Inspection on 10/05/07 for Fenton Lodge

This inspection was carried out on 10th May 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.

Other inspections for this house

Fenton Lodge 23/01/06

Fenton Lodge 17/08/05

Fenton Lodge 16/11/04

Fenton Lodge 03/06/04

Fenton Lodge 02/07/02

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Fenton Lodge Fenton Lodge Hazel Road Ash Green Surrey GU12 6HP Lead Inspector Unannounced Inspection 10th May 2007 14.15 Fenton Lodge DS0000013640.V337106.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 Fenton Lodge DS0000013640.V337106.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. Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fenton Lodge Address Fenton Lodge Hazel Road Ash Green Surrey GU12 6HP 01252 317211 F/P 01252 317211 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) Mrs Pamela Mary Eales Mrs Rosemary Judith Diana Wykes Care Home 3 Category(ies) of Learning disability (3), Old age, not falling registration, with number within any other category (1) of places Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be 25 - 65 YEARS OF AGE Date of last inspection Brief Description of the Service: Fenton Lodge is a home for up to three people who have learning disabilities. The property is owned and maintained by the Thames And Chiltern Trust (TACT). The registered provider of care and support at the home is Mrs. Mary Eales, trading as Just Homes. Just Homes runs another home nearby and has four further homes in Surrey and Berkshire. The home is a detached bungalow, situated in a quiet residential cul-de-sac in Ash Green. Each resident is accommodated in a single bedroom and communal space is provided in a bright lounge. A large kitchen also includes a dining area and there are a number of toilets, a bathroom and a shower room. An office is available. There is a well maintained garden to the rear of the home and car parking is available on the front drive for a limited number of vehicles. The home has access to local shops and community facilities in Ash, or in the larger nearby towns of Farnham, Guildford, Camberley, Aldershot and Farnborough. The registered manager informed the inspector on the day of the site visit, the fees range for the home are from: £1,244.08 to £1,453.39 per week. Additional charges are made for holidays and personal items. Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit formed part of the key inspection process and took place over four hours commencing at 14.15 and ending at 18.15pm. Mrs V Bulbeck, Regulation Inspector carried out the visit. A full tour of the premises was undertaken. Two care plans were sampled and the care observed for the two service users. The inspector spoke with the three service users to obtain feedback. Three members of staff were spoken to during the visit. A number of records were observed. The registered manager Mrs Rosemary Wykes was on duty. There were three service users living in the home on the day of the site visit and there were no vacancies. The inspector would like to thank the service users and staff for their cooperation and hospitality during the inspection. The service users living in the home wish to be called service users, therefore service users will be referred to throughout the report. What the service does well: Service user’s views are continually sought to improve the service the home provides. Regular meetings are held with service users, records were seen and found to be well documented with an action plan to enable any suggestions or points of view to be actioned. The inspector spoke to the three service users; all were cheerful and happy to speak with the inspector. Observation by the inspector that service users and staff have a good rapport. Service users living in the home appeared to be contented; they were well dressed and stated they enjoyed their evening meal on the day of the site visit. Service users are able exercise their choice in the home. The inspector spoke with three members of staff on duty on the day of inspection; staff commented they feel supported by the management of the home and work as a stable team. The home was homely and welcoming and all areas in the home were nicely decorated and furnished. Some service users had some items of furniture in their bedrooms, which they had purchased since living in the home. One service user commented “the food is very good”. There are extra residents living in the home, two cats named “Sefa and Tibby”. One of the service users feeds the cats. Two rabbits belonging to two service Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 6 users, and the service users help to clean the rabbits shed with staff support. One resident has a fish tank in his bedroom with goldfish. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Fenton Lodge DS0000013640.V337106.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 Fenton Lodge DS0000013640.V337106.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. This judgement has been made using available evidence including a visit to this service. Each service user is only admitted to the home following a full needs assessment to ensure that the home can meet the service user’s identified needs. The home does not offer intermediate care. EVIDENCE: All service users entering the home have a pre needs assessment carried out to ensure the home can meet the service users needs. The registered manager explained that full details of any potentially new service user would be undertaken when the service user enters the home. The admission procedures and criteria reflect the principles of admission and assessment appropriate to the home. The pre assessment document was seen and it was noted that service users are involved in the assessment to ensure the home is able to meet the service user’s needs, prior to admission to the home. The registered manager informed the inspector that a copy of a personal copy of the service users guide is provided to each individual service user, relatives are also provided with a copy. This document was checked and found to be informative and detailed, it is updated on a yearly basis. Fenton Lodge DS0000013640.V337106.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. This judgement has been made using available evidence including a visit to this service. The service users health, personal and social care needs are set out in an individual plan of care, to demonstrate needs are met in accordance with the homes philosophy. Service users are treated in a respectful and sensitive manner. EVIDENCE: Two service users care plans were sampled and there was evidence that service user’s health, personal and social care needs had been identified and assessed. Care notes were detailed to include service users daily routines. All service users are involved with their care planning and where possible indicate they agree with their care plan. An action plan is in place to meet the physical care needs of the service users, to ensure the support, comfort and dignity of the service users is maintained. The care plans are kept in the office in a lockable cupboard and staff have access to the care plans to enable staff to use them as a working tool. Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 10 Staff stated that service users are supported to make decisions affecting their lives in a number of ways. Each service user has an allocated key worker, who is trained to offer one to one support and who knows the service user well and understands his or her needs. The service users communication is limited and staff have the experience to enable service users to make decisions and choices, for holidays, menu planning and outings. Staff advised that information is provided to service users to assist with decision- making and this is in a format to suit their individual needs. Service users care plan should indicate service users who are unable to hold a key to their bedroom; care plans must be documented to include the reasons for not holding a key. Observation by the inspector was staff are respectful to the service users. It was also noted that service users and staff have a good rapport. Fenton Lodge DS0000013640.V337106.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 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users have opportunities for personal development and to take part in appropriate activities within the home and in the local community. They are supported and enabled to maintain and develop appropriate personal and family relationships. Systems are in place to ensure that service users’ rights are respected. EVIDENCE: Service users are supported to make choices in their everyday lives as far as they are able. Families of service users are consulted and encouraged to be involved in the decision making process. The three service users attend various clubs everyday. They also enjoy going to car boot sales, bowling and having meals out. Every Wednesday there is a social club at Lockwood Day Centre and the service users enjoy the visit. One service user visits the Hydropool every week with the physiotherapist. Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 12 During 2006 the three service users went to Norfolk for their holiday. There are plans for a holiday in Exmouth Devon this year, this is currently being arranged by a member of staff. The meals observed were nutritional and well balanced. Staff informed the inspector that service users are involved with the menu planning. The menu is in pictorial form service users are able to make decisions regarding the food they want to eat, but staff support service users to ensure they eat healthily. Food intake and nutritional content is monitored and all service users are weighed monthly. The dietician is involved with one service user who has swallowing difficulties, and provides the home with advise on the food intake. The home has a quality assurance system in place to gain feedback from service users and their families. All members of staff receive training at induction on respecting and promoting the rights of service users. Fenton Lodge DS0000013640.V337106.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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care and healthcare support and assistance is planned and was seen in care notes, to be provided, where needed, in a respectful and sensitive manner. Policies and practices are in place for the administration and management of medication. EVIDENCE: The inspector was informed by a service user they are able to choose when to go to bed and when to get up and are supported to choose their own clothes, hairstyles and other aspects of personal grooming. There are regular visits to the local G.P and service users have an annual health check. All service users have good support from the medical team as well as other professional health care people, including the dentist, optician, chiropodist and physiotherapist. One service user has recently had a blood test. The management of the home will liaise with support services to ensure appropriate equipment is received for example, hoists. A number of risk assessments were seen and are reviewed three monthly, several risk Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 14 assessments were in place for each service user, and the registered manager explained the process is updated on a regular basis. The system for medication administration was seen and was generally carried out to a high standard. The Medication Administration Record (MAR) sheets were seen and no gaps in the recording were noted. Staff stated key workers, who report in turn to the registered manager, monitor the MAR sheets. Any recurring gaps or errors would be referred to the manager, and this would be discussed at a supervision meeting. It was pleasing to see that guidelines are in place for medication that is given “as required”. A photograph of each resident is provided with the MAR sheets to guide staff to the correct service user and a medication information sheet gives details of the medications for each service user. Staff stated that any additional entries to the MAR sheet, which have been handwritten on, are signed by the member of staff making the entry and by a second member of staff who checks that it is correct. This had been carried out. Two staff signs the MAR sheet for all medication given and for the receipt of medication into the home. Sample signatures of all staff that administer medication were held with the MAR sheets for ease of reference. Medication was seen to be well organised and all staff have received training except one new member of staff. There are no service users who are able to self medicate. Fenton Lodge DS0000013640.V337106.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. This judgement has been made using available evidence including a visit to this service. All required policies, procedures and practices are in place to ensure that service users are safeguarded, as far as reasonably possible, from harm or abuse. EVIDENCE: There was one recorded complaint; which had been handled appropriately the registered manager informed the inspector there were no external complaints received. Records seen indicated that complaints would be responded to within the guidelines. The homes complaints procedure for service users is in pictorial form and some service users would be able to use it when necessary. The complaints form is written with widget symbols and easy for service users to understand and a copy is held in each service users bedroom. All relatives have also received a copy of the complaints procedure. Two new members of staff are in the process of completing mandatory training including vulnerable adults training. The registered manager confirmed that she would undertake the training for the two new members of staff. Staff spoken to, stated that they had undertaken training in the protection of vulnerable adults and would report any concerns they had to the manager. Staff said they would be willing and able to report any concerns and “would go to any level to protect service users”. Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 16 Service users finances are paid directly into their bank and fees for their placement is deducted by direct debit. The manager manages any personal allowance money and relatives are involved. The finances of two service users were checked and found to be correct and the money balanced against the records held. The receipts were available and matched the records maintained. Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 17 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements in the home are continuous in order to ensure a safe and wellmaintained environment for service users. The home was observed to be clean and hygiene. EVIDENCE: The environment is homely and welcoming all bedrooms were personalised with some items purchased by the service users, observation by the inspector service users have a good rapport with the staff and enjoy living in the home. The bolt on the shower room door needs to be changed to a lock than can be opened by staff from the outside in the event of an emergency. The other toilet/bathroom door needs a lock fitted and staff should be able to open the door in an emergency. There is a maintenance person who works in the home on a regular basis, who undertakes jobs in the house and keeps the garden nicely presented. Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 18 The garden is accessible to the service users and clearly the service users enjoy sitting in the garden when the weather permits. There is ample room and the garden is nicely laid out. Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 19 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 excellent. This judgement has been made using available evidence including a visit to this service. The home has a comprehensive staff recruitment procedure, which is designed to ensure, as far as reasonably possible, that service users are supported and protected. The number of staff on duty was adequate to meet the needs of service users. Staff that is trained and competent supports Service users. EVIDENCE: The management of the home constantly review the staffing arrangements. At present there are two members of staff on duty for each shift. The night time arrangements are one waking member of staff on duty, and an on call person. Three staff files were inspected and it was noted that staff files were in order and relevant documents were in place. All staff had completed induction training over a two-week period Staff training was up to date apart from two new members of staff. The home would benefit from all staff undertaking equality and diversity training. The inspector would advise the home to produce a training programme to enable management to have a clear view of the staff training needs. Each member of Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 20 staff has their own training folder including the training certificates these folders are maintained by the staff member and are held in the office. Two members of staff spoken to confirmed they are aware of the different needs of the service users and staff work with service users in this area to ensure their needs are being met. Interaction between staff and service users was observed to be good. Two members of staff have completed NVQ Level 2, and two members of staff have completed NVQ Level 4. Two staff are in the process of completing NVQ Level 3 and one member of staff has expressed an interest in undertaking NVQ Level 4. Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 21 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 and 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users are able to make their views known and management of the home ensure that the health, safety and welfare of service users is promoted and protected from harm and abuse. EVIDENCE: The registered manager has completed the Registered Managers Award and is experienced and competent to manage the home. Staff confirmed the manager is supportive and has an open door policy. A quality assurance audit is undertaken on a regular basis and the comments made by relatives were complimentary. The monthly monitoring visits by the responsible person were well documented and covered a wide area of care practice in the home. Timescales and action was included. Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 22 The home operates a number of good practices with regard to health and safety. For example, risk assessments are in place for all service users, the hazardous substances cupboard was securely locked, and a member of staff has been given responsibility for overseeing the health and safety of the home. A variety of safety certificates were seen and found to be satisfactory. The relevant policies and procedures have to be read by each staff member and then signed by them. It was noted that maintenance records were clear and dated when work completed. The registered manager informed the inspector that the maintenance person works in the home on a regular basis and any work that needs to be completed is undertaken as soon as possible. The Commission for Social Care Inspection received eight surveys in total: three surveys were completed by service users, with staff support, and two were from relatives. Two surveys were from health professionals and one from a care manager. The majority of comments were positive for example: • • • • extremely happy and impressed with the care Care and support over and above expectations Impressed with the care provided Meals smell good. There were some comments made regarding; • • • • not sure what to do or how to make a complaint service users should not be left too long unattended more staff on duty Keeping good staff Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 23 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 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 X X 3 X X 3 X Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 24 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. 1 Refer to Standard YA24 Good Practice Recommendations Appropriate safety locks to be fitted on bathroom/toilet/ shower room doors. Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Fenton Lodge DS0000013640.V337106.R01.S.doc Version 5.2 Page 26 - 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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