Inspection on 12/09/06 for Fernbank

This inspection was carried out on 12th September 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 02/02/06

Fernbank 19/07/05

Fernbank 01/02/05

Fernbank 24/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Fernbank 25-27 Gratwicke Road Worthing West Sussex BN11 4BN Lead Inspector Mrs D Peel Unannounced Inspection 10:00 12 September 2006 th 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 DS0000014515.V302351.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 DS0000014515.V302351.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fernbank Address 25-27 Gratwicke Road Worthing West Sussex BN11 4BN 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) 01903 202821 South Coast Nursing Homes Limited Mrs Susan O`Connell Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd February 2006 Brief Description of the Service: Fernbank is a care home able to accommodate up to thirty-two service users who are over the age of sixty-five of age. The premises are situated in a quiet residential area of Worthing close to shops and other facilities. The accommodation is arranged on two main floors that are served by a passenger lift/ stair lift and an additional mezzanine floor, which is accessed by a short flight of steps. The majority of bedrooms have en suite facilities. There is ramped access to the rear garden. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by Mrs Diane Peel on the 12th September 2006. The intended outcomes for 32 standards were assessed; these included the key standards for care homes providing a service to older people. Prior to the visit to the home the inspector reviewed information provided by the manager in a pre inspection questionnaire completed at the request of the inspector some weeks prior to the visit and other information received from the provider since the last visit to the home on the 2nd February 2006 A case tracking exercise for four residents was undertaken to look at how the assessed needs of this group of residents with diverse needs were being met. Residents were spoken with to gain some information about what it is like to live at the home. All comments made were positive and commended attention and care of the staff and management of the home. Two residents questionnaires were returned to the inspector prior to the visit to the home which made positive comments about the home. The inspector visited all communal and private accommodation, speaking with residents who preferred to spend time in their own rooms and viewing the provision of homely accommodation. Staff were observed assisting and interacting with residents in the dining room and lounge. Residents were spoken with meaningfully and staff demonstrated respect and recognition of individual residents needs. The records of four staff were inspected and staff were spoken with informally during the visit. Samples of other records required to be kept by the home were viewed during the visit to ensure that the provider is meeting their obligations with regard to the administration of the home. The current scale of fees being charged at the home is from £400 to £550 per week. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? There is a continued programme of redecoration of bedrooms within the home. Furniture is being replaced as bedrooms are being redecorated. The outside of the property is being re painted to give it a fresher appearance. Care plans have now been replaced with a more user friendly versions which residents are contributing to. Staff records have improved and now include required documentation . A formal quality assurance system is now in place which surveys the views of residents, their families and friends to measure how successful the home is at meeting its aims and objectives and the statement of purpose of the home. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 7 Regulation 26 reporting is now being carried out by the company to show that they monitor the service. 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. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 8 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 DS0000014515.V302351.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5,6 Prospective residents, their relatives and friends have an opportunity to visit the home to look at the facilities available and assess its suitability before moving in for a trial period. Residents are assessed prior to moving into the home to make sure that the home can meet their needs. Outcomes for residents are good. EVIDENCE: Fernbank has a Statement of Purpose and Service User Guide, which describes the facilities and services available at the home. Residents returning questionnaires to the inspector prior to the visit to the home reported that they felt that they had enough information about the home before they decided to move in so that they could decide if it was the right place for them. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 10 One resident returning the questionnaire had stayed at the home for a period of respite care on a previous occasion and this had helped them to make their mind up about moving to the home as a permanent resident. Another resident spoken with in the privacy of their room stated that they were at the home for a holiday and had stayed for a period of respite care previously. They commented that they would have no reservations about moving to the home permanently if they should need to. Other residents spoken with commented that their relatives had assisted them to find a home. Some had visited a number of homes before making a decision about moving to Fernbank. Fernbank does not offer intermediate care. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Systems for care planning give clear information to assist with all aspects of health, personal and social care needs. The homes medication procedures ensure that medication is well managed. Staff treat residents as individuals, recognising their need to be treated with respect and that their right to privacy is maintained. Outcomes for residents are good. EVIDENCE: Since the last visit to the home the home has completed the introduction of a new care planning system which the organisation has provided to ensure that all the homes within South Coast Nursing Homes Limited have a consistent approach to care planning. The four care plans viewed at this visit had been developed from a detailed assessment of need. The care plans had been reviewed monthly and had been signed by the resident at each review to show their agreement to the plan. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 12 Plans were informative, identified problems, set goals and had expected outcomes. They explained what staff should do to care for that individual resident without taking away any independence, which that resident might have. An example of this was that it was identified in one persons care plans that they wished to remain independent with personal care tasks for as long as possible. It stated that they “liked to wash and dress themselves, although staff should assist if requested.” Discussion with the resident confirmed that they wanted to be able to take care of personal tasks in the morning but was able to ask staff to help with “pulling up trousers” and “felt safer if staff help them have a bath”. They said, “I like being fussed over by staff.” Care records and daily care notes record any changes in the heath and welfare of each resident. They record any visits by medical professionals and outcomes to these visits. Residents returning questionnaires to the inspector commented that they felt that they received the medical support, which they need. One resident stated, “the district nurse visited daily to do a dressing.” The home has a medication policy, self-administration of medication and a homely remedies policy, which were observed during the visit. The inspector observed the secure storage and administration of medication during the visit to the home to see if the policy was being followed. Records of medication administration were viewed for the four residents who were part of the case tracking exercise. These were observed to be completed clearly and up to date with no gaps in recording identified. Residents spoken with in the privacy of their room were of the opinion that they are encouraged to maintain their independence for as long as they can and that staff treat them as individuals, treating them with respect and dignity. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The home has flexible routines which allows those who are able, to exercise choice and some control over their lives. Activities are offered and residents who are able are encouraged to be part of the community. Residents are encouraged to maintain contact with their family and friends so that they so that they can satisfy their social and emotional needs. Home cooked food is provided to a good standard with choices of alternatives available. Outcomes for residents are excellent. EVIDENCE: Residents spoken with at this visit were complimentary about the flexibility of the home. Whilst visiting residents in their rooms the inspector discussed routines and activities with residents. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 14 One resident told the inspector that they would be going by taxi to the train station to join a coach, which would take them to Henfield for lunch with other members of the arthritis club. This resident also spoke about the various craft activities, which they did to keep occupied, this included making cards, knitting and sewing. At the time of the visit they were knitting dolls clothes. This resident said that they liked living at Fernbank “ when you weigh it up its better here because you are not on your own. I don’t like being on my own at night.” One resident told the inspector that they were going to either to Arundel or down to the sea front at Worthing that afternoon with a friend, depending on the weather. At lunchtime a resident was heard to ask a member of staff if she had ordered a taxi for her. She told another resident that she was going out to meet a friend. The organisations own quality assurance results shown to the inspector show that the majority of residents felt that the activities provided by the home were either good or acceptable. Information provided to the inspector prior to the visit state that activities provide include: Bingo, professional sing a longs, music for heath, outside shows, crosswords, poetry mornings, visits from local schools for concerts. Menus provide prior to the day of the visit showed variety of food offered. The inspector joined residents for the main meal of the day, which was fish pie with fresh broccoli and cauliflower. The inspector had the alternative of a salad with a Jacket potato. Desert was either, cherry cheesecake, strawberry mousse followed by cheese and biscuits and tea or coffee. One resident spoken during the visit said “ I cant speak highly enough of the food. If you don’t like something the staff ask you what you would like instead.” The organisations own quality assurance results shown to the inspector show that the majority of residents felt that the menu offered and food provided was of an excellent standard. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The complaints procedure enables those using the service to have the confidence that their complaint will be responded to within a maximum of 28 days. The homes adult protection procedure is clear and residents are protected by arrangements in place to protect residents from being placed at risk of harm or abuse. Outcomes for residents are good EVIDENCE: The complaints procedure is on display in the entrance hall for residents and visitors to see. Residents spoken with during this visit were aware told the inspector that they always raise any concerns, which they have directly with the manager or the deputy manager. Resident surveys returned to the inspector prior the visit reported that the resident knew how to make a compliant. There had been no complaints recorded in the complaints record book since the last visit to the home and there have been no complaints made to CSCI about the home since the last visit in February 2006. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 16 Fernbank has its own policies and procedures to safeguard residents from abuse in addition to the West Sussex Multi Agency policies and procedures. The manager told the inspector that Adult Protection training for staff is on going throughout the company to ensure that all staff attend. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 The home is clean and residents have a comfortable, homely environment to live in. Bedrooms are comfortable and meet the needs of the residents. Residents are encouraged to contribute to making their bedrooms their own by having their own personal possessions around them. The home is well maintained and provides a reasonably safe environment for residents to freely move around in. Outcomes for residents are good. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 18 EVIDENCE: Since the last visit to the home in January 2006 the painting of the exterior of the building has commenced. During this visit to Fernbank the inspector visited all parts of communal and private accommodation. Fernbank was observed to be clean and the environment is homely. There is an ongoing improvements to bedrooms as they become vacant recently redecorated bedrooms have new furniture, which includes a lockable cupboard. Some residents have chosen to have a lock on their bedroom door whilst records show that other residents have opted to not have a lock fitted. The manager confirmed that the fire officer had visited since the last inspection by CSCI and said that as far as she was aware all requirements made by the fire officer had been carried out. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Staffing levels at the home are meeting the needs of the residents living at the home. Recruitment procedures safeguard and protect residents at the home. Staff have taken part in training and Vocational Qualifications to maintain their skills and ensure that residents are safe. Outcomes for residents are good EVIDENCE: Duty rotas provided by the provider at the inspector’s request some weeks prior to this unannounced visit to the home showed that there are care staff on duty throughout the day and night. They are supported during the daytime by kitchen and domestic staff. During this visit it was observed that staff were readily available to attend to residents needs when needed. Staff records and information provided by the manager of the home prior to the visit about the qualifications of staff show that just over 50 of care staff have an NVQ qualification. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 20 The records of four staff were examined during the visit to see if recruitment policies of the home were being followed and to ensure that those employed had Criminal Record Bureau Clearance and Protection of Vulnerable Adult clearance. Records seen were organised well and had all information required. The inspector discussed training opportunities with a member of staff who had just started working at the home at the last visit in February 2006. This person was able to confirm that they had attended training, which had helped them to gain the skills to do the job. The organisation has an ongoing training programme which staff from all the homes within the company attend. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37,38 Residents have the confidence that they live in a home, which is run and managed by a competent person. Quality assurance systems are now in place to ensure that the views of residents, their families and friends are sought to measure how successful the home is at meeting its aims and objectives and the statement of purpose of the home. Resident’s financial interests are safeguarded by policies and practices within the home. Environmental risk assessments are in place, which protect residents from the majority of environmental risks to their heath and safety. Outcomes for residents are good. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 22 EVIDENCE: Residents spoken with were aware of the management structure of the home and had positive comments to make about the manager. One resident spoken with said, “ matron is very good. I cant speak highly enough of her.” The manager has the relevant qualifications and experience to run the home and together with the deputy manager provide strong leadership for the team. Since the last visit to the home a quality assurance policy has been introduced which is providing the manager with information about how residents feel the home meets their needs. Outcomes observed by the inspector were good and excellent in most areas considered. Resident’s monies are overseen by their families and advocates. Fernbank then invoices resident’s families and advocates for any additional expenditures, which are not covered by the fee, paid. The manager has confirmed that the fire officers requirement have now been carried out. No other heath and safety issues came to the attention of the inspector at this visit. Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 23 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 3 X 3 3 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 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 3 Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 24 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. Refer to Standard Good Practice Recommendations Fernbank DS0000014515.V302351.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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. 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