Inspection on 25/04/06 for Ferendune Court

This inspection was carried out on 25th April 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

Ferendune Court 11/06/07

Ferendune Court 17/10/05

Ferendune Court 25/04/05

Ferendune Court 28/01/05

Ferendune Court 21/05/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Ferendune Court Ash Close Faringdon Oxfordshire SN7 8ER Lead Inspector Philippa MacMahon Unannounced Inspection 25th April 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 Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 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. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ferendune Court Address Ash Close Faringdon Oxfordshire SN7 8ER 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) 01367 243834 01367 244421 samantha.bell@anchor.org.uk sharon.blackwell@anchor.org Anchor Trust Samantha Bell Care Home 48 Category(ies) of Dementia (6), Old age, not falling within any registration, with number other category (48), Physical disability over 65 of places years of age (9) Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. On admission persons should be aged 60 years and over. 1 young chronically sick/disabled - Short Stay Nursing Unit. Rehabilitation, Convalescent or Respite for a period not exceeding 6 weeks - Short Stay Nursing Unit. Maximum of 18 persons with nursing needs. The total number of persons that may be accommodated at any one time must not exceed 48 17th October 2005 Date of last inspection Brief Description of the Service: Ferendune Court is a purpose built home that opened in 1992 in Faringdon. It is divided into three units, one looking after elderly residents in their own flatlets, one unit looking after residents for a short stay and one looking after the more dependent resident with long term nursing needs. Each resident in the residential unit has their own flatlet that has a bedroom, lounge, a hallway and an en-suite shower room with toilet and wash hand basin. Each flat has its own lockable front door, letterbox, doorbell and peephole to enable residents to identify visitors prior to opening the front door. There is one flat identified for residents coming in for short stay. The home has a nine-bedded nursing wing on the ground floor. Each room has its own en-suite facilities comprising wash hand basin and assisted toilet. One bedroom has en-suite shower facilities. The home has a short stay nursing unit and there are strict admission procedures for these beds. There is an agreement between Anchor Trust and the primary care trust on referrals for admission. There is a good range of assisted baths and toilets in addition to the en-suite facilities. There are two ground floor sitting rooms, and access to a large pleasant dining area. A lift serves all floors. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 5 There is a patio area outside the lounge/dining room with an attractive bank of shrubs and flowers beyond. The fees range from £424.32 per week to £650.00 per week. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector, accompanied by a colleague, Carole Moore, arrived at the service at 13:00 hours and was in the service for 5½.hours. The inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspectors asked the views of the people who use the service and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspectors looked at how well the service was meeting the standards set by the government and has, in this report, made judgements about the standard of the service. The inspectors, in carrying out this inspection, spoke to the registered manager, a number of residents, care staff, nurses, the assistant chef, the activities co-ordinator and the handyman. The staff handover of shifts were observed on both the residential and nursing wings. A sample of care plans were examined, and were followed through by meeting the residents to see if the identified care needs were being met. Staff records were examined, and records required by regulation. A tour of the building also took place. What the service does well: The home provides a homely, clean and well-maintained environment for the residents who live there. The registered manager and other staff spoken to are firmly committed to providing the best quality care for the residents. There are good opportunities for staff training. There is good teamwork across all staff areas. Residents spoken to spoke are very appreciative of the care given, with comments such as, “I like living here and the staff are lovely” and, “I am well looked after”. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 7 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. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 8 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 Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 9 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, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is no intermediate care service provided in the home. It is good that the registered manager assesses all long stay residents before they are admitted to the home. Short stay residents admitted via the Primary Health Trust are not always assessed by the registered manager prior to admission. EVIDENCE: The inspector examined two care plans of people living in the nursing wing, and found pre-admission assessments of care needs in both. The registered manager had carried out both of these assessments. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 10 The inspector had received a report on an unannounced visit by the Head of Continuing Care, and the locality manager of the South East Oxfordshire Primary Care Trust. This visit was on behalf of the Commission for Social Care Inspection and was to specifically look at the “respite care nursing unit”, where admissions are generally emergency admissions from the community that are made by the local GPs, or from acute hospitals. The report shows that there are inconsistencies and lack of clarity in the assessment of care needs and how these will be met by the home. There were different assessment tools being used and, in most cases, these were incomplete. Discussion with the registered nurse on duty and the registered manager confirmed that there was a lot of confusion and difficulty with the differing tools of assessment, and poor communication between the PCT and the home’s staff in relation to the appropriateness of admissions to the short stay service. Anchor Trust and the PCT are addressing this issue, and new corporate documentation is being implemented in the near future to support the care provision. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 11 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 adequate. This judgement has been made using available evidence including a visit to this service. There are adequate systems in place to meet the health and personal care needs of residents in the residential wing. The nursing wing requires new clear documentation underpinned by training in the use of care plans for all staff who input into the care planning process. The staff have a good understanding of the issues of privacy and dignity, and the residents are treated with respect. EVIDENCE: Residential Wing: A sample of two new residents’ care notes were examined and each one had the care needs clearly identified in line with the current corporate paperwork. New paperwork is to be introduced which should further improve the actions needed to explain how the needs of the residents are to be met. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 12 It was also clear from speaking with residents that they are involved in their care planning where possible. Residents confirmed that staff were patient, sensitive, caring and respectful of their wishes - ”Marvellous staff”, “Everyone so helpful”. The inspectors each observed staff handover of care, one in the residential wing and the other in the nursing wing. It was evident during the course of this communication that the staff have an understanding of the individual residents, their care needs and how these will be met. It was good to see that the emotional needs of residents were seen to be as important as their physical needs. A sample of care plans was examined in the nursing wing and the inspector had difficulty in obtaining a clear picture of the care needs and how these were being met. The daily record was kept separate from the care plan, and did not always link together. Not all of the care plans were regularly reviewed and the reviews appeared to be about the written care plan rather than the actual care delivery, as outlined in the daily record. The registered manager explained that the new care planning documentation was being piloted elsewhere in the country and as soon as the final documentation is accepted they will be implementing training for all staff in its use. It is a requirement that all the care plans must be reviewed on a regular basis, and that the inspector is advised when the care plan reviews are up to date. The medication systems were examined and in both wings were found to be in good order overall. The supplying pharmacist visits the home on a quarterly basis to check that the systems are working well. One of the store cupboards contained a paper bag with a quantity of Diamorphine water for injection, and a further medicine for injection. These were prescribed for a person living in the community who had never visited the home, and had been left by a district nurse in case they were needed over the weekend. No record had been made of their receipt or when they had been left. The nurse in charge had no knowledge of their being in the home. The registered manager arranged for these to be taken to the supplying pharmacist for safekeeping. The registered manager did this immediately and informed the relevant surgery of her action. It is recommended that the registered manager should contact the PCT over this issue and also to put in place a policy to prevent a recurrence of this incident. The inspector noted that one of the medications had a label with the instruction “as directed” printed on it. There was no other direction given by the prescribing GP and the medication administration record had the same instruction. This is not good practice and it is recommended that the Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 13 prescribing GP should be asked to provide a written instruction when prescribing any medication for residents in the home. The senior care worker in charge of the residential wing discussed with the inspector various ways in which the recording of medication administered could be improved and is committed to continuous improvement of the systems. This is commendable. Those residents wishing to take responsibility for their own medication are able to do so following a risk assessment of their ability to manage them safely, and a written agreement from their GP. Copies of these documents were found in the resident’s individual documentation. Throughout this inspection the inspectors observed staff interacting with the residents and, on all occasions, noted that the residents were treated in a kindly and respectful manner. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 14 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. Residents enjoy a good, varied diet and there are good opportunities to exercise control over their daily lives. From the evidence seen by the inspector and comments received, the inspector considers that the home would be able to provide a service to meet the needs of individuals of various religious, racial or cultural backgrounds. EVIDENCE: The activities co-ordinator works 15 hours and explained how she encourages residents to join in activities. She also encourages members of the community to come into the home to entertain the residents. The inspector joined the residents at the end of their residents’ meeting and those present said that they really enjoyed the activities and trips out into the community. Two residents said how much they enjoyed the monthly music and movement activity. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 15 On the day of the inspection all activities were clearly displayed on the notice board at the entrance to the main communal area. It has been identified by the manager that an extra 15 hour post needs to be put in place to further extend the activities to benefit all the residents, and time needs to be spent encouraging those less active ones to partake in some activity that meets their individual needs. . The residents were keen to say how good the food was and how much it had improved. The inspector discussed the home’s food arrangements with the assistant chef and he confirmed that residents were given alternatives should they not like the choices of the day. A selection of menus was seen and showed a good range of fresh foods being used. There is now a full cooked breakfast being offered daily which has gone down well with many residents. The inspector viewed the comments book and there were many positive remarks about the overall cooking. The assistant chef was keen to talk to residents and get their individual likes and dislikes. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 16 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, 17, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good complaints procedure in place and good systems to ensure that residents are protected from abuse. The registered manager handles complaints in an appropriate manner. EVIDENCE: The home has a clear complaints procedure and the inspector viewed the complaints log and was happy with the outcomes listed. Residents spoken to confirmed that they were able to voice any concerns and felt confident that any area of concern would be listened to and acted upon. Residents’ meetings were also a forum for discussion as well as the chef’s comments book. The manager confirmed that she had attended training within Oxfordshire Social Services in relation to the protection of vulnerable adults and that she would be cascading the training as a refresher to all staff. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 17 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. Overall, the home’s housekeeping and standards of maintenance and cleanliness are good. EVIDENCE: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment was bright, clean and reasonably fresh smelling and it was evident that the housekeeping team works hard maintaining standards. The handyman is responsible for daily maintenance and this works well. All water temperatures are being regularly checked following the fitting of new valves and is well monitored. There was one area of the nursing wing where there have been difficulties in maintaining freshness - carpets have been replaced, and still there is a problem. It is recommended that further advice should be sort from the continence adviser about the management of people with incontinence. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 18 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. Staffing levels are good. Recruitment procedures, staff training and development programmes are in place, ensuring that residents needs are met and that they are in safe hands at all times. EVIDENCE: The inspector examined a sample of staff files, and found them to be in accordance with regulation. There has been an improvement in staff achieving NVQ and the manager has set a target for the home that 70 of staff are NVQ trained by the end of 2006. Currently eight members of staff have gained NVQ Level 2 and 11 care staff are working towards NVQ Levels 2 and 3. Staff spoken to confirmed that training opportunities are good and each staff member has a clear individual training profile. Anchor will be ensuring that training for all staff on record keeping and planning of care will be undertaken as soon as the new paperwork has been introduced. This will be essential to the overall improvement of care planning and is needed to enable Ferendune to meet the standards required. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 19 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, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager has good management skills and manages the home very well. There are regular residents meetings and these provide a good forum to ensure that the service is meeting the needs of all the residents. There are good systems in place to ensure that the health and safety of residents is protected. EVIDENCE: The registered manager is competent and dedicated and currently is managing the home without a deputy in post. She is supported by monthly visits from her line manager but the overall monitoring of practices within the home cannot be carried out until the deputy post has been filled. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 20 The staff are supportive of one another and there has been improvement in how the staff work together across the residential and nursing wings. Residents’ finances were not inspected on this occasion, as the administrator was not available on the day. However, the current practice of managing residents’ money has not changed since the last inspection and, at that time, it was well managed. There are regular monthly meetings to ensure that the views of residents are taken into account and the inspector did sit in at the end of one meeting that was taking place on the day of the inspection. The health and safety of residents is protected by the robust procedures that are in place. Anchor Trust carried out a health and safety audit on 24th November 2005 and recommendations were made in relation to the updating of some documentation. The environmental health officer visited on 24th January and no recommendations were made. Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 21 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 3 18 3 3 X X X X X X 2 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 2 x X X X X 3 Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 22 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 OP7 Regulation 15(2)(b) Requirement It is a requirement that all care plans must be reviewed on a regular basis, and that the inspector is advised when the care plan reviews are up to date. Timescale for action 05/06/06 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 OP9 Good Practice Recommendations It is recommended that the prescribing GP should be asked to provide a written instruction when prescribing any medication for residents in the home. It is recommended that further advice should be sought from the continence adviser about the management of people with incontinence. 2. OP26 Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Ferendune Court DS0000027147.V291369.R02.S.doc Version 5.1 Page 24 - 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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