Inspection on 03/12/07 for Fern Lodge

This inspection was carried out on 3rd December 2007.

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 Lodge 15/01/07

Fern Lodge 03/01/06

Fern Lodge 19/10/04

Fern Lodge 25/06/04

Similar services:

Claremont House

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Firstlings

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Fern Lodge 108 Broad Road Bocking Braintree Essex CM7 9RX Lead Inspector Tina Burns Unannounced Inspection 3rd December 2007 10:15 Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 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 Lodge DS0000017715.V356001.R01.S.doc Version 5.2 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 and 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 Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fern Lodge Address 108 Broad Road Bocking Braintree Essex CM7 9RX 01376 550432 01376 342928 braintreehcltd@aol.com 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) Braintree Health Care Limited Mrs Jennifer Woolliams Care Home 8 Category(ies) of Dementia (2), Learning disability (8), Learning registration, with number disability over 65 years of age (8) of places Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 8 persons) Persons of either sex, aged 65 years and over, who require care by reason of a learning disability (not to exceed 8 persons) Two persons, under the age of 65 years, who require care by reason of a learning disability and dementia, whose names have been made known to the Commission The total number of service users accommodated in the home must not exceed 8 persons 15th January 2007 Date of last inspection Brief Description of the Service: Fern Lodge is a care home registered to provide accommodation, personal care and support to eight people; of either sex, under the age of 65 years and over the age of 65 years, who have a learning disability. The home is owned by Braintree Healthcare Ltd, and the Registered Manager is Mrs Jenny Woolliams. Fern Lodge is a purpose built bungalow situated in pleasant secluded surroundings, in a semi rural location on the outskirts of the town of Braintree, in the county of Essex. All bedrooms are of single occupancy and offer spacious accommodation with a small lounge area, kitchen facilities, en suite bathrooms and patio access to the garden. The home also has a dining room, lounge and an attractive garden with garden furniture. The inspector was advised that the current fees ranged between £799.80 to £1975.80 per week, at the time of the inspection. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 3rd December 2007, over a period of seven hours. All of the Key National Minimum Standards (NMS) relating to the mixed category of Young Adults and Older People and the intended outcomes were assessed in relation to this service to reflect the wide range of service users needs met by the home. This report has been written using accumulated evidence gathered from the service prior to and during the inspection. The inspection process included reviewing a range of documents required under the Care Home Regulations including staff and residents records, staff rosters and a number of policies and procedures. A tour of the premises was also undertaken and interaction between staff and residents was observed. The inspector also met the residents living at the home and spoke with staff that were on duty on the day of inspection. The Registered Manager Mrs Jenny Wooliams, was present throughout the day and fully contributed to the inspection process. Information was also gathered from the homes Annual Quality Assurance Assessment (AQQA) submitted to the Commission in October 2007 and notifications made by the home since the last inspection. Five questionnaires were also completed by health and social care professionals. What the service does well: What has improved since the last inspection? Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 6 Since the last inspection the home has addressed the shortfalls in their recruitment practices and could evidence that appropriate checks, including Criminal Record Bureau checks (CRB’s) are undertaken. The records of three residents admitted to the home since the confirmed that appropriate pre admission assessments take more care plans had been developed to include clear guidance residents preferred routines and the tasks that needed to be meet their personal and healthcare needs. last inspection place. Further for staff about undertaken to 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. The summary of this inspection report can be made available in other formats on request. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3,4,& 5 (Young Adults) and 1, 2,3,4 & 5 (Older People) Standard 6 in Older People does not apply to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents or their representatives can expect to make an informed choice about the suitability of the home and whether or not it is able to meet their needs. EVIDENCE: The home had a Statement of Purpose and Service User Guide that reflected the aims and objectives of the service and informed prospective service users of the services and facilities offered at Fern Lodge. The Service User Guide was produced in Makaton and since the last inspection it had also been developed to include pictures and symbols so that it was more suitable for the needs of the residents. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 9 Three residents had been admitted to the home since the last inspection. Discussion with the manager, examination of records and feed back from health and social care professionals confirmed that full and appropriate assessments of need had been undertaken before their admission to the home. The admission process included a trial stay followed by a review to determine whether or not the home was appropriate to their needs. Care files examined also included an agreement of terms and conditions between the service and the individuals accommodated. Residents were assured that “whenever any decisions are considered that affect your well being or your continued residency at Fern Lodge, then you; your family, a friend, advocate or key worker, will be entitled to comment on these decisions and make your representations”. The home provided aids and equipment appropriate to support the care needs of the service users. There was also good evidence that the home worked closely with health and social care professionals to meet residents complex and special needs. Staff training was provided to promote good care practice and enable staff to develop the skills required to meet the assessed needs of the service users accommodated. Staff demonstrated a good awareness of individual’s specific communication needs and provided support and encouragement to assist them with making choices throughout their day. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 (Younger Adults) and 7, 14 & 33 (Older People) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to be involved in decisions about their daily lives. Further more they can expect to have a needs led, person centred service. EVIDENCE: People living at the home have a wide range of needs. The home continues to successfully support younger adults towards a more independent lifestyle while providing appropriate care and support for older people. Despite several of the resident’s complex and ‘special’ needs the home promotes an ordinary lifestyle and works hard to empower people to make decisions about their every day Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 11 lives. Residents are consulted with regard to the running of the home through regular resident meetings and one to one consultations. It was positive to see that minutes of the residents meetings were completed in a suitable format that included pictures and symbols. Discussion with the manager and records seen confirmed that the home had worked hard to improve the standard of their care plans and it was positive to see that they included detailed accounts of residents preferred daily routines and the tasks that needed to be undertaken to meet their individual and specialist needs. Moving and handling and individual risk assessments were in place and there were guidelines for staff regarding support and intervention techniques for one resident with potentially challenging behaviour. The strategies in place had been agreed by a multi professional team including specialist health care professionals, however since settling in to Fern Lodge the resident’s difficult behaviour had dramatically reduced. Observations during the inspection and feedback from health care professionals confirmed that staff had a good understanding of resident’s needs and preferences. Comments included; “Fern lodge provides an excellent service and supports clients with some complex physical and psychological needs. The service always rises to each new challenge”. “Fern Lodge provides a fantastic, consistent and professional approach to caring for one of my clients. With their dedication and determination the clients health and social needs have improved dramatically”. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 (Young Adults) and 10,12,13, & 15 (Older People) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 13 Residents can expect to enjoy a wide range of in house and community activities. They can also expect to maintain relationships with their friends and families and enjoy healthy and appetising meals. EVIDENCE: Feedback received in survey forms and observations made during the inspection confirmed that the range of activities offered to residents are varied and appropriate to their needs, age, motivation and dependency. On the day of the inspection the home was celebrating one resident’s birthday and staff were making every effort to ensure that the day was made special for them. Various activities were provided in house and ex residents now living in the organisations supported living scheme visited the residents regularly and joined in the activities. An art session was being run by a tutor from the local college who confirmed that they came to the home twice a week to run an art and a cultural studies programme. At the time of the inspection a group of residents were learning about the rain forest. Colourful and interesting examples of their art- work were displayed creatively throughout the home. Sensory lights and equipment was provided in communal and private areas for residents with sensory, cognitive and mobility needs. Observations were that residents were confident and relaxed and enjoyed a positive and supportive relationship with carers. Carers spoke with residents in a positive and friendly tone using appropriate language and communication methods. During the day residents were seen coming and going and accessing community facilities with staff support. Staff spoken with confirmed that the home routinely offered the residents opportunities to access the community and participate in chosen leisure activities both individually and as a group. Examples given included shopping, lunch or coffee outings, picnics in the warmer weather, going to the cinema and bowling. Discussion with the manager and information provided to the Commission indicated that the home welcomed visitors and encouraged resident’s relatives to participate in their care. Staff and residents spoken with confirmed that most residents participated in menu planning and shopping. Meals were prepared and cooked by the care staff and the more independent service users were given the opportunity to assist. Staff had undertaken food hygiene training and procedures were in place to ensure that food was stored, prepared and cooked safely. The weight and nutrition of residents was monitored and those spoken with confirmed that they enjoyed the meals provided. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 14 The home provided a relaxed, comfortable and homely environment. Residents were encouraged to be as independent as possible and can assist if they wish with tasks such as the cleaning, laundry and cooking. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21 (Young Adults) and 8, 9, 10 & 11 (Older People). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to have their personal and health care needs met. They can also expect to be protected by the homes procedures for the handling and administration of medicines. Further more, residents are assured that at the time of their death, staff will treat them and their family and friends with care, sensitivity and respect. EVIDENCE: Observations made during the inspection and feedback from social and health care professionals confirmed that residents have their privacy and dignity Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 16 respected. One health care professional said: “This is always high on the agenda”. Evidence indicated that support was provided in a way that respected residents as individuals. Care plans included residents preferred routines, likes and dislikes. Staff were attentive to residents at all times. Discussion with the manager, records examined and surveys returned indicated that the home works closely with health care professionals to ensure residents personal and healthcare needs were met. Comments received in surveys included: “The service does not hesitate to seek advice from generic and/or specialist health services at the appropriate time”. “Fern lodge provides an excellent service and supports clients with some complex physical and psychological needs. The service always rises to each new challenge”. “Provides individual & timely support, Promotes and facilitates good health”. “Overall I find the care given at Fern Lodge extremely good. Staff are always professional in their approach”. “Fern Lodge has provided a fantastic, consistent and professional approach to caring for one of my clients. With their dedication and determination the clients health and social needs have improved dramatically”. “There is generally a good rapport between Fern Lodge & the local LD health team which in turn works for the good of the client”. The home had appropriate procedures in place for the safe handling and administration of medication. Medication was supplied by the local pharmacy in Monitored Dosage Systems (MDS) and stored within locked cupboards in residents own rooms Staff responsible for the administration of medications had been suitably trained and Medication Administration Records (MAR sheets) were in place and completed satisfactorily. Information submitted to the Commission confirmed that the home has supported previous residents appropriately in the end stages of their life. Residents that suffered the loss of two fellow long-term residents before the last inspection were still being actively supported in their bereavement. Photographs of their late friends were displayed. One resident had been supported to plant a rose bush in the garden as a memoriam that they could see from their bedroom window. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 (Young Adults) and 16,18 & 35 (Older People) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to have their complaints and concerns listened to, taken seriously and acted upon. Furthermore, they can expect to be safeguarded by the procedures in place to protect them from abuse. EVIDENCE: The Commission had not received any complaints or concerns about the service since the last inspection. The manger also confirmed that there had been no complaints made directly to the home. Feedback from surveys indicated that the home listens to complaints and takes them seriously. The manager advised that any matters raised are dealt with quickly and usually resolved before they reach the complaints process. The homes complaints procedure was displayed in a suitable format that included pictures and symbols. It was noticed that the procedure did not include the timescale for responding to a complaint. The manager confirmed that complaints are dealt with within twenty-eight days and agreed to add that detail to the procedure. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 18 The homes Adult Protection policy had been updated in April 2007 and included the contact numbers for reporting concerns and allegations. It was used in conjunction with the homes Whistle Blowing Policy, the Local Authority procedures for safeguarding adults and the Department of Health ‘No Secrets’ guidelines. The home had not received any allegations of abuse or made any safeguarding referrals. There was evidence that staff had received appropriate training about recognising the signs and symptoms of abuse, responding to disclosures and reporting concerns. Discussion with the manager, observation on the day of inspection and records seen demonstrated that physical and verbal aggression by a resident is understood and dealt with appropriately. Mostly relatives or solicitors handled resident’s financial affairs although the manager was appointee for two residents benefits. Appropriate lockable facilities were provided for residents to keep their personal money and records were kept and audited regularly. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 & 30 (Young Adults) & 19, 20, 21, 22, 23, 24, 25 & 26 (Older People) Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment that enables residents to express their individuality and promotes their independence. EVIDENCE: Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 20 Fern Lodge is a purpose built bungalow that provides high quality attractive and spacious accommodation. Individual accommodation included a bedroom with en suite, direct access to the garden, a kitchenette and a private sitting area. Each of the resident’s rooms was decorated and furnished to a high standard and personalised to each individual. The quality of the private accommodation enabled the home to support residents in a person centred, needs led way. Sensory areas, made up of various coloured lights and textures were set up in private and communal areas of the home to enhance stimulation for those residents with sensory needs. Moving and handling and specialist equipment was in place and maintained in safe working order. Communal areas included a lounge and separate dining room. Both were comfortable, nicely decorated and furnished with matching furniture that was domestic in style. A large attractive conservatory had also just been built onto the front of the home. It was accessed through the dining area and overlooked the garden and entrance to the home. The conservatory was not in use at the time of inspection as the carpet was due to be laid later in the week. However, it was clearly going to significantly improve the communal space and facilities already available. A rolling programme of redecoration and maintenance was efficiently managed by the manager and maintenance person. The maintenance person carried out routine health and safety checks and day-to-day repair work of the premises, including electrical personal appliance testing. The home was clean, light, and airy and there were no unpleasant smells. Appropriate laundry facilities and infection control procedures were in place. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36 (Young Adults) and 27,28,29,30 & 36 (Older People) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the homes recruitment procedures. Further more they can expect staff to be trained, skilled and sufficient in numbers to meet their needs. EVIDENCE: Records examined, feedback from staff and health care professionals and observations on the day of inspection confirmed that the home has an effective staff team with sufficient numbers and skills to meet resident’s needs. Staff spoken with enjoyed working in the home and demonstrated a good Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 22 understanding and commitment to the service users within their care. They were aware of their individual roles and responsibilities and felt they received good support and development opportunities from the management. The examination of four staff files evidenced that the home had improved their recruitment practices since the last inspection. Recruitment records evidenced that Enhanced Criminal Record Bureau Checks had been undertaken and there was also evidence of verification of identity, copies of work permits where applicable, and a minimum of two written references. The homes AQQA informs us that they have a well trained and dedicated staff group who specialise in the care of people with a learning disability. It confirms that staff undertake a full Skills for Care Induction programme and undertake National Vocational Qualifications (NVQ’s). Records seen and discussion with the manager confirmed that over eighty percent of staff had completed or were working towards a National Vocational Qualification (NVQ) in care at level 2 or above. Staff spoken with and records seen confirmed that the home provides appropriate induction programmes and on going training. Comments included “We get lots of training” and “Jenny’s really hot on training”. Training provided included Moving and Handling, Administration of Medication, Infection Control, Food Hygiene, First Aid, Protection of Vulnerable Adults, Health and Safety, Diabetes Awareness, Non-abusive Psychological and Physical Interventions, Dementia Care and Fire training. Feedback from social and health care professionals indicated that the home sometimes employed young and inexperienced care workers. Never the less evidence indicated that this had not had a negative impact on outcomes for residents (See sections of the report for the outcome groups Individual Needs and Choices, Lifestyles and Personal Healthcare and Support). At the time of this inspection there were no care workers employed under eighteen years of age. There was a specific job description in place for young workers under eighteen that confirmed they must not be responsible for delivering personal care. Discussion with the manager indicated that they were clear about the support a young worker would be likely to need and the supervisory arrangements that should be in place. Staff spoken and observations made confirmed that the manager had a ‘hands on’ approach to managing the home. They frequently worked alongside care staff providing some practical supervision through daily contact. Staff meetings also provided additional opportunities to discuss concerns or care related issues. Records examined also confirmed that progress has been made with the frequency of more formal individual supervision sessions. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 (Young Adults) and 31,32, 35 & 38 (Older People). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 24 Overall the home is well managed and the health, safety and well being of residents and staff is promoted and protected. EVIDENCE: The Registered Manager had successfully completed the Registered Managers Award and evidenced a commitment to ongoing training and development for themselves and the staff team. Discussion with the manager throughout the day demonstrated that they had a sound knowledge base and a good understanding of the residents psychological, physiological and healthcare needs. Staff spoken to during the inspection were highly committed and spoke positively about the management style and the support they received from the registered and deputy manager. Quality assurance and monitoring systems were in place and included the use of surveys to gather feedback from a range of professionals, the staff team and the residents. Since the last inspection the residents survey had been developed to include pictures and symbols. Discussion with the manager about the homes quality assurance processes confirmed that although they had made good progress in this area they did not have a process that clearly identified the outcomes for residents and the action that the home proposed to ensure continuing improvement. These findings were reflected in the information provided in the homes AQQA. The AQQA did not consistently evidence what the home did well, what areas needed improvement and how they intended to improve. However a lengthy discussion with the manager demonstrated that they were keen to develop systems to ensure that in the future there is good evidence of planning, action and review. Records relating to health and safety and the maintenance of equipment were in order. These included electrical and gas safety certificates and fire safety and system checks. Staff had undertaken appropriate training in areas such as infection control, food hygiene and moving and handling. Observation on the day of inspection was that the home was safe and well maintained. Discussion with the manager, examination of documents and observations made evidenced that the home had appropriate policies and procedures in place and these had been reviewed since the last inspection. Records required were also in place although they were at times disorganised or not filed and required the manager to locate them. Discussion with the manager about records and administration highlighted the fact that the home did not have administrative support. In addition to routine management responsibilities the manager undertook tasks such as staff pay. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 25 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 4 28 4 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT Standard No Score 37 3 38 3 39 2 40 3 41 2 42 3 43 X 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fern Lodge Score 3 3 3 3 DS0000017715.V356001.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard YA39 YA41 Good Practice Recommendations The home should identify and explore a wider range of quality assurance methods and tools to enable them to improve in this area. The recruitment of an administrator should be considered to ensure that the homes records are well maintained and kept in good order. Fern Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Lodge DS0000017715.V356001.R01.S.doc Version 5.2 Page 28 - 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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