CARE HOME ADULTS 18-65 Fenham Lodge The Street Hatfield Peverel Essex CM3 2EQ
Lead Inspector Brian Bailey Announced 16th May 2005 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Fenham Lodge Version 1.10 Page 3 SERVICE INFORMATION
Name of service Fenham Lodge Address Fenham Lodge, The Street, Hatfield Peverel, Essex, CM3 2EQ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01245 381550 01245 381069 rich.mc@lineone.net Miss Julie Sanderson Mr Matthew Larkin Care Home 7 Category(ies) of Learning disability (7). Physical disability (7) registration, with number of places Fenham Lodge Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 17/11/04 Brief Description of the Service: Fenham Lodge is a modern detached bungalow that has been adapted and extended to provide accommodation for seven adults with learning and/or physical disabilities. Accommodation is in single bedrooms, with communal daily living space (lounge/dining room, kitchen, gardens, etc.). The home is homely and domestic in character, and in keeping with the local community. It has established good links with the local community, and is within walking distance of the local facilities in Hatfield Peverel that include local shops, library, pubs, and public transport. The registered provider works alongside the registered manager within the home, and the current staff team has a wide range of experience and skills. The manager of Fenham Lodge, Matthew Larkin, was registered by the Commission for Social Care Inspection in January 2005 Fenham Lodge Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place on 16th May 2005 at 10.00am. This was the first inspection of Fenham Lodge in the inspection year 2005/6. The manager, Matthew Larkin, who was registered by CSCI in January 2005, and owner were on duty. During the inspection, a tour of the building was carried out, records and policies were examined, meals were seen and staff and residents were spoken with. All residents were seen during the inspection and all who were able to, indicated that they were very happy living at Fenham Lodge. All standards inspected were assessed as met. What the service does well: 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office.
Fenham Lodge Version 1.10 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Fenham Lodge Version 1.10 Page 7 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, & 4. The admission process is managed well and residents are given clear information regarding the services and opportunities to visit and assess its suitability. EVIDENCE: Appropriate documentation about the services provided at the home was available for prospective residents. All residents have lived at Fenham Lodge for several years. Assessments of residents’ care needs had been obtained and records showed that staff continue to monitor and assess their needs on a regular basis. Appropriate policies, procedures and documentation for assessing and admitting new residents was available. All new residents would have a trial period (a minimum of three months) before any decisions about permanent residency was agreed. All residents have been provided with the home’s statement of terms and conditions, which includes the items that are extra to the fees. Fenham Lodge Version 1.10 Page 8 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 9. Residents care need are well documented and followed with risk assessments to safeguard residents. EVIDENCE: All residents have care plans, which were revised during the past few months. These are clear and cover a range of needs appropriate to each resident. Evidence was available to show that care plans are reviewed monthly and the resident had signed those seen. The care records were easy to read and well maintained. Risk assessments were in place that showed how staff had identified when residents would be exposed to hazards. Fenham Lodge Version 1.10 Page 9 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15 & 17. Residents benefit from a range of educational and social activities and experiences that are a result of their influence. Residents have a balanced varied and enjoyable diet. EVIDENCE: A weekly programme of events showed that residents are busy attending a wide range of educational and social activities. Residents demonstrated how they were able to understand a notice board with pictorial illustrations for each of their activities for the week. During the inspection, all residents were spoken with about their classes and work experiences. They described with enthusiasm where they had been and showed examples of some of their work. They said how much they enjoyed the daily activities and clearly enjoyed telling the staff about what they had been up to. Residents said they were looking forward to their summer holidays that they had planned with the staff. Residents are encouraged to make friends with people of their choice. One resident was happy to talk about a friend whom he intends to invite to the home for tea.
Fenham Lodge Version 1.10 Page 10 Interaction between residents and staff was excellent. Residents spoke about their preferred meals and how much they liked the variety of food provided. Two residents have a budget to purchase their own food and toiletries. During the week they prepare a meal for each other. Good food stocks were available including fresh fruit. Menus were available. Lunch and the evening meal were served in the dining room where residents sat with staff as a family group. Fenham Lodge Version 1.10 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20. Residents are supported by staff that understand their role in ensuring individualised care services are provided. Residents’ health care needs are met appropriately. EVIDENCE: Care records showed that residents are supported to ensure their health care needs are met. Staff said that residents’ personal care needs vary from semiindependent to being totally dependent on staff for assistance. Staff were aware of residents’ preferences in terms of whom they preferred to assist them. Records showed that for some residents, assistance was limited to prompts for maintaining personal hygiene. All residents looked well cared for. Two residents were positive when commenting on how they are supported by staff to purchase their own clothing, food and toiletries and to prepare meals. Staff were observed as caring and sensitive to the needs of residents. They were seen to assist residents in a variety of ways such as re-making their beds with clean linen and generally being a good listener. Residents described staff as being good and helpful. Medication was kept in a locked cupboard and records were up to date and accurate. Since the last inspection, staff had received training on
Fenham Lodge Version 1.10 Page 12 administration of medication. Staff had access to information in the care records of the possible side effects of some medication. Fenham Lodge Version 1.10 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23. The home has appropriate arrangements in place to protect residents and to respond to their concerns. EVIDENCE: The home has a complaints procedure. No complaints have been received by CSCI or the home. Residents spoken with said that they would speak to any of the staff if they were unhappy about anything. From observation, residents were relaxed and at ease in the company of staff and actively sought their company when they returned from their daily activities. The home has an adult protection procedure and had obtained recently updated guidance. All staff have attended training on the protection of vulnerable adults from abuse. Fenham Lodge Version 1.10 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26 & 30 The home provides residents with a comfortable, well-maintained, safe standard of accommodation. It is ideally located and residents have good access to local amenities. EVIDENCE: The home is well maintained and ideally suited to residents’ needs. It is decorated and furnished to a good standard that creates a homely and comfortable appearance. There is a lounge/dining room that overlooks the garden. The residents’ bedrooms looked homely, as they had been able to personalise them with their own possessions. Residents spoke of having their rooms decorated. Residents said they liked their rooms and clearly exercised some choice over the rooms’ redecoration and they were aware of some areas being re-carpeted. The building is clean, appropriately heated and free from unpleasant smells. The kitchen had been modernised with new units and is well equipped. Fenham Lodge Version 1.10 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 & 34. Staff are recruited and deployed in sufficient numbers to safeguard residents and meet their varied needs. EVIDENCE: Staff rosters were available that showed that staff were available throughout the day to match the peaks and troughs in residents’ needs. Staff were knowledgeable about residents’ likes and dislikes and showed that they had established friendly and trusting relationships with residents. Fenham Lodge Version 1.10 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39 & 42. The home is managed effectively and residents enjoy the benefits of a safe and secure setting. EVIDENCE: The new manager had addressed the requirements made at the last inspection, and had arranged to commence training for a National Vocational Qualification level 4 in September 2005. Responses from relatives, residents and college and work place tutors to a survey carried out by the home showed that all considered the home to provide a good standard of care. Residents said that they enjoyed living at the home; they liked the activities, holidays, social events such as having takeaways and going to the cinema. Residents demonstrated that they liked the company of staff and were able to relax and have fun. Evidence was available to show that there was good compliance with Health and Safety matters. Equipment and services such as fire protection systems
Fenham Lodge Version 1.10 Page 17 and gas and electricity were serviced at the appropriate intervals. Risk assessments were available. Fenham Lodge Version 1.10 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x 3 x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x x x Standard No 31 32 33 34 35 36 Score 3 x 3 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 3 x Fenham Lodge Version 1.10 Page 19 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation None 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 None Good Practice Recommendations Fenham Lodge Version 1.10 Page 20 Commission for Social Care Inspection Fairfax House Causton Road Colchester COl 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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