Inspection on 15/06/06 for Fern Lea

This inspection was carried out on 15th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Fern Lea 31/01/06

Fern Lea 16/08/05

Fern Lea 17/02/05

Fern Lea 08/09/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Fern Lea Liverpool Road Moston Chester Cheshire CH2 4BA Lead Inspector Mr Val Flannery Key Unannounced Inspection 15 23rd June 2006 02:10 th and Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 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 Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Fern Lea Address Liverpool Road Moston Chester Cheshire CH2 4BA 01244 382509 01244 382509 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.macintyrecharity.org MacIntyre Care Christian Ruppenthal Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. This home is registered for a maximum of 4 service users in the category LD (Learning disability) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of service users at all times and shall comply with any guidance which may be issued through the Commission for Social Care Inspection 31st January 2006 Date of last inspection Brief Description of the Service: Fern Lea is a care home for four adults with a learning disability. Although close to a busy main road the home is in a secluded semi-rural location on the outskirts of Chester. Transport is required to access shops and other local amenities. All the four bedrooms in the bungalow are single and contain handwashing facilities. A bathroom with toilet and a shower room with toilet are provided. Communal space consists of one large lounge and a dining room which is beside the kitchen. The garden to the rear of the home is to be developed to provide a secure outside area for residents. There are plans to build a conservatory off the lounge. Lifting aids, including bath hoist, are provided for service users with mobility problems. Staff are on duty twentyfour hours a day to deliver care to service users. The current scale of charge for individual service users is £34,111.42 per annum. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This • • • key inspection report was written using evidence gathered from the Pre-inspection questionnaire Service history for the home Visit to the home on the 15th and 23rd June 2006 The visit to the home was carried out over five hours and involved talking with four service users, the home manager and four staff. A number of resident and home records were seen. A partial tour of the building was carried out. Feedback following the visit to the home was given to the manager on the 23rd June 2006. What the service does well: MacIntyre have developed a pre-admission procedure that ensures prospective service users’ have the information they need to make an informed choice about the home. Individual care plans were available that show how service users’ assessed care needs are to be met. The plans also include risk assessments that show how the safety and well being of service users will be addressed. Service users said they attend day centres and go out on trips. Their plans of care showed that they are supported by staff to take part in activities that fit within their capabilities. Menus seen showed that service users are offered a choice of meals. Records seen showed that relatives are encouraged to visit the home and maintain contact with service users. A separate healthcare file is kept on individual service users. This showed that they receive visits from doctors, nurse and other healthcare professionals. The file, along with the service users care plans, are kept in their bedrooms. MacIntyre have developed policies and procedure for staff that administer medication to service users. The complaints procedure has been provided in a format that makes it easier for service users to understand. Service users are accommodated in a safe, well-maintained and comfortable environment. The single bedrooms are individually decorated and furnished. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 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 Lea DS0000006683.V291034.R01.S.doc Version 5.1 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): 2/3/5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre-admission assessments are carried out by senior staff from the home; this combined with information provided by the local authority (where appropriate) ensures the home is made aware of the needs of prospective service users. This information also determines if the home can meet these needs. EVIDENCE: During the visit to the home, carried out on the 31st January 2006, two recommendations were made regarding the pre-admission assessments for prospective service users’ and one regarding service users’ terms and conditions of residency. These issues are being addressed by the home. Since the last visit to the home no new service users have been admitted. The manager confirmed that the organisation’s pre-admission assessment procedure, including the recommendations identified at the last visit, would be fully implemented for prospective service users. Two service users’ care files were seen during the visit. These showed that changes to their assessed care needs are addressed by the home. Although service users have restricted capabilities changes to the way they are cared for is discussed with them. Two services users spoken with commented that they’ like it here’. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 9 A copy of the residency agreement between the individual service users and MacIntyre are kept in the home. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 10 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): 6/7/8/9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Plans of care are available that show how the needs of individual service users are identified, monitored and changed as necessary. This ensures staff have the necessary information when caring for service users. EVIDENCE: The two service users’ records seen showed that their assessed needs are included in their plans of care. For example, the level of support they require with using the bathroom, dressing/undressing and moving about the home. During the visit staff were seen helping service users’ and encouraging them to be as independent as possible. During the visit records were seen that showed the home is developing Person Centred Plans for individual service users. These include personal profiles and daily routines for service users. Two service users’ spoken with said ‘staff help them’. Staff were seen asking service users’ where they would like to spend their leisure time, what they would like for tea and what they had done during their daily activities. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 11 Risk assessments are in place that identify possible dangers to service users’. These cover the home environment and when they are using community facilities. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 12 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): 12/13/14/15/16/17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. As the capabilities of service users’ change the staff are supported by the manager to ensure these changes are reflected in the service users’ lifestyle. Service users are enabled to have control over their lives within the limits of their capabilities.. EVIDENCE: One of the service users’ spoken with said he attends a local day centre. Three service users’ were seen returning for their daily activities. Records, including a separate diary for each service user, showed their weekly activity programme. Included in dairy were trips to local shops, cinema and attending a disco. The needs of service users’ is such that they require assistance with all aspects of daily living. The home has a people carrier that is used to take service users’ on outings to local places of interest. Staff spoken with said the needs and abilities of service users has changed, this in turn ‘put a lot of pressure of staff’ to ensure service users’ lifestyle is maintained. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 13 Risk assessments are in place to ensure the safety of service users when taking part in activities, both in the home and in the community. Staff said service users’ relatives and friend are able to visit the home at any reasonable time and are made welcome. Service users’ record contained details of family contacts and relationships. During the visit staff were seen caring for service users’ by, for example, helping them with personal care and moving about the home. Service users were also seen approaching staff and communicating their needs to them. The record of food offered to service user’ showed that they are offered choices at each meal. During the visit staff were seen asking service users what they would like for their tea. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 14 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. This judgement has been made using available evidence including a visit to this service. Service users personal and healthcare needs are shown in their plans of care. This ensures staff have the information on how these needs are to be met and how they can support service users in a way their prefer.. EVIDENCE: During the visit staff were seen offering personal support to service users’ with, for example, using the bathroom/toilet and having a drink. Staff were aware of the level of help service users’ required with these tasks. Records seen during the visit showed that the personal care needs of service users have been assessed and plans are available that show how these needs are to be met. A separate healthcare file is kept on individual service users and is stored in their bedrooms. These showed that service users receive visits from doctors, nurses and other healthcare professionals. Letters were seen that showed service users are supported by staff to attend hospital appointments as necessary. The record of medication administered by staff to one of the service users’ was seen and was satisfactory. One of the service users’ spoken with said has seen a doctor and has been in hospital. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 15 During the visit to the home staff were seen caring for service users’ and responding to their requests for help. Staff were aware of the likes and dislikes of service users and how they wished to be cared for. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 16 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. This judgement has been made using available evidence including a visit to this service. Satisfactory procedures are in place to ensure service users are protected from abuse. Service users, and other visitors to the home, have access to a complaints procedure that enables them to raise issues of concern. EVIDENCE: A copy of the complaints procedure is on display in the home. Details on how to contact the Commission for Social Care Inspection are included in the procedure. The manager and staff spoken with said the home has not received any complaints since the last inspection. CSCI has not received any complaints about the home. A copy of the complaints procedure has been provided in a format that makes it easier for service users’ to understand. This is kept in service users care files that are maintained in their bedrooms. The complaints and compliments record seen showed the following • One issue raised by relatives regarding a service users hospital appointment • One issue raised by one service user about two other service users • One compliment from staff at a day care centre. MacIntyre have provided an Adult Protection Procedure, a copy of which is kept in the home. Included in the procedure is a copy of the government guidelines ‘No Secrets’. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 17 Staff spoken with said they knew about the complaints and adult protection procedures and what to do if a problem arose. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 18 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): 24/25/26/27/28/29/30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient private and communal space is provided to meet the needs of, and suit the lifestyle, service users. EVIDENCE: The home provides a safe, homely and comfortable environment for service users. They are accommodated in single bedrooms that are individually furnished and decorated. Because service users have mobility problems bedrooms are laid out so as to ensure their health and safety. Communal space consists of a large communal lounge and a dining area off the kitchen. A conservatory has been added to the home and is accessed via the communal lounge. Since the last visit to the home outstanding repairs have been carried out on the conservatory. Bathing and toilet facilities consist of: one bathroom with toilet and one shower with toilet. Hoists and other lifting aids are available to assist those service users with mobility problems. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 19 On the days of the visits the home was safe, clean, and free from unpleasant odours. The carpet in one of the service users bedroom has been replaced. The following issues were identified during the visit • The garden to the rear of the home was very untidy and overgrown. However, during the visit on the 23/6/06 to feedback to the manager quotes were being gathered on the cost of improving this area. • The paintwork on the external door leading to the laundry and on some of windows to the side and rear of the bungalow was flaking. The manager confirmed that he is in contact with the maintenance department to address these problems. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 20 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): 31/32/33/35/36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are aware of the needs of service users’ and how they wished to be cared for. The delivery of care will be further improved as staff roles and responsibilities are further clarified by the manage. EVIDENCE: The staffing rota seen during the visit showed that there is normally two staff on duty during the morning/afternoon and early evening. There is one waking staff on duty during the night. The rota also showed that because of sickness, annual leave and staff recruitment problems existing staff, and agency staff, are covering any gaps in the rota. In discussion with the manager he confirmed that recruiting staff to cover nights has been difficult and that day staff have been covering nights. He also said that they have appointed one person to work nights but she is not due to start for a couple of weeks. Staff spoken with during the visit said the current staffing situation combined with the changing needs of service users has meant staff ‘feel under pressure’. Comments were also made about the rota, for example, that day staff are due to finish at 10 pm but night staff do not come on duty until 10.15 pm. There also occasions when they said working with agency staff puts additional Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 21 pressure on them. They also said that they sometimes have to miss training courses because of the staffing situation. Information provided in the pre-inspection questionnaire showed that six of the twelve care staff has achieved an NVQ. There was a list of training courses available to staff displayed on the notice board in the office. These included medication, finances, health and safety, fire awareness, first aid, food hygiene and moving handling. A list was also on display of planned supervisions for staff. The manager would carry these out. Staff spoken said they receive supervision from the manager. Also on display was a list of workshops arranged by MacIntyre. An agenda for a forthcoming staff meeting was seen during the visit. Staff details were seen during the visit and were satisfactory. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 22 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): 37/39/42/43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager continues to develop his leadership skills. This includes supporting staff to further develop their caring their skills and understand their roles and responsibilities. This will improve the level of care offered to service users. EVIDENCE: Staff spoken with during the visit said the manager, they feel ‘is still developing his management skills’. They said there ‘is still room for improvement’ in the overall running of the home. Staff said the manager is keen to ensure the home is run in the best interests of the service users. Service users are consulted as much as possible about the overall running of the home and on any changes that may affect their daily routines. In discussion with the manager he confirmed that he is currently doing his NVQ Level 4 and Registered Managers Award. He also confirmed that has attended courses relevant to managing a care home. Since his appointment the Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 23 manager said he has supported the staff to take more responsibility in their roles as support staff. Two service users plans of care were seen during the visit. These showed that service users wishes on how they wished to be cared for are included. Meetings are also held with service users in which they are supported by staff to air their views about the home. Records were seen that showed hoists, fire equipment, portable appliances and gas installations are serviced. Also seen were records of weekly fire tests, staff training and evacuation drills. The manager confirmed that health and safety audits are carried out on the home every month. The home does not a quality assurance system in place whereby the views of service users and their families can be sought (See Recommendation Number 1). Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 24 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 3 4 X 5 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 3 Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 25 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA39 Good Practice Recommendations The home should develop a system whereby the views of service users and their relatives should be sought on the service offered. Fern Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Lea DS0000006683.V291034.R01.S.doc Version 5.1 Page 27 - 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. 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