Inspection on 24/03/10 for Ferndale Mews

This is the latest available inspection report for this service, carried out on 24th March 2010.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ferndale Mews 06/02/07

Ferndale Mews 11/11/05

Ferndale Mews 22/07/05

Ferndale Mews 25/01/05

Ferndale Mews 06/08/04

Ferndale Mews 23/02/04

Similar services:

Sunny Bank (P.R.S.) Ltd

Chirnside House

Ashwood Court Unit 1

Thornton Lodge

Emmaus House

East Croft Grange

Craignair

Alfred House Residential Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 03/09/2010.

Key inspection report Care homes for older people Name: Address: Ferndale Mews St Michaels Road Ditton Widnes Cheshire WA8 8TD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Adele Berriman     Date: 2 5 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Ferndale Mews St Michaels Road Ditton Widnes Cheshire WA8 8TD 01514951367 01514244363 ferndalemews@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Manager Post Vacant Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender Either Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE Mental disorder, excluding learning disability or dementia - Code MD (maximum places: 2) The maximum number of service users who can be accommodated is: 34 Date of last inspection 34 2 Over 65 0 0 Care Homes for Older People Page 4 of 28 Brief description of the care home Ferndale Mews is a care home providing personal care for 32 older people with dementia. The home is located in the Ditton area of Widnes, close to local shops, pubs and St. Michaels church. The building is a two storey purpose built home on the same site as Ferndale Court Care Home. All the bedrooms are single with en-suite facilities. There is a passenger lift. The home has a large secure rear garden. Care Homes for Older People Page 5 of 28 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: We carried out an unannounced visit to the home. The visit formed part of a key inspection of the service in which all of the key national minimum standards were assessed. During our visit we spent time talking to people who live at Ferndale Mews, staff and the acting manager. We looked at all of the communal living area and bathrooms and a selection of bedrooms. We looked at a selection of records, policies and procedures during the visit, these included care plans, staff files, medication records and daily records. Before we visited they completed an Annual Quality Assurance Assessment (AQAA). This document gave them the opportunity to tell us what they thought they did well, what improvements they have made over the last 12 months and their plans for the Care Homes for Older People Page 6 of 28 next 12 months. The AQAA was well written and told us the information that we asked for. Since the last key inspection took place in November 2007 a random inspection of the service had taken place. Following the random inspection requirements were made of the service regarding medication procedures. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 8 of 28 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 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs assessed before they move into the home to ensure that their needs can be met. Evidence: We saw that a pre admission assessment was carried out prior to a person moving into Ferndale Mews. The purpose of this assessment was to ensure that the staff were aware of peoples individual needs and to ensure that the home had the facilities to meet these needs. We saw that information gained during the the pre admission assessment process was recorded on a set format. The document gave the opportunity to record peoples care and health needs within their day to day life. We saw completed pre admission assessments on peoples personal files. They told us that individuals and people important to them were able to visit the Care Homes for Older People Page 10 of 28 Evidence: home for a meal and to spend time with the residents and staff prior to them making a decision to move into Ferndale Mews. They told us that after the first initial six weeks of a person moving into the home a review of their care takes place. The purpose of the review is to ensure that people are happy at the home and that their needs are being met. Ferndale mews does not provide intermediate care facilities. Care Homes for Older People Page 11 of 28 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. Individual care plans demonstrated peoples needs. Evidence: We saw that each person had their own file that contained their personal information, pre admission information and their care plan. We looked at three peoples care plans in detail. We saw that the care plans contained information about peoples day to day needs and wishes. We saw that care plans identified peoples needs and what action staff needed to take to ensure that these needs were met. Care plans contained specific assessments relating to dementia. We saw that one of these assessments had not been reviewed for several years. All assessment that form part of peoples day to day care plans should be reviewed on a regular basis to ensure that they contain up to date information about the individual. Daily records were maintained by the staff team. A section of the care plan was available for staff to record what personal care had been offered and delivered to Care Homes for Older People Page 12 of 28 Evidence: individuals. We saw that not all of these records had been completed. For example, we saw that one record had not been completed for several days and another record did not state if a person had received mouth and nail care. To help ensure that people receive the care and support they require at all time detailed records of personal care should be maintained. Risk assessments specific to individuals needs formed part of peoples care plans. We saw risk assessments that considered peoples continence, changes to behaviour, risk of falls, nutrition, continence and skin condition. The care plans did not contain specific information relating to peoples capacity to make decisions. Where necessary, care plans should contain information about peoples capacity to make decisions under the Mental capacity Act 2005 framework. Records demonstrated that people had regular access to local health care professionals including community nursing from the Primary Care Trust. Throughout our visit we observed people being treated in a friendly, dignified manner by the staff team. They told us in their AQAA that all staff are trained to respect and maintain peoples dignity, privacy and quality of life and that staff identified as dignity champions monitor and support their colleagues. We saw that they had a policy and procedures for the recording, receipt, administration and disposal of medication. The majority of medication was dispensed to the home in a monitored dosage system (MDS). We saw that the medication was stored appropriately. Medication Administration Records (MAR) were in use for staff to record what medication had been administered. We saw that several people who were unable to made a decision about their medication had been prescribed medication on an as and when required basis (PRN). To ensure that a consistent approach is taken to the administration of PRN medication detailed written information about when the medication should be offered and administered should be available. We saw that appropriate storage facilities were available for controlled drugs. A controlled drugs register was available. We saw that information contained in the front of the register did not correspond with other information in the register. To help ensure that all medication is recorded and administered appropriately concise records Care Homes for Older People Page 13 of 28 Evidence: must be maintained. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides flexibility for people during their day. Evidence: We saw that an activities co ordinator was employed to support people in a flexible manner with things they liked to do. At the time of our visit people were receiving hand and foot massages and the hairdresser was visiting. They told us that every Tuesday a reading group takes place for people with dementia. This group is facilitated by a student from a local university. They told us that they had strong links with the local community and churches, enabling residents to participate in local activities. They told us in their AQAA that they provided flexibility within peoples daily routines. We saw that people were able to move freely around the home. They told us in that they had improved over the last 12 months by extending the range of activities available to people and have introduced a monthly programme of theme days. They told us that their plans for the next 12 months included developing Care Homes for Older People Page 15 of 28 Evidence: a reminiscence room suitable for everyones use. We saw that people were given a choice of what they wished to eat at mealtimes and two people who we spoke to confirmed that they were able to get up and go to bed when they wished. They told us that many people were in touch with their families and that visitors were encouraged to visit at any time. Meals were served in the dining room on the ground floor. We saw that the dining tables were set with cutlery and condiments. Staff told us that if a person wished they could take their meals in their bedrooms. We saw that a written menu was available. The introduction of other means for people to choose their food should be considered to help orientate people at mealtimes, for example, a pictorial menu. We saw that information on the notice board regarding the times of meals was out of date. To help people orientate throughout their day up to date information should be available. People told us that they liked the food served at the home. Care Homes for Older People Page 16 of 28 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 and procedures were in place to protect people. Evidence: We saw that information relating to the homes complaints procedure was available around the home. A register was available for the service to record any complaints that had been made. They told us in their AQAA that they had received one complaint within the last 12 months. We saw that this complaint was recorded and that it had been responded to with 28 days. People we spoke to during our visit told us that they knew who to speak to if they were not happy about the service they received. We saw that they had policies and procedures in place for the protection of vulnerable people. A copy of Halton Councils safeguarding procedures were also available. During our visit the acting manager demonstrated a good awareness of local safeguarding procedures. They told us that they had made several referrals to Halton Council under their safeguarding procedures, three of which had been investigated. Training records demonstrated that 94 of the staff team had received awareness training in safeguarding vulnerable adults. Care Homes for Older People Page 17 of 28 Evidence: Care Homes for Older People Page 18 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A comfortable environment is provided for people to live in. Evidence: At the time of our visit all of the people living at the home had bedrooms on the ground floor of the accommodation and the first floor of the accommodation was not in use. A maintenance person was employed to carry out general testing of equipment and repairs around the building. The garden area of the home had furniture for people to sit and enjoy the surroundings. They told us that since we last visited the home had won the Southern Cross north west Blooming Marvelous competition. We saw that peoples bedroom doors were fitted with door knockers and were brightly painted to help orientate people to their own rooms. We saw that the a lounge, dining room and conservatory area was available on the ground floor for communal use. We saw that these areas were comfortably furnished to meet peoples needs. Care Homes for Older People Page 19 of 28 Evidence: We looked at a selection of peoples bedrooms and saw that they had been personalised with individuals personal effects. They told us that redecoration of the building is ongoing and when a bedroom becomes vacant it is re decorated. We saw that hoisting equipment, grab bars and other equipment was available around the home to aid peoples mobility. We saw that two of the communal bathrooms in use had wall tiles missing and were in need of painting. To ensure that people are able to bathe safely an assessment and action plan must be developed for the maintenance required in these areas. At the time of our visit the home was generally clean and tidy. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a staff team who know them well. Evidence: We saw that a manager, three carers, an administrator and ancillary worker were on duty to meet the needs of the 16 people in residence. Throughout the visit we saw staff supporting people in a respectful manner. Staff demonstrated a good awareness of peoples likes, dislikes, needs and wishes. People told us good things about the staff team, comments included the girls are very good and staff are lovely. The service had a detailed recruitment procedure. We looked at the files of three members of staff. We saw records that demonstrated that references and Criminal Records Bureau disclosures had been applied for and application forms completed as part of the recruitment procedure. We looked at staff training information and saw that the majority of staff had received training in fire safety, food hygiene, moving and handling, the protection of vulnerable people and health and safety within the last 12 months. We saw that only 22 of staff had received training in infection control. To help ensure that staff are aware of up to Care Homes for Older People Page 21 of 28 Evidence: date infection control practices training should be available on a regular basis. Training records demonstrated that not all staff had received training in dementia awareness. To help ensure that peoples needs relating to dementia are understood all staff must receive training in dementia awareness. They told us in their AQAA that 81 of the staff team had achieved a National Vocational Qualification (NVQ) for their role. Care Homes for Older People Page 22 of 28 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. Systems were in place to promote and protect peoples health, safety and wellbeing. Evidence: At the time of our visit the manager in post was in the process of leaving Ferndale Mews to take up another position with the company. They told us of the temporary management arrangements that would be in place for the service. The home had not had a manager registered with the Care Quality Commission for some time. An application must be made by a manager of the service to register with the Commission. This will help ensure that people receive a consistent service. Prior to our visit the service completed an Annual Quality Assurance Assessment. This document gave them the opportunity to tell us what they did well, what improvements they have made over the last 12 months, how they felt they can improve and their plans for the next 12 months. The AQAA was well written and told us the information we asked for. Care Homes for Older People Page 23 of 28 Evidence: Systems were in place to monitor the standard of care delivered at the home. They told us that they conduct a survey to monitor quality assurance within the home on a regular basis. We saw a report of the responses from recent surveys that had been completed. The report demonstrated that people were happy with the service they received. We saw that in addition to people living at the Ferndale Mews, their families and social workers were also asked to participate in the survey. Senior representatives from Southern Cross visit the service on a regular basis to carry out an audit of the home. Procedures were in place for the safe management of peoples finances. We saw that peoples money was managed electronically by a national system operated by Southern Cross. The system is an on line banking facility that enable people to access their own statement when required. We saw that accidents were being recorded on a format that protected peoples personal information. A system was in place that ensured that the manager of the service carried out a regular audit of accidents that had occurred. We saw that detailed polices and procedures were in place to protect the health, safety and wellbeing of all. Care Homes for Older People Page 24 of 28 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 25 of 28 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 1 19 23 An assessment and action plan must be developed in relation to the decoration and tiling of the communal bathrooms. This will help ensure that people are able to bathe in a pleasant, hygienic environment. 30/06/2010 2 30 18 All staff must receive training in dementia awareness. This will help ensure that all staff will have a good understanding of the needs of the people they support. 16/07/2010 3 31 8 A manager of the service 02/08/2010 must make an application to the Care Quality Commission to register as the manager of the home. This will help ensure that people receive continuity of service. Care Homes for Older People Page 26 of 28 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 7 Personal hygiene records should be completed on a daily basis to help ensure that people receive the care and support they require. Dementia assessments forming part of peoples care plans should be reviewed on a regular basis. The information at the front of the controlled drugs register should be consistent with other information contained in the register. Care plans should clearly state when PRN medication should be offered and adminsitered to the individual. This information should be written by the prescriber. To help orientate people throughout their day the food menu should be available in a variety of formats and the display for the times of meals should contain up to date information. To help ensure that all staff are up to date with current working practices all staff should receive training in infection control procedures. 2 3 7 9 4 9 5 15 6 30 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 28 of 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!