Inspection on 02/02/09 for Ferndale

This inspection was carried out on 2nd February 2009.

CSCI found this care home to be providing an Good service.

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

Ferndale 02/02/07

Ferndale 22/02/06

Ferndale 06/12/05

Ferndale 17/02/05

Ferndale 22/12/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ferndale Ferndale 46 St Barbara`s Walk Newton Aycliffe Durham DL5 4AN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Elsie Allnutt     Date: 0 2 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Ferndale 46 St Barbara`s Walk Ferndale Newton Aycliffe Durham DL5 4AN 01325300296 01325314621 ferndale@oswaldhouse.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Ian Thomas Patterson Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 3 Ferndale is a Residential Care Home providing residential care services for up to 3 adults in the Category of Learning Disability (LD). It is part of a small group of homes owned by the Registered Provider Mr Ian Patterson and is located in a residential part of Newton Aycliffe within walking distance of the town centre and its amenities. Ferndale is a small terraced house providing suitable living accommodation for its residents. The accommodation comprises of 3 single bedrooms, a communal bathroom, a kitchenette and a lounge/ dining area. There are small garden areas to the front and rear of the house, but there are no dedicated car parking spaces. Care Homes for Adults (18-65 years) Page 4 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Before the visit we looked at, information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people, the views of people who use the service, staff and other professionals. The Visit An unannounced visit was made on 2nd February 2009 and during the visit we, talked to people who use the service, staff, the manager and visitors, looked at information about the people who use the service and how well their needs are met, looked at the records which must be kept, checked that staff had the knowledge, skills and training Care Homes for Adults (18-65 years) Page 5 of 29 to meet the needs of the people they care for, looked around parts of the building to make sure it was clean, safe and comfortable, checked what improvements had been made since the last visit. We told the manager and provider what we found. What the care home does well: What has improved since the last inspection? What they could do better: So that service users changing needs are addressed, the care plans should be Care Homes for Adults (18-65 years) Page 7 of 29 monitored, reviewed and updated each month. The registered provider should consider appointing a manager, specifically registered with the Commission for Social Care Inspection (CSCI), to manage this home. It is recommended that a formal Quality Assurance System is put in place, so that the monitoring systems already in place can be recorded together along with service users views about the service and the outcomes used to establish a service development plan. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good processes are in place both to inform prospective service users about the home and to inform the home about prospective service users needs. From these processes informed decisions can be made which means that service users have time to make a choice about where they want to live and the home can make a confident decision that they can meet service users needs. Evidence: To inform people about the service the home has developed a Service User Guide that is in a format that service users can understand and the organisation also has a website that gives extensive information about the service. When asked if they had a choice about living at this home one service user said I have lived here for a long time I wouldnt want to live anywhere else. Following any new referral the home requests a full assessment of need from the referring agency so that they can make an informed decision as to whether they can meet the persons needs. Following this decision the person is invited to visit the home Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: to meet staff and other service users and to see whether they want to live there. This process is taken at a pace determined by the individual so that an informed decision can be made. During this time and during a three month probationary period the home also carries out an assessment of need and from the information gathered, including the information received from the referring agency a care plan is developed with strategy plans in place to address any identified risks. This service does not receive any emergency admissions. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans that are the outcome of assessment, guide staff to appropriately support service users care needs, promote their independence by safely addressing risks and to support service users to make choices about their lives. Evidence: There is a care plan in place for each service user living at the home. The information recorded clearly guides staff to effectively address the individual service users personal, social and emotional care needs. The care plans demonstrate a 24 hour activity routine for each service user and the support they need. In addition a list of the individuals likes and dislikes and strengths and needs are included. The strength and needs list is detailed and promotes the individual service user in a positive way by indentifying their level of independence and by using the identified needs positively to develop individual care plans. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: Although service users are aware of their care plans and what is written about them, it is felt that they could be further empowered to take the lead in the development of them. Person Centred Planning is something that the manager and staff, with the support of a consultant from Valuing People, are working towards with service users. Individual books called My Life, that record everything about the service user, including their needs, aspirations, people involved in their lives and details of how their goals are achieved are in the process of being completed. Although records show that service users needs are addressed daily and reviews of the persons all round care are carried out annually, there are currently no records to show that care plans are regularly monitored. It is suggested that care plans are monitored monthly to show that they are up to date and that any changing needs are addressed. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported to live appropriate and fulfilling lifestyles, both in their own home and in the local community, while at the same time they are supported to maintain relationships with family and friends. Furthermore meals are attractive, healthy and nutritious and are prepared to meet service users individual dietary needs. Evidence: Service users have individual weekly activity programmes that are recorded in the care plan. These are flexible but act as a structure to the individuals week. They vary according to individual preferences but confirm well organised and active lifestyles. Some activities are centred around the community while others are based in the home depending on the needs and preferences of the service user. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: The home is run and organised to promote the recognition of respect, privacy and the rights of service users and the staff work to reflect this. Service users rooms are respected as their private space and service users move around the home with confidence demonstrating ownership of their surroundings. Service users have attended courses on assertiveness, stress control and conflict resolution. All have had a positive impact on their personal development and the promotion of their independence. The risks involved in promoting and supporting such independence have been addressed and risk strategy plans are in place. Each service user has a mobile phone with preset numbers of certain people who they can contact if needed. Service users openly discussed the variety of activities that they take part in. On returning from work they described with eagerness the job they do which they stated they enjoy doing and feel valued and respected by the people they work with. In addition to their jobs the service users enjoy taking part in different activities for example swimming, attending professional football matches in Darlington, cycling and going to the cinema and out for meals. All have bus passes and can travel independently. One service user described how they had learned to be an independent traveller by first doing the journey several times with a member of staff until they became confident to do it themselves. The different holidays that are taken were also discussed. Each service user has 2 holidays a year, one fully paid by the organisation to Keswick where they use the outdoor facilities of the Calvert Trust and one abroad. Service users are encouraged and supported to keep contact with family and friends and addresses, contact numbers and important dates are recorded in the care files. Meals are determined by choices made by the service users and any allergies they may have to food, individual service users preferences are recorded in the care plans. Menus are regularly reviewed and agreed by service users and mealtimes are flexible to reflect individual routines and activities. Service users were joined for an early evening meal that was both tasty and nutritious. Time was spent eating, relaxing and chatting around the table about the days events. Service users commented the meals are always like this and I enjoy making my own meals at weekends when I am not at work. Care Homes for Adults (18-65 years) Page 15 of 29 Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users personal and healthcare needs are met in a flexible but consistent manner, reflecting a healthy lifestyle. The medication arrangements in place are appropriate to the needs of service users. Evidence: Service users are supported to register and attend healthcare practices in the local community. Visits to the GP, dentists, opticians and other healthcare professionals are recorded in individual care files, with the outcome of the visit. The necessary support is provided to attend outpatient/health appointments. The people who are currently living here generally enjoy good health, however when service users have medical problems like epilepsy risk strategy plans are put in place to guide staff in relation to the support needed. All staff have attended training in relation to epilepsy. In addition to this the home has worked with the epilepsy specialist nurse to ensure that those service users who require recovery medication for epilepsy have RISK MAPS (a care plan/risk assessment signed by the resident, family, GP, nurse and consultant.) This ensures consent and the correct administration of the Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: prescription. Staff support service users to live healthy lifestyles and they have supported service users to lose weight by eating healthily and to give up smoking. The home has increased the people who self medicate and decreased the amount of medication taken. This is the result of working with local GPs and reviewing service users health needs. Appropriate risk management plans are in place for people who self medicate. The home has an effecient medication policy supported by procedures and practice guidance that staff understands and follows. Medication records are fully completed, contain required entries and are signed by appropriate staff. All staff have completed training regarding the safe administration of medication and the manager monitors compliance with the homes procedures. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good arrangements are in place to help protect service users from abuse and to seriously address complaints and concerns about the service. Evidence: The home has a comprehensive complaints procedure that is in picture format in an attempt to make it more accessible to service users. Service users stated that they are generally very happy with the service that they receive but if at any time they are not happy they know what action to take. One person said Staff listen to what you are not happy about and help to put it right. The manager stated that concerns are taken seriously and used to improve the service. Staff could explain the action they would take if someone was seen working in an abusive way or if an abusive incident was reported to them. All staff have received training regarding the local authoritys safeguarding adults procedures and a copy of the procedures is kept in the office for anyone to refer to. All staff have also received training regarding handling verbal and physical aggression. There is a clear system in place for the handling and recording of service users monies. Each service user has a bank account and records and receipts of purchases demonstrate how money is spent. Care Homes for Adults (18-65 years) Page 19 of 29 Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is homely, comfortable, clean and decorated and furnished to a high standard. It provides service users with spacious, private and communal spaces that are safe in which to live. Evidence: The service is situated in an ordinary house set in a terrace of other houses within an area that is attractive and close to community facilities. Each service user has their own room that is individually decorated and furnished to reflect their choice and personality. The decor and furnishings throughout the home are of a high standard. Service users have their own keys to their rooms and to the front door. Locked facilities are available within individual bedrooms for the protection of personal possessions and medication. The house was clean and tidy throughout and there were no presenting health and safety issues. The fixed and portable electrical and gas appliances/installations are serviced and certified as required by legislation and carbon monoxide detection is available for added safety. Weekly tests of all emergency detection and lighting installations are carried out and recorded. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: A comprehensive maintenance programme is in place to maintain the good standard and safety of the home. The home has recently benefitted from a new roof, new bathroom, new high secruity door, a wiring upgrade, redecoration and a new high efficiency condensing central heating system. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust recruitment and selection procedures and regular training opportunities ensure that service users are appropriately supported and protected by a competent, qualified and enthusiastic team. Evidence: Staff are allocated to work at the home to reflect the needs of the service users at different times of the day and night. Service users said that they feel that they get good support when needed and they are given their freedom to live as independently as possible within safe boundaries. Staff are supported and valued by the organisation, receive supervision and training that reflects the needs of service users and as an outcome are able to meet service users needs. One member of staff stated: I love working here, its a pleasure coming to work. Staff are up to date with mandatory training and all, but 2 have achieved NVQ 2 with some working towards level 3 and 4. In addition to this the staff training programme gives staff the opportunity to achieve accredited qualifications including, the Learning Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Disability Framework Award (LDAF), the MAKATON vocabulary, Managing Behaviour and the safe use of medication for epilepsy emergencies. The organisation has designated staff responsible for coordinating training and have recently had success in securing more training by working with the Durham Employers Care and Health Alliance (DECHA). The manager is aware of the training achieved and also of the training needs for the future. Staff interact sensitively and competently with service users, they are aware of the organisations aims and objectives and work to promote service users independence, dignity and self worth. Due to a low turnover in staff service users receive a service that is consistent and that is delivered by people who they know well. One service user said, I like all of the staff, they are good, they are there when I need them. I get a nice meal when I come in from work and at weekends I can make my own. Staff are recruited following the organisations robust recruitment procedures and a fully completed application form showing a clear work history, 2 references and a CRB check are kept on file. All new staff shadow experienced staff as part of their three month probationary period. This means that while they are going through their induction period they can model their performance on experienced and competent workers. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager provides good leadership and runs a service that has monitoring systems in place that are focussed in the best interests of the service users. Evidence: The manager, who is one of the original founders of the organisation has managed this home for the last two years. Although he is not currently registered with CSCI to manage this home, he is the registered manager for another of the homes within the organisation and which is situated within close proximity. He is qualified in the Diploma of Nursing Studies and has achieved the Registered Managers Award (RMA). He is also a NVQ Assessor and has recently attended a wide range of training including clinical supervision, first aid, the Mental Capacity Act, food hygiene, dementia care and safeguarding adults. The manager and the staff team follow comprehensive policies and procedures that are focussed on supporting people in their care to live ordinary lives. The outcome of this is that service users independence is promoted and supported postively and in a safe Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: way which means that they enjoy lives that are valued and interesting. Good health and safety systems are in place and staff work in a way that reflects these. Records are up to date, however the manager and staff recognise where improvements with care plans in particular can be made. Although monitoring systems are in place and a service that is of a good standard is delivered and maintained, there is no formal quality assurance system in place. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 The monthly monitoring of care plans should be recorded with comments relating to how the care plan is progressing. The registered provider should ensure that a manager registered with CSCI runs the home. Consideration should be given to establishing a formal Quality Assurance System so that monitoring systems can be recorded together and regular audits can take place. 2 3 37 39 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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