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Inspection on 01/04/09 for Ferndale Court Nursing & Residential Home

Also see our care home review for Ferndale Court Nursing & Residential Home for more information

This is the latest available inspection report for this service, carried out on 1st April 2009.

CSCI found this care home to be providing an Good service.

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.

What the care home does well

The further health care needs of people living in the home are met and people are treated with respect. In relation to what the service does well one staff member commented, "care staff dedicated to the needs of the service users - some will go that extra step giving time up on days off to escort for hospital visits or shop for personal items." The standard of catering is good and people are offered choice so they are well nourished. Ferndale Court is well maintained so people live in safe and comfortable surroundings. Staffing levels are good so that people`s needs are met. The home uses various methods to find out if the service is well run and providing a good service.

What has improved since the last inspection?

Management of the home has improved so that the home is run in the best interests of people living there. The management of complaints has improved and there are fewer complaints made about the home so that people appear satisfied with the care provided at Ferndale Court. The majority of staff have undertaken training in safeguarding adults procedures so they know what to do if they suspect someone is being abused and so people living in the home are protected. The manager has held separate meetings for relatives and staff so they can express their views about how th home is run. The management of medication has improved so people receive their medication safely.

What the care home could do better:

The assessments carried out before the person is admitted to the home need to be more detailed so that care staff have sufficient information about how to meet the needs of people coming to live in the home. Wherever possible, the person living in the home or their representative should be involved in the care planning and review of the care plan. This is so they know and understand what care will be provided and can contribute to this process and express any preferences about how care is delivered. Ferndale Court needs to provide more evidence that it is meeting the social care needs of people living in the home and particularly on an individual basis so that people arenot socially isolated. The few care staff who have not undertaken training in safeguarding adults should do this training so they know how to recognise abuse and what to do if they suspect someone is being abused. The home should aim to achieve a minimum of 50 percent of care staff with a NVQ2 qualification so they are skilled and knowledgeable in their role. Recruitment procedures need to be more robust so that people living in the home are protected.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ferndale Court Nursing & Residential Home Ferndale Court Nursing & Residential Home St Michaels Road Widnes Cheshire WA8 8TF     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: June Shimmin     Date: 0 1 0 4 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 27 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 27 Information about the care home Name of care home: Address: Ferndale Court Nursing & Residential Home St Michaels Road Ferndale Court Nursing & Residential Home Widnes Cheshire WA8 8TF 01512579111 01514200210 ferndalecourt@schealthcare.co.uk 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) : Southern Cross Healthcare Services Ltd care home 57 Number of places (if applicable): Under 65 Over 65 0 57 0 dementia old age, not falling within any other category physical disability Additional conditions: 24 0 5 The registered person may provide the following category of service only: Care home with nursing - Code N. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categoires: Old age not falling within any other category - Code OP. Dementia - Code DE (24). Physical Disability - Code PD (5). The maximum number of service users who can be accommodated is 57 Date of last inspection Brief description of the care home Ferndale Court care home provides care for 57 people, mostly older people needing nursing care. It is a two-storey purpose built home, opened in 1997, in the Ditton area of Widnes, close to local shops and churches. All the bedrooms are single with en-suite facilities. There are several lounges and dining rooms. A passenger lift is available for access to the first floor. The home is on the same site as Ferndale Mews care home; Care Homes for Older People Page 4 of 27 Brief description of the care home both homes are set in private grounds with parking and gardens. The current weekly fees range from 538 pounds for people receiving personal care only to 630 pounds for people receiving nursing care. Further details regarding fees are available from the manager. Care Homes for Older People Page 5 of 27 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: The last inspection on this service was completed on 10 April, 2008. The overall quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. This key unannounced inspection visit took place over five and a half hours. Two regulatory inspectors carried out the visit. This visit was just one part of the inspection. Other information received was also looked at. Before the visit the registered manager was asked to provide information about the home as part of this inspection process. We sent questionnaires to people living in the home and staff members to find out their views about Ferndale Court. We also spoke to a number of staff members and a Care Homes for Older People Page 6 of 27 visiting social worker during the visit. Their views are incorporated into the findings of this report. During the visit various records and the premises were looked at. Records of care plans, medication, maintenance and staff training records were also examined. What the care home does well: What has improved since the last inspection? What they could do better: The assessments carried out before the person is admitted to the home need to be more detailed so that care staff have sufficient information about how to meet the needs of people coming to live in the home. Wherever possible, the person living in the home or their representative should be involved in the care planning and review of the care plan. This is so they know and understand what care will be provided and can contribute to this process and express any preferences about how care is delivered. Ferndale Court needs to provide more evidence that it is meeting the social care needs of people living in the home and particularly on an individual basis so that people are Care Homes for Older People Page 8 of 27 not socially isolated. The few care staff who have not undertaken training in safeguarding adults should do this training so they know how to recognise abuse and what to do if they suspect someone is being abused. The home should aim to achieve a minimum of 50 percent of care staff with a NVQ2 qualification so they are skilled and knowledgeable in their role. Recruitment procedures need to be more robust so that people living in the home are protected. 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 27 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 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although an assessment of the persons care needs is carried out before admission to the home there is only limited information available about the persons mental health and care needs in relation to dementia so these needs may not be fully understood and met. Evidence: We visited the home the on 12 March 2009 to review the homes application to admit people with dementia who require nursing care. As a result of this visit the home has now been registered to accept people with these care needs but at the time of our visit in April the new unit had not opened. The manager of Ferndale Mews told us that if a person transfers into Ferndale Court, their keyworker from Ferndale Mews will work alongside the primary carer at Ferndale Court for a short period of time so there would be continuity of care. We looked at the assessments carried out for two people admitted to Ferndale Court. Care Homes for Older People Page 11 of 27 Evidence: In both cases the registered manager had carried out the assessment. Although both people had a diagnosis of dementia there was little recorded on the assessment about the persons type and degree of dementia so that staff may not be fully able to meet the persons care needs. There was sufficient information about the physical care needs of people coming into the home but not much about the social, family history and leisure care needs of these people so staff might not be able to provide care that is person centred and demonstrates a knowledge of the individual needs of the person. Ferndale Court does not provide intermediate care so standard 6 does not apply. Care Homes for Older People Page 12 of 27 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. The health care needs of people living in the home are met and in a manner that respects their privacy and dignity. Evidence: We looked at the care plans of six people living in the home. The content of the care plans was of a good standard and appropriate risk assessments had been provided so that actions would be taken to meet peoples needs. Some care plans had been evaluated and advice given by health professionals was included in these so that changing needs were identified and recorded. The evaluations of other care plans needed to be more detailed to reflect changing needs. There was also little recorded evidence that people living in the home or their relative/representative were involved in either the care planning or evaluation process so they might be unaware of what care was to be provided or be able to give their opinion about that care. There was good evidence that staff in the home contact health professionals when the need arises so that further health care needs are well managed. Care staff behaved in a courteous, sensitive and kind manner towards people living in the home so that residents were Care Homes for Older People Page 13 of 27 Evidence: treated with respect. The home said that a dignity champion had been nominated by the home to ensure that this important aspect of peoples life was observed. We looked at how medication was being managed and this was of a good standard so people living in the home received the medication for which they were prescribed in a safe way. The Operations Manager said that four nurses and six senior carers had attended medication training but the homes training statistics indicated that only four people in total had done this training so it was difficult to check the accuracy of the evidence. Care Homes for Older People Page 14 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to a limited range of activities so they might be socially isolated. Evidence: The Operations Manager for Southern Cross told us that two new activity coordinators have been appointed but that they cannot start work until security checks [POVA 1st] have been received. There was little recorded on assessment documentation and in care plans about the social care needs of people living in the home. For instance one persons client profile stated that they like old films but there was no reference to this in the care plan. This may be affecting their quality of life and also means that communication between people living in the home and care staff might be limited. Care staff have limited knowledge about the people for whom they care other than their physical care needs and information about visitors. People living in the home are likely to be at risk of social isolation and lacking in stimulation. Several seasonal events to coincide with Mothers Day and Easter had been organised by care staff to provide people living in the home with occasional activities but little was taking place on a daily basis. Visitors are able to come to the home at any reasonable time. In relation to equality and diversity the manager told us, we have many church groups which visit the home to help meet religious beliefs and hold service meetings for Care Homes for Older People Page 15 of 27 Evidence: clients who cannot attend church. The standard of catering at Ferndale Court is good with evidence of the use of fresh produce and homemade foods. People were enjoying a roast turkey lunch during our visit and we were told that alternatives are available for those who do not like the main choice. Menus were seen on the tables so people could see what was provided. Although they were not provided in large print the Operations Manager said that the home is providing white boards where the menu can be written in large print so the majority of people can read it. The home assisted people to eat in a manner that preserved their dignity and suitable protection was provided for the clothing of people living in the home. The cook told us that when the kitchen closes for the day, each satellite kitchen is checked to ensure there is, for example, cereal, milk, bread, butter, sandwich fillings, tinned soup, tinned spaghetti so that people who may be hungry can have something to eat regardless of the time of day. Care Homes for Older People Page 16 of 27 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. Policies, procedures and training about complaints and safeguarding adults are in place so that people living in the home are protected. Evidence: Ferndale Court has a policy and procedure in place for complaints and people living in the home and their families/representatives are given information about how to complain or raise concerns. The home has received few complaints during the last year and these have been investigated and appropriate actions taken. A number of allegations under safeguarding procedures have been notified to us during the last twelve months. In each case the home has followed the correct procedure and dealt with staff appropriately. A requirement was made at the last big inspection last year about all staff undertaking training in safeguarding procedures. A small group of staff have still not done this training and should do so to ensure they know how to recognise abusive behaviour and what actions to take. The Operations Manager told us that a training day on this subject is planned later in the month. Care Homes for Older People Page 17 of 27 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. Ferndale Court is well maintained so people live in safe, comfortable and pleasant surroundings and the new unit for people with dementia is organised and furnished in a way that will meet their needs. Evidence: The registered manager gave us written information about the home before we visited. We were told that the home is well maintained and that installations and services at the home are regularly maintained by external contractors or by the homes maintenance personnel. We looked at the building and in particular the new unit on the ground floor for people with dementia who require nursing care. The latter has been well designed and consists of two separate units accessed by doors with keypads so that the units are secure. The home has started the process of redecoration of both units and the standard of decoration is good. Where necessary carpets and furniture have been replaced. Access to bedrooms is through bright red doors that have a number, letter-box and door-knocker. People living in the home will be able to individualise their door, for example, with a collage, painting, photos, or memory box, completed as part of their therapy and with the support of keyworkers, relatives or friends. Aprons (rather than bibs) had been hung on the coat-hooks in the dining rooms, and there were lots of tea towels about so people living in the home could join in with household chores. Corridors have been decorated with tactile boards to Care Homes for Older People Page 18 of 27 Evidence: stimulate people living in the home and generate conversation. A decorated coatstand has been installed part-way along each units main corridor with hats, scarves and bags. Along each corridor, too, boxes had been fitted to the wall at regular intervals and filled with dusters, brushes, soft toys, etcetera for people with dementia to help themselves to. The doors of toilets and bathrooms were identified as yellow and blue to help people with dementia find their way there. In addition there were pictures of toilets and bathrooms so people could identify what the purpose of the room was. Most of the home was fresh smelling and there were measures in place to prevent the spread of infection in the home. Care Homes for Older People Page 19 of 27 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. Staffing levels at Ferndale Court are good but training is not fully up to date and recruitment procedures need to be more thorough so people living in the home are fully protected and cared for by well trained and knowledgeable staff. Evidence: Staffing levels in the home were good on the day of our visit. At present only the first floor is open until the opening of the new unit for people with dementia on the ground floor. The Operations Manager told us that new staff were being recruited for the new unit. We looked at recruitment records for two staff. In one case the records were satisfactory but there was no written explanation on file for the second staff member about whom one reference was unsatisfactory. There was a record of this staff members induction available at the home but the other staff member had taken this record home so we could not check if it was satisfactory. We were told that only six out of sixteen care staff have achieved an NVQ qualification and in this regard there has been little improvement since our last big visit. The Operations Manager said that six more staff are working toward an NVQ award. The home gave us a copy of their training statistics for the previous month, which indicated that training was not up to date in a number of topics including mandatory subjects such as health and safety. The Operations Manager felt that these statistics were incorrect but it was difficult to check what the correct numbers were. Care Homes for Older People Page 20 of 27 Care Homes for Older People Page 21 of 27 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. Ferndale Court is well managed so that it is run in the best interests of people living there. Evidence: The registered manager has completed the registered managers award since our last visit so she can demonstrate she has the management skills to run the home effectively. Although the registered manager was not present during our visit we received favourable feedback from a number of staff about how she carries out her role, she has been in my opinion the best manager I have worked for as I find her very professional in her approach and compassionate in her attitude to residents and staff. When the new unit opens the registered manager will be supported by a unit manager on each floor so she will have good support to carry out her role. Ferndale Court uses various methods to assess whether it is providing a good service to people living in the home and their families/representatives. These include meetings where people can express their opinions and also meetings for staff so they too can Care Homes for Older People Page 22 of 27 Evidence: contribute to the running of the home. We were also told that each staff member had been sent a survey about the home but there was no evidence that this had happened. Although the minutes of staff meetings did not indicate that staff could put their views forward several staff during the visit said that they could say what they thought. The Operations Manager for Southern Cross visits Ferndale Court on a frequent basis and supplies a monthly report about how the home is managed for the registered manager and which is also available to us when we visit so we can monitor how the home is performing. The registered manager provided us with information before the inspection about how small amounts of money are managed on behalf of people living in the home and these systems appeared satisfactory. We looked at training records for mandatory training such as fire drills and moving and handling, which indicated that not all staff had undertaken this training. The Operations Manager said that only three staff had not taken part in a fire drill and the training matrix may not have been correct. Care Homes for Older People Page 23 of 27 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 27 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 1 3 The assessment of care needs should include more detail about the persons mental state and cognition so that these needs can be identified and appropriate care provided. The assessment of new residents should include details about their family history, social interests, hobbies, religious and cultural needs so that these needs are identified and action taken to meet them. The person receiving care, or their representative, where this is appropriate, should be involved in the care planning and review process so they know what care they can expect to receive and whether this care is meeting their needs. Care plans should indicate what actions are being taken by staff to meet the social, spiritual and leisure care needs of people living in the home so they are able to benefit from a good quality of life. The registered manager should ensure that all staff who have not undertaken training in safeguarding adults do so in the next month so they know how to recognise abuse and what to do if they suspect someone is being abuse. The registered manager should ensure that all staff have Page 25 of 27 2 3 3 7 4 12 5 18 6 38 Care Homes for Older People taken part in a fire drill and attended fire training so they know what to do in the event of fire. 7 38 The registered manager should ensure that all staff take part in safe moving and handling procedures so they are safe practitioners. Care Homes for Older People Page 26 of 27 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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