Inspection on 23/07/07 for Ferndale Nursing Home

This inspection was carried out on 23rd July 2007.

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

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

Other inspections for this house

Ferndale Nursing Home 13/06/06

Ferndale Nursing Home 19/10/05

Ferndale Nursing Home 09/11/04

Ferndale Nursing Home 06/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Ferndale Nursing Home 124 Malthouse Road Crawley West Sussex RH10 6BH Lead Inspector Mrs S Gawley Unannounced Inspection 23rd July 2007 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 DS0000024142.V341553.R01.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. DS0000024142.V341553.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ferndale Nursing Home Address 124 Malthouse Road Crawley West Sussex RH10 6BH 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) 01293 520368 01293 528898 Ferndale Health Care Limited Mr Ishwurduth Mannick Care Home 28 Category(ies) of Dementia - over 65 years of age (28), Old age, registration, with number not falling within any other category (28) of places DS0000024142.V341553.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons in the home should not exceed 28. Date of last inspection 13th June 2006 Brief Description of the Service: Ferndale is a care home providing nursing care and accommodation for twentyeight older people with dementia. The home is owned by Ferndale Health Care Limited. The responsible individual on behalf of the organisation and registered manager of the service is Mr Ishwurduth Mannick. The home is in Crawley and close to the amenities offered by the town centre. The home was first registered in 1994 and consists of accommodation on three floors, all of which are accessed by a passenger lift. The home provides accommodation in eighteen single and five double rooms, one and three of which respectively provide en suite facilities. The home has a garden, which can be accessed by ramped pathways. The fees for this care home currently range from £535 to £650 per week DS0000024142.V341553.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit as part of the inspection process took place on 23 07 07 and was undertaken by S Gawley and A. Campbell-Currie. The Nurse in charge facilitated the inspection and the registered manager was also available to answer queries. The commission was in receipt of an Annual Quality Assurance Assessment (AQAA) and any documents required on the day were made available. Information on file with the Commission was also considered. Four residents were case tracked, their care plans and medicine administration charts were inspected and two of these four residents were spoken to. They expressed satisfaction with all aspects of the home saying that staff were very caring and the food was good. Other residents spoken to throughout the day stated that they received the care they need in a respectful manner and that staff are kind. Three relatives were spoken to on the day and they expressed satisfaction with the home. They stated that the staff were approachable and any concerns were dealt with. All of the above was considered in compiling this report. Most of the National Minimum Standards were met on this occasion with two requirements being made. What the service does well: Relatives spoken to confirmed that residents are treated with respect and that all staff are kind. Staff were observed communicating well with residents. The home is comfortably furnished. Residents enjoy a varied and nutritious diet. Visitors are always made welcome. DS0000024142.V341553.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. DS0000024142.V341553.R01.S.doc Version 5.2 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 DS0000024142.V341553.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Standard 6 not applicable People who use this service experience good outcomes because they are fully assessed prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A pre admission assessment is completd. Family are invited to participate. Evidence of these assessments were seen in care plans. A relative spoken to stated that she was happy with the admission process. DS0000024142.V341553.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7-10 Residents have a plan of care documented. The resident’s health care needs are met. Medication is safely stored and administered in the home. Resident’s privacy and dignity is respected and protected by the staff. People who use this service experience adequate outcomes because their health care needs are met according to their care plan. This judgement has been made using available evidence including a visit to this service. DS0000024142.V341553.R01.S.doc Version 5.2 Page 10 EVIDENCE: Four care plans were inspected and showed that they had been drawn up from the initial assessment. Aspects of the person’s health and social care needs were documented and clear guidance had been provided for staff to ensure that peoples’ needs would be met. It was clear that the care plans are kept under review. One of the care plans showed that a relative had been involved in sharing information and another showed that relatives are involved in the person’s care. There was no detailed information about people’s interests and preferences. It is clear that although there have been improvements in the care plan documentation there is room for further development. This was discussed with the nurse in charge and the registered manager. Risk assessments had been carried out and guidance provided for staff. Interventions from health professionals were recorded. Those residents in bed requiring nursing care had their fluid intake monitored and recorded. Medicines are appropriately stored, administered and recorded in the home. Medicine administration charts inspected were up to date. Each chart had the residents photograph on. Policies are in place Medicines are administered by Registered Nurses. There was a large stock of Sudocreme and the importance of using only medication from containers individually labelled was discused with the nurse in charge. There is a drug fridge and temperatures are recorded. DS0000024142.V341553.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 The lifestyle offered in the home does not meet all resident’s needs and preferences. Residents can maintain contact with relatives. Visitors are welcome and residents enjoy a varied diet. People who use this service experience adequate outcomes because they receive nutritious meals and visitors are always welcome. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is an activities coordinator who works three days a week; she was not working on the day of the inspection because she had helped to organise the open day and barbecue the previous day. The care staff spoken with said that they provide activities when the coordinator is not in the home. The assessments and care plans that were seen did not include details of people’s preferences regarding social, cultural, religious or recreational interests. The activities folder included a record of activities that people had taken part in during the day but there was no indication of people’s interests or choices. The DS0000024142.V341553.R01.S.doc Version 5.2 Page 12 majority of residents were sitting in the lounge and there were at least three members of staff available. Staff were observed to encourage people to take part in individual activities with them; one person was playing cards and another was taking part in a threading activity. The majority of people were resting. It was not clear how residents are encouraged to make choices about the activities they take part in. There was no evidence to show that there are any activities in the evenings. One member of staff said there are two open events during the year. Sixty-five relatives and residents had attended the barbecue held the previous day. Relatives spoken to stated that they are always made welcome and are offered refreshment. The four -week menus were on the notice board in the hall. There was also a vegetarian menu. People spoken with indicated that they like the food. The menu was varied and included fresh fruit and vegetables. The mealtime was relaxed and unhurried. Several people were sitting at tables that were attractively set out. Most people were assisted to eat their meal while in their chairs in the lounge. The food was well presented and looked appetising. Staff were talking to residents as they assisted them with their meal. Specialist diets are catered for. Nutritional needs were noted in the care plans inspected. Dislikes were noted on the kitchen notice board. The chef said that he and the staff are aware of the food that people like and if they refuse to eat what has been prepared for them an alternative or a sandwich will be provided. The manager and chef were advised to find ways to encourage people to make choices about the food and drink they prefer when people have difficulty expressing their choices. The chef stated that the kitchen is due to be extended and refurbished. DS0000024142.V341553.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Complaints made by residents and their relatives are listened to, taken seriously and acted upon. All staff have received training to ensure residents are protected from abuse. People who use this service experience good as staff are trained in protecting residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are policies available regarding safeguarding adults. There was evidence to show that staff have received training in protecting vulnerable adults. Staff spoken with were aware of the need to report any concerns to the manager. Relatives confirmed that any concerns are addressed immediately. DS0000024142.V341553.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,26 Residents live in a mostly safe and well-maintained environment. Not all specialist equipment required is available. The home is clean and hygienic. People who use this service experience adequate outcomes because they live in a mostly safe and well-maintained environment but do no have the ability to call for help if needed. This judgement has been made using available evidence including a visit to this service. DS0000024142.V341553.R01.S.doc Version 5.2 Page 15 EVIDENCE: All parts of the home were inspected. The bedrooms and sitting room and dining room were neat clean and free from offensive odour. Some wear was noted on the carpet but this is safely taped down and does not pose a risk to the residents. Rooms were well decorated and pleasantly furnished. They were comfortable and personalised. Some areas of the hallways had chipped paintwork. The kitchen is due for refurbishment. Radiators were covered and taps have temperature valves to control the temperature water is stored, circulated and delivered. There is a passenger lift. There are assisted baths. The need not to use communal toiletries was discussed with the nurse in charge, as there was a basket of such items in one bathroom. One ground floor bathroom had a toilet, which was loose and could pose a risk to the safety of residents. One further toilet on the first floor had a broken toilet seat. Screens were available in shared rooms. Beds for those residents requiring nursing care had integral bed rails. There were not any call bells in the bedrooms throughout the home. The nurse in charge stated that this was because they may pose a risk to residents. The need for these to be in place was discussed with the nurse in charge and will be a requirement of this inspection. There were appropriate laundry facilities for the management of resident’s laundry. Relatives confirmed that laundry is appropriately handled and does not get lost. DS0000024142.V341553.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Residents’ needs are met by an appropriate number and skills mix of staff. Residents are in safe hands at all times. Residents are mostly supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. People who use this service experience adequate outcomes because the home is suitably staffed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were sufficient numbers of staff on duty to meet the needs of residents. People cared for in their rooms were being checked every fifteen minutes. The recruitment process was discussed with the manager and a sample of staff records seen. The manager said that he is responsible for the recruitment of staff and carries out all the interviews; these are not documented to show that an equal opportunities approach to staff employment is being taken. Two of the files inspected showed that Criminal Record Bureau checks had been carried out but did not include a photograph. Training records seen showed that staff had attended a number of training sessions including mandatory training. Staff spoken with said the training DS0000024142.V341553.R01.S.doc Version 5.2 Page 17 opportunities are good. There is infection control training today. There was evidence to show that newly appointed staff have an induction. Supervision is in place. The manager has worked to improve the staffing shortfalls noted in previous inspections and to meet the requirement of the last random inspection of 30th October 2006. . All staff files had evidence of Criminal Records Bureau Clearance and POVA checks prior to employment and references were in place. There is still room for improvement. The need for him to get up to date information on staff transferring within the organisation and to include staff photographs in files was discussed with him. DS0000024142.V341553.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 A person fit to be in charge manages the home. The home is being run in the best interests of the residents. The registered provider has ensured that residents’ financial interests have been safeguarded. The health safety and welfare of residents is protected. People who use this service experience good outcomes because the home is run in their best interests. This judgement has been made using available evidence including a visit to this service DS0000024142.V341553.R01.S.doc Version 5.2 Page 19 EVIDENCE: A person fit to do so runs the home Records seen showed that staff receive supervision every two to three months and that these meetings are recorded and include agreed action. Staff spoken with said that they feel well supported in their jobs. The home has met the requirements of the last inspection. The detail of care plans has improved Staffing records have improved. Some still require a photograph, which the manager states he will put in place. The home has a friendly relaxed environment which relatives confirmed. Financial interests are safeguarded. The home does not manage accounts for residents. It may hold small allowances for residents and these are receipted and stored securely. Staff and residents benefit from a comprehensive training programme. Utilities and equipment are tested and maintained and records were available. The manager stated that there is a redecoration programme in place, which will deal with painting, upgrading the bathrooms as necessary. The kitchen is due for refurbishment. Some consideration is being given to replacing the carpets. Quality assurance systems are in place with surveys being sent annually to relatives. This mey be extended to professionals. The Commission was in receipt of an Annual Quality Assurance Assessment. DS0000024142.V341553.R01.S.doc Version 5.2 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000024142.V341553.R01.S.doc Version 5.2 Page 21 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 OP12 Regulation 12(2)(3) 16(m)(n) Requirement The routines of daily living and activities made available are flexible and varied to suit service users’ expectations, preferences, capacities and choice. Call systems with an accessible alarm facility to be provided in all rooms Timescale for action 01/10/07 1 OP22 13(4)© 23(2)(n) 01/10/07 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 OP9 Good Practice Recommendations The registered person to ensure topical items are only administered from individually labelled containers. DS0000024142.V341553.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 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 © 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 DS0000024142.V341553.R01.S.doc Version 5.2 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. 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!