CARE HOMES FOR OLDER PEOPLE
Fern Lea 52 Pearson Park Hull East Yorkshire HU5 2TG Lead Inspector
George Skinn Unannounced Inspection 22nd November 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fern Lea DS0000000848.V262152.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Fern Lea Address 52 Pearson Park Hull East Yorkshire HU5 2TG 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) 01482 441167 01482 474719 Richard and Carol Sheehan and Stephen and Jane Brown Mrs Carol Sheehan Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. To admit one named service user who is under the age of 65 (variation application 24923). 17th May 2005 Date of last inspection Brief Description of the Service: Fern Lea is a large Victorian house in Pearson Park approximately 1½ mile from Hull City centre. It offers permanent and respite accommodation for up to 20 older people of either gender, who may also suffer from dementia. The home usually operates with 19 residents when full but has spaces for 20. Staff provide a range of personal care and have the added knowledge of the Registered Manager (also one of the Registered Providers), who is a qualified nurse. Nearby are local shops, public houses and churches. The home is near to major bus routes into Hull. Accommodation is on three floors (two of these are split level with additional stairs), there is a chair lift from the ground to first floor only. There are currently seven single and six double bedrooms in use, but these are interchangeable, with many rooms reaching the requirement of 16m². Communal space consists of a lounge and dining room. There is a small, enclosed patio/garden area to the side of the home. The front garden is mainly for car parking with some seating areas. The grounds are well maintained and the décor in the home is of a good standard. Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken over 3 hours. The home was measured against the National Minimum Standards with some paperwork and the building being inspected. The majority of the residents who live at the home were spoken with. What the service does well: What has improved since the last inspection?
The home has provided plenty of training for the staff since the last inspection and this is planned for the coming year this includes training on dementia, first aid and many more subjects which are relevant to meeting the needs of the residents. More than 50 of the staff are now trained to NVQ level 2. This means that the staff are able to provide the residents with a high standard of care. The home has provided plenty of training for the staff since the last inspection and this is planned for the coming year this includes training on dementia, first aid and many more subjects which are relevant to meeting the needs of the residents. More than 50 of the staff are now trained to NVQ level 2. This means that the staff are able to provide the residents with a high standard of care. The main lounge has been decorated since the last inspection and residents thought this looked very nice. Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 6 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 DS0000000848.V262152.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 All residents including those who are self-funding are assessed prior to their stay at the home. This ensures the residents’ needs are met by the staff. EVIDENCE: There has been no change to the systems for obtaining information from local authorities and undertaking an assessment of residents needs since the last inspection. For individuals referred through a local authority care management team the manager obtains a copy of the assessment and care plan this is also applicable to those who are self funding. From a sample of records examined it was evident that the Manager and staff in the home complete a thorough needs assessment, based on nine areas of daily living. This is used to write a plan of care for daily living for each resident. The care plans are comprehensive and clearly presented. Those residents interviewed stated they had made a positive choice to live at the home. Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8, 9, & 10 The residents’ health needs are met with privacy and dignity being maintained; medication is handled safely. EVIDENCE: Discussion with the Manager revealed there have been no changes in the promotion of residents’ health since the last inspection. Evidence indicates that all residents are registered with a local GP and have good access to the local community health team. There is evidence to indicate that the residents are assessed regarding risk of developing pressure sores, and for other areas of risk. The home has good access to the community dietician, psychiatric services and continence advisors. Residents receive regular visits from chiropody, dentists and opticians where required. Details are recorded in plans of care, GP visit notes and diary notes. There is a medication and self-medication administration policy and procedure for staff to follow. There is a robust medication trail, which ensures all drugs are receipted into the home, are recorded as given or returned to the pharmacist. Medication administration record sheets show these and other
Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 10 details. Designated staff hold keys to storage and administer the drugs only after being trained to do so. The Manager is responsible for ensuring staff handling medication are appropriately supervised and monitored. Storage is in a locked and fixed cabinet or a medication trolley, fixed to the wall. There is a facility in a double locked cabinet for controlled drugs, which are double signed on administration. One resident self-medicates some of their medication. There is a policy on privacy, dignity and confidentiality and all staff receive information and instruction on how to behave, within induction training and through their copy of the home’s code of conduct. Staff were observed to be very caring, discreet and understanding and yet made the routines of the day lively and eventful. Conversation between residents and staff was friendly but professional. Practice was observed to be good in maintaining privacy and dignity for residents and records show how issues are handled. There is an office telephone with an extension, which residents can use, in private. Residents were addressed differently, some formally, others casually, therefore implying they are addressed according to their choice. Visitors are seen in private, for health, legal, financial or social reasons, but can also be seen in the lounge. Diary notes and plans of care show evidence of the frequency of visitors and of the practice of maintaining dignity and privacy for residents. Some double rooms have privacy screens for use by residents. Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 &14 Resident are part of the local community and can exercise choice. EVIDENCE: Discussion revealed there have been no changes since the last inspection concerning this aspect of life within the home they still encourage an open door visiting policy and this is discussed in the statement of purpose. This also states that residents are able to refuse visitors. Resident commented on going out to the local shops and visiting the Park on a regular basis. The home has links with the local Rotary Club and a local school. Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Residents know who to complain to and are confident that these will be taken seriously. EVIDENCE: There is a clear complaint procedure with information on how to contact the Commission for Social Care Inspection (CSCI) if the home cannot satisfactorily address the complaint. The procedure is posted in the home for all to see and is also printed in the statement of purpose. Thorough records are kept of all complaints along with details of the investigations and outcomes. There have been no complaints since the last inspection. Residents were very clear about who should be seen if they had a complaint. Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 Resident live in a safe well maintained environment. EVIDENCE: The home is situated in Pearson Park in the west of the city of Hull. It is a large Victorian house on three floors, serviced by a stair lift. Bedrooms are six large doubles and seven generous singles. These are interchangeable as the home has 20 registered places, but operates with 19, and several rooms are large enough to be doubles. There is one large lounge and one large dining room/lounge. The house is well maintained both inside and out and there is a programme of routine maintenance. Grounds are accessible to residents, the front is tarmac for car parking but there are some seating areas. There is an enclosed patio/garden area that receives the sunlight. From examination of records and observation in the home it was evident that the requirements of the local fire service and environmental health department are being met. The hot water in the bathroom was found to be over the
Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 14 required temperature this was dealt with by the manager/registered provider within 24 hours. There are no CCTV cameras. Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 The skill mix and numbers of staff meet residents’ needs. EVIDENCE: The home is pre-existing registration and complies with the requirements of the previous regulatory authority, in that enough staff are on duty at any one time to meet the needs of the residents Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 The registered person does ensure, as far as it is reasonably practical, the health safety and welfare of the residents. EVIDENCE: The home was seen to be safe and free from hazards. The registered person had complied with any requirements placed on the home from other agencies for example environmental health department. All the maintenance certificates were up to date for all the equipment used by the residents and staff. Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x 3 Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 18 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. Refer to Standard Good Practice Recommendations Fern Lea DS0000000848.V262152.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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