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Inspection on 22/08/08 for Fer View, The

Also see our care home review for Fer View, The for more information

This is the latest available inspection report for this service, carried out on 22nd August 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Not yet rated. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

CARE HOMES FOR OLDER PEOPLE Fer View, The 163 Bounds Green Road London N11 2ED Lead Inspector Margaret Flaws Unannounced Inspection 22nd August 2008 14:00 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 Fer View, The DS0000010758.V372591.R02.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. Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fer View, The Address 163 Bounds Green Road London N11 2ED 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) 020 8881 4602 020 8881 6264 shashi2ferview@yahoo.com Mrs Shashikala Kuruvitage Mrs Shashikala Kuruvitage Care Home 6 Category(ies) of Learning disability over 65 years of age (6), registration, with number Mental Disorder, excluding learning disability or of places dementia - over 65 years of age (6), Old age, not falling within any other category (6) Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users aged 62 and over in the specified service user categories can be accommodated. 25th August 2006 Date of last inspection Brief Description of the Service: The Fer View is a private care home for six older people who may also have a learning disability or mental disorder. The registered provider is also the registered manager. The home is located in a busy but residential area on Bounds Green Road, North London. It is close to the North Circular Road and within walking distance of the Bounds Green Underground Station on the Piccadilly line. The Wood Green shopping complex and transport facilities are not far away from the home and can be accessed by bus. There are local shops, cafés, restaurants, chemists and a post office close to the home. The home has two single rooms and a double bedroom on the first floor. Two single bedrooms are on the ground floor. A stair lift is available, if required, to access the first floor. There are sufficient bath and toilet facilities in the home. The communal areas include a dining room and the lounge. There is a small car park at the front of the building. The garden at the back of the building is relatively small, well kept with a paved area with garden seats close to the building. The paved area is accessible for people with mobility needs. The registered manager stated that the fees for the home are £450 per week. She also stated that information about the home, including CSCI inspection reports are made available to stakeholders on request. The home’s stated aim is to provide 24 hour care for service users in a safe, harmonious and pleasant environment, to enable residents to achieve their potential capacity- physical, intellectual, emotional and social. Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two days, one day visiting the service and one day reviewing information received. We saw the care records for all the people living in the home, three staff files and a range of other general records and policies and procedures. Throughout the inspection, we spoke with the Registered Provider/Manager and her husband, the Administrator. We also spoke to three people living in the home and one staff member on duty. There was an excellent response to the surveys we sent out. We received five surveys from people using the service, five from staff and four from health professionals. The Registered Provider/Manager gave us a tour of the home, which was in the middle of a major refurbishment during our visit. The quality rating for this service is three stars. This means that the person who using this service experience excellent quality outcomes. What the service does well: The home continues to provide a small scale and friendly place to live that residents value and appreciate. The home clearly demonstrates commitment to and expertise in meeting the needs of older people who have a mental health history. Staff are familiar with peoples’ needs and care records are good. The home has a clear commitment to the training and development of staff. The home has an effective system for seeking the views of residents, relatives and health and social care staff in order to continue to improve the quality of the care offered at the home. Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 6 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. Fer View, The DS0000010758.V372591.R02.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 Fer View, The DS0000010758.V372591.R02.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): 3 People who use the 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 and existing residents needs are fully assessed so that the home can plan to meet their needs. These needs continue to be monitored once people are living in the home so that changes can be considered. EVIDENCE: Six people live at the home. One was in hospital at the time of this inspection and two people were out at day centre. Three new people have come to live at Fer View since the last inspection in 2006. All the residents at the moment are women. We saw all six care files. They had very good quality assessment information, for example, community care assessments by the referring local authorities, mental health and nursing assessments and notes of multidisciplinary care coordination meetings prior to placement. The home’s own assessments were comprehensive and carefully considered how each person’s needs could be met. The Registered Provider/Manager and her staff were able to talk very knowledgably about the current needs of all the people living in the home and explain how these needs were being addressed. Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 9 People living in home have complex histories and the home has gained a detailed understanding of their needs and how to meet them. The home does not provide intermediate care. Fer View, The DS0000010758.V372591.R02.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 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The needs of people using the service are clearly recorded on their care plans, which guide staff on how to meet these needs. Risks are appropriately assessed to protect people. People are well supported with their health care needs and have access to a range of healthcare professionals. Effective medication procedures are in place to safeguard residents. Residents are treated with respect and their dignity is protected. Their wellbeing and sense of worth is effectively promoted. EVIDENCE: The care files for all the people living in the home were inspected. They contained comprehensive and up to date care plans. They were regularly reviewed and gave detailed guidance to staff on how to address people’s identified needs in an effective way. Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 11 The care plans included comprehensive risk assessments, with a general risk assessment giving an overall picture and other specific risks being assessed. These included moving and handling, mental health, physical health, skin and pressure care. These risk assessments had been reviewed on a monthly basis. Health care monitoring is continuous and the home is in regular contact with health professionals. Input from health professionals such as doctors, district nurses and mental health professionals, had been recorded clearly, with actions and follow-up. Health professionals surveyed said that the home always seeks advice promptly when they need it when people’s needs change. They were also praised the high standard of care provided. People living in the home have a range of health needs and individualised planning for these needs is in place and reviewed. There are regular visits by and appointments with the chiropodist, dentist and optician. These are now recorded in a separate section of the files to assist monitoring and planning. Medication policies and procedures are in place and of good quality. We checked the medication and medication administration (MAR) charts for people living in the home. These were clear and accurate, with no errors or omissions noted. Each person had a medication profile on her care file. The pharmacist visits regularly and makes up the medication into dossett boxes for dispensing. The pharmacist also provides regular training to the staff. We checked the medication storage arrangements. The temperature of the medication cupboard had sometime gone over 25 degrees. It is recommended that the home look at ways of reducing high temperatures in medication cupboard The three residents we spoke to and the five surveys from residents gave excellent feedback about the quality of care they receive and their general views of the home. One resident said: “they are so kind. This home is like paradise for me”. Another resident said “….I would like to spend the rest of my life here, this is my home sweet home”. They all said that the staff listen to them and respond to their wishes, include being respectful in providing personal care. The Registered Provider/Manager and the staff were observed interacting kindly and professionally with residents throughout the inspection. Fer View, The DS0000010758.V372591.R02.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): 12,13,14,15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Residents benefit from a range of activities that they enjoy Families and visitors are made welcome at the home, which they and residents appreciate. Residents are encouraged to exercise as much choice and control over their lives as they can to maximise their independence. Residents also enjoy a range of good quality meals. EVIDENCE: People living in the home can take part in a small range of activities within the home although some said they prefer to stay at home, read, listen to music, play games and watch TV and films. One person said that they enjoyed reading and gets a selection of books from the local library. Two people go to day centre three days a week and people also go out for local walks, for lunches, to the garden centre, the cinema and to the theatre. Some people also said that they have been to the seaside. Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 13 People living in the home are culturally diverse and these needs have been assessed and considered in planning to meet them. One staff member said, “it’s my responsibility to respect the feelings, diversity and individuality of others”. Several residents are Catholic and a priest visits regularly. Relatives and friends are encouraged to visit and are in regular contact with the home. People spoken to and surveyed said that they are supported to exercise choice and control over their lives. For example, they are encouraged to personalise their rooms in whichever way they wish. The bedrooms had a wide range of personal items and decorations around. We saw the menu for the week. The Registered Provider/Manager said that meals could vary according to the residents’ preferences on any particular day. The Registered Provider/Manager cooks many of the meals herself. She was committed to providing good quality meals for the residents. This includes making meals from different cuisines, including some of the residents’ own cultures and from Sri Lanka and Malaysia, where the Registered Provider/Manager, her administrator and some of the staff are from. All people living in the home said that the food was “excellent”, “wonderful” and said they loved it. The kitchen was clean and tidy. Records of fridge and freezer temperatures are kept. A range of food, including fresh fruit and vegetables was available and was appropriately stored. Fer View, The DS0000010758.V372591.R02.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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Residents and their relatives can be confident that any concerns they raise with the home will be effectively dealt with. Residents are protected by an adult protection policy and procedure that staff are familiar with. EVIDENCE: The home has good complaints procedure. The Registered Provider/Manager stated that no complaints had been received by the home since the last inspection. People we spoke to and surveyed confirmed that they felt very happy to raise any concerns with the Registered Provider/Manager or her staff. They all knew how to complain if they wished. No safeguarding allegations have been made since the last inspection. The home had a copy of the local authority’s safeguarding adults procedure and the home’s own safeguarding policy and procedure is good. There was evidence that staff training in adult protection is up to date. Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 15 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): 19,26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. This home is a real home that meets the needs of the people living there. The home was is well kept and hygienic, creating a pleasant environment for residents, staff and visitors. EVIDENCE: The home is domestic in scale, well decorated and maintained and provides a safe comfortable environment for people to enjoy. There are two single rooms and a double bedroom on the first floor and two single bedrooms on the ground floor. A stair lift is available, if required, to access the first floor. There are sufficient bath and toilet facilities in the home. The communal areas include a dining room and the lounge. There is a small Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 16 car park at the front of the building. There is a small garden at the back of the building, with a paved area with accessbile garden seats. On the day of our unannounced site visit, the home was undergoing a complete refurbishment. The outside of the house has been redone, all rooms were being repainted, redecorated and newly furnished. New carpets have been laid and one bathroom had been stripped out and refurbished. The Registered Provider/ Manager said the second bathroom was also due for work. The work completed was of a good standard. People who live in the home said that they loved the quality of the physical environment and that it felt like a really homely place for them to spend their lives. There is a laundry with appropriate washing facilities and good infection policies and procedures. Staff have been trained in infection control. The home was clean and tidy throughout during the inspection. Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 17 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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Safe staff recruitment, good training and consistent staff support protect the interests of people living in the home. EVIDENCE: The home is staffed with a sufficient number of people on duty. Residents said that staff were always available if they needed them. We saw the rota, which accurate and showed consistent and appropriate staffing. The Registered Provider/Manager works full time at the home and is supported by her husband as administrator. No new staff have been appointed since the last inspection and the current staff team have been in place for several years. The home has a good staff recruitment policy and procedure to guide recruitment. We saw three staff files. These all had satisfactory recruitment checks, evidence of identity, training and supervision records. Staff have made good progress in national vocational qualification (NVQ) achievement. Of six care staff, one has NVQ2, another has NVQ 2 and NV3 and one other has just commenced studying for NVQ4 in Care. Staff have been trained in food hygiene, diversity awareness, medication, infection control, safeguarding adults, manual handling, first aid, health and safety at work, fire safety and other core training areas. The pharmacist provides medication training updates regularly. Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 18 Staff meetings are held monthly and supervision held and recorded every two months. Staff were very positive about the way they are supported , trained and managed and said that this contributed to their effectiveness in meeting the needs of the residents and building good morale and relationships within the home. Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People living in the home benefit from excellent management. People’s views are actively sought to help improve the quality of care and of the service. People living in the home are well protected by effective policies and procedures to safeguard their financial interests. The home has effective health and safety procedures in place to protect residents and others that work or visit the home. EVIDENCE: The Registered Provider/Manager has extensive knowledge and experience of work in the care sector. She has completed her Registered Managers’ Award. Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 20 Feedback about the management from the residents, staff and healthcare professionals was extremely positive. We discussed the management cover arrangements. The Registered Manager/ Provider said that, if she goes on holiday, the home has good back up arrangements with a care home close by, where the manager is on-call if needed and one senior staff member/ deputy in the home acts up as manager. The home has very good quality assurance procedures. Surveys returned in July 2008 matched those received in previous years – feedback was consistently excellent for people using the service, relatives and health professionals. The feedback we received in this inspection confirmed these results. Health and safety checks and certificates for the home were up to date, including the maintenance checks for fire and fire equipment servicing; servicing of the home’s stair lift; current gas safety and electrical installation certificates; portable appliance testing and evidence that the water storage system had been inspected to minimise the risk of legionella. The home had a satisfactory fire inspection in January 2008. There are weekly fire alarms tests recorded and regular drills. Fire safety is discussed with the residents and they participate in the drills. Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Fer View, The DS0000010758.V372591.R02.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations The home should consider ways of reducing occasional high temperatures in medication cupboard. 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