and one has achieved Level 2. The manager confirmed that recruitment procedures are robust and they include the use of an application form and interviews. The company seeks references and carries out criminal record bureau checks. The people living in the home are introduced to any prospective member of staff. There is an ongoing programme of training for staff and induction training includes the use of a mentor from the existing, experienced staff team. Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home and their health and safety is promoted and protected. EVIDENCE: The current manager used to be the registered manager of the home and has known the people living at Forge House for a long time. She had previously completed part of the registered manager’s award and intends to complete this in the New Year. Staff were positive in their comments about how she manages the home. Subsequent to completing the annual quality assurance assessment (AQAA) she has identified that the organization’s quality monitoring system could be built upon and she intends to look at this aspect of running the home. The key worker sessions with individuals who live at Forge House allows for opinions to be expressed and there is a questionnaire which is Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 17 sent to relatives. The responsible individual visits the home regularly but there is not always a report compiled under Regulation 26. The written information provided by the manager indicated that service and maintenance contracts are appropriate and up to date. Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 X 27 4 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 19 NO Are there any outstanding requirements from the last inspection? 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 YA39 Regulation 26 Requirement The organization must ensure that visits and reports are completed in keeping with this regulation Timescale for action 31/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Maidstone Local 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 Forge House DS0000023831.V352419.R01.S.doc Version 5.2 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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