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Inspection on 05/04/07 for Fenham Lodge

Also see our care home review for Fenham Lodge for more information

This inspection was carried out on 5th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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.

What the care home does well

What has improved since the last inspection?

What the care home could do better:

CARE HOME ADULTS 18-65 Fenham Lodge The Street Hatfield Peverel Essex CM3 2EQ Lead Inspector Brian Bailey Unannounced Inspection 5th April 2007 09:00 Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 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 Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fenham Lodge Address The Street Hatfield Peverel Essex CM3 2EQ 01245 381550 01245 381069 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) Miss Julie Sanderson Matthew James Larkin Care Home 7 Category(ies) of Learning disability (7), Physical disability (7) registration, with number of places Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home accommodates seven people with learning disabilities who may also have physical disabilities 22nd November 2005 Date of last inspection 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 good 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. The home has established good links with the local community, and is within walking distance of the local facilities in Hatfield Peverel that include general 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 registered manager of Fenham Lodge is Matthew Larkin. The fees for living at the home range from £540 to £804 per week. Items considered to be extra to the fees include toiletries, hairdressing, magazines, papers and leisure activities although the cost of holidays is inclusive. Inspection reports of Fenham Lodge are available from the home and also from the CSCI website www.csci.org.uk Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection looking at the core standards for the care of adults. This report is based on a range of information that has been accumulated from our inspection records, a site visit to the home that took place on 5/4/07 at 11:30am, discussions and observations with residents, staff, questionnaires issued by CSCI and the records kept at the home. Comment cards were returned from relatives and residents and all indicated they were satisfied with the service provided. A survey of relatives, residents and other people showed that all considered the home to be well run and in the interests of the residents. This inspection concluded that the overall service provided to those living at the home was excellent. Healthcare arrangements were well managed and support from various healthcare professionals was evident. Residents are helped to access the community to do the things they have said they wish to do as far as possible. This includes the use of local amenities for social, leisure, work and educational support The environment was homely and comfortable and a positive effort is made by staff to encourage service users to be as relaxed and ‘at home’ as possible. What the service does well: What has improved since the last inspection? • • • • • • • Two bedrooms redecorated and three new beds purchased; Two showers replaced; Residents’ independent flat kitchen refitted and two new fridges purchased; Garden furniture replaced; Washing machine replaced New items of bedroom furniture purchased; More staff training. Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 6 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. Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. The admission process is managed well and residents are given clear information regarding the services and opportunities to visit and assess its suitability. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All seven residents have lived at Fenham Lodge for several years. The previous inspection showed that assessments of residents’ care needs had been obtained and records showed that staff continue to monitor and assess their needs on a regular basis. Any prospective residents considering the home, as a place to live, 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 DS0000017816.V335415.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. People at the home are enabled and encouraged to contribute to the daily life and routines of the home. Residents care needs are well documented and followed with risk assessments to ensure their needs are met and are safeguarded from hazards. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information was available to show that all residents have care plans. Two care files were selected at random and checked in detail. These were consistent in layout and information was readily available. Records showed that care plans are reviewed regularly and that residents are involved. The care records were easy to read and well maintained. Daily records and information relating to each of the care plans recorded by the manager provided an excellent account of each persons daily lives and well being. Good information was also available to show that staff monitored the health needs of residents and regular appointments were made with a range of health care professionals Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 10 Risk assessments were in place that showed how staff had identified when residents would be exposed to hazards. People were observed spoken with in a variety of settings in the home including the privacy of their rooms, the kitchen and the lounge. They spoke of shopping and being supported to buy food and of preparing their own meals, normally twice each week, of getting their own breakfasts and of employment. Residents spoke about the holidays they had chosen and taken during 2006. From observation, staff were patient and knowledgeable about residents needs respected their views and wishes. Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is excellent. Residents benefit from the homes arrangements to support opportunities to access the community. They also benefit from an open and flexible approach to visitors and maintaining links with family and friends, the manner in which support is provided by staff and from the catering arrangements provided This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents at Fenham Lodge have family members who are involved in the home, and who visit regularly. Several residents visit their parents on a regular basis, which was the case on the day of inspection. Staff encourage contact between residents and their families/friends, and there are no restrictions on when visits can be made. Residents are able to meet with visitors in their own rooms, if they wish. From observation and discussion with residents, it was evident they are able to determine for themselves where they spend their time. Three residents had spent much of the day at home either relaxing in their own rooms or spending Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 12 time with staff. The residents normal routines had been interrupted owing to the closure of colleges during the Easter break. Staff and other residents welcomed residents that returned home during the afternoon home. The atmosphere throughout the inspection was again relaxed and good-humoured. Residents were seen to act independently and to help in the kitchen with washing up. A resident spoke of the holidays they had taken the previous summer and how they had chosen the type of holiday, which they had enjoyed. A pictorial timetable of weekly activities is used within the home, which makes this information more easily accessible to most of the people. Residents spoken to were aware of the activities they had planned and said they were happy to continue with them, although they felt they could change their minds if they wanted to. Residents’ finances held in safe custody by the home were not inspected as part of this visit. The midday lunch of soup and bread was prepared and served to two residents, whilst the third person prepared their own lunch in a separate kitchen. A resident spoke of favourite foods and of how they can make choices if they disliked the selected meal. Staff said they considered that residents enjoyed a good variety of food and were given sufficient portions. Observation of the evening meal showed that good quality food was prepared and that some residents had excellent appetites. Two residents are supported by staff to purchase their own food and on some days each week they prepare their own meals, which was observed. One resident spoke of the pleasure gained from cooking food and had recently started working in a café. Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. Residents are well supported by a team of staff that understand their roles in ensuring individualised care services are provided. Residents’ health care needs are met appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care records showed that residents are supported to make sure their health care needs are met. Records showed that residents’ personal care needs vary from semi-independent 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 very well cared for. Two residents were positive when commenting on how they are supported by staff to attend work and college, purchase their own clothing and food and to preparing meals. Staff were knowledgeable about residents needs and observed as caring and sensitive to meeting those needs. Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 14 Medication was kept in a locked cupboard and records were up to date and accurate. Since the last inspection, staff had received training on administration of medication. Staff had access to information in the care records of the possible side effects of some medication. Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. The home has appropriate arrangements in place to protect residents and to respond to their concerns. This judgement has been made using available evidence including a visit to this service. 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. Surveys completed by relatives showed they were aware of how to make a complaint. The home has an adult protection procedure and all staff have attended training on the protection of vulnerable adults from abuse Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 & 30. Quality in this outcome area is excellent. Residents’ benefit from living in a well maintained, clean and comfortable environment. Some good facilities have been provided to enable and encourage residents to be independent of staff. It is ideally located and residents have good access to local amenities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well maintained and ideally suited to meeting residents’ needs. It is decorated and furnished to a good standard that creates a homely and comfortable appearance. There is a large lounge/dining room with sufficient comfortable chairs that overlooks the rear garden. The residents’ bedrooms are homely in appearance and each room has been personalised with their own possessions. Residents spoke of having their rooms decorated. Some new bedroom furniture had been purchased and carpets replaced. Residents said they were very pleased with their rooms and clearly exercised choice over their Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 17 possessions and how the rooms were laid out. Residents were observed retiring to their rooms throughout the day. The building was clean, appropriately heated and free from unpleasant smells. There were no obvious health and safety hazards noted in the home. Access to the building is adequate for wheelchair use. The front of the bungalow is mainly laid to hard standing for vehicular use. The well-equipped kitchen was maintained to a good standard of cleanliness. The home had been awarded a gold award by the local district council for good food and hygiene standards. New shower units had been fitted. Two residents share a separate kitchen, which had been upgraded. Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 18 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. Residents’ benefit from staff being provided with appropriate training. Staff are recruited and deployed in sufficient numbers to safeguard residents and meet their varied needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff spoken with stated they felt very supported and that an open and communicative way of working operated with all the staff team, including the manager and owner. Staff were observed as relaxed and confident at all times and had clearly established excellent relationships with the seven residents. It was also apparent that the residents responded well to staff and were happy with the way the home operated. A key worker system was in operation and staff spoken with demonstrated an understanding of how this worked in practice and their role within the process. Of the seven support staff employed, five have acquired a National Vocational Qualification, which represents 72 of the staff. This means the home has already reached the objective of having 50 of the staff having a NVQ. by 1st April 2008. A staff member spoken with confirmed that they had completed the appropriate induction training and had since obtained an NVQ. Additional Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 19 training over the past year includes health and safety, food hygiene, POVA, first aid, medication, computers and training in the future is planned. There had been no changes to the staff team since the last inspection and the owner had confirmed to CSCI that CRB disclosure checks had been obtained for all staff. Information was available at the home to show that all staff had a CRB, the date this was obtained and the level of disclosure. Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 20 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is excellent. Residents benefit from, a service that is well managed, the home’s approach to health and safety and staff seeking the view of residents as a matter of routine. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Manager is qualified and experienced to operate the home and updates skills and knowledge periodically. The registered provider also works at the home and enjoys an excellent working relationship with the manager and staff. The ethos and leadership within the home is very positive as confirmed by care staff. Evidence was available to show that the home carries out Quality Assurance surveys each year. Questionnaires at the home from relatives, residents and other people showed that there is a high level of satisfaction with the care and safety of residents, the staff and the way the home is managed. A CSCI Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 21 survey carried out in March 2007 also showed that people were happy with the care provided and had no concerns. Information provided to CSCI by registered provider shows that matters relating to Health and Safety are up to date. Equipment and services were serviced at the appropriate intervals. The last fire drill, emergency lighting check, portable appliance check and gas safety check were all current. Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard Good Practice Recommendations Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Fenham Lodge DS0000017816.V335415.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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