Inspection on 28/11/05 for Fernbank

This inspection was carried out on 28th November 2005.

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 10/10/06

Fernbank 06/03/06

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 28th November and 5th December 2005 11:00 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.V265578.R01.S.doc Version 5.0 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.V265578.R01.S.doc Version 5.0 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) 01616264079 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.V265578.R01.S.doc Version 5.0 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 10th January 2005 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. Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the inspection five service users were interviewed, as was one staff member. Additionally discussions took place with the manager. The inspector also undertook a tour of the building and scrutinised a selection of service user and staff records as well as other documentation, including staff rotas, medication records and the complaints log. ‘Comment cards’ were received from ten service users and one relative. This inspection was unannounced on the first day. The second visit was made by appointment, to talk to service users and staff. What the service does well: What has improved since the last inspection? The appropriate levels of care and support identified at previous inspections has been maintained. Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 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. Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 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.V265578.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5. Each service user has a copy of the service user guide, but not all service users are given fully completed terms and conditions of their stay. Service users have their needs assessed and do not move to the home unless it is believed their needs can be met. EVIDENCE: A selection of service users’ files was scrutinised. All service users had a copy of the home’s statement of purpose and service user guide. Each service user guide contained a sample copy of the home’s terms and conditions, although not all were fully completed, signed or dated. All files seen had a copy of an assessment undertaken by an appropriate professional. There was also evidence that those assessments were complemented by Fern Bank’s own assessment prior to the prospective service user being offered a place at the home. One service user confirmed that the registered person had visited him before he came to the home. Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 Page 9 Discussions with the manager and registered person have indicated that careful consideration is given to the suitability of each new service user moving to the home. It was reported by the manager that the home’s suitability is confirmed by the registered person to the referring professional. However, the manager also reported that service users are not routinely given a written confirmation of the home’s suitability to meet their needs. It is the policy of the home that service users are able to visit before making a decision to move in. One service user confirmed that he had moved in for a trial period, after which he had decided to stay. Fern Bank does not offer intermediate care. Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 and 10. Each service user has a written plan of care. Not all plans are reviewed with sufficient regularity nor updated following a review. Medication was appropriately stored and administered. Service users’ privacy was upheld. EVIDENCE: In the random selection of service users’ files scrutinised, all had a written copy of a care plan. Documentary evidence of the involvement of the service user in the formulation of the care plan was inconsistent. Similarly there was documentary evidence of the regular review of the plan in some, but not all, files seen. Fern Bank is a relatively small home with a consistent staff steam. Staff confirmed that there was verbal handover at each shift change. Discussion with the manager and staff indicated that these mechanisms meant that staff were aware of the changing needs of the service users, even though they were not always well documented. In one file, the care plan identified the need for Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 Page 11 a service user to have hourly checks which should be recorded. This was not being done. The manager and staff confirmed that was because it was no longer felt to be necessary, however the written plan had not been amended. This was indicative of too great a reliance on verbal information, which while important, must be backed up by accurate documentation. Several service users were spoken to during the inspection. None expressed negative views about the care they received and most were very positive. One service user reported that Fern Bank was “a nice home, the staff are good and treat you well.” Another said “the staff are great with me.” Fern bank uses a pre dispensed monitored dosage system to administer service users’ medication. Medication was seen to be stored appropriately. A sample of medication administration records was examined, which presented as being appropriately maintained. All service users’ comment cards which were returned reported that service users’ privacy was respected. Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Service users are able to participate in a range of outings organised by the home. Service users are able to exercise choice and control over their lives within the context of communal living. There are no unreasonable restrictions on visitors or the maintenance of contact with people outside of the home. The provision of food is good. EVIDENCE: Service users spoken to were positive about the range of activities and outings available. Service users were observed helping with the laying of tables and clearing up after a meal. Service users confirmed this was a voluntary undertaking and they enjoyed participating in the process. A weekly meeting is held by the registered person, to which all service users are encouraged to attend. At this meeting the week’s forthcoming menu and social outings are discussed. Service users are free to access any community based activity and frequently visit local pubs. At the time of this inspection several service users were getting ready for an outing to a restaurant, which was reported by one service user as happening Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 Page 13 every few months. Service users also confirmed that they went to Blackpool earlier in the year. There were no unreasonable restrictions on visitors, although many service users receive infrequent visits. The manager reported that service users could receive telephone calls. There was documentary evidence of one service user having frequent telephone calls from a friend. Service users spoken to confirmed that they could exercise choice and control over their lives within the context of communal living. One meal was sampled during the inspection. This was pleasantly presented and tasty. Service users spoken to were positive about the provision of food at Fern Bank. Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Service users are confident that complaints are dealt with appropriately. Service users are protected from abuse or exploitation. EVIDENCE: Fern Bank has an appropriate complaints procedure. Service users spoken to expressed the view that they were able to talk to staff and management about any complaints they may have, and that they would receive an appropriate response. The carer spoken to also believed that any complaints would be appropriately dealt with. Inspection of the complaints log showed that no complaint had been recorded since the previous inspection. Discussion with the registered person, manager and service users, indicated that this was an administrative oversight as some complaints had been made and swiftly resolved. As with some other aspects of documentation identified at this inspection, this failure to keep full records, while not detracting from appropriate outcomes for service users, served to undermine the transparency and accountability of the service. Service users spoken to expressed the view that they were safe at Fern Bank. Similarly all comment cards returned, where the service user expressed a view, indicated that they felt safe at the home. Service users reported being treated well by the staff team. The staff member interviewed confirmed that she had received training in connection with issues Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 Page 15 around the protection of vulnerable adults. She also demonstrated an understanding of the whistle blowing policy of the home. Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 21, 23, 24, 25 and 26. Fern Bank presented as well maintained, clean, tidy and odour free throughout. Bedrooms were appropriately personalised. Appropriate communal areas, toilets and bathrooms were available for all service users. 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 furniture, were identified. Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 Page 17 A selection of bedrooms was seen. These presented as clean, tidy and appropriately personalised. Several bedrooms are double rooms. Service users spoken to expressed satisfaction with the accommodation. The home has three lounges and a dining room. One lounge is the dedicated smoking area. 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 and service users who were asked. Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30. Adequate numbers of appropriately trained staff are provided. The procedure for vetting staff is not undertaken with sufficient rigour. EVIDENCE: The staff rota for the week beginning 21st November 2005 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. One ‘relatives comment card’ was returned. This relative expressed the view that there were always sufficient numbers of staff on duty. A selection of files relating to staff who had been employed since the previous inspection was scrutinised. These did not all contain evidence that appropriate vetting had been undertaken before the staff member commenced employment. This particularly related to gaps and anomalies in connection with previous employment for which there was no explanation recorded. In one example seen the application form appeared to have been completed after the person had started work. Discussion with the manager and a staff member indicated that a range of training opportunities was available for staff. While much of this is ‘in house’, staff were confident that external training was available as required. Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 Page 19 Appropriate NVQ training was supported by the registered person and manager. All service users spoken to during the inspection were positive about the attitude and approach of the staff. Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 and 38. The manager is appropriately experienced and maintains and open and responsive environment in the home. Routine testing of some equipment in the home is not undertaken sufficiently regularly to ensure its effective working. 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 completed an appropriate NVQ IV and commenced the Registered Managers Award. The home runs a weekly meeting where service users are able to express their views on the running of the home. All respondents to the ‘service user comment cards’ stated that they liked the home, were well cared for and Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 Page 21 treated well. Service users spoken to described the staff and management as open and approachable. 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. Records indicated that the routine testing of the fire detection and alarm system had not been undertaken in the previous three months. Similarly the freezer temperatures had not been recorded in the previous few weeks. Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 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 3 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 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 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X X X 2 Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 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 OP2 Regulation 5 Requirement The registered person must ensure that all service users have an appropriately dated contract or terms and conditions. These documents must be signed by the service user unless they do not have the capacity to do so. The registered person must ensure that service users’ plans of care are appropriately reviewed and updated. The registered person must ensure that all complaints are recorded. The registered person must ensure that prospective staff are fully vetted before starting employment. The registered person must ensure that all equipment, including fire detection and alarms, are appropriately monitored, and that accurate records are kept of the monitoring and maintenance. Timescale for action 01/02/06 2 OP7 15 (2) 01/03/06 3 4 OP16 OP29 22 19 01/02/06 01/02/06 5 OP38 13 and 23 01/02/06 Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 Page 24 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 Refer to Standard OP7 Good Practice Recommendations The registered person should ensure that service users sign to confirm their involvement in the care planning process, unless they do not have the capacity to do so. Fernbank DS0000005506.V265578.R01.S.doc Version 5.0 Page 25 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: 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 DS0000005506.V265578.R01.S.doc Version 5.0 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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