CARE HOMES FOR OLDER PEOPLE
Ferndale 8 Stein Road Southbourne Emsworth Hampshire Lead Inspector
Mrs H Church Announced Tuesday, 31 May 2005, V220610 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 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Ferndale Address 8 Stein Road, Southbourne, Emsworth, Hampshire PO10 8LD 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) 01243 532500 01243 774471 chichester@sussextraining.co.uk Sussex Training Services Ltd Mrs K M Greenfield Care Home (CRH) 17 Category(ies) of Dementia – Over 65 years of age (DE(E)) - 17 registration, with number Old age, not falling within any other category of places (OP) – 17 Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 14 January 2005 Brief Description of the Service: Ferndale is a privately owned care establishment providing personal care to 17 service users with dementia of a mental disorder in the category of Older Persons. Ferndale is a detached three-storey Victorian establishment in Southbourne, Emsworth, near Chichester and is situated approximately two miles from the centre of Chichester with all its amenities and a mile from the sea front. Accommodation is provided in 17 single rooms, four of which have en-suite facilities. They rooms are arranged on two floors with a lift giving access to all rooms. A sitting area in the hall, a lounge and new conservatory/dining room provide the communal space. Mr K Firman is the Responsible Individual representing the registered providers Sussex Training Services Limited and the registered manager is Mrs Kathy Greenfield. Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection, one of two required under the Commission for Social Care Inspection was planned to interview night staff and take part in the handover from night to day staff. The manager was present as it is the habit of residents to rise early and their expectations are to be washed and dressed and be in the lounge from about 06.30am. The workload is high at this time so the manager assists the night staff prior to the day staff coming on duty. To prepare for this unannounced inspection, previous reports were reviewed, letters and formal paperwork or reports sent after the last inspection were reexamined. Two documents, the Statement of Purpose and Service Users Guide form a contract of service provided to inform any enquirer or resident how they may expect the home to be run and how they can change the way things are done to improve their lives there. During the inspection, seventeen residents were being cared for. Nine residents were spoken with privately and four of these residents’ records examined to see if all care was being provided. Although residents are confused, they were able to give a clear account of their life at Ferndale and without exception all comments were enthusiastic. It was clear that residents are encouraged to say what they like or don’t like about the home. A relative was very enthusiastic about the care being provided to his relative and a district nurse gave very positive comments on the health care being provided. The residents were cheerful and dressed in clean appropriate clothing and it was clear that they were happy there. The staff were unanimous in their support of the manager and her leadership skills. The care plans showed that staff provide the appropriate amount of support. There were no requirements or recommendations made at this inspection. What the service does well:
Ferndale Residential Care Home provides good information about the home in a specially formatted large print version of the Statement of Purpose and Service Users Guide. Staff enable residents to own it as their own home by listening to their comments and providing very individual care in a secure environment. From resident’s comments and observing staff at work, it was
Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 6 clear that staff are committed to treat residents with respect and dignity and ensure that they are fully informed about their personal or collective activities planned for that day. Residents are encouraged to make suggestions or propose any changes they feel would improve their home or individual lives. 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 1-H60-H11 S37606 Ferndale V220610 310505 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 1-H60-H11 S37606 Ferndale V220610 310505 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, 2, 3, 4 & 5 All residents had been assessed before moving into the home. The staff at the home are meeting the residents identified needs. Relatives were given enough information to help them decide the home would be suitable. EVIDENCE: The manager has provided large print versions of the Statement of Purpose and Service Users Guide for all their residents and representatives. Four care plans, including a new resident’s records were examined and it was clear residents had been assessed to ensure the home would be able to meet their needs. Relevant risk assessments were in place and had been updated. Care plans to instruct staff how to meet identified needs had been written from the assessments and it was clear from the handover meeting from night staff to day staff that they were well informed about the care needed and were updating records accordingly. Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 10 & 11 All residents had an individual care plan set out for staff to follow. No resident is managing any part of their medication. Staff are meeting the health care needs of the residents in a respectful manner. EVIDENCE: Four care plans gave good, clear information of care needed with risk assessments giving staff good information about the risks and how to minimise these. Medication sheets were completed accurately and the district nurse The district nurse confirmed that appropriate referrals are made regarding any nursing intervention required, assisting her when necessary and following up the care as directed by the primary health care team. Staff were observed speaking to and caring for the residents and treating them with respect. Staff knocked on doors before entering and then spoke to the residents in a caring manner. Four resident’s commented and said “ staff were kind”. “staff aren’t bad”, “staff are lovely” and “staff are good”. Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 10 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, 13, 14 & 15 Activities are suited to the conditions and dependency levels of each of the current residents. Visiting is positively encouraged. Residents are served meals that are nutritious and appetising and these were highly regarded. EVIDENCE: Activities are based on ability with a dedicated member of staff providing these. These are listed on the day’s activities notice board in the hall where all the information required for residents to remind them of the day planned is given. This also included the staff on duty, the name of the home and the day and date. The inspector accompanied two residents going out to a coffee morning at the church opposite and observed the care the member of staff took in ensuring residents were safe in crossing the road and were aware of the time to be collected. There are 17 residents living in the home at present but this did not prevent staff being able to spend individual time with them and they were seen to do this on many occasions. The visitor told the inspector he was always made welcome and it was clear from the visitor’s book that visitors come every day, sometimes on their way to work or by notifying staff of a late evening visit. Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 11 The residents told the inspector that they really enjoyed their food. It was clear from the menus that these are changed regularly from feed back at each meal. The cook told the inspector that she has a likes and dislikes list for each resident that is updated regularly and any returns are noted for future meal planning. One resident told the inspector “on the whole it is very good. You can’t expect to like it all or I may be off colour. They do offer something else”. Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 12 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, 17 & 18 Residents are confident that any complaints they may have are taken seriously and acted upon appropriately. Some residents voted at the last election. Staff training in adult protection procedures are up-to-date so staff are equipped to protect residents from abuse. EVIDENCE: The home has a complaints procedure displayed in a prominent position and it is included in the Statement of Purpose and Service Users Guide. One resident said they knew who to complain to, but had no occasion to do so. The manager told the inspector that voting had taken place for some residents at the last election. The West Sussex Multi Agency guideline was available and training records showed staff are continuously updated in procedures. The Commission for Social Care Inspection had been involved in these procedures in the past and the manager was commended for her prompt and timely actions. Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 13 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, 21, 22, 23, 24, 25 & 26 The indoor areas used by residents are clean, safe and homely with good access to the rear garden. The resident’s rooms are suitable for their needs and are homely. EVIDENCE: During a tour of the home it was clear that residents are encouraged to move around the home as they wish and have access to a the front hall where the fish tank is a great talking point, the lounge and the conservatory/dining room, which is comfortably furnished with tables accommodating six residents giving it a homely atmosphere. There is a passenger lift for those residents whose rooms are upstairs. The rear garden has been redesigned to assist residents to walk independently around the raised flowerbeds and take part in any gardening activity they wish. It is wheelchair friendly and is furnished with occasional garden furniture.
Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 14 There are enough toilets and assisted baths to meet the needs of residents and thermostatic valves protect residents from scalding water temperatures. Radiators are guarded and the home was clean and hygienic. Resident’s rooms were visited and were homely and comfortably furnished with their own possessions around them. Training records showed that staff have received training in fire safety procedures and fire risk assessments were in place. Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 15 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 & 30 The duty rotas did indicate that enough staff are on duty over the 24 hours period to meet needs and that recruitment processes are robust and ensure residents are protected. EVIDENCE: The inspector joined the night staff and the manager as they assisted residents before breakfast and joined the handover from night to day staff. The rota and front information board confirmed the staff on duty. The numbers and skill mix of staff was appropriate to meet their needs. Two staff spoken with said they were happy working at the home and felt well supported by the manager. From the two records seen, recruitment records were consistent and staff received good induction, supervision and training that is well documented. A record of staff signatures was seen to say they have received an appropriate job description. Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 16 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) 31, 32, 33, 36 & 38 The registered manager is Mrs Kathy Greenfield who is well qualified and well experienced to manage the home and is actively involved in the care of residents on a daily basis. The home is run in the best interests of the residents whose health, safety and welfare is promoted and protected. EVIDENCE: Mrs Greenfield is a qualified National Vocational Qualification Assessor and has a counselling award. Mrs Greenfield has obtained the National Vocational Qualification level 4 and completed the Registered Managers Award. All the staff said Mrs Greenfield supports them to carry out their roles and provides a good clear sense of direction that puts residents at the centre of all activities. Recruitment, induction and supervision records confirm that the resident’s best interests were safeguarded. All communal rooms and rooms meet the National
Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 17 Minimum Standards giving resident’s sufficient space for them to have personal possessions or necessary equipment to support their care needs and move around their rooms safely. Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 18 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 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 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 3 3 3 3 3 3 3 3 3 3 Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 19 No 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations Ferndale 1-H60-H11 S37606 Ferndale V220610 310505 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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