Inspection on 24/08/05 for Ferndale Court Nursing & Residential Home

This inspection was carried out on 24th August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ferndale Court Nursing &... 10/04/08

Ferndale Court Nursing &... 03/07/07

Ferndale Court Nursing &... 09/08/06

Ferndale Court Nursing &... 28/02/06

Ferndale Court Nursing &... 01/11/04

Ferndale Court Nursing &... 24/05/04

Ferndale Court Nursing &... 15/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Ferndale Court St Michaels Road Widnes Cheshire WA8 8TF Lead Inspector Gill Matthewson Unannounced 24 August 2005 9:30 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. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ferndale Court Nursing & Residential Home Address St Michaels Road Widnes Cheshire WA8 8TF 0151 257 9111 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) Southern Cross Healthcare Care Home 57 Category(ies) of Old age, not falling within any other category registration, with number (57) Both of places Physical disability (5) Both Dementia - over 65 years of age (1) Both Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 57 service users to include:* Up to 57 service users in the category of OP (Old age, not falling within any other category) * Up to 5 service users in the category of PD (Physical disability under 65 years of age) * Up to 1 service user in the category of DE(E) (Dementia over 65 years of age) * Within the 57 beds up to 33 service users requiring nursing care may be accommodated 2 3 The registered manager must attain an NVQ Level 4 in Management by 31st December 2006 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 1 November 2004 Date of last inspection Brief Description of the Service: Ferndale Court is a care home providing personal care and accommodation for 57 people. Of those 57, up to 33 may be older people in receipt of nursing care, up to 5 may have a physical disability and 1 may have dementia.The home is located in the Ditton area of Widnes, close to local shops and churches. It was opened in 1997 and is a two-storey purpose built home. All the bedrooms are single with en-suite facilities. The home also has several lounges and dining rooms. A passenger lift is available for access to the first floor. The home shares the same site as Ferndale Mews care home, both homes being set in private grounds with parking and gardens. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by two inspectors of the Commission. The lead inspector spent two hours planning the inspection by reviewing previous inspection reports and the service history over the last twelve months. The inspection took place over six hours and included a tour of the building, inspection of records and discussion with four service users, three relatives and seven staff. Since the last inspection there had been a change in manager and deputy manager. Feedback was given to the Home Manager and Operations Manager at the end of the inspection. What the service does well: Prospective residents are provided with all relevant information at the time of enquiry. They have a full assessment of their needs and are involved in care planning to ensure that the home can met their needs. They can visit the home prior to admission and can enter the home on a six week trial basis. Care plans are well documented to ensure that staff have all the information they need to provide the appropriate care. Residents are assisted to access local health services as necessary. Residents are treated with respect and their wishes in relation to daily activities are recorded. The home has a full time activities organiser and there is a varied programme of social activities in place. The home also provides a varied and well balanced menu. Residents’ concerns are taken seriously and investigated and action taken, if required. The home is clean and suitable and sufficient equipment is provided to meet the needs of the residents. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 6 The home provides sufficient numbers of staff to meet residents’ needs and there is always a registered nurse on duty. Recruitment procedures include the appropriate checks to afford protection for residents. Staff are provided with a comprehensive induction and ongoing training and development. There are safe systems in place for taking care of residents’ money and valuables handed in for safe keeping. 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. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 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 standard(s) 1, 3 & 5. Prospective residents needs are assessed and they are provided with the information they need to make an informed choice about whether to take up occupancy in the home. EVIDENCE: Residents had a copy of the home’s statement of purpose and service users’ guide. The statement of purpose included aims and objectives, philosophy of care, terms and conditions of admission, mission statement, qualifications of the registered provider and manager. Also included was the organisational structure of the home, age and range of service users, complaints procedure, fire procedure, details of how privacy and dignity would be maintained, with examples given and arrangements for consultation with residents and relatives. A copy of the most recent inspection report was also available. This guide was well presented, clearly written and easy to read and understand. The service users guide contained a introduction to the care team, admission criteria, home facilities, home services, information regarding visitors, fire, health and safety, complaints procedure, financial matters, quality assurance, mission statement and the philosophy of care. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 9 Each resident had a contract stating terms and conditions of occupancy. This document contained personal details, room to be occupied, registration with the Commission, Social Services information, whether nursing care was to be provided, date of arrival, next of kin, trial period details and admission procedure. It also included services to be provided, additional services, insurance details, funeral arrangements and the complaints procedure. These documents were signed by the service user and witnessed by the manager. A sample of eight care plans examined showed that assessments had been carried out with each person before moving into the home. The assessment document covered personal information, personal care and health care needs. It enabled staff to assess if the prospective resident’s needs could be met by the home. The manager said that prospective residents visited the home prior to admission. Six weeks after admission a review meeting was held with the resident, their representative, the social worker and the home. Following this six monthly reviews were held internally and social services undertook annual reviews. The home does not provide intermediate care, therefore standard 6 is not applicable. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 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 standard(s) 7, 8 & 10. There is a clear and consistent care planning system in place that provides staff with the in formation they need to satisfactorily meet residents’ needs. Residents’ health needs are well met with evidence of good multi-disciplinary working taking place on a regular basis. Personal support is offered in such a way as to promote residents’ privacy, dignity and independence. EVIDENCE: Samples of eight residents’ care records were seen during this inspection. A new system was being introduced at this time and some of the new paperwork had not yet been completed. Photographs were ready to be added to the files. The plans were comprehensive and well presented in individual folders. Each contained basic information covering all areas of health and personal care and risk assessments. They also included records of activities, visiting professionals, a relative comment sheet and daily report sheets. The care plans seen were drawn up in consultation with the residents and their families and were based on their assessed needs and risks. The residents or their representatives had signed their care plans to show that they agreed with the contents. Care plans were reviewed on a monthly basis. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 11 Daily record sheets seen showed day-to-day activities of each resident. They were written clearly with detailed information and were easy to follow Information on the visiting professional sheets showed that residents had been referred to GP’s, chiropodists, district nurses, opticians, dieticians and specialist nurses as required. Records also contained evidence of visits to hospital outpatients departments. Previous recommendations with regard to wound care and residents’ weights have been addressed. During the inspection staff showed respect for the residents by the way they spoke to them. They acted in a friendly and warm manner towards all the residents. Residents spoken with confirmed that staff were very helpful and treated them with respect. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 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 standard(s) 12 & 15 Residents are able to engage in a varied programme of recreational activities. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meet residents’ needs and tastes. EVIDENCE: Residents’ daily preferences were well recorded in the care plans. The residents’ religious preferences were also noted in the care plan. It was said that residents could see the minister of their choice. The social interests of residents were recorded well in the old care plan format, however within the new format the information is not adequately recorded. See Recommendation 1. The home employed a full time activity organiser and a weekly programme of activities was displayed in every sitting area. A hairdresser visited the home every week. Activities for the week of the inspection included balloon games, music and movement, reminiscence, bingo, carpet bowls, a singalong and beauty therapy. Some residents were going on a day trip to Southport the following day. Residents confirmed that the home provided a suitable programme of activities. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 13 During a tour of the kitchen it was seen to be clean and tidy. Dry food stores were seen and some open packets were noted. See Recommendation 2. Records of menus and daily checks on fridge, freezer and hot food temperatures were kept. A four weekly menu was available and showed a well balanced diet was offered to residents. The breakfast was seen being served and residents had a choice of porridge, cereals, bacon and egg, toast etc. The main meal of the day was a roast pork dinner with pineapple upside down sponge for dessert. Alternatives were always available for residents. Specialist diets for vegetarians and diabetics were available on request. Residents spoken with were all complimentary about the meals. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 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 standard(s) 16 The home has a satisfactory complaints procedure with evidence that residents’ views are listened to and acted upon. EVIDENCE: The policy on complaints was seen and this included timescales for dealing with a complaint and Southern Cross Healthcare and the Commission for Social Care Inspection’s contact details. The Commission had received no complaints since the previous inspection. Four complaints had been received by the home. One of these had been referred to Social Services, two had been resolved to the complainants’ satisfaction and one was ongoing. All relevant paperwork was available in the event of a complaint being received. Copies of the complaints procedure were available in the statement of purpose and service users guide. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 15 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, 22, 25 & 26. In the main, the standard of the environment within the home is good, providing residents with an attractive, well equipped, homely place to live. EVIDENCE: During the tour of the home all resident areas were seen. The home was furnished in a domestic style with additional equipment such as grab rails, raised toilet seats, hoists and pressure relieving equipment provided as necessary to meet the residents’ needs. The lounges had a variety of seating affording choice of style of seating for residents. A good standard of décor was evident throughout. A refurbishment and redecoration programme was in place. The corridors and some bedrooms had recently been redecorated and the manager said that lounge and corridor carpets were to be replaced the following month. A previous requirement with regard to the smoking lounge carpet to be replaced had not been met. See Requirement 1. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 16 The grounds to the home were well kept with car parking space available. The heating and lighting were sufficient throughout the home. The home was clean, tidy and free from any unpleasant smells. The home had a large separate laundry room, which was clean and tidy. There were two industrial washing machines with sluice facilities available and two industrial driers. The manager said that these met the current needs of the residents. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 17 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 &30. Residents needs are met by sufficient numbers of adequately trained staff. The home’s recruitment procedures afford some measure of protection for the residents. EVIDENCE: At the time of this inspection there were 23 residents requiring nursing care and 27 residents requiring personal care only. Agreed staffing levels were being maintained with one registered nurse in charge twenty-four hours a day, supported by eight care staff during the morning, seven care staff in the afternoon and evening and four at night. In addition there were cooks, domestic staff, administration support and maintenance support. The home also employed a full time activities organiser. The care staff team comprised five qualified nurses and twenty-eight care staff. The person in charge said that seven staff had obtained NVQ level II or III in care and that four staff were undertaking NVQ level III in care. Twentyfive percent of the care staff team were qualified to NVQ level II or above. See Recommendation 3. Three staff files were examined. These contained completed application form, job description, confirmation of Criminal Record Bureau checks, two references, terms and conditions of employment, interview assessment sheet, health check form, confirmation of identity and staff handbook receipt confirmation. Although all the information necessary was in the file it was Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 18 difficult to find. See recommendation 4. The manager said that this would be completed within six months. Induction workbooks were used at the home. These covered five areas: understanding the principles of care, the organisation and the role of the worker, the experiences and needs of the service user groups, safety at work and the effects of the service setting on providing services. Each area within the book had questions for the staff to answer and each section was dated and signed by the staff member and mentor or manager on completion. A certificate was awarded at the end of the induction. The manager said that induction covered over a six week period. For health and safety training see Standard 38. Other training undertaken included product information on continence products, medication, person centred approach to dementia care and catheter training. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 19 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) 35 & 38. EVIDENCE: The home only handled personal allowances for service users, which were held in cash in individual wallets. Receipts and two signatures were obtained for all monies debited and receipts given for all monies credited. Money and valuables were held in the safe. Records were maintained of all items handed over for safe keeping. Only one person held the key. Staff had completed mandatory training in fire awareness, moving and handling and food hygiene. Thirteen staff had current first aid certificates. Each staff member had a training record which showed mandatory training had been undertaken and copies of certificates were on file. In one bedroom (F36) the electrical flex for the dynamic mattress was trailing across the floor at the foot of the bed, to a socket in the far corner. It would Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 20 have been safer to trail the flex under the bed to the empty socket at the head of the bed, thus eliminating the trip hazard. See Requirement 2. One resident had a risk assessment in place because he wished to keep his bedroom door open at all times. Control measures had been recorded, but these only took account of risk to the individual resident and not the risk posed to other residents if a fire started in his room. See Recommendation 5. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 21 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 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 2 3 x 3 x x 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x 3 x x 2 Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 22 Yes 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 19 Regulation 16(2)(c ) Requirement The registered person must replace the floor covering in the smoking lounge. (Timescale 31.12.04 not met) The registered person must ensure that electrical flexes are not left trailing across bedroom floors. Timescale for action 31.10.05 2. 38 13(4)(a) 24.08.05 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. Refer to Standard 12 15 28 29 38 Good Practice Recommendations The registered person should ensure that the social interests of residents are well documented. The registered person should ensure that food in open packets is transferred to sealed containers. The registered person should ensure that 50 of the care staff team are qualified to NVQ level II or above by the end of 2005. The registered perosn should ensure that the staff files are re-organised. The registered person should ensure that risk assessments take account of risks to other residents, where applicable. Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection TUnit D, Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Ferndale Court F51 F01 S5172 Ferndale Court V245749 240805 Stage 4.doc Version 1.40 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!