Inspection on 30/11/06 for Fern Court

This inspection was carried out on 30th November 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fern Court 14/09/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Fern Court Down Hatherley Lane Down Hatherley Nr Gloucester Glos GL2 9QB Lead Inspector Mr Tim Cotterell Key Unannounced Inspection 30 November 2006 13:30 Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fern Court Address Down Hatherley Lane Down Hatherley Nr Gloucester Glos GL2 9QB 01452 731984 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) New Beginnings (Gloucester) Ltd Alan Gilbert Howe Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Registered Manager must complete the Registered Managers Award by 31 December 2005. Ferncourt is a Care Home for 8 YA LD Date of last inspection 14th September 2005 Brief Description of the Service: Fern Court is a residential care home for 8 people with a learning disability and associated challenging behaviours. The home opened in May 2005. Fern Court is one of three homes in Gloucestershire owned by New Beginnings. Fern Court is a large Victorian House that has been fully refurbished to provide single rooms with en suite facilities. People living at the home have access to two lounges and a dining room and large well maintained gardens. Fern Court is situated in open countryside between Cheltenham and Gloucester Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The inspection was undertaken over three visits. The registered manager was on duty on two occasions and the new group manager on one. All of the care staff were seen and spoken to individually. All of the service users were seen, and in a group setting were spoken to. The accommodation was seen and a number of records to include medication care plans, staff records, rotas and risk assessments. The home accommodates very vulnerable adults and it was evident they had a positive relationship with staff who were seen as approachable and good listeners. The registered manager was seen as approachable by both staff and service users. However a number of issues were raised through the questionnaires given to staff by the Commission. The matters raised have been dealt with in the staffing outcome section. What the service does well: What has improved since the last inspection? Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 6 Care plans have been developed Records of the meals are kept A quality assurance system is in place Staffing levels have improved at weekends 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. Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Individual needs are identified in comprehensive plans of care. . The home is now clear about the category of care it is able to accommodate. EVIDENCE: The home had recently admitted a service user and the assessment of need which had been completed by the sponsoring authority was seen. The home advised the inspector that care is taken over admissions and pre admission visits and over nights stays are encouraged. It is essential that any assessment of need is kept under review and where appropriate revised. Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 679 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The service users plans and risk assessments provides a structure for support, guidance and a safe environment. The home encourages a degree of independence. EVIDENCE: The individual plans of care cover all aspects of personal and social support. The plans are wherever possible drawn up with the involvement of the service user, his/her family and relevant agencies. The home has a key worker system, and “senior carers” undertake this The majority of service users are not able to undertake many activities without supervision however after assessing individual risks it was noted that one service is able to have a degree of independence over how he spends his day to include going to the local shops on his own. The home is aware of the various advocacy schemes available. Staff ensure service users have Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 10 information and support so that they may be able to exercise their judgements over day-to-day matters. Action has been taken to minimise identified risks and hazards and the missing person procedure was discussed with the registered manager Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 15 16 17 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Activity plans ensure everyone is involved in meaningful activities. Links with the community and families are maintained. There is flexibility about how service users spend their time. The home consults service users over the food provided and there is always choice for each meal. EVIDENCE: Individual needs are identified and met and service users are able to exercise a degree of choice over how they spend their time. Service users enjoy a range of activities and their rights and responsibilities are recognised through an individual approach. . Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 12 Whilst there are no service users who have supported employment the home ensures that access to appropriate training/education is available. Most of the service users need direct staff support when they are in the community. This is provided in a sensitive and wherever possible unobtrusive manner. Family and friends are encouraged to visit the home. The activities ensure that there is contact with other `people who do not have disabilities. The daily routines of the home promote individual choice and freedom of movement. Service users have unrestricted access to the grounds and are able to lock their bedrooms. Staff were aware of “healthy eating” and whilst they arrange the menus with service users on a weekly basis there is an attempt to ensure that they provide a balanced and healthy diet. Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Service users are supported in a way they prefer and have access to all health care to include specialist services. Service users enjoy a range of appropriate social and educational activities. EVIDENCE: The personal care provided by the home is flexible and wherever possible responds to the individual needs. This included the times they get up and go to bed and where and what they have to eat. Staff ensure there is full access to all of the health care facilities this will include arrangements made for specialist health care before admission. There was evidence that the home has consulted the Community Learning Disability Team. There was a record of the healthcare received and it was evident that staff encourage service users to take advantage of the range of health care facilities. The home retains all mecines and there is a record of the receipt, administration and disposal of all medications. Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 14 There are a number of protocols and these are written and reviewed. They are also in a prominent position to ensure staff have easy access. It is essential that all behavioural plans to include any actions for physical interventions are undertaken on a multidispilary basis. There was evidence that the Community Learning Disability Team were consulted and at the time of the inspection the home were awaiting some guidance from them in respect of the care of one service user. Medication is reviewed by the prescribing doctor/consultant. Staff who administer medication have received accredited training. Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service Service users are supported by competent staff who are aware of the many forms of abuse and the need to protect vulnerable adults. EVIDENCE: The home has a complaints procedure however the level of disabilities may mean that service users have a limited understanding. The registered manager was aware of the advocacy services available and of the circumstances which may require such services. Staff have undertaken the LADAF modules (induction and foundation) and this included some training in the identification of abuse. The staff were aware of the potential for physical and verbal aggression and felt competent in managing any episodes of challenging behaviours. It is essential that the home has multidisciplinary protocols for both planned and unplanned physical intervention. Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 30 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The home has been maintained to a satisfactory standard and provides a comfortable environment. EVIDENCE: All of the accommodation was seen The home was found to be clean, warm and odour free Service users have their own bedrooms and many are ensuite. The rooms were pleasantly decorated and furnished appropriately. One service user has had a worktop added and this enables him to complete some hobbies/interests without having to go to the communal areas. One bedroom requires attention the curtail rail was missing and the wall and door had been damaged. The bedroom also requires a bedside locker. Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 17 The home has a maintenance person and all minor repairs are undertaken after the registered manager has made a request. To ensure repairs and replacements are dealt with promptly it is recommended that staff complete a work book which would be a running record of jobs required together with the date of the request. The record can then be audited by the registered manager to ensure the required work is undertaken without delay. Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Staff were seen as caring and competent, having a good relationship with service users. EVIDENCE: All of the staff on duty were seen individually and they confirmed that training is available and that they felt competent to do the job. The induction and foundation modules of LADAF are being completed and one piece of work which is being submitted was seen. Staff also attended a “total communication” course recently and a number felt they would benefit from further training to ensure good communication between them and service users. A number of staff records were seen and they consisted of an application form, two references and evidence of the CRB disclosure. Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 19 The registered manager advised the inspector that staff meetings are held and minuted it is recommended that the frequency is discussed with staff to ensure good communication is maintained It is recommended that any “physical intervention” protocols are agreed on a multi disciplinary basis. This must include both planned and unplanned strategies of intervention. It was noted that the staffing had now increased at weekends. In view of the number and needs of the group it would be appropriate to have four carers on duty during the waking day. The registered manager said that he was making very effort to ensure this happened. A number of staff questionnaires provided by the Commission were completed and returned. Staff felt that the registered manager was approachable, however they would appreciate more frequent staff meetings and a staff rota that was completed to enable them to plan ahead more effectively. Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The home was well managed Service views are taken into account for all practices. Health and Safety matters have been addressed. EVIDENCE: The registered manager had a good knowledge of the needs of the service users and was making great efforts to provided a comfortable and stimulating environment. Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 21 The responsible individual for the Company who run the home has recently left and the replacement was present for part of the inspection. The inspector was advised that the new Group Manager is to be the responsible person for the Company. It will be necessary for the Company to write to the Commission to confirm this and to be advised about action they need to take. The company must advise the Central Registration Team, Commission for Social Care Inspection, Riverside Chambers, Castle Street, Tangier. Taunton. TA1 4AL. The service users and relatives are consulted and their views would be reflected in the homes policies. The annual questionnaires are sent to relatives and the home confirmed that they are happy to consider any changes, which were requested. All of the records which are required to be held must be held in the home. The change in the group manager has brought our attention to the fact that the home provides an office in the home for the purposes of giving administrative support. It must be remembered that Frencourt is a registered care home and access to the “office mentioned should be provided without anyone third party having such access without having to go through any areas used by the service users. Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 23 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 YA24 YA6 Standard Regulation 23 13 Requirement Repairs/repacnemts in bedroom identified in the report The home to have multi disciplinary written protocols for both planned and unplanned events which may require physical intervention Appoint in consultation with the Commission a responsible individual Timescale for action 31/01/07 31/01/07 3 YA38 10 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard Good Practice Recommendations Ensure that four care staff are on duty during the waking day and providing direct care Staff to have additional training in “total communication” Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Fern Court DS0000062152.V310581.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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