Inspection on 01/11/05 for Fern Croft

This inspection was carried out on 1st November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Fern Croft 24/01/07

Fern Croft 31/05/05

Fern Croft 10/12/04

Fern Croft 20/04/04

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 Croft Ferncroft 14 Heathville Road Gloucester GL1 3DS Lead Inspector Peter Still Unannounced Inspection 1st November 2005 13:30 Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 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 Croft DS0000048719.V261498.R01.S.doc Version 5.0 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 Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fern Croft Address Ferncroft 14 Heathville Road Gloucester GL1 3DS 01452 505803 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 Miss Nicola Carlill Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2005 Brief Description of the Service: Fern Croft is a residential care home registered for seven adults with a learning disability in the Kingsholm area of Gloucester. The home specialises in supporting people who may present behaviours that challenge the service. The home is owned by New Beginnings (Gloucester) Ltd and part of a group of three homes, first established in Gloucester in 2002. Fern Croft, which opened in January 2004, provides single en suite accommodation for six people and a second floor bed sit for one person. Residents have access to a comfortable lounge, a dining room and domestic size kitchen. To the rear are spacious gardens laid mainly to lawn with a patio area. People living at the home have access to the homes small mini-bus and use local transport. The home has access to local facilities and is five minutes from Gloucester city centre. Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection lasted three and a half hours and the manager was present throughout, confidently providing evidence to support the inspection. One resident was talked with and there was communication with another. The deputy manager was also spoken with. Some residents were out during the inspection and one resident is currently in hospital and being supported during the waking day by staff from the home. A tour of the home was completed and a range of records reviewed. The atmosphere at the home was relaxed and friendly. A resident said they were very happy at the home and another resident was observed to be relaxed and communicating well with staff. It should be noted that the manager has needed to prioritise tasks and the staff team has worked very hard to make the improvements set out within this and the last inspection report. The staff, provider and manger should not be disheartened by the seemingly long list of issues within the environment section but should be congratulated for their achievements overall. What the service does well: What has improved since the last inspection? The last inspection recorded a number of requirements and recommendations and the manager should be praised for acting on these so robustly and in the process demonstrating commitment to good practice. There was also evidence Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 6 of delegation of tasks and the deputy manager has provided great help with new documentation and recording systems. A new overview, quick reference file for staff is a valuable tool for busy staff. 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 Croft DS0000048719.V261498.R01.S.doc Version 5.0 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 Croft DS0000048719.V261498.R01.S.doc Version 5.0 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 Residents are carefully assessed prior to admission ensuring their needs can be met. EVIDENCE: One residents’ file reviewed provided comprehensive information and a care plan to enable the home to make a judgement about suitability of placement; two overnight visits had also taken place. Another resident had come to the home under similar arrangements but the manager was concerned that the past records in terms of the person’s psychiatric history were missing and had not been available to the previous placement. It is to the credit of the manager that through persistence and ensuring the support of the community nurse, that a year later the lost files were found. Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 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): 6, 7, 9 Residents are protected by good individual care planning and are supported to make decisions, which promote independence. EVIDENCE: Two care plans were reviewed; they were detailed and signed by residents. Staff use different approaches to help good communication and feedback, finding the easiest form of communication for the individual. The new resident overview record file, which is a duplicate of some of the information held on individual files, was considered to be a very good way of ensuring needs are met. A new Service User feedback form has been used to provided information on resident likes and dislikes. A total communication approach is continuing to be developed. One resident said they had a key worker and staff support them to do the things they want. An example of how residents are supported to make decisions and to take risks was seen within a detailed care plan concerning a very small but crucial issue for a resident. An action plan was developed with small steps and showing Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 10 staff initiative. Staff worked consistently and there was frequent review. The outcome for the resident was privacy in their bedroom, more comfort and a more ordinary life and this was still being developed. Residents use the post office once a week for their personal finances; residents buy the things they want when shopping, supported with staff present and take part in activity such as abseiling. Key workers produce a monthly review of each person’s needs and a consultant psychologist continues to be employed by the home. He spends a day at the home each month, with further time when needed. Incidents at the home are monitored, using ABC charts. Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 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, 16, 17 Residents lead varied lives, where independence and choice is encouraged. Residents enjoy a good diet, and are involved in the process of menu planning. EVIDENCE: A new magnetic board is used and being developed to help residents know about the activities they are involved with. Photographs are used to show activity such as: Collage; music sessions; swimming; youth club and pub trips. Residents enjoy a take away meal once a week and have been strawberry picking during the summer. Residents are known at the local post office and rambling and walks are popular. Residents have had a holiday though one resident said they thought, “Going out on trips in the home minibus was best”. Staff only do things for residents that they cannot do for themselves and provide support for improved independence. An example was personal washing. The menu is varied, balanced and nutritious. A record is maintained, and alterations are recorded. The home is going to advocate for one resident concerning their diet and a member of staff is due to undertake a training course concerning nutrition. Fresh fruit was seen to be available for residents Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 12 and the evening meal was a stew with dumplings. Four different vegetables and more fruit were seen in the larder and looked fresh. Some residents diet is controlled and these details were on the care plan. Residents meet to choose the food for the following week on Sundays. One resident said they have choice in the food they have. Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 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): 20 Residents are protected by a good recording system, which is well organised. EVIDENCE: The manager should be commended for working hard to produce a sound medication system; the last inspection noted that improvement was needed. A new medication file was reviewed. It had an index and it included leaflet information about specific medication. A problem about delay, concerning the local pharmacy had been resolved following a request for action by the manager and this demonstrates that the home is being proactive when issues are identified. A lockable metal container is used for any controlled drugs. Records seen included: medication changes; resident’s consent forms; and a medication return book. Countersignature was also seen. Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 14 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 Residents are listened to and changes are made to meet needs. Staff have received training to promote the protection of vulnerable adults. EVIDENCE: The manager has worked very hard concerning these two standards and is supported by her staff team. A resident survey has been completed to find out individual needs and key workers have supported this where needed. The current staff team of three staff to four residents enables frequent one to one time for residents. One resident maintains their own diary so they can make a note of things, which are important to them so they can be discussed with staff. One resident’s care plan has a specific requirement for staff to spend individual time with a member of staff and this has made a significant difference to the resident. The resident “is now really opening up”. The last inspection required that training in the protection of vulnerable adults be provided to staff. This has been complied with, through a known company, Studio 3. The manager should be commended for instigating a new file with symbols for residents about making a complaint and this was considered by the inspector to be a very good piece of work. A comments book has been provided for everyone to use and it includes the last inspection report. The home has the Gloucestershire Adults at Risk policy and procedures and staff sign their induction book to record that they have read it. One resident said they knew whom they would go to if they had a concern and that staff would listen. Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 15 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 The home provides a comfortable environment for residents. Some work being undertaken, planned, or to be considered will improve the home further. EVIDENCE: Four requirements from the last inspection have been complied with. A fly screen needs to be fitted in the kitchen and there are plans to deal with cracks to an external wall and repair to a window frame will be resolved when a new conservatory is constructed after March of 2006. The provider should be commended for resolving heating problems by the installation of a new boiler system. A new tumble dryer and washing machine has also been provided; the door to the laundry room is about to be repaired following installation of the equipment. The bed-sit on the second floor for one resident has sloping ceilings, directly under the roof and it is understood that this can be hot at times. A new portable air conditioning unit has been provided and the resident who was not at the home is understood to be happy with the arrangement. Whilst this may be fully satisfactory, it will be recommended that it be monitored and thought given to any other way of improving the situation. Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 16 Only one item of sensory equipment was seen and consideration should be given to other equipment, which residents may choose to have, which could improve the enjoyment of their lives. Storage space was seen to be a difficulty, as it is with many homes, and consideration should be given to any ways of improving this. It is possible that the new conservatory will be valuable in this respect. Considering the needs of residents, space is also an important aspect, especially where new residents may be considered who are a challenge to the service. There was agreement that the dining room could be brightened up to become more interesting. This room is also valuable for activity. The garden is large and provides great opportunities for development and it will benefit from the imagination shown by staff in other aspects of their work. Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 17 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, 36 Residents are supported by effective and trained staff that are recruited following a thorough process and once in post, supervised, ensuring a commitment and focus on the needs of residents. EVIDENCE: The last inspection made a number of requirements and points about these standards and the manager and staff team should be commended for working hard to address them. Three staff have the NVQ level 2 award and 2 staff hold level 3. It is acknowledged that staff have shown great commitment to a number of key training events since the last inspection as well as NVQ work and should be commended. During the inspection a copy of the staff training overview was provided for the Commission files. This showed a list of 23 different training opportunities and the names of staff attending with dates. It was considered that this is an excellent management tool. Training concerning Autism had been raised as a need at the last inspection and it was seen that six staff have completed this. Whilst the LDAF (Learning Disability Award Framework) training is seen to be highly important for the staff to undertake, it was agreed that the manager is showing good sense by taking care not to overload staff and lose the benefit of training in the process. This means that the manager is well aware of the importance of the training and has a clear plan for it with individual staff. Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 18 The manager has now produced a robust recruitment approach and two staff files reviewed supported this. Two staff supervision files reviewed showed comprehensive notes following a new format, which has recently been produced and was seen to be very good practice. The manager has a supervision schedule, which is six weekly from mid October. The manager was not content with the previous format, which she considered to be too basic for such a vital task. One supervision file was up to date and the other was about to take place. Six supervisions are planned in the near future. Staff meetings are scheduled and an advance agenda is provided, which staff can add to. Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 19 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 The manger has demonstrated that her clear development plan and vision for the home has improved the lives of residents. EVIDENCE: It was helpful that the manger was present during the inspection since she was able to demonstrate confidence and professionalism in the way she is managing the home. One resident and other staff reinforced the drive and enthusiasm for development of practice. There have been a significant number of tasks completed, which show this standard has been well met. The manger has now completed her Registered Managers Award. The deputy manger should be commended for supporting the manager with the development of new documentation and systems, which have included a staff supervision format and review of care document. This work will lead to greater staff consistency and ease of use. The discharge of a resident recently, which involved other agencies was not considered by the deputy manager to present good practice and this may be Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 20 communicated to the Commission. It may be that a meeting with the home and agencies involved could be helpful to consider learning points. The homes focus was on the care of the resident. Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fern Croft Score X X 4 X Standard No 37 38 39 40 41 42 43 Score 4 X X X X X X DS0000048719.V261498.R01.S.doc Version 5.0 Page 22 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 Standard 24 Regulation 23 Requirement Provide a fly screen to the kitchen window Timescale for action 28/04/06 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 2 3 4 5 6 Refer to Standard YA34 YA24 YA24 YA29 YA24 YA24 Good Practice Recommendations Staff should complete LDAF training as part of their induction. The dining room could be improved to become more interesting and homely. The garden could be developed for residents benefit. One or more residents may benefit from sensory equipment. The bed-sit should be monitored during warm weather to ensure the portable air conditioning unit is sufficient and that the room is satisfactory for the resident. Consider if extra space can be provided for residents and equipment. Fern Croft DS0000048719.V261498.R01.S.doc Version 5.0 Page 23 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 Croft DS0000048719.V261498.R01.S.doc Version 5.0 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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