Care Home: Frindsbury House

What the care home does well Frindsbury House is committed to providing high quality care and support to its residents. Its ethos centres on promoting individuals rights to lead ordinary and meaningful lives. This is achieved by ensuring residents are consulted and are given clear choices about their lives. Residents spoken with were positive about the home, and told the inspector that` `It`s good living here, all the staff are nice`. `I like the garden, it`s great in the summer`. `Staff help me do the things I want to do`. Staff are highly trained and competent, and working practice reflects the ethos of the home. What has improved since the last inspection? The manager has moved the office into the main house. This move has created increased opportunities for service users to enjoy increased communication with the management team. Relationships with care managers and other stakeholders have improved. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 What the care home could do better: Care plans and risk assessments require more detail to ensure service users are supported appropriately. Consideration should be given to bring key information together in one file. Clear behaviour guidelines should be developed to ensure consistent working practice. CARE HOME ADULTS 18-65 Frindsbury House 42 Hollywood Lane Frindsbury Rochester Kent ME3 8AL Lead Inspector Sarah Montgomery Key Unannounced Inspection 27th June 2007 10:00 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 Frindsbury House DS0000028882.V337247.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. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Frindsbury House Address 42 Hollywood Lane Frindsbury Rochester Kent ME3 8AL 01634 719942 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) The Mortimer Society Elaine Runeckles Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Sixteen (16) People with Learning Disabilities between 18 & 65 years of age. 7th November 2005 Date of last inspection Brief Description of the Service: Frindsbury House is a residential home for Young adults with Learning Disabilities, the home is owned by ‘The Mortimer Society’ and has been established for a number of years. All the residents at the home are male and the staff team reflects this with a high majority of male carers. Frindsbury House is a large detached property, with an extensive garden area to the rear, there is also a garden area and driveway at the front of the premises. Accommodation is offered over 2 floors; all the bedrooms at the home offer single occupancy with a washbasin. Downstairs there is a lounge, with a large conservatory area adjacent and a separate dining room. In addition there is an identified ‘quiet’ lounge within the home. There are additional buildings situated within the rear garden, offering facilities for residents on site, which include an Art room/ Workshop and an Occupational Therapy kitchen; there is also a separate room within these buildings set aside for the use of staff. The statement of purpose and service user guide are kept in the office and are accessible to service users. Weekly fees start from £1200. The home is located within a residential area, within easy reach of Strood town centre and general facilities within the Medway towns. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Sarah Montgomery conducted this inspection on June 27th 2007. Evidence was gathered by speaking with the manager, staff team and service users, and by inspection of documents and policies. The inspection process evidenced that this home is committed to promoting and practicing equality and diversity for all service users and staff. Outcomes for service users are positive, and all information gathered demonstrates that service users living at this home are leading valued and fulfilling lives. What the service does well: What has improved since the last inspection? The manager has moved the office into the main house. This move has created increased opportunities for service users to enjoy increased communication with the management team. Relationships with care managers and other stakeholders have improved. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 6 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. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 7 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 Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 8 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): Standards 2, 3 and 4. Quality in this outcome area is excellent. Prospective service users can be confident that their individual aspirations and needs are assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Inspection of service user files evidenced a thorough pre-assessment process. In assessing this standard, the inspector looked at service user’s preassessment documentation, spoke with service users, and discussed with staff and management the home’s process of gathering information. The home has demonstrated a thorough approach to pre-assessment, gathering information from individual service users, their families, advocates, carers, care managers, and from conducting their own assessment. Assessment documentation included details on prospective service user’s skills, health, behaviour, likes and dislikes, goals and aspirations, and a full social history. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 9 Following assessment, prospective service users are supported to have a transition to the home. This involves a gentle introduction to the home encompassing day and overnight visits. During this time, assessment is ongoing, and informs initial care planning and risk assessments. Conversations with service users confirmed their involvement in the assessment process. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 10 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): Standards 6, 7 and 9. Quality in this outcome area is adequate. Service users know their needs are assessed, but would benefit from having clear goals reflected in their individual plans. This judgement has been made using available evidence including a visit to this service. EVIDENCE: To assess the above standards, the inspector read through care plans and risk assessments, looked at a sample of notes from individual daily recordings, and spoke with service users and staff. The team at Frindsbury House work with service users to develop care plans and risk assessments designed to ensure service users are supported appropriately with assessed needs and aspirations. Individual care plans are written in close correlation to the assessment of needs. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 11 Current care plans lack detail. Although they are descriptive of the need, and of the desired outcome, the steps to achieving the outcome need to be more specific to enable clear guidance for service users and staff. Similarly, risk assessments require more detail. Some risks identified in preassessment documentation have not been translated into risk assessment tools. The inspector spoke with service users regarding how decisions are made in the home. Service users gave examples of consultation around day-to-day life in the home, and more specifically about their choices regarding what they like to do. It was evident from these discussions that service users are consulted, and contribute to the life of the home. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 12 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): Standards 12, 13, 15, and 17. Quality in this outcome area is good. Service users can be confident they will be supported to make positive lifestyle choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Records inspected and discussions held with staff and service users, demonstrated that the home has a strong commitment to enabling residents to lead meaningful and fulfilling lives. Individual service users are supported to identify their goals, and within that, decide what support they may need to make their goals achievable. All service users have weekly timetable. These are devised in consultation with the individual, and are based around goals and aspirations. Inspection of a Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 13 selection of timetables evidenced activities both in house and in the local community. The home has a day service. This is based in the grounds, and employs a separate staff team. Day service staff work with care staff to support service users. Detailed notes are written regarding activities, goals and outcomes. These notes influence future goals and choices for service users. Service users spoke enthusiastically about activities, and said they enjoyed living at the home, and were given opportunities to do things they liked. The home supports service users to maintain contact with family and friends. This includes support with travel and visits, and keeping in touch by phone and letter. Frindsbury House employs staff to cook meals. Menus have been formulated in response to service users preferences, dietary needs, nutrition and balance. All service users spoken with praised the food, and confirmed that they were involved in menu planning. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 14 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): Standards 18 and 19. Quality in this outcome area is excellent. Service users can be confident their personal, physical and emotional support needs will be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Record keeping regarding health needs is thorough, and details all healthcare appointments, what support is needed, any outcomes, and any follow up actions. The home has recognised the importance of maintaining good health, and to this aim has adopted a proactive approach to supporting people in understanding and maintaining health, fitness and mobility. Specialist health needs are assessed and service users are supported to access specialist services. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 15 The home needs to record in greater detail the wishes of residents in relation to personal support needs. Conversations with staff evidenced an in depth understanding of individuals needs, and this understanding must be recorded to ensure all staff, including future appointments, are fully aware of individuals wishes, and support people in a consistent way. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 16 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): Standards 22 and 23. Quality in this outcome area is good. Service users can be confident their views will be listened to, and that they will be protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We spoke with service users about making complaints. Service users were confident about their rights, and knew key people in the home who they would talk to about any concerns or complaints. When asked about talking to people outside the home, they identified family members and care managers. Service users said they felt listened to by staff. They indicated that sometimes people did have complaints, but that living with a lot of people could ‘get on your nerves’. Some of the comments made by service users about making a complaint were; ‘Staff help sort things out’. ‘I talk to my key worker’. ‘The manager will sort it out for us’. All service users have access to a complaints procedure, which has clear information on about how to complain and who to talk to. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 17 The manager spoke knowledgably about adult protection, including her responsibilities in terms of reporting and ensuring a safe environment for residents. Training of staff in adult protection is regularly arranged. Staff spoken with had adequate knowledge of adult protect issues, including their role and responsibilities as carers. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 18 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): Standards 24 and 30. Quality in this outcome area is good. Service users benefit from living in an environment that is comfortable, homely and safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Communal areas of the home were inspected. Frindsbury House is a large home, but manages to create a homely environment for people to live in. Certainly, the residents spoken with were proud of their home, and it was evident how relaxed and comfortable they felt. The home is spacious, and affords residents choices about where to spend their leisure time. There is a lounge, with a large conservatory area adjacent and a separate dining room. In addition there is an identified ‘quiet’ lounge within the home. There are additional buildings situated within the rear Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 19 garden, offering facilities for residents on site, which include an Art room/ Workshop and an Occupational Therapy kitchen. The home was clean and hygienic. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 20 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): Standards 32, 33, 34 and 35. Quality in this outcome area is good. Service users benefit from being supported by trained and competent staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussions with the staff on duty evidenced that all staff receive a thorough induction during their initial weeks at the home. This includes coaching and shadowing shifts, reading policies and procedures, reading through all service users care plans and risk assessments, and getting to know the routine of the house. Staff are supported by the management team on a daily basis. In addition, they receive regular supervision, and team meetings are monthly. Observations during the inspection evidenced that staff support service users competently and in a way that ensures choice and dignity. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 21 Inspection of staff files evidenced that the home is committed to robust recruitment procedures, but must ensure appropriate references are taken up prior to appointment. Records demonstrated and staff confirmed that the home prioritises training, seeing it as essential not just for staff development, but to ensure a highly skilled staff team able to meet all assessed needs of the resident group. We spoke with day service staff and care staff. Both were clear about their roles in the team, and their responsibilities towards service users. They described a service that has meeting the needs of people at its core, and indicated that staff were valued by management, leading to positive teamwork. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 22 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): Standards 37, 39 and 42. Service users benefit from living in a well run home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager presented as knowledgeable and competent, is clearly highly committed to the home, and in running a service dedicated to meeting the needs of all service users. Discussions with the manager, the staff and service users evidenced effective leadership skills, and a working ethos of openness and transparency. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 23 Records are of a good standard, although the manager recognises the need for improvement in areas of risk assessment and care planning. The views of service users, their families and stakeholders are seen as a crucial in the development and growth of the home. Annual quality assurance questionnaires are distributed to service users, families and stakeholders. Feedback is constantly sought from service users in key work meetings, house meetings, and day-to-day discussions. The home has a full range of policies and procedures to promote and protect service users health and safety. All staff have been highly trained, and inspection of records and observation demonstrated positive working practice within recognised procedures. Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 24 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 4 3 4 4 4 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 X X 3 X 3 X X 3 x Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 25 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. 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 Frindsbury House DS0000028882.V337247.R01.S.doc Version 5.2 Page 26 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 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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