Inspection on 06/02/06 for Fern Lodge Nursing Home

This inspection was carried out on 6th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Nursing Home 08/05/07

Fern Lodge Nursing Home 19/08/05

Fern Lodge Nursing Home 01/02/05

Fern Lodge Nursing Home 19/07/04

Fern Lodge Nursing Home 05/02/04

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

CARE HOME ADULTS 18-65 Fern Lodge Nursing Home 5 Eversley Park Chester Cheshire CH2 2AJ Lead Inspector Jayne Telfer Unannounced Inspection 6th February 2006 09:00 Fern Lodge Nursing Home DS0000018746.V274183.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 Lodge Nursing Home DS0000018746.V274183.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 Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Fern Lodge Nursing Home Address 5 Eversley Park Chester Cheshire CH2 2AJ 01244 372288 01244 374425 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) Fairhome Care Group (Fern Lodge) Limited Mr Marcus Fluegge Care Home 21 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (21), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (5) Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th August 2005 Brief Description of the Service: Fern Lodge is a Victorian, three storey semi-detached house close to the Chester city centre. The home is situated close to a main bus route and ten minutes walk from the nearest shops. The house is also within walking distance of the Countess of Chester Health Park. Bedroom accommodation is on three floors. The home does not have a passenger lift and access to all floors is via a staircase. The bedroom accommodation consists of four twin bedrooms and thirteen single rooms and there are en suite facilities in one of the single rooms. There is an external fire escape. Service users primary care needs are due to mental disorder and in accordance with statutory requirements there are Registered Mental Nurses on duty at all times. Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This short, unannounced inspection looked at standards which were not examined during the detailed inspection on 19th August 2005. A tour of the home was completed, files and other documents examined. Staff and residents were both observed and spoken with. Discussions took place with the Registered Manager. What the service does well: What has improved since the last inspection? All residents have their wishes with regard to death and dying recorded on their individual files. Fern Lodge Nursing Home DS0000018746.V274183.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 Lodge Nursing Home DS0000018746.V274183.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 Lodge Nursing Home DS0000018746.V274183.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): 4 Potential residents are given an opportunity to ‘test drive’ Fern Lodge before deciding whether to move in. EVIDENCE: Potential residents are usually referred to Fern Lodge through psychiatric services, often via hospital. Residents are offered a ‘progressive admission’ procedure. This means that they can come to visit the home, stay for a meal, then stay overnight and progressively increase the time spent at Fern Lodge until they are sure their needs will be met at the Home. Records are kept of these visits so that should an individual choose to move into Fern Lodge staff already have information about individual need. Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 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 the following standard(s): 8 and 10 Efforts are made to encourage residents to participate in the running of Fern Lodge. Records and documents are stored appropriately. Both the policies and practices of the Home reflect good confidentiality procedures. EVIDENCE: Resident’s meetings are held at Fern Lodge each month. All residents are able to attend these meetings and are encouraged to contribute to the agenda. A copy of the agenda was on display on the resident’s notice board and they are able to add new items to this. The Registered Manager stated that he was planning to share the minutes of these meetings with residents. It was discussed with the Registered Manager and staff members other ways of getting residents to participate in the running of the home and including a discussion and review of policies and procedures at resident’s meetings was recommended. Residents were observed to take part in the daily routines of Fern Lodge. Residents have responsibility to launder their own clothes and keep their room tidy, although staff will assist if necessary. Some residents participate in Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 Page 10 chores around the home such as emptying bins and laying tables, these residents are given extra money for doing this. Residents do not currently get involved with staff selection. It is recommended that the manager and staff discuss ways of doing this with residents. Fern Lodge has a clear policy regarding confidentiality and staff were aware of it’s content. Staff sign a confidentiality agreement. Fern Lodge has asked other visiting professionals to sign up to it’s confidentiality policy. Documents and records are stored securely and appropriately. See Recommendations 1 and 2. Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 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 the following standard(s): 11 and 15 Residents are given opportunities to improve life skills and access specialist services. Residents are supported and encouraged to maintain and develop personal relationships. EVIDENCE: Fern Lodge does not provide specific rehabilitation facilities, for example residents do not have access to the kitchen. Residents are encouraged to participate in specialist services outside the Home, for example supported employment. Some residents have an outreach worker, provided by the local psychiatric service, who will do specific rehabilitation work on an individual basis. One resident has recently moved to independent living following rehabilitation work with an outreach worker. Staff at Fern Lodge do work with residents around life skills, for example budgeting, social activities in the local community and household chores. Some residents were noted to have a fridge and microwave in their own room, as well as a kettle, and this promoted their independence. Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 Page 12 Residents are supported to fulfil spiritual needs by staff if required. Some residents attend local church services and a weekly visit and service from a Catholic Lay preacher is popular. Fern Lodge has an open visiting policy. The Registered Manager stated that relatives are encouraged to visit and are able to see residents in private, but often choose to sit in the lounge and chat to everyone. Some residents are in intimate relationships and this is supported by the staff team. One resident has been assisted by staff to obtain appropriate contraception. The Registered Manager stated that discussions had taken place with residents regarding appropriate relationships. Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 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 the following standard(s): 21 Fern Lodge will support residents who are ageing, ill or dying in line with a comprehensive policy. EVIDENCE: The Registered Manager stated that, where possible, residents remain at Fern Lodge until the end of their life. There had been instances, in the past, when the decision to move a resident to hospice care or to elderly care services had been deemed appropriate in order to meet individual need. However, in general, residents who are ageing, ill or dying are able to remain at Fern Lodge with support from staff and appropriate care services, for example Macmillan Nurses. Fern Lodge has a clear and comprehensive policy with regard to the ageing, illness and death of residents. This enables staff to give residents appropriate information about the long term care they can expect to receive. The Registered Manager described how funerals had gone from Fern Lodge and how he had participated in services for residents in the past. Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 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 the following standard(s): 23 There is clear information and procedures regarding the protection of vulnerable adults, and staff are fully aware of their role with regard to this issue. EVIDENCE: Fern Lodge has thorough policies and procedures regarding the protection of vulnerable adults. The policy details what is meant by abuse and describes ways of spotting whether abuse is occurring. This means that staff have a clear idea of the issues after reading the policy. The policy goes on to describe a clear and appropriate procedure for reporting and dealing with alleged abuse. There are notices in the Home, both for staff and residents, which advise about what to do if abuse is happening or suspected. The Registered Manager had a clear understanding of the procedures regarding the Protection of Vulnerable Adults (POVA) list. Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 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 the following standard(s): All standards were looked at during the previous inspection and found to be fully met. EVIDENCE: Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 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 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): 34 Fern Lodge has clear recruitment procedures and staff are employed following adequate identification and personal checks. EVIDENCE: Staff are recruited at Fern Lodge following appropriate procedures. One new staff member described the thorough checks which had been carried out prior to her starting work, including identification, references, Criminal Record Bureau check and the checking of her Nurses PIN (Personal Identification Number). Residents are not involved in staff selection, although the issue has been raised in resident meetings. The Registered Manager stated that he was planning to look at ways of getting residents involved in this. Once staff are employed they are given an induction pack, which they then work through. This contains a range of information and workbooks which provides the staff member with a clear understanding of their role and expectations at Fern Lodge. The induction pack is based on the Training for Care standards. The use of this pack benefits the residents as all staff are working with the same information and have the same baseline knowledge regarding life at Fern Lodge. Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 Page 17 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): 42 Fern Lodge has good health and safety policies and procedures. Safety checks and risk assessments are in place and these have been combined with individual resident’s risk assessments to ensure a safe environment for all. EVIDENCE: Fern Lodge has clear policies and procedures regarding health and safety issues. Fire safety is prioritised with training, risk assessments, precaution assessments and drills being thoroughly documented. Each room in Fern Lodge has a clear map showing means of escape should a fire occur. Risk assessments have been completed, and are regularly reviewed, for the environment, for example the kitchen. All risk assessments have been done together with individual resident’s risk assessments, for example smoking risk and fire risk, and this has led to a comprehensive analysis of risk. Appropriate documents are in place for relevant health and safety legislation, including Control of Substances Hazardous to Health Regulations (1999), Reporting of Injuries, Diseases and Dangerous Occurrence Regulations 1995, Gas and Electricity Safety regulations. Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 Page 18 Food is stored appropriately and procedures regarding control of infection are in place. Accidents and injuries are recorded and reported as appropriate. The staff induction manual includes information and training with regard to a wide range of health and safety issues. Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 4 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X 3 X 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X 3 X X X X X 4 X Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 Page 20 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. Refer to Standard YA8 YA8 YA28 Good Practice Recommendations It is recommended that residents are given opportunities to participate in the development and review of the Home’s policies and procedures. It is recommended that residents are involved in staff selection. The registered person should provide staff with separate staff facilities. Fern Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 Page 21 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 Lodge Nursing Home DS0000018746.V274183.R01.S.doc Version 5.1 Page 22 - 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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