Inspection on 10/10/06 for Fernbank

This inspection was carried out on 10th October 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

Fernbank 06/03/06

Fernbank 28/11/05

Fernbank 10/01/05

Fernbank 10/08/04

Similar services:

Chirnside House

Sunny Bank (P.R.S.) Ltd

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE Fernbank 93 Queens Road Oldham Lancashire OL8 2BA Lead Inspector Steve Chick Unannounced Inspection 10th October 2006 12:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fernbank DS0000005506.V316288.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. 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. Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fernbank Address 93 Queens Road Oldham Lancashire OL8 2BA 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) 0161 626 4079 F/P 0161 626 4079 Mr Mark Brakspear Mrs Margaret Lorraine Brakspear Mrs Lynda Bennett Care Home 23 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (10), Old age, not falling within any other category (13) Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service user up to 13 OP, up to 10 MD and up to 10 MD(E). Date of last inspection Brief Description of the Service: Fernbank is a detached Victorian property, registered to provide care for up to 23 people suffering from mental health problems and for people with disabilities resulting from Old Age. Their aim is to provide community based living with integration into the wider community, where possible, for those service users with mental health problems. Facilities include seven single bedrooms and eight double bedrooms. Several bedrooms have en-suite toilets. There are four lounges, one of which is the home’s smoking area, and one dining room. There was a well maintained garden to the front of the building and a smaller, secluded, patio garden area to the rear. The home is a privately run business owned by Mr and Mrs Brakspear. At the time of this visit Fern Bank charged between £313.88 - £425.00. Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection included an unannounced site visit to the home. All key standards were assessed. For the purpose of this inspection three service users were interviewed in private, as were two visitors to the home. Briefer discussions took place with a number of other service users Additionally discussions took place with the manager, the registered person and two staff members were interviewed n private. The inspector also undertook a tour of the building and looked at a selection of service user and staff records as well as other documentation, including staff rotas, medication records and the complaints log. What the service does well: What has improved since the last inspection? All requirements from the previous inspection had been effectively addressed and the good quality of care has been maintained. A new system has been introduced to further improve communication with health care professionals. Patio doors have been installed in the smoking lounge. Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5 and 6. Quality in this outcome area is good. Service users’ needs are appropriately assessed and they, or their representatives, are able to visit before a decision is made that the home is appropriate for them. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: A selection of service users files was looked at. All had a copy of an assessment undertaken by an appropriate professional. There was also documentary evidence that the registered person undertook their own assessment to complement the independent assessment. The registered person and the manager also confirmed that this was standard practice at Fern Bank. Service users who were asked also confirmed that the registered person had been to assess them, and they had the opportunity to visit and spend time at the home before making a decision to move in. Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 9 Fern Bank does not offer intermediate care. Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. Service users’ have individual plans of care which are regularly reviewed to ensure they reflect current physical needs. Service users have access to appropriate community based medial services to ensure their health needs are met. The home’s procedures in connection with administration of medication are implemented to the benefit of the service users. Practices in the home promote the dignity of service users. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: A selection of service users’ files was inspected. All had a written copy of a care plan and there was documentary evidence that the plan was reviewed at appropriate intervals. Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 11 There was also documentary evidence that service users had signed their personal care plan to confirm their involvement and agreement with the plan. Examples were seen of detailed risk assessments, including appropriate review and amendment. The registered person and manager reported that each day begins with a thorough discussion about the current needs of each individual. This was confirmed in discussion with staff and by looking at the notes used for that purpose. Service users talked to, expressed the view that staff involved them in the way their care needs were met. One service user said “[staff do talk about how best to assist. … [there is] nothing you can’t approach them about.” There was documentary evidence that service users had appropriate access to the full range of medical and para medical services available in the community. The registered person reported good relationships between Fern Bank and community and hospital based medical and psychiatric services. A newly introduced ‘health care file’ was seen. The registered person reported that this was successful in further improving communication with hospitals, offering a simple written communication process between the home and hospital. The registered person reported that the process for reviewing service users’ medication 6 monthly was generally working well, but that some GPs were less willing to be involved than others. Service users and staff spoken to were confident that appropriate medical support was accessed, when necessary and in a timely manner. The home uses a pre dispensed monitored dosage system to administer service users’ medication. Medication was seen to be appropriately and securely stored. A selection of medication administration records was looked at and presented as being appropriately maintained. The manager reported that no service user was administering their own medication, although, subject to a risk assessment, they could. Interactions between staff and service users presented as relaxed, with assistance and support being offered in a sensitive manner. Observation and discussion with service users visitors and staff indicated that service users were treated with respect, and that their dignity was maintained. All service users spoken to during the inspection were positive about their experience at Fern Bank. Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. An appropriate range of activities was available for service users to participate in if they wished, which enhanced their fulfilment and social stimulation. Service users are able to maximise their autonomy within the context of community living. The provision of food to maintain service users’ health and well being is good. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: A range of social activities are provided at Fern Bank. These include daily outings to the local park and a group activity – such as quizzes – in the afternoon. Additionally outings to pubs are organised four times a week and further afield on a regular basis. These activities were publicised on a notice board in the home, and confirmed as happening by staff and service users spoken to. Service users also confirmed that involvement in activities was entirely voluntary. Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 13 The registered person reported that service users were able to attend church services of their choice. Fern Bank has a policy of allowing visiting at any reasonable time. One visitor was spoken to during the inspection. They confirmed that there were no unreasonable restrictions on visiting. They also reported that they were made to feel welcome and ‘at home’ by the staff at Fern Bank. Service users spoken to during the inspection confirmed that they were able to exercise control over their lives, within the context of communal living. Observation and documentation, confirmed that the only restrictions on some service users being able to come and go from the building unescorted, were based on risk assessments, which were subject to continual review. Service users spoken to were positive about the provision of food at Fern Bank. One service user cited the food as one of the best things about the home. Another confirmed the availability of choice and that they could always ask for an alternative. Main meals were divided between ‘sittings’ to ensure service users who needed assistance could be effectively accommodated without any pressure on time. Staff were observed to be eating the same food as provided for the service users. The registered person reported that service users were involved in consultation about the menu on a weekly basis at the home’s meeting. Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17. Quality in this outcome area is good. Service users are confident that any complaint they may have would be dealt with appropriately. Service users are protected from abuse or exploitation by the homes policies and practices. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: Fern Bank has an appropriate complaints procedure which was not looked at during this visit. All service users who were asked, were confident that any complaint they may have would be dealt with appropriately. Similarly all staff spoken to were confident that any complaint would be appropriately dealt with by the management team. All service users who were spoken to presented as being confident about talking to staff. One service user said “[they are] nice staff – you can tell them what you want.” Only one complaint had been logged since the previous visit to the home. This presented as being well dealt with and appropriately recorded. Discussion with the manager indicated an understanding of the need to log all complaints and Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 15 not just formal ones. The home could give evidence for this, in so far as the recorded ‘complaint’ investigation was initiated after a passing comment (rather than a formal complaint), made to a member of Fern Bank staff by bar staff at a local pub, frequently visited by accompanied groups of service users. Fern Bank has an appropriate policy and procedure for the protection of vulnerable adults, which was not looked at during this visit. Staff who were interviewed demonstrated an understanding of the need to be vigilant to protect service users. They were also aware of their responsibilities under the ‘whistle blowing’ procedures. All service users and visitors who were asked, expressed the view that people were safe at Fern Bank. Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24 and 26. Quality in this outcome area is good. The home is appropriately maintained, decorated and cleaned to enable service users to live in a pleasant, safe and hygienic environment. Appropriate communal areas, toilets and bathrooms were available for the benefit of all service users. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: Fern Bank presented as being appropriately maintained and decorated throughout. A tour of the building was undertaken and no issues requiring remedial action in connection with maintenance of the décor, fabric or Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 17 furniture, were identified. The registered person reported that carpets in some communal areas were due to be replaced a few days after this visit. A selection of bedrooms was seen. These presented as clean, tidy and appropriately personalised. Several bedrooms are double rooms. Service users spoken to, including some who share a room, expressed satisfaction with the accommodation. The home has three lounges and a dining room. One lounge is the dedicated smoking area. Since the previous inspection patio doors had been added to the designated smoking lounge. This had improved ventilation and gave direct access to the rear garden. Fern Bank has well maintained gardens to the front and rear. Appropriate toilet and bathing facilities were available. The home presented as clean and tidy throughout, with no unpleasant odours. This was confirmed as the usual state of the building by staff, visitors and service users who were asked. Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. The numbers and skills mix of staff on duty promotes the independence and well being of service users. Recruitment and vetting procedures are predominantly effectively applied to minimise the risk to service users of inappropriate staff being employed. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The staff rota for the week beginning 2nd October 2006 was seen. This demonstrated that there were usually a minimum of three carers on duty during the day. (08:00 – 22:00) and two waking care staff at night (22:00 – 08:00). Additionally a domestic and a cook were on the rota. It was reported by the manager that of the sixteen carers, seven held NVQ II or higher, and two were undertaking that training. A random selection of certificates were seen to confirm this. A selection of files relating to staff who had been employed since the previous inspection was looked at. These provided evidence that appropriate vetting had been predominantly undertaken. However, one example was seen where the applicant’s full employment history was not recorded. Without this information Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 19 it is not possible to identify and explore the reasons for any gaps in employment. The manager had produced a ‘training matrix’ which showed which staff had received what training. This demonstrated a range of training opportunities for staff, including issue such as induction and foundation, health and safety, mental health and medication. Much training is offered ‘in house’, and at the time of this unannounced visit staff were receiving a session on dealing with challenging behaviour and a moving and handling update. Documentary evidence was seen of individual staff having a written ‘learning development plan’. Staff who were interviewed confirmed the availability of training opportunities, and management support to undertake training. Service users and visitors spoken to were positive about the attitude and competence of the staff team. One visitor described staff interactions with service users as “fabulous”, noting that staff always seemed to have time to spend with service users. One service user commented that staff “do everything to make sure you are well …” Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. The manager is appropriately experienced and qualified to run a care home for the benefit of service users. Quality Audit processes provide a framework to further improve services for the service users. Service users’ financial interests are protected by the home’s procedures and practices. Service users and staff are protected by the implementation of the home’s health and safety procedures. This judgement has been made using available evidence, including a visit to the service. Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager has many years experience as the manager of Fern Bank. Observation and discussion indicated that she had a good understanding of the needs of the service users. The manager reported that she has successfully completed Registered Managers Award, and her certificate to confirm this was seen. Service users spoken to described the staff and management as open and approachable. Staff presented as confident that they could seek support from any colleague, the manager or the registered person, and that would be forthcoming. The home runs a weekly meeting where service users are able to express their views on the running of the home. This was confirmed by service users spoken to, who also expressed the view that they could contribute to the meeting, and their views would be taken into account. Since the previous visit Fern Bank had produced an Annual Development Plan, which included feedback obtained from questionnaires completed by service users and their relatives. A selection of records relating to money held by Fern Bank on behalf of service users was looked at. The records presented as being appropriately maintained to safeguard the interests of the service users, with receipts for items purchased on behalf of service users and signatures to confirm when cash had been returned to service users. During the inspection no obvious risks to the health and safety of the service users were observed. Staff confirmed the availability of disposable gloves and aprons, as well as their mandatory use, to minimise the risk of cross infection. A selection of records relating to the routine maintenance of equipment, fire detection and alarm and hygiene procedures in the kitchen were seen. These records presented as being appropriately maintained. The manager reported that sufficient numbers of staff were appropriately trained in first aide to ensure at least one first aider was on duty at all times. Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 23 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. 1 Standard OP29 Regulation 19 Requirement The registered person must ensure that the vetting process for staff includes a full employment history to enable the exploration of the reasons for those gaps. Timescale for action 15/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Fernbank DS0000005506.V316288.R01.S.doc Version 5.2 Page 25 - 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. 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