CARE HOMES FOR OLDER PEOPLE
Ferfoot Care Homes Old and New House The Folly, Old Hardenhuish Lane Chippenham Wiltshire SN14 6HH Lead Inspector
Key Unannounced Inspection 10:20 17 & 18th April and 14th May 2007
th 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 Ferfoot Care Homes DS0000028628.V335777.R05.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. Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Ferfoot Care Homes Address Old and New House The Folly, Old Hardenhuish Lane Chippenham Wiltshire SN14 6HH 01249 658677 01249 445972 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) www.concensusupport.com Caring Homes Healthcare Group Ltd Mrs Bridget Christina Novik Care Home 56 Category(ies) of Dementia - over 65 years of age (56), Mental registration, with number disorder, excluding learning disability or of places dementia (1) Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No more than 1 service user with Mental Disorder, under the age of 65. 7th December 2005 Date of last inspection Brief Description of the Service: Ferfoot Care Homes is a care home consisting of two buildings, which are known as the Old House and the New House. The two buildings share the same grounds and are registered as a single establishment. The Old House was the original building and the New House was developed later to provide purpose built accommodation. Ferfoot Care Homes is located in a quiet residential area, although is close to main roads and transport links. Ferfoot Care Homes was a family business but since the last inspection has been taken over by Caring Homes. One of the previous registered managers, Tina Novik is the registered manager. A permanent staff team provides 24 hour care and support to people who live in the home. Information about the service is available to people in the statement of purpose and service user guide. These have been amended recently to reflect the changeover to Caring Homes. The fees range between £510.50 and £550.00 per week. Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection included one unannounced visit to the home on 17th April 2007 and a planned visit the following day. The pharmacist inspector made a separate visit on 14th May 2007 to inspect the arrangements for medication. During the visits information was gathered using: • • • • • • Observation Discussion with the manager Discussion with the deputy Discussion with staff Discussion with a relative Reading records. Other information and feedback about the home has been received and taken into account as part of this inspection: • • • • The manager provided information prior to the inspection about the running of the home. A comment card was received from one person who lived in the home. Comment cards were received from thirty relatives and visitors. Comment cards were received from six members of staff. The judgements contained in this report have been made from all this evidence gathered during the inspection, including the visits. What the service does well:
Many positive comments were received from relatives about the service. These included ‘We are basically delighted with Ferfoot.’ ‘Ferfoot seems to be a happy, friendly, busy and efficient community. We feel very lucky to have found it.’ ‘My husband has been in Ferfoot for three years. I am satisfied with all aspects of his care.’ ‘My sister has been an in-mate of Ferfoot for almost two years. I visit her regularly. and have always found her clean, cared for and comfortable, staff is excellent in my opinion.’ Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 6 ‘Whenever I have made a visit I have always found everything satisfactory. Highly recommended.’ ‘The family run business has changed owners and this has been seamless.’ ‘My father has been in Ferfoot for three years and I am very happy with the attentions and care he receives.’ ‘There has been a very marked improvement since my mother arrived. Staff have worked really hard to get this improvement and we are very grateful.’ ‘Mum has only been in your care for two weeks. We think she has settled as well as we had hoped.’ ‘Quality of service is outstanding and my mother who has been a resident there for over two years has always been given the utmost in care and support. The staff for the main are very approachable and we are also given a good deal of support.’ ‘Overall I am very happy with my mothers care. I have never had any reason to make a complaint.’ There was a statement of purpose and a service user guide. Each person was given a copy of the service user guide, which was in large print. People had sufficient information to make an informed decision about whether to move into the home. The records showed that each person had a detailed assessment of needs. This included their personal, health and social care needs and there was also a personal history. This ensured that each person’s needs were assessed so that their diverse needs would be met. Most people had a contract so they knew the terms and conditions and fees for the service. Everyone who paid for their own care had a contract with the home and statement of terms and conditions. Most people whose care was paid for by social services had a contract. Each person had a detailed care plan. People’s health, personal and social care needs were set out in their individual plans to ensure that their needs would be met. People were registered with a GP and had appointments with a range of health care professionals including dentists and opticians. Their health care needs were being met. There was a medication policy and there were appropriate systems for the recording and storage of medication. People were protected by the home’s policies and procedures for dealing with medicines. People were treated with dignity and respect and their right to privacy was upheld. Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 7 Daily life and the provision of social activities reflected people’s different needs and expectations. There was an activities organiser who provided a good range of social and therapeutic activities. Relatives were welcome in the home at any time throughout the day. People kept in contact with family and friends and representatives of their local community as they wished. People had opportunities to exercise choice and control over their lives. They spent time where they chose and they had brought personal items into their rooms. There was a varied menu and special diets could be catered for. Meals were well presented and unhurried. Special occasions such as birthdays and anniversaries were celebrated. People had a wholesome appealing and balanced diet served in pleasant surroundings at times convenient to them. People knew that their concerns would be listened to, taken seriously and acted upon. There was a complaints procedure and information was available to people about how to complain. Relatives knew how to make a complaint on behalf of people. There had been one complaint made to the home since the last inspection. The record showed that this had been appropropriately investigated and the complainant was notified of the outcome. Records were kept of complaints and compliments. There was a policy and procedure about protection from abuse. Staff had information about safeguarding adults and knew about the adult protection procedure. The manager ensured that any allegations were appropriately investigated. People were protected from abuse. The home consisted of two separate houses each with its own lounge and dining facilities. There was a programme of maintenance so that people lived in a safe and well maintained environment. There was a pleasant garden where people liked to sit when the weather was fine. There were two laundry rooms and there were cleaning schedules. The home was clean, pleasant and hygienic. There was a high number of staff on duty and they were observed to be very attentive and to anticipate people’s needs. The numbers, and skill mix of staff met people’s needs. More than 50 of staff had a National Vocational Qualification at level 2 or above. There was a range of training including specialist training about dementia. People benefited from staff who were qualified, trained and familiar with their needs. New staff only started work after all the appropriate checks were carried out. People were supported and protected by the home’s recruitment policy and practices. People benefited from an experienced management team. The manager and deputy were appropriately qualified and trained to run the home. Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 8 The new owners had conducted a customer satisfaction questionnaire after the takeover. They planned to do this annually and produce a development plan so that the home was run in the interests of the people who lived there. There were comprehensive health and safety measures so that safety was well promoted within the home. What has improved since the last inspection? What they could do better:
Some people required blood testing and staff were not always using the correct blood testing devices. The registered person must ensure recent information from the Medicines and Healthcare Regulatory Agency (MHRA) is followed so that staff and people who live in the home are kept safe. .
Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 9 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. Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 10 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 Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People had sufficient information to make an informed decision about whether to move into the home. Each person’s needs were assessed to ensure that these needs would be met. Everyone who paid for their own care had a contract and statement of terms and conditions. Most people whose care was paid for by social services had a contract. EVIDENCE: A new statement of purpose and service user guide have been sent to the Commission reflecting the change to the service. The manager reported that the statement of purpose will be presented with a copy of the inspection
Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 12 report, fire and emergency procedures and information about the number and size of rooms. The statement of purpose and service user guide contain most of the required information except the service user guide does not provide information about the fees. Instead it describes the arrangement for fees and states that each person will receive a copy of their terms and conditions and the fees. The service user guide is in large print and provides detailed information about the service to help people decide whether they wish to move into the home. Each person received a copy of the service user guide. Copies of the statement of purpose, inspection report, fire procedures and floor plans were available in the entrance hall of each house. One person who completed a comment card said that their carer was given enough information about the home to decide if it was the right place for the person. The care records of four people were read. Two people had assessment information and a care plan from the community mental health team. Each person had a very detailed in house assessment of their care needs. This included personal care and health care needs, nutritional needs, pressure area needs, a risk assessment, including the risk of falls and a manual handling assessment. Each person also had a detailed personal history including their previous job, interests, family and social contacts, their likes and dislikes and preferred routines. Families were involved in putting together the assessments and personal histories. This was to ensure that people would receive individualised care and their diverse needs would be met. One person had English as a second language. The home employed several staff who spoke their language and were familiar with their culture. The manager reported that there was usually a member of staff on shift who spoke their language. The home was in the process of changing its assessment forms from the Ferfoot Homes forms to the Caring Homes forms. Most people had a contract. All the people who paid for their own care had a contract with their statement of terms and conditions and the fees. A representative usually signed these contracts. Some people whose care was paid for by social services had social services contracts. However, some did not and the manager said that there was often a long delay before they received a signed contract back from social services. Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 13 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. 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. People’s health, personal and social care needs were set out in their individual plans to ensure that their needs would be met. Their health care needs were being met. People were protected by the home’s policies and procedures for dealing with medicines. People were treated with dignity and respect and their right to privacy was upheld. EVIDENCE: The records of four people were read. Each person had a detailed care plan to ensure that their personal and health care needs were met. One person had a
Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 14 very new plan, which had not been reviewed. The other three plans were regularly reviewed, at least monthly, and changed if needed. The complexity of the plans depended on the needs of the person. Some people had additional plans for specific needs. For example there were plans for pressure area care, pain control, poor diet and fluid intake. The care planning format was in the process of being changed from using Ferfoot Homes forms to Caring Homes forms. The arrangements for health care were described in the service user guide. Each person was registered with a GP. Nursing was provided by the community nurse. Details of health care appointments were recorded in the personal notes. People saw the GP, community nurse, optician, chiropodist, dentist and physiotherapist. People who were spoken with said that they saw their GP, optician and dentist. In September 2006 there was an allegation from the hospital social work team that on admission to hospital a person had pressure sores on their heels. A random inspection was made and the persons care records were checked. They had a care plan, risk assessment, manual handling assessment, pressure area risk assessment and care plan and a district nursing care record. They also had daily records and records of contacts with health care professionals. These showed that they had received visits from the district nurse and the GP before they were admitted to hospital. There was no reference in the notes to pressure sores on the heels. Examination of the records and discussion with the manager showed that all appropriate care had been given and the pressure sore developed after admission to hospital. All the relatives who completed comment cards said that they were satisfied with the overall care provided. One person who completed a comment card said that they usually had the care and support that they needed. A recommendation was made at the last inspection that further details are included on the record of pressure sore prevention care. This would include for example the time at which care was given and the recording of an entry within each two-hour period to avoid any uncertainty about what care was needed at that time and whether a period of bed rest had ended. The record sheets had been amended to include the time and care given. However, new Caring Homes record sheets were being introduced to replace these records. The pharmacist Inspector looked at arrangements for the handling of medicines. The home had recently changed its supplying pharmacist and there had been a few problems during the first month. These had been resolved by the manager meeting with the pharmacy and GP surgeries to ensure that the printed medication administration records were accurate. All medicines were stored securely including controlled drugs and items requiring refrigeration. Staff received training before being able to administer medicines and a new member of staff being supervised with medication was observed. Information
Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 15 about medicines was available in both houses and photographs aided identification of the residents. All the receipts, administrations, refusals and returns for disposal of medication were recorded. Protocols were available for the use of medication prescribed ‘as required’ and any use of these medicines was recorded with the time, reason for use and effects. Behaviour monitoring forms were used for some residents and used to inform the discussions with doctors. Doctors’ visits and changes to medication were recorded. Blood monitoring equipment for diabetics did not comply with recent safety guidelines from the Medicines and Healthcare Regulatory Authority. A recommendation was made at the last inspection that medication administration records should reflect all current drug treatments and doses in addition to any information kept elsewhere. This had been addressed by the introduction of the new medication administration records. Each persons preferred form of address was recorded in their care plan. People wore their own clothes and were individually dressed. Staff were observed to be attentive and to ensure that people were kept clean at all times. A relative commented that if someone had an accident they were changed immediately. Staff were observed to knock on doors and wait for a reply before entering. There were screens in the double rooms. Personal care took place in the privacy of the bedrooms and bathrooms. Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 16 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. 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. Daily life and the provision of social activities reflected people’s different needs and expectations. There was a good range of social and therapeutic activities being provided. People kept in contact with family and friends and representatives of their local community as they wished. People had opportunities to exercise choice and control over their lives. People had a wholesome appealing and balanced diet served in pleasant surroundings at times convenient to them. EVIDENCE: The routines appeared to be flexible and the times that people liked to get up and go to bed were recorded. Peoples interests, hobbies and special relationships were also recorded. There was a range of activities recorded.
Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 17 People who were spoken to said that there was a variety of activities. Some liked to sit in the garden in the sunshine. Two of these people said that they would like to go out. This was discussed with the manager who said that these two people regularly go out with their family and also with staff. One person who completed a comment card said that there were sometimes activities that they could take part in and they were aware that there was not much for them to do. There was a recommendation at the last inspection that further information about the involvement of individual service users should be included in the record of activities. There was an activity programme and each person had an individual log of activities and an activities diary. It was therefore possible to tell who had partcipated in which actvities and whether people had activities which suited their interests. There was an activities organiser who arranged different types of activities. The records showed that most people participated in some form of activity. All relatives who completed comment cards said that they were made welcome in the home at any time. During the inspection several relatives were seen visiting. They came at various times of day and were welcomed in the home by staff and offered tea or coffee with their relative. People who were spoken with talked about visits from their relatives and going out with them. One relative said that they were welcome in the home at any time and they visited at various times of the day. They said that the staff had arranged a golden wedding party for them and their partner who lived at the home and they could not have done more. The records showed that people who liked to go to church went to church. People were observed moving around the home freely and choosing to spend time in the communal rooms, their own rooms or the garden. People had brought personal possessions into their rooms. Relatives helped people to manage their money and staff helped people with their medication. People were seen to be enjoying their meals and several people said that the food was very good. Peoples nutritional needs were assessed and supplements were provided if people needed them. Special dietary needs were catered for. Nutritional and fluid needs were monitored. Some people needed their meals liquidised and these were presented in an appealing way. Meals were unhurried and staff were observed offering help with eating in a sensitive way. There were four meals served every day and drinks and snacks were available throughout the day. One visitor said that they had Christmas lunch with their relative and the meal was well presented with all the trimmings. There were no vegetarian or cultural diets but the kitchen staff could provide a vegetarian meal with very little notice. One person who completed a comment card said that there was no doubt that they always enjoyed the meals. Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 18 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. 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. People knew that their concerns would be listened to, taken seriously and acted upon. People were protected from abuse. EVIDENCE: There was information in the statement of purpose and service user guide about how to complain and the procedure for responding to complaints. One person who completed a comment card with the help of a relative said that they would need help to make a complaint. All relatives except one who completed comment cards said that they knew about the complaints procedure. There was a complaints and compliments folder. There had been one complaint since the last inspection. This had been investigated by the manager and appropriate records were kept. A letter was sent to the complainant about the outcome of the investigation and they were satisfied with the result. The home has a policy and procedure about vulnerable adults and the prevention of abuse. Other guidance for staff has been produced in related areas such as risk taking, the use of restraint and the reporting of bad
Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 19 practice, including ‘whistle blowing’. Staff received information about the ‘No Secrets’ guidance about prevention of abuse. There was a notice board in the staff room with information about protection of vulnerable adults posted on it. The management team had had experience of the adult protection referral system. Since the last inspection one issue was referred through the vulnerable adults procedure and the home co-operated fully with the follow-up random inspection in an open and positive manner. The allegation was unfounded. Six staff who completed comment cards said that they were aware of the adult protection procedures. Training about abuse was included in the induction programme. Staff also received training about abuse as part of the course, which led to a qualification in dementia care. The training records also showed courses, which contained components about prevention from abuse. At the last inspection it was recommended that the detail about which courses included training about abuse should be included in the training plan. The manager had produced a new training flow chart but this was to be replaced by the new Caring Homes training plan. During the inspection, staff members were seen to be dealing with people in a positive and friendly manner. People were able to move around within the accommodation, with prompting and encouragement from staff to maintain safety and prevent disorientation. Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 20 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. 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. People lived in a safe and well maintained environment. The home was clean, pleasant and hygienic. EVIDENCE: The property was in a residential area of Chippenham. The accommodation consisted of two separate houses, each with their own entrance. Each house had lounge and dining facilities. The accommodation was well maintained. There was a programme of maintenance and there were plans to replace several carpets. There was an accessible garden where people liked to sit in fine weather. This was well stocked and attractively planted. There was a plan to link the two houses so that people could move between the two houses
Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 21 without going through the garden. The building complied with the requirements of the local fire and environmental health officers. There were two laundry rooms, one in each house. All the people were well dressed and had clean clothes. A relative said that people were always kept clean and their clothes were well maintained. During the inspection the housekeepers were seen going around the home cleaning. The home was cleaned to a high standard. There was an odour in one of the homes on the first day of inspection. This had been eliminated by the second day. Cleaning schedules have been produced and there are rotas for particular jobs, such as shampooing the carpets. The person who completed a comment card said that they were happy with the appearance of the home. Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 22 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. 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 numbers, and skill mix of staff met people’s needs. People benefited from staff who were qualified, trained and familiar with their needs. People were supported and protected by the home’s recruitment policy and practices. EVIDENCE: The rota showed that there were nine or ten staff on duty at all times during the day and three staff at night. There were separate laundry and housekeeping staff. During the inspection positive relationships were observed between the staff and people who lived in the home. Staff supported people and anticipated their needs. Twenty six relatives who completed comment cards said that there were always sufficient staff on duty, one said mostly yes, one said that they were not in a position to know, one said they thought so and one was not sure. A relative who visited during the inspection said that there was always a high number of staff on duty. The person who completed a comment card said that staff always listened and acted on what they said. They also said that staff were always available when they needed them. Two
Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 23 people who lived in the home did not have English as their first language. Examination of the rota and comments from the manager showed that there were usually staff on duty who could speak their language. Twenty three out of forty care staff had National Vocational Qualifications (NVQ) at level two or three or their equivalent. Three more were working towards NVQ. Over 50 of the staff had an appropriate qualification. There was a recruitment procedure and examination of the recruitment records showed that it was being followed. The records of seven members of staff were checked. All had completed application forms and been interviewed. Two written references had been received for each of them. Criminal records bureau (CRB) checks and protection of vulnerable adults (POVA) checks were obtained. Some staff had started work with people before their CRB’s came through. However, as allowed by the regulations, a POVA First check was obtained and they worked under supervision until the CRB arrived. Proof of identity was obtained and an employment history. Any gaps in employment were explored at interview. Each applicant made a written declaration on their application form that they had no offences. There was a training plan. New staff completed the Skills for Care induction. Staff received a range of training including first aid, food hygiene, manual handling, infection control, health and safety, abuse awareness, pressure area care, dementia awareness and managing challenging behaviour. Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefited from an experienced management team. The home was run in the interests of the people who lived there. People were not able to safeguard their own financial interests and this was the responsibility of people outside the home. Safety was well promoted within the home. Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 25 EVIDENCE: The manager was suitably qualified and experienced. Mrs Novik’s qualifications included the Registered Managers Award and NVQ level 5 Operational Management. The deputy had NVQ level 4 and the registered managers award. At the time of the inspection the manager had just handed in her notice and the deputy was to become the acting manager. There was a business plan and the manager produced an improvement plan every two months. This involved the staff and identified areas for improvement. The home had the Investors in People award. Caring homes had undertaken a quality assurance survey as part of the takeover to assess satisfaction. They planned to conduct an annual survey and produce a development plan annually. The first was planned for June this year. The people who lived in the home had dementia and related needs, which reduced their capacity to manage their own financial affairs. Mrs Novik said that the home had no involvement with people’s personal money and that this was dealt with by relatives or by an appointee from Wiltshire County Council. Mrs Novik said that the fees covered all of people’s day to day needs, other than the cost of clothes. The home had several health and safety related policies and procedures. These covered such areas as the kitchen, fire safety, accident reporting and environmental hazards. Guidance had been produced about maintaining safety in icy weather. Problems and items in need of repair were reported in a book for the attention of the maintenance person. The records showed that jobs were promptly responded to. A daily handover sheet was filled in by the shift leader and this included the completion of a security checklist. There was a fire risk assessment. Other risk assessments were being carried out in relation to specific hazards. In some cases, at the last inspection, reviews were shown by changing the original date of an assessment, rather than by adding a new date. A recommendation was made that the original date should not be changed. This had been addressed and the risk assessments had been reviewed and updated. New bedrail risk assessmentrs were being introduced. The home’s fire log book was up to date. A recommendation was made at the last inspection that the time at which fire drills took place should be added to the record, together with the names of all staff who have participated. The time and names of staff had been added to the records of fire drills in 2006 and 2007. Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 26 There were arrangements for the servicing of specialist facilities and items of equipment such as hoists. There were reords of servicing and testing. New health and safety checks of individual rooms were being introduced by Caring Homes. Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 27 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 3 x 3 3 X x 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 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 X X X 3 Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 28 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. 1. Standard OP38 Regulation 13 (3) Requirement The registered person must ensure that the safety of staff and residents is not compromised by the use of inappropriate blood testing devices. Recent information from the Medicines and Healthcare Regulatory Agency (MHRA) must be actioned. Timescale for action 14/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Ferfoot Care Homes DS0000028628.V335777.R05.S.doc Version 5.2 Page 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
