Inspection on 31/01/06 for Fern Lea

This inspection was carried out on 31st January 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 15/06/06

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 Unannounced Inspection 31st January, 2 and 8 February 2006 03:45 nd th Fern Lea DS0000006683.V278362.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.V278362.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.V278362.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.V278362.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 16th August 2005 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. Fern Lea DS0000006683.V278362.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 6.5 hours on the 31st January, 3rd February and 8th February 2006. The visits on the 31st January and 8th February were in the home. On the 3rd February a meeting was held with the registered manager and area manager at Macintyre’s area office at Belford’s Quay. Feedback following the inspection was given to the registered manager on the 8th February. One hour was spent preparing for the inspection which included reading the previous inspection report and reviewing the service history for the home. Four service users, area manager, registered manager and three permanent staff (plus one agency staff) were spoken with during the inspection. Two service users’ care files were seen as were a number of the home’s records. A partial tour of the building was carried out. The service users currently living the home have limited communication capabilities. What the service does well: What has improved since the last inspection? The new conservatory, when complete, will offer service users additional communal space. Fern Lea DS0000006683.V278362.R01.S.doc Version 5.1 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 DS0000006683.V278362.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.V278362.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): 1/2/3/4/5 Although pre-admission assessments are carried out before service users come to live in the home these need to be fully completed and seen by all staff. EVIDENCE: Three of the four service users have lived in the home for a number of years. Since the last inspection a new service user has come to live in the home. Records seen showed that the new service user was able to visit the home prior to moving in. This included overnight stays, visits for meals and to meet the other service users and staff. Also seen were minutes of meetings, held prior to his admission, to discuss any concerns and/or worries. Plans of care showed that the service user’s needs were identified, also included were details on how the home was to provide care as agreed with the service user. An assessment of the service user’s needs, carried out by the placing authority, were seen during inspection. Staff from the home did not carry out the pre-admission assessment developed by MacIntyre. (See Recommendation Number 1) It was not signed by the person who actually carried out the inspection (See Recommendation Number 2). A copy of the terms and conditions of residency between the new service user and MacIntyre was not available (See Recommendation Number 3). During the visit to the home on the 31st January the staff on duty said they were not made fully aware of the assessed needs of the new service user. However, records seen during the inspection on the 31st January and 8th Fern Lea DS0000006683.V278362.R01.S.doc Version 5.1 Page 9 February showed that a range of information, including a copy of his assessed needs, were available on the new service user (See Recommendation Number 4). Fern Lea DS0000006683.V278362.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): 6/7/8/9/10 The assessed needs of service users are identified and included in their plans of care. However, not all changes to these needs are recorded in the plans of care. EVIDENCE: Two service user plans were seen during the inspection. These showed that their assessed needs have been identified. However, changes to these needs are not always recorded particularly if the service users link worker is absence from the home (See Recommendation Number 5). The registered manager said it is the aim and philosophy of the home that service users are enabled to take responsible risks. For example, the manager said service users could move between the communal areas, their bedrooms and using the bathroom with minimal staff support. However, during the visit on the 31st January staff were seen using wheelchairs to move service users between these areas. Service user plans of care also showed how they wished to be cared for and their daily routines (See Recommendation Number 6). A record was seen that showed that a meeting was held between staff from the home and from the health authority in which the risk assessment for the new service user was discussed. Fern Lea DS0000006683.V278362.R01.S.doc Version 5.1 Page 11 Although service users have limited communication capabilities the manager said they are consulted about changes that affect them and also about the overall running of the home. For example, annual holidays, meals and changes to the environment of the home. This is carried out via meetings, one-to-one with service users and annual reviews. A copy of the statement of purpose and service user guide is kept on service users files. Fern Lea DS0000006683.V278362.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): 11/12/13/14/15/16/17 Service users are encouraged and supported to be part of the local community. Families and friend are able to maintain contact with the service users. EVIDENCE: During the visit on the 8th February a service user was being supported by staff to go to a day centre. Staff were seen asking the service user if he wished to attend or stay at home. Another service user, who was staying in the home and not going out, was having a lie in. Again staff were seen asking him if he wished to stay in bed for a while longer or wanted assistance to dress and have breakfast. The location of the home, although close to a busy dual carriageway, ensures the privacy of service users is protected. Although service users’ are enabled to use local facilities this requires the use of the mini bus as the facilities are not within walking distance. Chester city centre is within a ten-minute drive of the home. A record of the daily activities in place for each service user was seen during the visit. These included in house and community based activities. Service users require staff support when using community facilities. Fern Lea DS0000006683.V278362.R01.S.doc Version 5.1 Page 13 The manager said the weekly menu is planned, with service user help, every Sunday evening. Pictures are used to help the service users with communication issues. Staff said service users’ relatives are welcome to visit and help as they wish. Service user plans of care showed that families and friends are invited to attend reviews, social events and birthday parties. Records seen showed that one service user was supported by his family when he was recently admitted to hospital. The manager said he is investigating the possibility of advocacy services supporting two of the service users. Individual service user files are not consistent in the way the information is laid out. They also need to be better presented and contain the most up to date information on service users needs (See Recommendation Number 7) Fern Lea DS0000006683.V278362.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): 18/19/20/21 The health and personal care of service users is identified and action taken to address any concerns. However, personal care is not always given to service users as outlined in their plans of care. EVIDENCE: The level of personal care required by service users is not offered in a consistent manner by all staff. For example, during the visit on the 31st January staff were seen taking service users to the bathroom in wheelchairs to help with their personal care needs. In discussion with the manager, and as seen in the plans of care, service users are able to manage certain tasks with minimal staff support (See Recommendation Number 6). A separate healthcare file is kept on individual service users. The files seen showed that their health needs are addressed and that they receive input as required from doctors, nurses, occupational therapists and physiotherapists. Service users require full assistance from staff with their medication. During the visit on the 8th February the manager was seen administering medication to a service user, this was carried out in a satisfactory manner. The record of medication administered to service users was seen and was signed by staff. Fern Lea DS0000006683.V278362.R01.S.doc Version 5.1 Page 15 MacIntyre have provided policies and procedures on caring for service users who are ill or dying, copies of which are kept in the home. Fern Lea DS0000006683.V278362.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 Satisfactory arrangements are in place for dealing with complaints and protecting service users’ from abuse. 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 said 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 guidelines ‘No Secrets’. Staff knew about the complaints and adult protection procedures and what to do if a problem arose. Fern Lea DS0000006683.V278362.R01.S.doc Version 5.1 Page 17 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 Service users’ live in a well maintained and comfortable home which provides a safe standard of accommodation. 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. However, because there are a number of outstanding building issues yet to be resolved the conservatory is not ready for use. During the visit on the 8th February workmen were in the home carrying out repairs to 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.V278362.R01.S.doc Version 5.1 Page 18 On the days of the visits the home was clean, warm and free from unpleasant odours. Fern Lea DS0000006683.V278362.R01.S.doc Version 5.1 Page 19 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): 31/33/35/36 There have been a number of changes to the staff team that have affected the staffing rota. However, the manager with support from his line manager has begun to address the staffing issues. EVIDENCE: During the visit on the 31st January the staff on duty said the morale ‘was low’ within the team. They also commented on the staff vacancies and the high level of staff sickness which they said may be affecting the delivery of care to service users. Staffing rotas seen showed that staffing shortages are covered by relief staff, either from other MacIntyre homes or by agency staff. However, the staffing levels are not significantly different from those in place at previous inspections. On the 3rd February a meeting was held with the area manager for MacIntyre West Cheshire and the registered manager for the home. During the meeting discussion took place on the concerns raised by the staff. The area manager said that additional staff hours have been allocated to the home and that planned staff re-deployment will be taking place within the coming weeks. This involves a senior support from another service coming to work in the home and the current senior support worker moving to the supporting people scheme run by the organisation. MacIntyre have also been involved in a staff recruitment ‘open’ day that was held at the job centre. (See Recommendation Number 8) Fern Lea DS0000006683.V278362.R01.S.doc Version 5.1 Page 20 The staff spoken with during the visit on the 8th February said they receive supervision and support from the manager. The senior support worker said she has recently come to work in the home and is currently doing her induction training. An agency member of staff was also on duty with the manager. She said she has done a number of shifts in the home and has received support and help from the staff team. Fern Lea DS0000006683.V278362.R01.S.doc Version 5.1 Page 21 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): 37/38/40/41/42/43 The registered manager is working to ensure the needs/views of service user under pin the day-to-day running of the home. EVIDENCE: During the last year there has been a change of registered manager for the home. Staff on duty the 31st January commented on how this, and the changing needs of service users, has affected the overall running of the home. At the meeting, held on the 3rd February, with the area manager and registered manager, discussion took place on the issues raised by the staff. They confirmed that the organisation is committed to ensuring service users’ views, and assessed care needs, underpin the day-to-day running of the home. The manager said he is providing support and guidance to staff so as to ensure they ‘are on board’ with the stated aims of the organisation. MacIntyre have provided a range of policies and procedures, copies of which are kept in the home. The area manager for the organisation visits the home on a monthly basis. Head of service meetings are held on a regular basis. Fern Lea DS0000006683.V278362.R01.S.doc Version 5.1 Page 22 This provides an opportunity for managers to share information and support each other. The following maintenance records were seen: • Letter from British Gas re: gas safety • Portable Appliance Test • Periodic Inspection of Electrical Installation • ‘Homecare’ agreement with British Gas to service other equipment in the home • Health and Safety inspection carried out by the manager (6 Monthly) • Service carried out on the hoists The fire book showed that a fire risk assessment was in place and that other safety checks such as weekly checks, monthly checks on emergency lights and drills/ training has been carried out. Fern Lea DS0000006683.V278362.R01.S.doc Version 5.1 Page 23 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 3 2 2 3 3 4 3 5 2 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 2 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 3 3 3 X 3 3 3 3 Fern Lea DS0000006683.V278362.R01.S.doc Version 5.1 Page 24 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 2 3 4 5 6 7 8 Refer to Standard YA2 YA2 YA5 YA2 YA6 YA9 YA16 YA31 Good Practice Recommendations Staff from the home should carry out the pre-admission assessment for prospective service users. The person carrying out the assessment should sign the pre-admission assessment. A copy of the terms and conditions of residency should be kept on individual service users files. All staff should be made aware of the assessed care needs of new service users. All changes to service users assessed needs should be recorded in their plans of care. The level of support offered to service user by staff should be as set out in their plans of care. Information on service users’ and their assessed care needs should be accessible. The roles and responsibilities of staff should be discussed on a regular basis. Fern Lea DS0000006683.V278362.R01.S.doc Version 5.1 Page 25 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.V278362.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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