Inspection on 23/06/08 for Ferndown Nursing Home

This inspection was carried out on 23rd June 2008.

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

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

Other inspections for this house

Ferndown Nursing Home 12/07/07

Ferndown Nursing Home 09/03/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Ferndown Nursing Home 9 Dudsbury Crescent Ferndown Dorset BH22 8JG Lead Inspector Jo Palmer Unannounced Inspection 10:20 23rd June 2008 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 Ferndown Nursing Home DS0000067567.V362077.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. Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ferndown Nursing Home Address 9 Dudsbury Crescent Ferndown Dorset BH22 8JG 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) 01202 875909 Mrs Claire Louise Hughes Mr Gary Douglas John Hughes Mrs Claire Louise Hughes Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th July 2007 Brief Description of the Service: Ferndown Nursing Home is registered with the Commission for Social Care Inspection to provide accommodation for up to twenty-three people over the age of sixty-five. The premises are situated in a pleasant residential area of Ferndown, within easy access of local amenities and within reach of both Poole and Bournemouth. Accommodation is provided on two floors, with a passenger lift to access the first floor. All rooms have en suite facilities. The home has a lounge, which overlooks pleasant, secluded gardens to the rear of the home. Mr and Mrs Hughes, who have experience of running a care home, own the home and Mrs Hughes is the registered manager of the service. Current fees are £585 to £750. See the following website for further guidance on fees and contracts: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choos.aspx Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection took place on 23rd June 2008 between 10.20 and 15.30. Mrs Hughes, owner and registered manager was present who assisted with the inspection process. The main purpose of this key inspection was to check that the residents living in the home were safe and properly cared for and to review the homes performance against the key National Minimum Standards and in addressing the requirements of the last inspection. The inspector spoke with eight residents, Mrs Hughes and two staff members, took a tour of the premises and examined relevant records. What the service does well: Prior to moving into the home, residents and their families can be assured that Ferndown Nursing Home is a suitable place to live where their needs can be met as systems are in place to ensure that each persons needs are assessed and the home is an appropriate place where those needs can be met. Based on assessment information prior to the person moving to the home, a care plan is devised detailing how care needs are to be met, care files are regularly reviewed and updated to ensure care can be delivered satisfactorily and that all care needs are addressed in the daily routines. Residents can be assured that their needs will be met respectfully and that care practices support their dignity. People living in the home are encouraged to make choices and decisions about their own lives and are able to pursue their preferred level of activity and recreational pass-times. Residents maintain good levels of contact with friends and family and the local community. Meals provided are of a good standard and residents confirmed these are enjoyable, plentiful and meet their dietary requirements. Residents living at the home are protected by the home’s policies regarding adult protection and complaints and can be assured that any concerns will be taken seriously and acted upon. Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 Page 6 Residents in the home have a comfortable, relaxed environment in which to feel at home where cleanliness, maintenance and health and safety are programmed. Residents benefit from appropriate numbers of well trained staff at the home and can be secure in the knowledge that Ferndown Nursing Home is well managed and Mrs Hughes has a good understanding of the principles and focus of the service, Mrs Hughes is supported by the homes senior staff team and it was evident from discussion that the management systems are transparent 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. Ferndown Nursing Home DS0000067567.V362077.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 Ferndown Nursing Home DS0000067567.V362077.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 is not applicable) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A pre admission procedure is in place and assessments are routinely undertaken to ensure that only residents whose needs can be met by the home are offered places there. EVIDENCE: Four resident care files were reviewed, each of these contained assessments undertaken prior to the person moving to the home. The pre-admission assessments demonstrate that all aspects of the person’s health and welfare needs are identified in order to establish whether Ferndown Nursing Home can meet those needs. It was evident also that the person being assessed and their carers, were involved in the process of assessment and the resident or their representative had been asked to sign a declaration acknowledging that the assessment and care files were available to them to review. It was evident that a registered nurse was involved in the assessment process where needed as required following the previous inspection. Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 Page 9 Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to provide staff with the information they need to meet the health and personal care needs of residents. The principles of respect, dignity and privacy are put into practice EVIDENCE: Following the initial assessment prior to admission, further, more detailed assessments are undertaken once the resident has come to live at the home. Plans of care are then produced demonstrating that each aspect of the person’s daily routine is considered and made known to staff in order that they may assist them correctly and provide specialist support where needed. Care records are well organised with an index providing an ‘at a glance’ method of finding the correct part of the records, and care records are consistent and rational with each assessed need being followed by an action plan. Each aspect of the care plan is reviewed regularly to ensure any changes to the residents health is identified and made known to staff. Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 Page 11 Staff keep a record of the care provided demonstrating that each area of the care plan has been implemented and detailing the resident’s progress along with other significant events as appointments, visitors, social activity etc. Care plans and records are written respectfully and it is evident that in doing so, staff are mindful of resident’s privacy and dignity Medication records examined evidenced that residents are in receipt of any medication as prescribed by their GP, storage of medicines and administration records were safe and in order. Mrs Hughes explained that the week following the inspection would see a change to the home’s management of medication as they had chosen to switch to a monitored dosage system which provides medicines in 28 day blister packs with associated records. Staff who administer residents medication were aware of these impending changes and were committed to a smooth transition to the new system. Residents spoken with said that they were treated well and that staff were kind and friendly. Staff were seen to treat residents with courtesy, patience, kindness and respect. Although not inspected fully, standard 11 was considered during this inspection as a recommendation of the last inspection was made regarding residents wishes regarding resuscitation. The recommendation has been addressed and Ferndown now uses a format approved by the Resuscitation Council entitled ‘Five Wishes’. The form is given to the resident with their relatives at the time of admission and although a sensitive time, the format enables the resident to consider their future and to take control of what they would like to happen at the time leading up to their death. It was evident that many residents had completed this form providing staff at the home with instruction including favourite music, the level of pastoral support, who they would wish to be with them and whether they would like life support or resuscitation. Mrs Hughes was advised to ensure that the difference between these two points was clear to the residents and their relatives as their were some conflicting answers given to these questions. Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The level of activities provided are tailored to individual residents needs and people are encouraged to make choices about their life style and to maintain contact with their family and friends. The meals in this home are wholesome and varied and meet resident’s dietary needs. EVIDENCE: Assessments of residents social, emotional, mental health and psychological welfare are in place to ensure staff have a basic understanding of individual need. Care plans, produced from assessment provided staff with instruction on how needs are to be met, the expected level of contact with family and friends, some group activities and the resident’s preferences for self directed recreation. The home’s cook also works as the activities coordinator and arranges group activities and games for residents such as crosswords, giant scrabble and snakes and ladders (team events), which residents can enjoy. An entertainer is scheduled to attend twice each month. Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 Page 13 Residents spoken with confirmed that there was sufficient activity and stimulation in the home and that they were able to have ‘alone’ time if they wanted. The main meal of the day is served at lunch time, residents spoken with confirmed that they enjoyed the meals in the home. The cook was spoken with briefly who confirmed that there is no set menu and that she plans meals each week with sufficient advance to order appropriate stocks. Cook confirmed also that having worked in the home for many years, she gets to know all the residents and their individual likes and dislikes. At the time of inspection, no special diets were provided for although two residents with diabetes have specifically low sugar diets and some residents have pureed meals due to swallowing difficulties. Residents stated that the meals were of a good standard, appetising and plentiful. Breakfasts are served by individual choice in each resident’s room at a time which suits them. Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies, procedures and staff training programmes are in place to protect the residents living at the home; residents can be assured that they can express any concerns they may have and that any incidents will be managed appropriately EVIDENCE: The last inspection reported that a complaints procedure is available to residents and visitors to the home; this was not reviewed as Mrs Hughes confirmed that it has not changed and also confirmed that no complaints have been received. Adult protection procedures are in place detailing the correct action to be taken should any concerns or allegations be made. The home holds a copy of local authority and Department of Health guidance on adult protection matters and all care staff have received training in adult protection and recognising abuse; no referrals have been made. Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Ferndown Nursing Home provides residents with a comfortable environment in which to live where they are safe, warm and have suitable facilities to meet their needs. EVIDENCE: Residents spoken with confirmed that they are comfortable in their rooms and are able to bring personal effects to make their space more homely; a tour of the premises viewing some rooms evidenced that they were clean, well maintained and homely. Bedrooms have en-suite toilet and wash facilities and shared bathrooms are available with suitable aids and adaptations to assist residents. Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 Page 16 Communal areas of the home are well used by residents and the rear garden is accessible when the weather permits. All communal spaces were seen to be homely, clean, well furnished and decorated. The home was clean and well maintained at the time of inspection; infection control procedures are in place with suitable hand washing facilities for staff in respect of infection control procedures. Residents spoken with confirmed that the laundry systems in the home work well and that their clothing, bedding etc is returned promptly, clean and in good condition. The laundry was seen briefly and noted to be clean and of a good standard. Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Rotas show that the home is staffed efficiently and the staffing structure is clearly defined. Management are aware of the benefits of a skilled, trained workforce and invest in training programmes to ensure all staff are up to date. There is a good recruitment procedure that is followed in practice for the protection of residents. EVIDENCE: Staff rotas seen demonstrate that there are sufficient numbers of staff on duty to meet residents needs; residents confirmed that staff are available when they need them. There is one first level registered nurse on each shift with 6 care assistants each morning and 4 care assistants each afternoon. At night there is one first level registered nurse and 2 health care assistants. For two days each week, there are two first level nurses to allow the head of care (a senior nurse) management and administration time. Staff training files seen demonstrated that each staff member undertakes training and regular up dates in mandatory subjects relating to health and safety such as moving and handling, infection control, food hygiene, first aid, Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 Page 18 health and safety and fire safety. Additionally, clinical updates are undertaken to ensure that the trained staffs registration remains current and that they continue to meet resident’s needs. Mrs Hughes confirmed that all new staff undertake the ‘Skills for Care’ induction programme as well as an internal induction and that the home’s AQAA (Quality Audit) has shown that 44 of care staff have attained NVQ level 2, two staff are to start this award at level 3 this year. Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are can be confident that the home is well managed and that systems are in place that centre around their care needs. Management practices and records kept, confirm the health and safety of people in the home. EVIDENCE: Mrs Hughes has been considered competent to manager Ferndown Nursing Home and with the support of a fully trained nursing staff is able to provide residents with confidence that their needs will be met. Residents spoken with confirmed they were happy with the management arrangements stating that Mrs Hughes and the staff were available when needed. Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 Page 20 The Commission for Social Care Inspection send all care homes an AQAA (Annual Quality Assurance Assessment) at the start of the inspection year (April). The AQAA for 2008 has yet to be completed, although it was evident throughout this inspection that Mrs Hughes was over half way through this document it is a requirement that the AQAA is completed within the 28 day time frame; the AQAA for Ferndown Nursing Home was due to be completed and returned to the Commission by 21st May 2008. The AQAA for 2007 was completed which identified what the home felt they did well and set out their plans for improvement over the next twelve months. This inspection evidenced that some of these improvements had been implemented with various aspects of the accommodation being upgraded and some document review. As part of the home’s quality assurance programme, Mrs Hughes has distributed surveys to residents, relatives, visiting professionals and other interested parties, and results of these have been appropriately responded to although there is no overall audit. Mrs Hughes was advised to ensure that results of any surveys are audited in order to provide stakeholders with a response. In order to protect residents, it is the policy of the home not to have any involvement with their personal finances. Therefore, any resident unable or not wishing to handle their own affairs has a relative or other representative to deal with their personal affairs and finances. The home’s Fire Risk Assessment had just been reviewed at the time of inspection; the report was not available although the hand written confirmation from the contracted fire engineer was available to evidence that this had been carried out within the time scale. Other records were seen relating to regular testing and maintenance of fire fighting equipment, alarms and emergency lighting systems. All staff receive fire safety and awareness training regularly. Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 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 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 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 3 X 2 X 3 X X 3 Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 Page 22 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 OP33 Regulation 24 Requirement It is a requirement that the home complete and return the AQAA within the given timescale. The completed AQAA was due to be returned by 21st May 2008 Timescale for action 30/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Ferndown Nursing Home DS0000067567.V362077.R01.S.doc Version 5.2 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!