Care Home: Frome House

What the care home does well One resident said, ` if I had all the money in the world I would still want to live at Frome House `, another resident said, ` I looked at a lot of homes before I came here and this one came out the best `. Residents are supported by staff who are caring and hard working. Residents` care plans and assessment records are generally informative and, demonstrate needs are met. The staff do a good variety of care related training. Residents are provided with a good standard and variety of food. There is a variety of low key social and therapeutic activities put on for residents in the Home. The environment is designed to meet the needs of the residents, and it is suitable for the people who live there. What has improved since the last inspection? Overall standards have remained good. The previous manager retired in 2006, and a new manager has been recruited. Ms Denise Pearson (who is the new manager), has continued to lead the Home effectively over the last twelve months. What the care home could do better: When residents self-administer medication a record should be kept of the date that medication has been given to them. This is to keep an audit trail of all medication in the Home. To maintain the health and safety of residents and staff, the fire alarms must be tested on a more regular basis. This relates to the need for fire alarms to be checked each week to make sure they work. CARE HOMES FOR OLDER PEOPLE Frome House Cranleigh Court Road Yate South Glos BS37 5DE Lead Inspector Melanie Edwards Unannounced Inspection 26th February 2008 09:30 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 Frome House DS0000035230.V359623.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. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Frome House Address Cranleigh Court Road Yate South Glos BS37 5DE 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) 01454 866046 01454 866822 terri.bryant@southglos.gov.uk South Gloucestershire Council Ms Denise Pearson Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category- Code OP The maximum number of service users who can be accommodated is 31. 8th August 2006 Date of last inspection Brief Description of the Service: Frome house was purpose built in the 1960s to provide accommodation, personal care and support for 31 older people. It is run by South Gloucestershire Council. The home is situated off a busy main road in a residential area of Yate, South Gloucestershire. It is a short walk to shops and is within easy reach of the towns main shopping centre where there is a full range of community facilities. There is a regular bus service to Yate town centre and to the centre of Bristol. The accommodation consists of a two-storey building that is fully accessible to residents. There are ramps, a passenger lift and a staircase. All the homes bedrooms are single. Each bedroom has a wash hand basin. The home has gardens that are well maintained and are easily accessible. The fees to stay at the Home are £511 a week. Frome House DS0000035230.V359623.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. The inspection was carried out over one day and was unannounced. We (the Commission) met seventeen of the thirty residents living at the Home. We met the registered manager, four care assistants, and a chef .We spoke to them about roles, responsibilities, training needs, and how they assist residents. Staff were observed assisting residents with their needs. The lunchtime meal was observed being served. A selection of records relating to the running and management of the Home were looked at. These included staff training files, staff recruitment files, staff duty rotas, the fire logbook record, maintenance records, menus, and medication records, training records, staff rotas, and supervision records. Three resident’s care records and care plans were inspected. We saw most of the environment. The only areas that were not seen were a small number of bedrooms. The Home was operating within the required conditions of registration set down by The Commission. The conditions of registration set out the type of care and the needs of residents as well as the numbers of residents who may stay at the Home. What the service does well: One resident said, ` if I had all the money in the world I would still want to live at Frome House ’, another resident said, ‘ I looked at a lot of homes before I came here and this one came out the best ’. Residents are supported by staff who are caring and hard working. Residents’ care plans and assessment records are generally informative and, demonstrate needs are met. The staff do a good variety of care related training. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 6 Residents are provided with a good standard and variety of food. There is a variety of low key social and therapeutic activities put on for residents in the Home. The environment is designed to meet the needs of the residents, and it is suitable for the people who live there. 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. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can get hold of the information they may need to make an informed choice about living at the Home. Residents’ needs are assessed so that their needs can be met. Residents are not provided with intermediate care at the Home. EVIDENCE: To find out what sort of information there is available for people to find out about the Home and the service, a copy of the service users guide and statement of purpose were read. Ms Pearson keeps copies of the service users guide, and statement of purpose in the entrance hall of the Home. This is so people can easily get hold of information about the place. The complaints procedure is in the service users guide so that people can complain about the service. However the complaints procedure still has our old address on it (we Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 9 moved in July 2007). This information must be up to date so that people can contact us if they need to. The statement of purpose and service users guide contain information about the service provided, the qualifications of the staff employed, and the accommodation. The philosophy of the Home and how the service aim to meet residents needs is also included. Three assessment records were read to find out how well residents’ needs are assessed. There were assessments of each resident mobility needs, their risk of falling, and their skin vulnerability and risk of developing pressure sores. The assessment records showed the residents had been consulted with to find out about their range of physical, mental and social needs. The Home does not provide residents with intermediate care. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are well met, and this is supported by the information in each persons care plan. Residents’ medication is generally handled and administered safely. Residents are treated respectfully and their dignity is maintained. EVIDENCE: Three care plans were read to find out how residents care needs are met. The care plans have helpful information in them to show how to meet the residents physical, social, and communication needs. The care plans are reviewed and updated regularly. This shows residents care needs are being monitored and kept under review. As quoted in the last Inspection report and as also observed on this inspection: ‘All of the staff on duty were observed helping residents with their needs, and speaking to them in a very polite and respectful way. Staff were also observed Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 11 knocking on bedroom doors before entering them. All of the residents who were consulted spoke extremely positively about the attitude of staff as has already been referred to. All the residents said that staff are very polite, kind and courteous to them ’. The procedures for the administration storage and disposal of medication were checked to see if the systems are safe. Medication is kept in the clinic in a locked cabinet. All staff who give out medication do an intensive training course run at a nearby Hospital to make sure they can do this safely. The medication administration charts of five residents were read. There was a photo of each resident kept with the administration charts. The charts were legible and up to date, they had the signatures of the dispensing member of staff, and the reasons for omissions had also been recorded. There was evidence recorded on a selection of the drug administration charts that stock checks are being carried out. However currently when residents selfadminister medication the date that medication has been given to them is not being recorded. Recording this information would be very helpful as it relates to the need to keep an audit trail of all medication in the Home. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive a nutritious well-cooked diet. Residents can take part in a variety of low-key social and therapeutic activities. Residents are well supported to receive visits from family and friends. EVIDENCE: There are a variety of organised social activities for residents to take part in, and these include bingo, a regular exercise group, and occasional trips to areas of interest in the community. There is also a newsletter published regularly for residents, keeping them well informed about life in the Home. Residents were observed walking around the Home, and talking with the staff, they looked relaxed and settled in their surroundings. There is a hairdresser who attends to hair, and cuts and `sets’ hair while residents are at the Home. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 13 Residents were seen receiving visitors. The Home has a relaxed and flexible visiting policy. The staff talked with visitors in a warm and courteous manner. A portion of the lunchtime meal was sampled in the company of residents. This was a choice of lamb hot pot and three fresh cooked vegetables, or homemade fish pie also with three fresh cooked vegetables. There was a choice of homemade ginger sponge with custard, fresh fruit salad, or yoghurts for desert. The meals were very tasty, and well cooked. The residents we met all spoke very positively about the quality of the meals that are provided. The residents menu choices were well balanced, and traditional. Residents can make a choice of what meal they would like to have. The daily menu is written on a large notice board in the dining room to assist residents. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents ’ views are listened to, and acted on by Ms Pearson and the staff. Residents are protected from the risk of abuse or harm by systems and staff training. EVIDENCE: The residents we met told us they see Ms Pearson regularly and she walks around the Home to meet them. Residents said they speak to her or to any of the staff about any concerns they may have. There are residents meetings held .The minutes were seen of the last residents meeting. The minutes showed residents are consulted in the Home and are given good opportunities to express any concerns or complaints they have. Residents are given their own copy of the Homes complaints procedure. This helps to make sure residents have the information they need to make a complaint. The complaints procedure includes the contact information for the Commission if a person wants to contact us directly. However as already mentioned in the report this information is not up to date as it includes our old address. This makes it potentially harder for people to contact us if they need to. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 15 There is an up to date policy in place relating to the issue of protection of vulnerable adults from abuse. The policy is to help to guide staff to take the correct course of action if they ever have to respond to an allegation of abuse. All staff do regular training in the understanding of the principle of the protection of vulnerable adults from abuse. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 16 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): 19,22,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in an environment that is clean, satisfactorily maintained and suitable for them to live in. Residents have the necessary adaptations and equipment in place to meet their mobility needs. EVIDENCE: This section of the report has been reprinted from the last inspection report, as it is still applicable here: ‘ Frome House is a purpose built Home set in its own grounds. The gardens are satisfactorily maintained and there are seats and an area where residents can sit and walk safely. There is wheelchair access to the Home and the gardens. There is a lift to get to the first floor. The Home is a two-storey building, and residents have access to all areas. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 17 There are adaptations in place to assist residents and visitors with disabilities throughout the Home. There are a dining room and three smaller lounges. Residents were observed sitting in the lounges and dining room, looking very relaxed and comfortable in their surroundings. There are bedrooms situated on the ground and first floor. The décor and domestic style furnishings and fittings in rooms, lounges and seating areas helped to minimise the institutional effects of the environments design. Bathrooms include specially adapted baths to assist residents who may have reduced mobility. There are toilets situated in readily accessible parts of the Home near to communal areas and bedrooms. The bathrooms and toilets were clean, and were well stocked with hand towels and soap to help minimize risk from cross infection in the Home. The Home looked clean and tidy in all of the areas that were viewed and domestic staff were carrying out their duties during the inspection. Bedrooms are not en-suite but they do have hand washbasins in them, for residents’ personal use. There are sluice washer disinfector facilities on each floor. These are separate from residents’ toilet and bathing facilities to minimise any risk of cross infection to residents’. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 18 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): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are cared for by a sufficient number of competent trained staff. The Homes recruitment procedures could not be inspected on the day of the inspection. EVIDENCE: We checked the staff duty for February 2008 to see if residents are cared for by a sufficient number of staff to meet their needs. There is a minimum of four care staff on duty as well as at least one manager working during the day, with extra staff available at busy periods. There are two care staff on duty at night, and an on call manager available if needed. Ms Pearson works full time. Residents are also supported by catering, domestic and ancillary staff although the numbers of these staff were not checked on this inspection. The staff were seen helping, and talking to the residents in a courteous and patient manner. Residents spoke positively about how the staff help them, one resident said,‘ I find the staff all very helpful ’. The staff we met demonstrated that they had a good understanding of the needs of the residents in their care. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 19 The training records of the staff team were looked at to see if staff are keeping up to date in their knowledge of the needs of residents. There was good evidence that staff had attended training sessions, and updating over the last twelve months. There is a training programme for all staff that includes manditory training. Ms Pearson is supporting all staff who have not yet done so to, to undertake National Vocational Qualification in care award training courses. The staff recruitment records of staff could not be checked to see if the Home carries out employment safety checks on staff before they start work. Staff employment records are kept at South Gloucestershire Council head office. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 20 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): 31,33,36,37,38. 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 Home that is well run. The Home is run in residents best interests. Residents are cared for by staff who are appropriately supervised. The health and safety of residents and staff is only partly protected in the Home. EVIDENCE: Ms Pearson has been the manager of the Home since January 2007.She has many years of experience caring for people with a range of needs, and in running Care Homes. She is registered with us as the manager of the Home. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 21 This demonstrates she is fit and competent to be the manager. A number of residents said they see Ms Pearson every day and she will walk round the Home and make time for them. There is a quality assurance system in place in the Home to check on the quality of the care and the service residents receive. A copy of the audit ‘ tool ’ used was looked at. Ms Pearson and the team have recently reviewed and audited the care and the service. Ms Pearson said that residents are encourged to complete annual service questionnaires.The information is used to improve standards in the Home . One resident told us, ‘ they don’t mind asking us our views ’. The staff told us that they are supported by senior staff with regular one to one supervision sessions. The supervision records that we looked at demonstrated staff are being well supervised and supported. Residents’ records were satisfactorily maintained, up to date, legible and in order. The records relating to the management of the Home were also satisfactorily maintained and in order. Individual records and the Home’s records are kept secure , and are available to staff when needed. Other records are referenced elsewhere in the report. The environment looked satisfactorily maintained throughout. There are regular health and safety audits done on the whole environment, to make sure it is safe. All staff do regular health and safety training in range of areas including food hygiene, fire safety, and infection control. This helps ensure staff have a good understanding of health and safety principals and practises. The fire logbook records showed fire alarm tests are being carried out. However the fire alarms must be tested on a more regular basis. There were gaps of time seen in the fire logbook record when the alarms had not been tested for three and four weeks. There are fire drills carried out on a regular basis to help protect the health and safety of residents and staff. The kitchen was clean and tidy and in good order. All kitchen staff do regular food hygiene training to ensure they have a good understanding of safe practises for preparing and cooking food. The staff team won a food safety award in 2007.This helps to demonstrate the kitchen is safe and well run. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 3 2 Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 23 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 OP38 Regulation 23.4 c, (v) Requirement The fire alarms must be tested on a regular basis. This requirement relates to the need for the fire alarms to be checked each week. Timescale for action 28/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations When residents self-administer medication record the date that medication has been given to them. This recommendation relates to the need to keep an audit trail of all medication in the Home. Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Contact Team Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Frome House DS0000035230.V359623.R01.S.doc Version 5.2 Page 25 - 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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