CARE HOMES FOR OLDER PEOPLE
Fernbank Retirement Home 346 Heysham Road Heysham Lancashire LA3 2BW Lead Inspector
Unannounced Inspection 10:00 22 September 2006
nd 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 Retirement Home DS0000009699.V306803.R02.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 Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Fernbank Retirement Home Address 346 Heysham Road Heysham Lancashire LA3 2BW 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) 01524 854936 01524 851787 Deluxemain Limited Mrs Patricia Ann Goodger Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Fernbank Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service is registered to accommodate a maximum of 18 service users in the category OP (older people 65 and over) 11th November 2005 Date of last inspection Brief Description of the Service: Fernbank is situated on Heysham Road in Heysham and is registered as a home for elderly people of both sexes who are 65 years old and over. The home is registered to take a maximum of 18 residents. Accommodation is provided in single bedrooms. None of the bedrooms have an en suite facility. The home has two floors and a stair lift is available to access the first floor. Residents can use the lift independently if they wish. The home is adequately fitted and furnished. A portable television is provided for those who want one in their bedrooms. A small garden area and a car park are available at the rear of the home. The home is close to all the amenities but still too far for most of the residents to access on their own because of their frailties. There were 17 residents living at the home at the time of the inspection. Current weekly fee is £400 and additional extras like hairdressing, private chiropody and newspapers are paid for by the residents. Fernbank Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Under IBL (Inspecting for Better Lives) Fernbank was assessed as requiring a statutory key visit (inspection) between April 2006 and March 2007. An unannounced key site visit was carried out on 22nd September 2006 which lasted for 5 hours. The inspection was carried out against the National Minimum Standards for Older People. The inspection despite being an unannounced one was carried out in a friendly atmosphere and with the full cooperation of the staff and the residents. The registered manager has recently retired and a senior staff from another home within the company is currently managing the home. She has management experience and she will be applying to CSCI to be registered as the manager of Fernbank. At the time of the inspection, the manager elect was on leave and the home was being managed by the assistant manager. She is new to the home but has many years experience working at a senior level in another home. She was assisted by a senior care staff who has worked at the home for many years The managers from the other two homes within the company are providing support and assistance. During the inspection, some records were looked at and several residents and staff were spoken to. The residents were very positive about the care they receive and the way the staff treat them. Evidence about the inspection is usually gathered from the manager completing and returning a pre inspection questionnaire. Questionnaires are also sent to residents, the families and the staff. In this instance, no questionnaire was returned before the inspection. Therefore all evidence for this inspection is based on the actual site visit. During the inspection, case files of residents were looked at to check that records of needs and action taken were recorded and reviewed. Residents and staff were spoken to and their comments noted. Fernbank Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 6 There were 17 residents living at the home at the time of the inspection and there were 2 care staff, 1 senior carer, a cook and a domestic staff on duty. The staff were observed to be polite and attentive when talking and dealing with the residents. What the service does well:
All the residents said that they are well looked after and that they can do what they want. They said that there are no restrictions which stop them living independently within their own limitations. Residents were observed moving around the home quite freely and where assistance was required, this was provided by willing and cheerful staff. At the start of the inspection, the inspector found that most of the residents were in the 2 lounges and a few were sat in the porch. They were cheerful and chatty. They said that they are very well cared by the staff who are very kind and helpful. Ten residents completed a questionnaire provided by the inspector during the inspection. They all had positive comments about the home and the staff. Although the home has no registered manager, it is still being well run and managed. The person in charge at the time of the inspection although new to Fernbank, is well experienced and qualified. She was supported by a senior carer who has worked at the home for many years and other staff. A written pre admission assessment is done to ensure that residents admitted to the home are provided with care to meet all their needs. The staff had an awareness of equality and diversity and said that they treat everyone as equals and respect people’s different ways and habits. The staff benefit from a good standard of training. It was also pleasing to note that the home continue to meet the national target in NVQ (National Viocational Qualification) training, with 88 of carers holding the qualification at level 2 or above. This qualification is recommended by CSCI (Commission for Social Care inspection) for care staff. The staff were observed to be polite and respectful when talking and caring for the residents.
Fernbank Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 7 What has improved since the last inspection? 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 Retirement Home DS0000009699.V306803.R02.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 Retirement Home DS0000009699.V306803.R02.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): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good procedures to ensure that new residents are given appropriate information before choosing the home. EVIDENCE: The records of admission of the last resident admitted to the home were examined. The person in charge said that in this instance, information was obtained from the relatives who visited the home on behalf of the resident. The service user guide contains information about the home, the care provided, the charges, the staffing, the complaint procedure and other useful information.
Fernbank Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 10 A copy of the last inspection report is given to all new residents or their families. Existing residents can request a copy of the report if they want. A member of the management team always visit prospective residents who are unable to visit the home, either in their own home or in hospital. A written pre admission assessment is done at this stage to ensure that the staff of the home can meet the assessed needs. A form is used to record information under the heading of: personal care, vision, mobility, eating and several more areas relevant to the care of the resident. The staff said that they are given as much information about the new residents as possible so that they can provide tailor-made care. The person in charge said that referrals from residents of an ethnic background would be welcomed. She said that the management would find information about the ethnicity of the person, for example about their cultural, religious and dietary needs. The residents said that they were very pleased with the home and that they are very well cared for. They said that the staff are very good and that nothing is too much trouble for them. Intermediate care is not provided at this home. Fernbank Retirement Home DS0000009699.V306803.R02.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems in place to meet residents’ health care and personal needs. EVIDENCE: Two residents, one of whom being the last one admitted to the home were case tracked. This means that two residents were selected by the inspector and the care they receive examined closely. Their assessments and care plans were examined and they were spoken to. The records show that detailed written information about the residents has been recorded. These include an assessment to identify the needs of the residents and also a care plan which shows how the needs were being met. The physical assessment covers; personal hygiene, mobility, hearing, vision and other areas. The care plans give details of how the assessed needs are
Fernbank Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 12 met. For example, if someone needed help with personal hygiene, the record will show that this person needs staff to wash and dress her. The care plans are reviewed monthly to meet the changing needs of the residents. The residents are involved in this exercise. The two residents said that they are very well looked after by a team of very good staff. Other residents spoken were very positive about the staff and the management of the home. They said that Fernbank is a very good home and that they are well looked after. Ten residents completed the survey cards during the inspection and they were all positive about the staff and the care they receive. The inspector observed a very relaxed and friendly atmosphere in the home. There were good interactions between the staff and the residents. The residents were keen to tell the inspector about the good quality of care they receive. Their comments about Fernbank were ‘a very good home’; ‘ it’s like home’; ‘the staff are marvellous’. To meet the needs of residents who need support when walking along the corridors, handrails have been fitted on the walls. Some of the toilets have been fitted with grab rails to help those residents with poor balance and mobility. Some of the baths and showers have easy access and facilities to help residents who are disabled. A bath hoist is available to help with lifting residents in and out of the bath. Access to the front door is by several steps via a steep incline. Handrails have been fitted to help everyone. All the residents are white British, but the person in charge said that if a resident who is not white and British was to be admitted to the home, she will make sure to have as much information as possible by doing some research in order to meet their care and dietary needs. Resident’s health care needs are met by involving health care professionals. GP’s, District nurse and chiropodist visit when required. During the inspection, the senior carer was arranging for a doctor to visit a resident who was feeling unwell. The medications of two residents were audit trailed and were found to be correct. Residents who are able and willing can keep and administer their own medications. Fernbank Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 13 The staff at the home are sensitive to the needs of all the residents and do everything to help them remain as independent as possible. The staff said that their job is to work with the residents and meet all their needs. They said that they have very good relationships with all the residents. They were observed talking and helping the residents with dignity and respect. Fernbank Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good arrangements to meet the social and recreational needs of the residents EVIDENCE: When the inspector arrived to start the inspection at 10 am, all the residents were up and about. Some were in the lounges and a few were in the porch. All appeared to be content and were very chatty and welcoming. They said that although they do not have to get up early, they have got used to the routines of the home and get up when the night staff brings a cup of tea to them. Residents can opt out of this routine if they want. The staff said that they assist the residents to do what they like. Activities in the home include Tai Chi, Bingo, board games etc. A Tai Chi session was held a couple of days before the inspection.
Fernbank Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 15 The staff said that they try and meet residents’ individual needs. They said that if residents wanted to go for a walk or do something, they would try to oblige. The residents said that they do what they want and that the staff are very helpful and would assist them when required. The domestic staff was observed having a good chat with the residents in one of the lounges. They all seemed to enjoy it. The residents said that the food is very good and that they are offered choices at all mealtimes. On the day of the inspection, the choices for lunch were Baked Fish or Cornish Pasty. A choice of potatoes and vegetables were also offered. Meals are served in the dining room which is well furnished and decorated. Residents may eat in the lounges or in their rooms if they prefer. There is a good choice of food to choose from at breakfast and teatime. A cooked breakfast is available for those who want it. Records of meal served examined show that a good variety of meals are offered to the residents. The chef said that within reasons, he would cater for every taste. He said that he is able to cook food to suit ethnic needs and if he did not know how, he will try and find out. Residents are offered hot drinks at regular intervals during the day. They said that they find that regular drink rounds are adequate for their needs, but would ask the staff for a drink if they wanted one at other times. Fernbank Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are procedures in place to safeguard the residents from harm. EVIDENCE: The home has a robust procedure for dealing with complaints. All complaints and incidents are recorded on a form as part of the quality monitoring system. Written information about how and who to complain to is given to residents or their families. The residents said that if they had any complaints, they would speak to the manager and had every confidence that their concerns would be dealt with. The management team is always available to speak to the residents or their families. There are systems in place for staff to report any incident of abuse either by staff themselves or by families. All the residents appeared to be safe and free from harm, neglect and abuse. Staff were observed treating the residents with respect and dignity. The staff spoken to were aware of different types of abuse.
Fernbank Retirement Home DS0000009699.V306803.R02.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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live a safe and clean home. EVIDENCE: Fernbank is situated in Heysham and the home can accommodate a maximum of 18 residents of both sexes who are 65 years old and over. Accommodation is provided in all single bedrooms but none of them has an ensuite facility. A stair lift is available to access the first floor and residents who are able can use it independently.
Fernbank Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 18 The home is well maintained and there is a programme of maintenance and decorating. The front door is kept locked and all visitors are let in by a member of staff. This is to ensure the safety of the residents and the staff. The residents said that they feel safe living at the home and that all the staff are very good. A tour of the building was carried out. The home was found to be clean and in good order. The residents said that the staff clean their rooms daily. They said that they can do a bit of their own cleaning if they want. There are two good size lounges and a dining room. Residents can use these facilities freely. Most of them said that they prefer to stay in the same lounge and sit in the same chair. Some residents like to sit in the porch. They said that it is a good place to see what’s going on and also who is coming and going. The home was free from hazards and all equipments such as bath hoist and stairlift are maintained by qualified people. The domestic staff spoken to said that she has attended a course on infection control and is aware of the hazards of all the cleaning chemicals she uses. Fernbank Retirement Home DS0000009699.V306803.R02.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good practices to ensure that competent staff care for the residents. EVIDENCE: The number of staff on duty has been maintained to a good level to meet the needs of the residents. At the time of the inspection, there were 2 care staff, 1 manager, a cook and a domestic staff on duty. Staff rotas checked showed that the staffing level is maintained to a good level to care for all the residents. The staff files examined show that appropriate checks had been carried out before offers of employment had been made. Such checks included CRB (Criminal Records Bureau) checks and a POVA (Protection Of Vulnerable Adults) check. Training records show that the staff at Fernbank have attended several courses. These include: Abuse, Moving and Handling, First Aid, Medications, etc. Fernbank Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 20 Staff spoken to said that they treat all the residents with respect and accept any difference people may have. CSCI (Commission for Social Care Inspection) recommends that at least 50 of care staff achieved NVQ (National Vocational Qualification) level 2. The percentage of care staff at Fernbank with this qualification is 88 and is commendable. The staff spoken to said that they enjoy working at the home very much. They said that the management is very supportive and listens to what they have to say. The residents said that the staff are marvellous and will do any thing for them. There were good interactions between the residents and the staff. They all appeared to be happy and content Fernbank Retirement Home DS0000009699.V306803.R02.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 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is an adequate management cover at the home. EVIDENCE: The home is owned by a company called Victoria and Thornton Court Ltd. Mr Robert Wilson and Miss Maureen Mackay are the directors of the company. The registered manager has recently retired and the home is being managed by an experienced manager from another home in the company. The intention is for this person to apply to CSCI to register as the manager of Fernbank.
Fernbank Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 22 The inspector found that the home is being well managed and that the residents are well looked after. The staff on duty were competent and was running the home well. Residents and or their families are encouraged to deal with their own finances. Most of the fees due to the home are paid for by direct debit arrangements. Where the home, keeps money on behalf of residents, appropriate records are kept. The managers from other homes within the company visit Fernbank regularly and once a month completes a Regulation 26 form. This form is completed to ensure that owners who do not work at the home on a daily basis either himself or herself or a representative looks at all areas of the home and leaves a written report. A copy of the report is also sent to CSCI. Fernbank Retirement Home DS0000009699.V306803.R02.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 X X 3 X X 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Fernbank Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 24 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 OP31 Regulation 8 Requirement The home must have a manager who is registered with CSCI. Timescale for action 31/12/06 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 Retirement Home DS0000009699.V306803.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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