Inspection on 28/02/06 for Ferndale Court Nursing & Residential Home

This inspection was carried out on 28th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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

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

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

Ferndale Court Nursing &... 24/08/05

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 Nursing & Residential Home Ferndale Court Nursing & Residential Home St Michaels Road Widnes Cheshire WA8 8TF Lead Inspector A Gillian Matthewson Unannounced Inspection 28th February 2006 09:30 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 Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ferndale Court Nursing & Residential Home Address Ferndale Court Nursing & Residential Home St Michaels Road Widnes Cheshire WA8 8TF 0151 257 9111 0151 420 0210 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) Southern Cross Healthcare Services Limited Care Home 57 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (57), of places Physical disability (5) Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 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 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 24th August 2005 2. 3. 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 Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 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 four hours and included a tour of the building, inspection of records and discussion with eight residents and five 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: What has improved since the last inspection? Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 6 Residents’ social interests are recorded in the care plans in order that an appropriate activity programme can be provided to enable them to pursue their interests. Some carpets have been replaced. Recruitment continues to improve and the home now has a full complement of staff and does not use any agency nurses. This has improved the continuity of care. Staff files have been reorganised with sub-sections to make it easier to find the required information. 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 Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Prospective residents are assessed prior to admission to ensure that the home can meet their needs. EVIDENCE: A sample of five care plans were examined. These showed that assessments had been carried out with each person before they moved into the home. The assessment document covered personal information, personal and health care needs, and social needs. It enabled senior staff to assess whether the prospective resident’s needs could be met by the home. The manager said that prospective residents could visit 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 Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 9 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. 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. Residents receive the medication prescribed by their GP. Personal support is offered in such a way as to promote residents’ privacy, dignity and independence. EVIDENCE: Samples of five residents’ care plans were seen during this inspection. New documentation had been introduced since the last inspection and the staff confirmed that it worked well. Each resident had a care plan file that was subdivided into five sections: assessment, admission, care plan, progress and supplementary. A photograph of the resident was included in the file. The plans were comprehensive and well presented in individual folders. Each contained detailed information covering all areas of personal and health care, and included risk assessments in relation to falls, nutrition, moving and handling and pressure areas. They also included records on activities, visiting professionals, relatives’ comments and daily progress reports. The care plans Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 10 seen were drawn up in consultation with the residents and their families and were based on their assessed needs and risks. The residents signed their care plans to show that they agreed with the contents. Daily progress reports documented the day-to-day activities of each resident. They were written clearly with detailed information, easy to follow and were signed by the nursing or care staff. Information regarding bathing and weight was also recorded. Information on the visiting professional sheets showed that GP’s, chiropodists, district nurses, opticians and social workers had visited the residents. The home uses the Boots Monitored Dosage Blister Pack System. Each floor has its own treatment room. Steel medication cabinets were secured to the walls in these rooms. The records examined showed that medication was recorded and administered appropriately. Controlled drugs were stored in line with current regulations. An audit of the controlled drugs in stock was carried out. The amounts in stock tallied with the controlled drugs register. Records confirmed that senior staff checked the controlled drugs twice a day. Locked fridges were available in each treatment room and items stored were appropriate. During the inspection staff showed respect for the residents by the way they spoke to them. Staff acted in a friendly and warm manner towards residents. Residents spoken with confirmed that staff were very helpful and treated them with respect. Their mail was delivered unopened. Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 11 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): 13, 14 & 15 Residents are able to receive visitors at any reasonable time and are encouraged to retain control over their lives. Meals are good and offer choice and variety to those on solid diets, but there is a lack of choice for those that require a pureed diet. EVIDENCE: Residents confirmed that they could see visitors in their own rooms or any of the communal areas. Quiet rooms were available for residents to use. It was noted that there were no visiting restrictions within the home. The home had links with the local primary school and church. Residents were encouraged to personalise their own rooms and on a tour of the home it was noted that most rooms were personalised with mementoes and photographs. Some residents had also brought some of their own furniture in as well. Staff confirmed that residents could see their own records and it was noted that residents had signed to say they had seen and understood their own care plan. Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 12 Inspectors saw the main meal of the day being served, steak and kidney pudding, mashed potatoes and mixed vegetables. The dessert was rice pudding. The alternative meal was ham salad. Most residents had chosen the hot meal option. The portion sizes reflected personal choice and the meal looked hot and appetising. Staff were sitting next to residents when assisting them at the mealtime. On discussion after the meal residents confirmed that they had enjoyed the meal. Hot and cold drinks were served during the mealtime. On discussion with the manager it was noted that the alternative meal was usually a “cold option” such as salad or sandwiches. In the past two hot options were available. This was of particular concern for those residents that required a pureed diet, because effectively they had no choice other than to have the hot option. The manager said that she would look into this. See Requirement 1. Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 13 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): 18 Residents are safeguarded from abuse. EVIDENCE: The home had satisfactory policies on recruitment, adult protection, whistle blowing and restraint. Halton Borough Council Adult Protection Procedures and Department of Health guidance ‘No Secrets’ were available in the home. Training in the protection of vulnerable adults was given to all staff on induction, but there had been no refresher training since October 2004. See Recommendation 1. Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 14 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, 22, 25 & 26 The standard of the environment within the home is good, providing residents with an attractive, well equipped, homely place to live. Residents could be at risk of infection due to poor staff practice in relation to cleaning of equipment. EVIDENCE: During the tour of the home all the shared areas and a selection of bedrooms were seen. Bedrooms were entered with the consent of the residents. All the bedrooms were single with en-suite facilities. There was a passenger lift. The home was furnished in a domestic style with additional equipment such as grab rails, raised toilet seats, pressure relieving mattresses and hoists provided as necessary to meet the residents’ needs. The lounges had a variety of seating affording choice for residents. A refurbishment and redecoration programme was in place.A good standard of décor was evident throughout. The heating and lighting was sufficient throughout the home. Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 15 The previous requirement regarding a new carpet for the smoking lounge had been met. The previous recommendation about replacement of communal carpets had also been met. The grounds to the home were well kept with car parking space available. The home was clean, tidy and free from any unpleasant smells. However, some bedpans and urinals that had been replaced on the racks in the sluices were noted to have stains on them, as though they had been rinsed after use but not properly cleaned. See Requirement 2. Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 16 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. Residents needs are met by sufficient numbers of staff, but further investment is needed to ensure that national workforce training targets are met. The home’s recruitment procedures afford some measure of protection for the residents. EVIDENCE: At the time of this inspection there were 21 residents requiring nursing care and 23 residents requiring personal care only. The home had a full complement of staff and was not using any agency staff at the time of inspection.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 three 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 five staff had obtained NVQ level II or III in care and that one was undertaking NVQ level III in care. Three more were awaiting a start date. When these are trained the home will only have 33 of the care staff team qualified to NVQ level II or above. See Requirement 3. Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 17 The staff files of a new care assistant who had commenced employment the previous month was examined. It contained completed application form, job description, confirmation of Criminal Record Bureau check, two references, terms and conditions of employment, interview assessment sheet, health check form, confirmation of identity and staff handbook receipt confirmation. Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 18 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. The home regularly reviews aspects of its performance through a programme of audits and consultations with residents and their representatives. EVIDENCE: A new manager had been appointed since the last inspection. She had previously worked in the home as a registered nurse and latterly as the deputy manager. She had submitted an application to CSCI for registration as the manager and was undergoing assessment of her fitness for the post. Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 19 Internal audits were carried out by the Home Manager, Regional Manager and Divisional Facilities Manager. These covered the environment, medication, care plans, pressure sores, accidents, complaints, staff records, training and activities. Action plans were devised to address any shortfalls. Policies and procedures were regularly reviewed. Customer satisfaction surveys seeking views of service users and their representatives were carried out approximately four times a year. The last surveys had been sent out in December, and all the responses were positive. Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 20 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 X 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X 3 X X 3 2 STAFFING Standard No Score 27 3 28 2 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X X X X x Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP15 Regulation 12(3) 16(2)(i) 16(2)(j) Requirement The registered person must ensure that there is a choice of menu for residents who need a pureed diet. The registered person must ensure that staff place bedpans and urinals in the sluicing disinfector after use. The registered person must increase the number of staff training for an NVQ Level II in Care. Timescale for action 30/04/06 2 OP26 03/03/06 3 OP28 18(1) 30/09/05 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 Refer to Standard OP18 Good Practice Recommendations Staff should receive refresher training in the protection of vulnerable adults on an annual basis. Ferndale Court Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Northwich Local Office Unit 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 Nursing & Residential Home DS0000005172.V273043.R01.S.doc Version 5.0 Page 23 - 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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