Inspection on 16/08/05 for Fern Lea

This inspection was carried out on 16th August 2005.

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 15/06/06

Fern Lea 31/01/06

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 CH2 4BA Lead Inspector Val Flannery Announced 16 August 2005 14:50 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 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 Stationary 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 F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Fern Lea Address Liverpool Road Moston Chester CH2 4BA 01244 382 509 01244 382 509 www.macintyrecharity.org Macintyre Care Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Christian Rupenthal Care Home 4 Both Category(ies) of Learning disability (4) registration, with number of places Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 4 service users in the category LD (Learning disability) 2 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 17 February 2005 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 showeroom 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 develop 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 twenty four hours a day to deliver care to service users. Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 16th August 2005 as part of the yearly inspection process. One hour was spent preparing for the inspection which included reading the previous inspection report and reviewing the service history for the home. Three service users, two relatives and three staff were spoken with during the inspection. One service user’s care file and information on a prospective service user were seen during the inspection. A number of home records were also seen during the visit. Three service users, two health professionals and one relative comment cards were returned. The service users’ have limited communication capabilities. Feedback on the findings of the inspection was given to the manager on Friday 19th August 2005. What the service does well: Relatives said staff are caring and do their best for service users. Information seen on a prospective service user showed that a comprehensive preadmission programme is carried out. This included the service user visiting the home and staying overnight. A statement of purpose and service user guide was also available which showed the level of service offered by the home. Staff were seen caring for service users and involving them in the routines of the home, for example, cutting the grass and preparing for the evening meal. Service users’ were relaxed and were able to approach staff for help and assistance. Service users’ plans of care showed how their assessed care needs are to be met. This includes risk assessments which showed the level of support service users’ required to be as independent as possible. Relatives spoken with said they are able to visit the home and are kept informed on any incidents/accident involving service users. Service users are supported by staff with their personal appearance. The care files showed that information on service users’ background and their daily routines is available. Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 Page 6 A copy of the complaints procedure is on display in the home. Relatives spoken with said they are able to raise any concerns with the manager and know they will be taken seriously. Because the home is a bungalow service users are able to move freely between their bedrooms and the communal areas. The home is maintained to a high standard. The comment cards were, on the whole, positive about the service offered. 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 F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 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 standard(s) 1/2/3/4/ Information is provided which allows service users to make a decision about the service offered by the home. Service users are able to visit the home before making a decision about moving in. EVIDENCE: The three service users have lived in the home for a number of years. A copy of the statement of purpose and service user guide were seen during the inspection. Information was seen on a prospective service who may come to live in the home. This included a pre-admission assessment that was carried out by senior staff and a record of visits to the home made by the prospective service user. Also seen was a copy of the standard assessment documentation provided by the placing authority. It is the policy of MacIntyre Care that, wherever possible, prospective service users visit the home before making a decision about moving in. The entries in the service user plans of care showed their care needs have been identified, are monitored and action taken to address any changes. Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 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 standard(s) 6/7/8/9/ There are care plans in place that show how service users’ care needs are to be met. Risk assessments are in place that help ensure the well-being and safety of service users. EVIDENCE: The relatives spoken with said they have witnessed staff caring for service users in a kind and caring manner. They also said they are informed of changes that occur and how these changes affect the level of care offered to service users. For example, a service user requires additional staff help with moving about the home. A service user’s care file, which includes plans of care, was seen during the inspection. This showed that service user changing care needs are monitored. Service users require staff support and supervision twenty four hours a day. A comprehensive risk assessment procedure is in place. Assessments are in place which cover service users ability to manage in the home and in the local community. Also in place are assessments on possible dangers to service users’ safety. Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 Page 10 Relatives said service users are asked about their choice of meals and what activities they wish to do. Staff were seen talking to service users about everyday things such as what they did at the day centre and what music they wished to listen to. They were also seen encouraging service users to make decisions about where they wished to relax. Service users’ care files are kept their bedrooms. Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 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 standard(s) 11/12/13/14/15/17 Service users are able to take part in activities that suit their abilities. Staff support service users’ to access community based amenities and social events. EVIDENCE: A list of activities for individual service users was on display. This included attendance at day centres, day trips, walks and social events. Relatives spoken with said they are able to visit the home as they wish and see the service users in private. They also said they are made to feel welcome by the staff and are involved in discussions about the care needs of service users. Plans of care showed that service users’ are supported by staff to take part in community based events such as shopping, eating out and going on holidays. The relatives spoken with said they have seen staff encourage service users to take part in activities ‘regardless of their abilities’. Records were seen during the inspection which showed that advice and guidance on service users’ diets has being sought from healthcare Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 Page 12 professionals. A care plan for each service user on managing their diet/how to help them eat their meals was on display in the dining room. Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 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 standard(s) 18/19/20 Service users are, on the whole, looked after with regard to their personal and healthcare needs. EVIDENCE: Two comment cards received from healthcare professionals said that, on the whole, their advice and guidance on specific issues relating to service users is acted upon. However, they did comment that not all staff are aware of /follow this advice and guidance. They feel there may be a training issue with some staff and are going to liaise with senior management in the organisation. During the inspection staff were observed helping service users’ with their evening meal and using the bathroom. This was done in a way that ensured the dignity and privacy of service users was protected. For example, bathrooms doors were closed and staff were talking to service users and allowing then to eat at their own pace. Records showed that doctors and other healthcare professionals are consulted as necessary; also that the reason for their visits are recorded. Service users require full assistance with the administration of medication. A copy of the organisation’s procedure on the administration of medication is kept in the home. Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 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 standard(s) 22/23/ Satisfactory arrangements are in place for dealing with complaints and protecting service user’s from abuse. EVIDENCE: Relatives spoken with said they are aware of the complaints procedure. They also said that any issues raised would be taken seriously by the manager and acted upon. 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. Staff confirmed that the home has not received any complaints since the last inspection. CSCI has not received any complaints about the home. 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 guideline ‘No Secrets’. Staff knew about the complaints and adult protection procedures and what to do if a problem arose. Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 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 standard(s) 24/25/26/27/28/29/30 Service users’ live in a well maintained and comfortable home which provides a safe standard of accommodation. EVIDENCE: Although access to the home is off a busy dual carriageway it is in a quiet and secluded location. Car parking is available to the front of the home whilst the garden to the rear of the home overlooks fields. The home is comfortable and offers sufficient communal space to meet the needs of service user. Bedrooms are individually decorated and furnished and contain personal possessions belonging to service users. A bath hoist as well as toilet aids, wheelchairs and grab rails are provided for service users. On the day of the inspection the home was clean and free from unpleasant smells. Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31/32/33/35/36 Staff receive training and, are employed in sufficient numbers, to meet the needs of service users. Staff are aware of their responsibilities to the service user group. EVIDENCE: Staff spoken with said there are aware of their roles and responsibilities which is ensuring service users are well cared for. This in re-enforced through individual supervision and staff meetings. Senior staff also monitor/provide guidance on care practices as part of the normal working day. Three staff members have worked in the home for a number of years. The staff spoken with said they have received training, including NVQ Level 2/3, on first aid, protecting vulnerable adults and care planning. They also said they receive supervision from the manager. Rotas showed that there are normally two staff on duty during the day/afternoon/early evening. A waking staff in on duty during the night. The relatives spoken with said the staffing has improved over the last few months. They said the home does not use as many agency staff to cover shifts. However, they were concerned that when the new service user comes to live in the home there may not be sufficient staff on duty during the night to care for the service users. The senior member of staff spoken with said the staffing Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 Page 17 levels will be reviewed as part of the admission process for the new service user. This was also confirmed by the manager. Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37/38/42/43/ The home is managed efficiently and is run in the best interests of service users. The manager is committed to ensuring the home delivers a high quality care to service users. EVIDENCE: The manager was appointed in January 2005. Relatives and staff said ‘he is doing ok’ and that he would take action to address any worries/concerns they may have. They also said he has ‘a caring attitude to the service users’. He has a qualification in nursing people with a learning disability and is due to commence NVQ Level 4 in management. MacIntyre Care have provided a range of training opportunities for the manager to assist in the day-to-day running of the home. This includes handling/lifting, risk assessment and protecting vulnerable adults. MacIntyre provide support mechanisms for the manager including regular visits by the area manager. Monthly reports on the home are sent to CSCI as part of the care homes regulations. Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 Page 19 A partial tour of the building showed that maintenance issues are addressed to ensure the health and safety of service users. Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 Page 20 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 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fern Lea Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x x 3 F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 Page 21 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 Regulation No 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 No Good Practice Recommendations Fern Lea F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich CH1 2HS 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 F51 F01 S6683 Fern Lea V235810 160805 Stage 4.doc Version 1.40 Page 23 - 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!