Inspection on 19/07/05 for Fernbank

This inspection was carried out on 19th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 12/09/06

Fernbank 02/02/06

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 Diane Peel Announced 19 July 2005, 09.30am, V230372 th 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 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 H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Fernbank Address 25-27 Gratwicke Road, Worthing, West Sussex, BN11 4BN Telephone number Fax number Email 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 OConnell CRH 32 Category(ies) of OP-32 registration, with number of places Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 01/02/05 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 H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 6.5 hours on the 19th July 2005. The inspector arrived at 9.30 am and was welcomed by the manager of Fernbank and three residents sat in the foyer of the home A full tour of the home took place and the majority of the twenty-five residents living at the home were met. Five residents were spoken with in depth to find out if they felt that their needs were being met. The inspector joined residents for lunch to sample the meal and observed musical entertainment provided by visiting entertainers. The care records of four residents were inspected during the visit along with other records, which showed how care needs are to be met. The records of three staff were also inspected and two staff were spoken with informally. Nine service user comment cards were returned prior to the visit to Fernbank all indicating that residents were satisfied with the facilities at the home and the standard of care provided. What the service does well: Fernbank provides a well-maintained homely environment for residents who commented that the home is comfortable and they feel safe living there. Care plans are clear and provide staff with the information, which they need to meet the needs of the residents. There is a low turnover of staff, which provides residents with consistency, and a team of carers with whom they can build up relationships and trust. The staff team treat residents as individuals and are able to assist them to maintain their dignity. Residents are offered choices in all aspects of daily living to promote independence. Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 6 Meals are varied, nicely presented, offer choice and are served in pleasant surroundings. Staff and residents spoken with all had confidence in the managers approach to running the home. What has improved since the last inspection? What they could do better: There have been improvements to the contract/ resident’s agreement, which sets out the terms and conditions of living at the home however the contract does not state the room to be occupied. To make sure that the home is safe for residents the management of the home must should consult with the Fire Officer to discuss the practice of wedging bedroom doors open. Some radiators remain uncovered and these should be covered by the time that the central heating system is switched back on for the winter. Details off events in the home, which affect the wellbeing of residents, are not being forwarded to the Commission for Social Care Inspection (CSCI). The manager will need to review and improve the systems of reporting such events to the CSCI. Please contact the provider for advice of actions taken in response to this Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 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 standard(s) 1,2,3,4,5 and 6 A service user guide provides information about the home and the service, which it offers to enable prospective residents to make an informed choice about moving into the home. Residents are assessed prior to moving into the home to make sure that the home can provide a care plan which residents or their families know will meet their needs. 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. EVIDENCE: A new Statement of Purpose and Service User Guide has been produced to provide accurate information about the service, which the home is able to offer and sets out the criteria for admission to the home. Information observed in care plans showed that a summary of care requirements is carried out prior to residents moving into the home. Once the Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 10 resident has been admitted to the home a further assessment is carried out which includes risk assessments. A sample contact was viewed during the inspection but it did not include the room number to be occupied. As the inspection process sampled care records the inspector is not assured that all residents have contracts. Residents spoken with about coming to live at the home all commented that a member of their families had found Fernbank for them. One resident who was staying at the home for a period of respite care said that her daughters had found the home and she had liked it so much that she didn’t want to go home. Intermediate care is not provided by the home although the home does offer periods of respite care. Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 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 standard(s) 7,8,9 and 10 The care planning system gives clear information to assist with all aspects of health, personal and social care needs. The medication at Fernbank is well managed, promoting good health. Residents are treated with dignity and their right to privacy is respected. EVIDENCE: Care plans examined were clear and gave staff the information, which they need to meet the needs of the residents in all aspects of heath, personal and social care. They had been reviewed regularly to show the changing needs of the residents. Daily progress notes are in use to monitor the heath and well being of residents and assessments are in place ensure the safe moving and handling of individual residents. Visits to residents by other heath care professionals are recorded and outcomes detailed. During the visit staff were observed to treat residents in a respectful and courteous manner. Staff were heard to respond to a resident who had become Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 12 distressed in a comforting, caring way, which provided the resident with reassurance. Medication records were observed to have clear recording systems and medication was observed to be stored in a well organised locked trolley. Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 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 standard(s) 12,13,14 and 15 The home provides a flexible lifestyle for residents which allows them to exercise choice and some control over their lives. Activities provided are regular and varied to suit resident’s preferences and abilities. Residents are able to have visitors and are encouraged to be part of the local community. Meals are well managed and provide choice and variation. EVIDENCE: All residents spoken with during this visit to Fernbank had positive comments to make about the flexibility of routines in the home. One resident explained that they were able to maintain independence whilst not having to worry about living alone and having to cook and clean. Another resident who had recently moved to the home talked about trips into Worthing and having a relative visit the home who was provided with overnight accommodation. The resident commented, “they are very open minded here for the benefit of the residents” One resident who was having a period of respite care at Fernbank commented that they liked being at the home and liked the company. She was making celebration cards for the forthcoming garden party to be held at the home. Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 14 Fernbank has a variety of activities taking place, which residents can choose to take part in. During the visit fifteen residents took part in a musical entertainment held in the lounge. The inspector was impressed with the standard of the entertainment and was encouraged by the participation from residents. Residents comments about the standard of food at the home varied but on the whole the majority of residents felt that food was of a good standard and provided plenty of choice and variety. The inspector joined residents for the main meal of the day. The meal was nicely presented and was of a good standard. Menus provided prior to the visit to the home show variety and choice. Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 The clear complaints procedure enables those using the service to have the confidence that their compliant will be responded to within a maximum of 28 days. Not all staff have attended adult protection training to ensure that they were fully aware of their responsibility to recognise and report abuse. EVIDENCE: The complaints procedure is available in the Service User Guide and on display in the entrance hall. It is clear and specifies how complaints should be made, with an assurance that any complaint will be responded to within 28 days. There have been no complaints made to the home or to the Commission for Social Care and Inspection (CSCI) since the last visit to the home. Fernbank has its own policies and procedures to safeguard residents from abuse in addition to the West Sussex Multi-Agency Policy for protecting vulnerable adults from abuse. Adult protection training was provided in 2004 and is scheduled to take place again in October 2005 but staff records viewed at this visit did not record that staff had attended last years training. A recommendation has been made that all staff attend adult protection training. Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25, and 26 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 EVIDENCE: The inspector visited all parts of communal and private accommodation. Fernbank was observed to be very clean and had a fresh appearance. It was well maintained and has homely touches to encourage residents to feel comfortable. A number of bedrooms on the upper floor are accessed by a stair lift. One resident spoken with who had a room on this floor told the inspector Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 17 that this was not a problem; they could use the lift without assistance. Limited access to this floor is outlined in the homes Service Users Guide. Residents spoken with in their rooms commented about their personal items, which they had on display. One resident remarked that “the cleaners come in every day, some days they do a more thorough clean, checking flannels and sheets”. Discussion with domestic staff confirmed that as bedrooms become vacant at the home they are usually redecorated (if they need to be) and given a thorough clean. It was observed that a number of vacant rooms had recently been redecorated; furniture in these rooms appeared to be new and had lockable drawer facilities. Some bedroom doors at Fernbank have locks to enable residents to lock their rooms when they wish. It was observed that in residents care records some residents had signed a statement to say that they didn’t want a lock on their bedroom door. There remain a number of radiators in the home, which do not have covers to protect residents from scalding when the central heating is on. A recommendation has been made that these radiators are covered before the central heating is switched back on. The bathrooms and toilets seen by the inspectors were clean and had grab rails to assist in the use of toilets. Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 The staffing numbers are set at level, which allows residents assessed needs to be met. Recruitment procedures safeguard and protect residents at the home. The staff-training programme provides staff with the majority of skills, which they need to do their job, and enables them to provide a reasonably safe environment for residents EVIDENCE: Staffing rotas observed at the visit and prior to the visit show that sufficient staff are employed with the appropriate skill mix to meet the needs of residents over the 24-hour period. One resident spoken with said” you can’t fault the staff. In the night if I can’t sleep there is always someone with a cup of tea or a word of encouragement”. Staff records viewed at this visit showed that there has been an improvement to the records kept. Records seen were in good order. There is a staff-training programme organised by the company. Records showed that staff attended training regularly and since the last visit to the home the majority of staff had attended dementia training, which had been a recommended at the last inspection. As stated in Standard 18 not all staff have attended adult protection training. Many staff working at the home now have an NVQ Care qualification and others are currently undertaking an NVQ. Whilst the current percentage does Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 19 not meet the target of fifty percent by 2005 it is anticipated that the percentage will be higher by the end of 2005. Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,37 and 38 The home is well managed providing leadership and guidance for staff. Environmental risk assessments are in place, which protect residents from the majority of environmental risks to their heath and safety. Management procedures do not ensure that all events affecting the wellbeing of residents is brought to the attention of the CSCI. EVIDENCE: All residents spoken with during the visit to the home spoke highly of the manager. The manager has more than two years experience in a manager and has completed an NVQ Level 4 in Care Management. The manager was not able to confirm that any progress had been made by the company to introduce a formal quality assurance system. The Responsible Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 21 individual has not provided the CSCI with Regulation 26 reports required to show regular monitoring of the homes practices. Some residents want their bedroom doors open. This matter should be discussed with the fire officer and appropriate measures taken to safeguard residents. The laundry room door has a self-closing device, which allows for the door to be left open. At the time of the visit it was observed that residents could have access to the laundry and washing powder had been left in an uncovered container in the unattended laundry room. There have been a significant number of accidents/ incidents involving residents, which have not been notified to the CSCI. The manager must review this practice and ensure that all incidents notifiable through Regulation 37 of the Care Homes Regulation are reported to the CSCI. During the visit it was observed that three bedroom doors were being wedged open and that a resident commented that she couldn’t find the rubber stopper for the door, indicating that this is the usual practice for some residents. This matter was discussed with the manager and a recommendation made that the fire officer is contacted to ask for advice. Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 2 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 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 1 1 x x 3 3 1 Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 23 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. 1. Standard 32,33 Regulation 26 Requirement Regulation 26 reports must be supplied to the CSCI in accordance with Regulation 26.5 (previous timescale of 1st June 2005 not met) A formal quality assurance system must be established (previous timescale of 1st June 2005 not met) All incidents affecting the welfare of residents must be reported to the CSCI as listed in Reg 37. Timescale for action 1st Sept 2005 2. 33 24.1 1st Oct 2005 1st Sept 2005 3. 8,38 37 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Fernbank Refer to Standard 2 18 25 38 38 Good Practice Recommendations The contract should state the room number to be occupied. All staff take part in Adult Protection training and staff records record attendence. All radiators are guarded by the time the central heating system is put on for the winter. The fire officer should be consulted with regard to the practice of wedging bedroom doors open. It is recommended that washing powder should be stored H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 24 in a container which has a lid when the laundry room door is open on the self closing device. Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Fernbank H60-H11 S14515 Fernbank V230372 190705 Stage 4.doc Version 1.30 Page 26 - 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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