Inspection on 25/08/06 for Fer View, The

This inspection was carried out on 25th August 2006.

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

Fer View, The 23/01/06

Fer View, The 05/09/05

Fer View, The 05/11/04

Fer View, The 22/06/04

Similar services:

Ashlong House

Norbury Crescent (30)

Henry Nihill House

Birchwood

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

The Infirmary

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

CARE HOMES FOR OLDER PEOPLE Fer View, The 163 Bounds Green Road London N11 2ED Lead Inspector Peter Illes Key Unannounced Inspection 25th August 2006 09:30 X10015.doc Version 1.40 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 Fer View, The DS0000010758.V303331.R02.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 Older People. 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. Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fer View, The Address 163 Bounds Green Road London N11 2ED 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) 020 8881 4602 020 8881 6264 Mrs Shashikala Kuruvitage Mrs Shashikala Kuruvitage Care Home 6 Category(ies) of Learning disability over 65 years of age (6), registration, with number Mental Disorder, excluding learning disability or of places dementia - over 65 years of age (6), Old age, not falling within any other category (6) Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2006 Brief Description of the Service: The Fer View is a private care home for six older people who may also have a learning disability or mental disorder. The registered provider is also the registered manager. The home is located in a busy but residential area on Bounds Green Road, North London. It is close to the North Circular Road and within walking distance of the Bounds Green Underground Station on the Piccadilly line. The Wood Green shopping complex and transport facilities are not far away from the home and can be accessed by bus. There are local shops, cafés, restaurants, chemists and a post office close to the home. The home has two single rooms and a double bedroom on the first floor. Two single bedrooms are on the ground floor. A stair lift is available, if required, to access the first floor. There are sufficient bath and toilet facilities in the home. The communal areas include a dining room and the lounge. There is a small car park at the front of the building. The garden at the back of the building is relatively small, well kept with a paved area with garden seats close to the building. The paved area is accessible for people with mobility needs. The registered manager stated that the fees for the home are £450 per week. She also stated that information about the home, including CSCI inspection reports are made available to stakeholders on request. The home’s stated aim is to provide 24 hour care for service users in a safe, harmonious and pleasant environment, to enable residents to achieve their potential capacity- physical, intellectual, emotional and social. Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took approximately five hours with the registered manager and her partner who shares responsibility for finances and some administration tasks being present or available throughout. There were six service users accommodated and no vacancies at the time of the inspection. The inspection included: independent discussion with all six service users; independent telephone discussions with two relatives and independent discussion with one care staff. Further information was obtained from a tour of the premises, positive feedback cards from stakeholders as well as service users and a range of documentation kept at the home. 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective and existing service users needs are assessed, including by the home, to assist staff meet their needs when they are first admitted. Their needs continue to be monitored once admitted to ensure that the home can continue to meet their changing needs. EVIDENCE: Two new service users had been admitted to the home since the last inspection. The files for these two service users and the file for another service user that had been accommodated for a longer period were inspected. The files of both new service users contained a community care assessment of need undertaken by the referring local authority. Both these assessments were current and were available to the home prior to the service users respective admissions. The file for one of these service users also contained a separate nursing assessment, physiotherapy assessment and a hospital discharge summary completed immediately before that service user was admitted to the home. There was also a record of a review being held for both new service Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 8 users by their respective referring local authority’s between six and eight weeks after their admissions. The registered manager also confirmed that she carried out her own assessment of need for all service users that were admitted and stated that on occasions she had not pursued a referral to the home as she did not believe the home would best meet the person’s needs. The file of the service user that had been accommodated for a longer time also showed up to date assessment information recorded by the home. This service user is self-funded with no current local authority input. The registered manager was able to talk knowledgably about the current needs of all the service users and how these needs were being addressed. The registered manager confirmed that the home does not provide intermediate care. Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are clearly recorded on their care plans and give guidance to staff on how to meet these needs. Service users are well supported regarding their health care needs with access to a range of healthcare professionals. However, a different way of recording contact with these professionals may further assist staff in this area. Effective medication procedures are in place to safeguard service users. Service users are treated with respect and dignity by staff at the home, which they clearly appreciate. EVIDENCE: The files of three service users inspected all contained up to date care plans. These were detailed and based on the current needs of the service users. The plans gave clear guidance to staff on how to address the identified needs in an effective way. The plans were reviewed monthly with notes of any changes in the way care and support was to be given. One service user had vulnerable skin and was receiving weekly visits from a community nurse to monitor this. A separate nursing care plan was inspected and this indicated that the home was Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 10 providing appropriate care in this area. All three care plans were informed by a range of risk assessments including the following as appropriate: moving and handling, mental health, physical health, skin vulnerability and an overall personal risk assessment. Evidence was seen that the risk assessments were being reviewed on a regular basis. All service users are registered with a G.P. with evidence seen that a range of medical conditions were being appropriately monitored and/ or treated by relevant health care professionals. An example of this is the community nurse visits referred to above. An optician and a chiropodist had visited the home during August 2006 and the registered manager confirmed that both of these visit on a regular basis. The registered manager went on to say that because of the needs of the service users currently accommodated a dentist does not visit the home on a regular basis. However, she stated that the home will arrange visits as appropriate e.g. to check dentures when required. Records to evidence health care appointments were clear although not together on individual service user’s files. A good practice recommendation is made that the home should use a separate section of the service users files to record all their health care appointments. This will provide a clearer summary and overview of these appointments and further assist staff to monitor service users overall health care needs. Medication and medication administration (MAR) charts for three service users were inspected and found to be satisfactory. Each of the three service users files contained a current medication profile. Evidence was seen that the dispensing pharmacist visited the home in April 2006 to check the medication procedures that were in place. The medication is supplied to the home on a weekly basis in individual dossette boxes that are filled by the dispensing pharmacist. The registered manager stated that the dispensing pharmacist was to visit the home in September 2006 to provide update training for all staff in the safe administration of medication. All six service users were spoken to independently and all indicated that they were satisfied with the care that they received. One service user stated that the “staff are very good”. Another service user stated that “…. I have been in four homes and this is the best one. The staff always listen”. Two different service user’s relatives were spoken to independently by phone and they were also complimentary about the registered manager, the staff and the care given by the home. The registered manager and the staff on duty were seen to interact appropriately with service users throughout the inspection. The two service users that shared a double room indicated that this arrangement worked well for them and were satisfied with the arrangements made to promote their privacy in the room. Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a range of activities that they enjoy although may benefit further if encouraged to try different things including going out more into the community. Families and visitors are made welcome at the home, which they and service users appreciate. Service users are encouraged to exercise as much choice and control over their lives as they can to maximise their independence. Service users also enjoy a range of good quality meals that they enjoy. EVIDENCE: Service users have the opportunity to take part in a range of activities within the home although the registered manager stated that most like to stay in their rooms for the majority of the day. One service user stated that they liked to read and had a selection of books from the local library. Two other service users enjoy playing cards and staff support and assist them in doing this. One service user enjoys playing chess and the registered manager confirmed that a chess teacher visits the home to assist the service user with this. The registered manager stated that the home offers to take service users out but they mostly decline to go when the time comes. Some service users are from a range of ethnic communities as are some of the staff. The registered manager Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 12 stated that a priest comes to the home to see one service user at their request. Comment cards from relatives and other stakeholders received indicate that those who completed them are satisfied with the care and facilities on offer at the home. However, although the service users stated that they were content with the activities on offer a good practice recommendation is made regarding this. The home should consider different and innovative ways of encouraging service users to participate in more varied activities including going out into the community where appropriate. Relatives and friends are encouraged to visit service users in the home and there was evidence from a range of documentation that many do. The relatives of two service users were spoken to independently by phone. They both indicated that they were made welcome when they visited. Another service user told the inspector that they go out for a meal with their relatives on occasion. The registered manager stated that the only service users money the home has dealings with is the personal allowance for two service users. Satisfactory records of these were seen. The registered manager went on to say that relatives or third parties deal with all other service users money. Service users are encouraged to personalise their rooms and all the bedrooms were seen to contain a range of personal items including photographs and ornaments. The whole home is comfortable and homely in nature. The home has a specimen menu that showed a variety of healthful meals. The registered manager stated however that meals on any day could vary according to service users preferences. The lunch on the inspection day consisted chicken and rice that the inspector was invited to try. The meal was well presented and delicious. The registered manager cooks many of the meals herself. She told the inspector that she was keen that service users had good quality meals as she felt this was one of the few pleasures they could still really enjoy. All the service users told the inspector that the food was good; one service user commented that they could always ask for me if they ever needed to. The kitchen was clean and tidy and a new fridge freezer had been purchased since the last inspection. Satisfactory records of fridge and freezer temperatures were seen. A range of food, including fresh fruit and vegetables were appropriately stored. Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives can be confident that any concerns they raise with the home will be effectively dealt with. Service users are protected by an adult protection policy and procedures that staff are familiar with. EVIDENCE: The home had a satisfactory complaints procedure that had been reviewed since the last inspection by the registered manager. The registered manager stated that no complaints had been received by the home since the last inspection. Service users spoken to confirmed that they felt happy to raise issues of concern with the registered manager or her staff. The home also records compliments and a record of one of these was seen. The home also had a copy of the adult protection procedure for the London Borough of Haringey, the local authority that the home is situated in. An inhouse adult protection policy was also seen that was consistent with the council policy. The registered manager had reviewed the in-house policy in the past twelve months. The registered manager stated that no allegations or disclosure of abuse had been made to the since the last inspection. Evidence was seen that staff training in adult protection was up to date. Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a home that is homely, domestic in scale and that meets their needs. The home was clean and tidy throughout creating a pleasant environment for service users, staff and visitors. EVIDENCE: The home is domestic in scale, very well decorated and maintained and provides a safe comfortable environment that service users enjoy. The home has two single rooms and a double bedroom on the first floor. Two single bedrooms are on the ground floor. A stair lift is available, if required, to access the first floor. There are sufficient bath and toilet facilities in the home. The communal areas include a dining room and the lounge. There is a small car park at the front of the building. The garden at the back of the building is realtively small, well kept with a paved area with garden seats close to the building that is accessible for people with mobility needs. Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 15 The home has satisfactory laundry facilities with a washing machine that has a sluice cycle. The home also has a satisfactory infection control policy that had been reviewed by the registered manager in the past twelve months. The home was clean and tidy throughout during the inspection. Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a staff team with sufficient numbers to effectively support the service users accommodated. Service users are protected by staff having access to relevant qualification training. Service users are protected by the home’s recruitment and staff have access to a range of training to assist them in meeting service users needs. EVIDENCE: The staff rota was seen and was satisfactory. The registered manager stated that the minimum staffing the home operates on is one care staff on the early shift with a second member of staff working from 7 am to 9 am, one care staff on the late shift with a second member of staff working 4 pm to 9 pm and one waking night staff. The registered manager works full time at the home in addition to this. The home was employing six care staff at the time of the inspection. One of these has completed the national vocational qualification (NVQ) level 3 in care. Two other staff are currently undertaking NVQ level 2 in care. The registered manager is aware of the requirement that at least 50 of care staff must be qualified to NVQ level 2 in care. No new staff had been employed at the home since the last inspection. The home had a satisfactory staff recruitment and selection policy that was to have been reviewed by the registered manager in the past twelve months. The Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 17 registered manager is also aware of having the necessary evidence to be able to demonstrate that a robust recruitment procedure is used when new staff are recruited in order to maximise protection for service users. The home keeps a work force development plan for each staff member that shows the training they have undertaken and when refresher training is due. Those sampled were seen to be satisfactory and up to date. Evidence was seen of a range of distance learning that staff had undertaken in the past twelve months and included training on food hygiene, infection control and adult protection. The staff member spoken to confirmed that they had undertaken distance-learning training in the past twelve months and found this helpful. The home has also arranged for the pharmacist that dispenses medication to the home to provide staff with safe administration of medication training in September 2006. Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from the home being run by a competent manager. Service users and other stakeholders views are actively sought to assist develop the quality of care the home offers. Service users are protected by effective procedures to safeguard their financial interests. The home has effective health and safety procedures in place to protect service users and others that work or visit the home. EVIDENCE: The registered manager stated that she has eleven years experience running this home and a range of experience of working with vulnerable people prior to that. She was knowledgeable about the management issues relating to running the home and the needs of the service users. She went on to say that she had Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 19 now completed her registered managers award and was awaiting her certificate. The home undertakes service user and stakeholder questionnaires regarding the quality of service offered by the home several each year. Returned questionnaires from April, July and August 2006 were seen and those sampled were overwhelmingly positive. A range of CSCI feedback cards were also received. In these one social care professional had written “My client has been a resident for 1 month and has picked up a lot since I last saw her. She seems happier and more alert, this must be the result of good care provided”. Feedback from the questionnaires is used to plan objectives for the home for the next twelve months. As indicated in the Daily Life and Social Activities section of this report above, the only service users money the home looks after is the personal allowance for two service user’s and the records for these were satisfactory. A range of satisfactory health and safety documentation was seen including: the fire and fire equipment servicing; servicing of the home’s stair lift; current gas safety and electrical installation certificates; portable appliance testing and evidence that the water storage system had been inspected to minimise the risk of legionella. Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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 OP8 Good Practice Recommendations The home should use a separate section of the service users files to record all their health care appointments. This will provide a clearer summary and overview of these appointments and further assist staff to monitor service users overall health care needs. The home should consider different and innovative ways of encouraging service users to participate in more varied activities including going out into the community where appropriate. 2 OP12 Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 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 Fer View, The DS0000010758.V303331.R02.S.doc Version 5.2 Page 23 - 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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