Care Home: Friars Mead

What the care home does well Residents live in a homely, clean and safe environment. They appeared well dressed and well cared for. Some were observed chatting among themselves in the lounge and the majority participated in a group activity (Quiz Game) organised by a member of staff in the afternoon. The home has volunteers who visit residents and offer one-toone interaction and social interaction on a regular basis. The service is well managed. Although the home manager was on annual leave, the members of staff carried on their work smoothly and team working was evident during the site visit. Staff have the skills and knowledge to care for the residents. There is a rolling training programme for staff and all staff are given the opportunity to be trained to NVQ level. The premises are well-maintained, including the attractive garden. Residents often spend their time in the garden when the weather permits. There is garden furniture and seating on the patio for residents and their visitors. There is a newly decorated balcony in the lounge on the first floor where residents often spend time together for morning coffee. The following comments were received from the residents, their relatives and stakeholders when interviewed and in a recent survey conducted by us: "Happy with the way things are. I can please myself and the food is very, very good." "Kept well clean daily with supply of fresh water, tea and coffee etc. and freshly cooked meals." "The place is spotlessly clean and everyone says the food is great." "There are daily activities, exercise class, regular fairs and trips out for residents." "Lots of different activities, day trips, religious services and exercise classes encourage social stimulation." "Staff know the residents well and respect their wishes. Feels like a happy home." "Residents feel secure in pleasant surroundings." "I have found the staff to be most helpful, kind and considerate to me and the residents." "They look after the residents and listen to their needs." "Friars Mead is everything I could wish for. My (relative) is so very happy here. Everyone is so caring and friendly." "All staff are very good, kind, and helpful.""We are very satisfied with the service and the carers." "Friendly staff, respect for the residents and relatives. Residents always dressed attractively in spotlessly clean clothes. Good attention to medical care." "They look after the individual needs, both emotional and physical very well. This is a home I would choose for my (relative) or myself in old age." "The management and staff are always approachable. Since my (relative`s) moved to the home, we have nothing but praise for Friars Mead." What has improved since the last inspection? Since the last inspection, the home no longer has a deputy manager but has appointed a care manager instead. The service has advertised for an activity co-ordinator to assist with the organisation of daily recreational and social activities for the benefit of residents. As a result of listening to residents and their relatives, positive changes have been made to improve the environment, equipment and facilities and recreational activities. There are coffee mornings organised in small groups for existing residents and new residents to get to know each other. What the care home could do better: The service has recently introduced a computerised care planning system and the members of staff interviewed said that they are getting used to the computerised version of the written care plan which is person-centred. This ensures that those who are looking after the residents have the required information to deliver the personal, social and healthcare needs of the people living in the home. The management indicated that the main objective in using the computerised version is to reduce the hours staff have to spend in writing individual reports so that valuable time gained can be best spend giving one-to-one attention and therapeutic stimulation to the residents. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Friars Mead Rockliffe Avenue Kings Langley Hertfordshire WD4 8DR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Yoke-Lan Jackson     Date: 1 7 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Friars Mead Rockliffe Avenue Kings Langley Hertfordshire WD4 8DR 01923270304 01923270324 friars.mead@btopenworld.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Abbeyfield Hertfordshire Residential Care Society Limited care home 27 Number of places (if applicable): Under 65 Over 65 27 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Friars Mead is a residential care home for 27 people in the older age category. It is provided by The Abbeyfield Hertfordshire Residential Care Society, a charitable organisation. The building is located in a residential area of Kings Langley at the end of a cul-de-sac, adjacent to a sheltered accommodation complex. Local shops are nearby, with Watford and Hemel Hempstead town centres only short bus rides away. Limited car parking is available to the front of the building. The home was purpose-built in 1991 and provides accommodation on two floors served by a lift. All bedrooms are singles with en-suite facilities although one is sufficiently large to be used as a double and some of the other bedrooms have interconnecting doors, making them particularly suitable for married couples. There are two lounges on the first floor and a spacious main lounge on the ground floor. The spacious dining room is adjacent to the main lounge. There is a well equipped, airconditioned kitchen on the ground floor and on each upper floor there is a small Care Homes for Older People Page 4 of 26 Brief description of the care home domestic style kitchen for preparing light refreshments and this is accessible to service users, their friends and family. There is an enclosed back garden with a water feature and sheltered patio areas. The home charges £490.99 - £530.83 per week. Further information can be obtained from the Statement of Purpose and the Service User Guide. A copy of the CQC inspection report should be available in the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This service had a key inspection in June 2007 and an annual service review in June 2008, which was a review of information received since the last key inspection without a site visit as the service was awarded a two star rating at the last key inspection. This unannounced key inspection was carried out on 17/07/2009. The deputy manager was present. There are 25 people in residence. The inspection included a tour of the premises, general observation and lunchtime observation of how the staff interacted with the residents. Both staff and residents were spoken to and key documents were examined. The inspection ended with a thorough discussion with the deputy manager. Further telephone discussion took place with the registered home manager as she was on annual leave on the day of the site Care Homes for Older People Page 6 of 26 visit. Survey questionnaires were sent to the residents and relatives and their responses and other information received by us were reviewed. This included the Annual Quality and Assurance Assessment (AQAA) which providers of registered services are required to complete annually. The AQAA focuses on how the outcomes are being met for the people using the service and also provides us with statistical data. What the care home does well: Residents live in a homely, clean and safe environment. They appeared well dressed and well cared for. Some were observed chatting among themselves in the lounge and the majority participated in a group activity (Quiz Game) organised by a member of staff in the afternoon. The home has volunteers who visit residents and offer one-toone interaction and social interaction on a regular basis. The service is well managed. Although the home manager was on annual leave, the members of staff carried on their work smoothly and team working was evident during the site visit. Staff have the skills and knowledge to care for the residents. There is a rolling training programme for staff and all staff are given the opportunity to be trained to NVQ level. The premises are well-maintained, including the attractive garden. Residents often spend their time in the garden when the weather permits. There is garden furniture and seating on the patio for residents and their visitors. There is a newly decorated balcony in the lounge on the first floor where residents often spend time together for morning coffee. The following comments were received from the residents, their relatives and stakeholders when interviewed and in a recent survey conducted by us: Happy with the way things are. I can please myself and the food is very, very good. Kept well clean daily with supply of fresh water, tea and coffee etc. and freshly cooked meals. The place is spotlessly clean and everyone says the food is great. There are daily activities, exercise class, regular fairs and trips out for residents. Lots of different activities, day trips, religious services and exercise classes encourage social stimulation. Staff know the residents well and respect their wishes. Feels like a happy home. Residents feel secure in pleasant surroundings. I have found the staff to be most helpful, kind and considerate to me and the residents. They look after the residents and listen to their needs. Friars Mead is everything I could wish for. My (relative) is so very happy here. Everyone is so caring and friendly. All staff are very good, kind, and helpful. Care Homes for Older People Page 8 of 26 We are very satisfied with the service and the carers. Friendly staff, respect for the residents and relatives. Residents always dressed attractively in spotlessly clean clothes. Good attention to medical care. They look after the individual needs, both emotional and physical very well. This is a home I would choose for my (relative) or myself in old age. The management and staff are always approachable. Since my (relatives) moved to the home, we have nothing but praise for Friars Mead. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have the information they need to make an informed choice and they can be assured that a thorough pre-admission assessment will be carried out before they are admitted to ensure that the home can meet all their care needs. Evidence: The pre-admission documents for two recent admissions were examined and they showed that a thorough pre-admission assessment was carried out prior to their admission to ensure that all their personal, healthcare and social care needs can be met. The home will not admit a prospective client whose care needs cannot be met. One of the residents who had dementia was recently transferred elsewhere as the home was not able to meet their healthcare needs. The service has a ten page website which provides a comprehensive and up to date information about the service. The website is easy to access and it includes Care Homes for Older People Page 11 of 26 Evidence: photographs of residents (with their consent) and staff and there is also a a monthly newsletter. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they will be treated with respect and that they will receive personal care and support in the way they prefer and require. They can be assured that the administration of medication is in accordance with the homes Medication Policy and Procedures. Evidence: Each person has a written care plan, which forms the basis of care to be delivered. The service has recently introduced a computerised person-centred care planning system and members of staff are getting used to the new system. The home manager ensures that the care plan reflects the personal, social and healthcare needs of the resident. The care plans for two residents were examined and they were found to be detailed and informative. However it would be more beneficial if there was a specific healthcare plan for a resident who has Parkinsons Disease. Since the inspection, the management has updated their care plan to reflect this condition. The home has the support of healthcare professionals such as the family doctor and Care Homes for Older People Page 13 of 26 Evidence: the community district nurse. The general practitioner (GP) visits the home once a week and those using the service are able to request a consultation if required. On the day of the inspection, the district nurse was attending to two residents who required wound dressing for minor leg ulcers. Residents spoken to said that they are pleased with the care and service provided. A trained member of staff administers the medication. All staff who administer medication have attained the BTEC certificate on medication administration. The home uses the monitored dosage system and residents medicines are stored in a drug trolley that is securely kept in the office on the first floor of the building. There is a controlled drug cupboard and Fentanyl patches are currently in use for a resident. The controlled drug register was checked and the drug in use was properly and correctly recorded. The medication administrative record (MAR) charts were correctly filled in and kept up to date. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they will be given the opportunity to make everyday choices and their preferences and requests, including recreational and social interests, and choice of menu will be respected. They will be encouraged to maintain links with their friends and families. Evidence: On the morning of the site visit, most of the residents were in the main lounge resting after having breakfast. Those interviewed said that they normally sit around before lunchtime and confirmed that there are activities in the afternoon. The home manager said that residents have specially requested to be left to themselves with minimal staff intervention after breakfast. A few residents were observed chatting among themselves. Three members of staff were nearby in the adjacent dining room busy writing the daily notes. However, the members of staff were readily available to assist individuals who needed personal help. Residents interviewed said that they had recently been on a trip to Southend and that they had a good time. It was noted that the majority of the residents participated in a quiz game in the afternoon. Other indoor activities include a game of skittles, bowling and a game of Care Homes for Older People Page 15 of 26 Evidence: darts. There is a bingo game every Saturday with prizes to be won. There is an internet linked computer available in the home for residents to use and computer lessons are provided once a week by a volunteer. Three residents have taken up the challenge and one of these residents is regularly communicating with their family by email. There are other volunteers who help out with the trolley shop. The senior care worker present on the day said that she organises activities and group outings. There is a day trip once a month and the residents are given choices as to where they would like to go. The home has advertised for an activity co-ordinator in recent weeks. Lunchtime was unhurried. There was a choice of hot meals of either scampi or fish cakes served with vegetables and mashed potatoes, followed by a desert. The cook deals with the menu and has one-to-one consultation with each resident. The residents spoken with gave positive feedback about the meals provided. A resident commented, There is a good selection on the menu and the meals are very good. Another said, Good variety of quality food. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that their views will be listen to and any concerns raised will be taken seriously and prompt action taken to improve the service. They can be assured that the service has a robust Complaints Policy and Procedure and that they will be protected from abuse. Evidence: There is a residents meeting every six weeks and this is attended by the chair of the board of the organisation and the home manager. Minutes are taken at these meetings. Residents may raise their concerns and any issue raised is addressed promptly. There have been no complaints or safeguarding issues since the last inspection. All members of staff are given training on the protection of the vulnerable, abuse awareness and the Whistle-Blowing Policy. The home follows the Hertfordshire County Council Joint Safeguarding Procedure. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they will live in a homely, comfortable and safe environment and they will have access to all communal areas and facilities. Evidence: On the day of the site visit, the home appeared clean and tidy. The service has a maintenance person who ensures that the premises and the garden are well maintained. The maintenance person conducted a tour of the garden which has bushes and shrubs, hanging baskets and potted flowering plants. Since the last inspection, some furniture has been replaced and there is a new tumble dryer, and the kitchen has air conditioning fitted to make it a more comfortable environment for the kitchen staff. One of the baths has been replaced with a Malibu high-low bath to make it more comfortable for residents to use and easier for staff to assist them. The balcony on the first floor lounge has been redecorated making it more pleasant for residents to sit in comfort and it is frequently used by residents for their morning coffee. The main staircase had been redecorated and bedrooms are redecorated as they become vacant and the new client gets to choose their favourite colour for their bedroom which will have new carpets thus providing a warmer and a more cosy environment for the occupants. Some residents bedrooms were examined and they appeared clean and tidy with personalised items on display. The residents Care Homes for Older People Page 18 of 26 Evidence: spoken to said that they are very happy with their bedrooms and confirmed that the bedrooms are cleaned daily. There is a rolling maintenance programme. Carpets are shampooed weekly and there are a number of fan assisted gel air-fresheners throughout the home to create a pleasant and fresh atmosphere. All electrical goods brought into the premises are P.A.T. tested initially and subsequently to ensure the equipment is safe to use. All aids and other equipment used in the home are serviced regularly and servicing records are kept up to date. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they will be protected by the homes robust recruitment policy and procedures and they can be assured that staff have relevant training so that residents care needs can be met appropriately. Evidence: On the morning of the inspection, the home was manned by a senior care worker and three care workers. They were supported by an administrator, two domestic staff, the cook and an assistant. We were told that the home manager was on annual leave. The deputy manager was present in the afternoon. The home was smoothly run and the residents seemed well cared for. In a recent survey by us, some members of staff commented: Our home is all about the welfare of our residents. The constant improvements made, make our residents feel as individuals and cared for with respect and dignity. Staff are looked after to the same high standards. The staff files examined evidenced proper recruitment processes. The files were all kept up to date. New members of staff commence working after they have had Criminal Bureau (CRB) checks and clearance. The Protection of Vulnerable Adult (POVA) checks were also carried out. Members of staff interviewed confirmed that they have a period of induction training. The home follows the Skills for Care induction programme. Care Homes for Older People Page 20 of 26 Evidence: The deputy manager confirmed that there is a rolling training programme for all members of staff. This ensures that members of staff maintain their skills and competency to meet the needs of those who use the service. Recent training includes dementia, care planning, challenging behaviour and medication training. All new staff are encouraged to enrol for the NVQ courses after they have been employed for three months. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that the home is run in their best interests and they can be assured that their health, safety and welfare are promoted and protected. Evidence: The registered home manager was not present during the site visit. However, the home was well-managed by the deputy manager and the senior care worker. Team working was evident on the day and members of staff interacted well with the residents who seemed well cared for. Proper accounting records are kept and well maintained for residents personal allowances. Receipts are kept for all purchases. There is a regular audit by the provider. Next of kin receive a copy of the balance sheet at the end of every month. This gives them an indication of when additional money would be required for their relative to spend as they wish. Care Homes for Older People Page 22 of 26 Evidence: On the day of the inspection, the maintenance person confirmed that the fire alarm system is checked every Friday and fire drill is held regularly. All servicing records are kept up to date. The provider carries out an annual quality assurance and monitoring survey. This includes written questionnaire feedback from residents, relatives and others. The audit documents were readily available for inspection. There is a monthly visit and report carried out by the provider in compliance with regulations. The Annual Quality Assurance Assessment (AQAA) forms issued by the Commission were received on time for this inspection. The information provided was detailed and has been included in this report. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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