CARE HOMES FOR OLDER PEOPLE
Ferney Lee Ferney Lee Road Todmorden Lancs OL14 5JW Lead Inspector
Liz Cuddington Unannounced 10 May 2005 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. Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Ferney Lee Address Ferney Lee Road Todmorden Lancashire OL14 5JW 01706 815507 01706 816025 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) Calderdale MBC Jean Conway (awaiting registration) Care Home - personal care only 25 Category(ies) of 24 x Old age (over 65 years) registration, with number of places Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service. Date of last inspection 19.01.2005 Brief Description of the Service: Ferney Lee is a residential care home offering personal care and single room accommodation for up to 25 older people. Ferney Lee offers a permanent home as well as respite and transitional care for the people of Calderdale. The home is owned and managed by Calderdale MBC. Ferney Lee has recently been completely refurbished and meets current fire safety standards. The communal rooms are attractively decorated, well furnished, light and spacious. The private rooms are also well decorated and furnished. The home is set in its own grounds and has ample car parking. The home is set just outside Todmorden town centre within reasonable walking distance of the main road and bus routes. Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was carried out by two inspectors and took five hours. A partial tour of the home was undertaken. The inspectors spent time speaking with nine service users, five members of staff, two relatives of service users and the home’s manager. Both the permanent residents and the people staying for respite care spoke well of the care and support they receive from the staff at Ferney Lee. We would like to thank the service users, visitors, staff and manager for their welcome and for giving their time to talk us during our inspection. What the service does well: What has improved since the last inspection? What they could do better:
The home’s Statement of Purpose, which outlines the services offered at Ferney Lee, needs updating to reflect the range of services available. To do this the contract for providing transitional care needed to be finalised with the Area Health Authority. Each service user’s individual plan of care, including how their assessed health care needs are to be met, needs a thorough review to make sure they are relevant and that all of their needs are being met. To be effective this review process has to include input from the service user, or their representative if they are unable to participate.
Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 Page 6 One to one staff supervision sessions need to be planned and started as soon as possible. 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. Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 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 Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 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 & 6 Ferney Lee’s Statement of Purpose is to be updated to better reflect the services they will be offering. This is to be completed after service details have been finalised with the Area Health Authority in respect of the transitional care service. EVIDENCE: The information confirming this was provided by the home’s manager. Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 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 & 10 The individual plans of care need to be thoroughly reviewed to ensure they each contain all the necessary information to enable the personal and health care needs of every individual to be properly met by the staff at Ferney Lee. Any care needs noted by staff must be followed through without delay and the care plan should show that this has been done. The staff were seen to treat each person at Ferney Lee with courtesy and respect and individual privacy and dignity was seen to be maintained. EVIDENCE: We examined the personal plans of care for seven service users. In every case there was some information such as moving and handling plans, risk assessments or medical records missing from the file. Not all of the plans showed evidence of the involvement of the service user or their representative in developing or reviewing their plan of care. The daily records showed that a care need for one person had been identified on several occasions, but there was no evidence to show that this had been followed up with appropriate action. There was evidence that specialist health care professionals are involved in providing suitable advice and care where needed.
Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 Page 10 From observation, as well as discussion with service users and staff, it was clear that all the people who live at Ferney Lee are treated with courtesy and respect. The service users who commented spoke highly of the care and support they receive. Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 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 standard(s) 13 During the inspection it was clear that visitors are made very welcome when they call to see their relative or friend at Ferney Lee. EVIDENCE: The service users’ comments and the inspectors’ observations of the relaxed and friendly interaction between service users, staff and visitors confirmed that this was the case. Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 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) None of these standards were assessed during this inspection. EVIDENCE: Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 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, 21, 25 & 26 Ferney Lee is safe, attractive and accessible to service users and the home meets fire safety requirements. There are plenty of accessible toilets and bathrooms and some bedrooms have an en suite toilet and washbasin. The heating, lighting and hot water supply meet the necessary standard as well as the needs of the service users. The laundry facilities for the home meet the standards for hygiene and infection control. EVIDENCE: The recent extensive refurbishment of Ferney Lee ensured that the home meets the necessary environmental and fire safety standards. Work was seen to be continuing in the grounds to improve the outside facilities. A tour of the building confirmed that there are adequate toilets and bathrooms for the number of people who live at Ferney Lee. The heating, ventilation, lighting and hot water were seen to meet the necessary standards. The home was seen to be clean and hygienically maintained throughout and washing machines and dryers were suitable to cope with the home’s laundry.
Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 Page 14 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 The staff rotas showed appropriate care and domiciliary staffing levels to meet the needs of the service users and maintain the smooth running of the home. EVIDENCE: Although at the time of the inspection there were some staff vacancies the manager assured us that recruitment to these posts either had occurred, or was about to take place. The staff who commented did not express concerns about the staffing levels at Ferney Lee. Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 Page 15 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, 36 & 37 The recently appointed manager has the experience and qualifications expected of a residential care home manager, as outlined in the National Minimum Standards. At the time of the inspection staff supervision was not taking place with the recommended frequency. All confidential records were seen to be stored securely, in accordance with the guidance of the Data Protection Act 1998. EVIDENCE: The home’s manager has applied to the Commission for Social Care Inspection for registration as manager of Ferney Lee. The information received confirms that she has the necessary qualifications and experience required for this position.
Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 Page 16 Due to a shortage of senior staff the regular one to one supervision of staff has not been taking place with the recommended minimum frequency of six times per year. We were assured that this would be rectified when the home has a full senior staff team. Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 Page 17 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 1 x x x x 2 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 x
COMPLAINTS AND PROTECTION 3 x 3 x x x 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 x x x x 2 3 x Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 Page 18 N/A 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. 2. Standard 1 7 Regulation 4& Schedule 1 15 Requirement The homes Statement of Purpose must accurately reflect the services offered. The individual plans of care must show that the service user, or their representative, has been involved in developing and reviewing the plan. The plans of care must demonstrate that all aspects of each individuals health care has been assessed and all needs are attended to appropriately. Timescale for action 30/09/05 30/09/05 3. 8 13 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. 2. Refer to Standard 6 36 Good Practice Recommendations The contract for providing transitional care at Ferney Lee needs to be finalised. Regular individual staff supervision sessions need to be planned and undertaken as soon as practicable. Ferney Lee J52J01_s34939_Ferney Lee_v228705_100505.doc Version 1.30 Page 19 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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