Inspection on 25/02/08 for Ferngrove House Care Centre

This inspection was carried out on 25th February 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

Ferngrove House Care Centre 09/02/09

Ferngrove House Care Centre 14/12/06

Ferngrove House Care Centre 06/05/05

Ferngrove House Care Centre 22/09/04

Ferngrove House Care Centre 08/06/04

Similar services:

Chirnside House

Emmaus House

East Croft Grange

Craignair

Croston Park Nursing Home

Conifers Nursing Home

Cloisters

Elmsdene Care Home

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

CARE HOMES FOR OLDER PEOPLE Ferngrove House Care Centre Blackstone Edge Old Road Littleborough Lancashire OL15 0JG Lead Inspector Val Bell Unannounced Inspection 25th February 2008 10:30 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 Ferngrove House Care Centre DS0000025471.V360369.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. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ferngrove House Care Centre Address Blackstone Edge Old Road Littleborough Lancashire OL15 0JG 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) 01706 378938 01706 375356 f.house@schealthcare.co.uk Ashbourne Homes Ltd ** Post Vacant *** Care Home 36 Category(ies) of Dementia - over 65 years of age (36) registration, with number of places Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maxinum of 36 service users in the category of DE(E) Dementia over 65 years of age. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The newly appointed Manager must make application to register with CSCI by 28th August 2006. Rooms numbered, as 30, 31, and 32 must not be used as personal accommodation. The Registered Person must ensure that all staff working in the home have dementia care training, which equips them to meet the assessed needs of the services users accommodated, as defined in the individual plan of care. The service should at all times employ suitably and experienced members of staff, in sufficient numbers, to meet the assessed needs of the service users with dementia. A revised Statement of Purpose and Service User Guide, in a format suitable for intended service users, must be provided to the CSCI by 1st September 2006. Work on the interior of home, to assist residents with audio and visual clues must be completed by 30th September 2006. 14th December 2006 3. 4. 5. 6. 7. Date of last inspection Brief Description of the Service: Ferngrove House, part of the Southern Cross Group, is a care home providing accommodation and personal care for up to 36 residents suffering from dementia on both a permanent and respite basis. The home is a conversion of two period semi detached houses that have been extended and modernised during 2006 to provide a home on three levels. Local shops and amenities are a short drive away from the home. There is ramped access to the front of the home with adequate parking. Safe enclosed garden areas are available at the rear of the home. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 5 The rooms and facilities of the home are spread over three floors with a passenger lift available to all levels. Two of the three floors were in use at the time of this inspection visit. All rooms are single and vary in size they all have ensuite toilets. There are four lounge/dining areas: two lounges on the ground floor, one of which has a bar area, and two smaller lounges on the second and third floors. The toilets and bathrooms on all floors have aids to assist residents. The weekly fees charged for this service range from £374 to £389. Additional charges are made for hairdressing and chiropody. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 6 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. Site visits to the home form part of the overall inspection process and the lead inspector conducted a site visit during daytime hours on Monday 25th February 2008. The purpose of this inspection was to look at the core standards of the National Minimum Standards (NMS) and progress made since the last inspection on 14th December 2006. This inspection will also be used to decide how often the home needs to be visited to make sure that the required standards are being met. During the visit, time was spent talking to three people living in the home and observing interactions between the people accommodated and care staff. Discussions were held with the manager, deputy manager, care assistants and the chef. An Annual Quality Assurance Assessment (AQAA), which is a selfassessment document, had been completed by the manager and returned to the Commission prior to the inspection visit. The Commission received completed satisfaction surveys from six members of staff, six relatives and four people living in the home. Relevant documents, systems and procedures were assessed and a tour of the home was undertaken. What the service does well: People have a full assessment of their needs and are offered the opportunity to visit the home before reaching a decision on whether the home will be suitable for them. People spoken to during the inspection visit confirmed that they were satisfied with the standard of care they received. A relative said, “I feel the whole team, from domestics throughout really care about the people they are looking after.” Significant development had taken place in offering varied and regularly scheduled activities that provide interest and stimulation for the people accommodated. Relatives were encouraged to become involved in the activities provided. This was identified as an area of good practice in encouraging people to maintain their family links. Completed satisfaction surveys and conversations held during the visit confirmed that people are provided with nutritionally balanced meals that take individual preferences into account. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 7 Robust systems are in place to deal with complaints and concerns and to protect people from harm. A relative said, “Any complaints have been dealt with sincerely and quickly.” Staff received regular training and support to achieve National Vocational Qualifications to ensure that they had the skills and knowledge required to meet the assessed needs of people living in the home. One member of the staff team remarked in a satisfaction survey, “Never had so much varied training in such a short time; food hygiene, fire training, lifting, COSHH (The Control of Substances Hazardous to Health) and dementia.” Particularly pleasing was the way staff were observed to offer unconditional support in comforting people that experienced distress and confusion as a result of the dementia they suffered. This was further evidence of good practice in meeting the emotional needs of people living in the home. All the people spoken to during the inspection visit commented that the home was being managed well and that staff listened to their views in order to make continual improvements to the way the service is provided. What has improved since the last inspection? The outstanding requirement and 11 of the recommendations made at the last inspection had been met. Information given to people enquiring about the service was now available in large print and audio versions and the complaints procedure was also available in a large print version. Changes had been made to the way staff were being deployed by arranging staggered meal breaks. This means that there is always a member of staff available to respond to individuals’ needs. Additionally, staff had been registered on a course of study to achieve a National Vocational Qualification to ensure that they have relevant skills in meeting the needs of people accommodated in the home. Recommended improvements to the environment had been carried out to the garden area to provide pleasant and safe outdoor space and laundry systems had improved to minimise the risk of individuals’ clothing going missing. Medication records had been improved to ensure that the actual times of administering were being recorded accurately. Procedures had been implemented to provide clear guidance to staff on the action they must take if abuse was alleged or suspected. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 8 People using the service had the opportunity to go on regular trips in the home’s minibus. One person said, “It was lovely at Hollingworth Lake. I had the time of my life.” Staff were involving people using the service and their representatives in care planning resulting in improved communication. A relative commented, “Staff always inform us of any changes”, “When his daughter rings she can quite easily speak to her father. When a patient is poorly, had a fall or needed a doctor the home have phoned up immediately to inform us of the situation. The support shown by the carers is excellent, also to the relatives.” Improvements had also been made to catering provision. People that chose to get up early were provided with toast and a cup of tea in addition to having a cooked breakfast later in the morning. What they could do better: Two requirements and eight good practice recommendations were made during this inspection visit. Two requirements were made in relation to the manager needing to apply for registration with the Commission for Social Care Inspection and healthcare professionals’ visits must be recorded and care plans must be updated to reflect their advice. This will provide written evidence that the current needs of people living in the home are being met. Eight good practice recommendations were made as follows. More detail needed to be recorded in care plans, daily records and risk assessments and all care records should be noted with the individual’s name for identification purposes. Staff should take care to record the outcome of peoples experiences in receiving care and support to meet their social and personal and healthcare needs. Care records need to provide more evidence that individuals’ cultural needs are being met. Additionally, decisions taken on behalf of people who lack capacity must be recorded to provide evidence that the decisions have been taken in peoples best interests and for the purpose of meeting assessed needs. Records were generally held in a confidential and secure way although the manner in which individuals’ weights was being recorded did not comply with data protection legislation. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 9 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. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 10 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 Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 11 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): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. A robust pre-admission process enables people to decide if the home will be the right place for them to live. EVIDENCE: Since the last inspection information provided to people enquiring about the home had been improved to include large print and audio versions of the Service User Guide. This had been recommended in line with current good practice in meeting the needs of people with different ways of communicating. Seven relatives and three people living in the home responded with “yes” or “usually” to the question in satisfaction surveys, ‘Do you get enough information about the care home to help you make decisions?’ One relative said, “I received information about the home by post and verbally. I and the family are happy with my sister’s care.” Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 12 Examination of three care records provided evidence that before people are admitted to the home care manager assessments are obtained and the manager, or a senior person in the organisation, carry out pre-admission assessments of need. Furthermore, people are invited to visit the home for a meal prior to admission. This means that the person and/or their representative have enough information to decide if the home will be the right place for them to live. It also provides the manager with enough information to confirm if the service will be able to meet that person’s needs. This home does not offer an intermediate care service. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 13 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People using this service receive good quality care, although the way this is recorded should be improved. EVIDENCE: Care plans belonging to three people were examined for evidence of how their assessed needs were being met. Generally, care plans recorded preferences and choice, risks to the safe delivery of care and social, physical and mental health needs. Two of the care plans lacked sufficient detail to inform care staff what tasks must be undertaken to meet that person’s assessed needs. The third care plan contained good detail and was an example of good practice. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 14 However, none of the care plans had been updated at the review stage to reflect changes in the individuals’ health needs. Referrals had been made to a dietician, continence nurse and a general practitioner, although care plans did not reflect this. Consequently, there was little written evidence to confirm that the three people were having their current needs met. This potentially places the health and welfare of people at risk. However, these three people told the inspector that they were happy with their care. One person who had completed a satisfaction survey said, “When I feel unwell I am immediately seen and if the staff are not happy they ring the doctor.” Three relatives made the following comments in satisfaction surveys, “Staff always inform us of any changes”, “When his daughter rings she can quite easily speak to her father. When a patient is poorly, had a fall or needed a doctor the home have phoned up immediately to inform us of the situation. The support shown by the carers is excellent, also to the relatives” and “Staff are very patient with the elderly. I would like to see the same standards maintained.” Monthly weight recordings were not being recorded in individual health records. When asked about this the manager stated that they recorded this in a diary. She added that the occasion was used as a social event and that monthly weigh-ins were held in one of the home’s communal areas. She said that residents enjoyed this. Recording this information in communal records, such as a diary does not comply with the requirements of data protection and freedom of information legislation to hold individuals’ personal information confidentially and securely. Secondly, people using this service suffer from dementia and may lack the capacity to give informed consent to being weighed in front of other people. There was no evidence in care plans that individuals’ or their representatives had been consulted or given their consent to this activity as required by Mental Capacity Act legislation in force. The three daily records seen lacked detail of the actual care provided to meet peoples assessed needs. Daily records mainly focussed on recording dietary and fluid intake, continence needs, sleep patterns and medication needs. The standard of care planning was discussed with the manager and she agreed that the quality of information needed to improve considerably. For example, daily records paid little attention to what people actually do during the day and the outcome of their experiences. The manager said there were mitigating circumstances such as current staffing levels, resistance to change and the management of reinforcing training in care planning. She had an action plan in place to deal with this and with the recent appointment of a deputy manager she was confident that the management team now had the resources to provide the necessary support to staff in achieving these improvements. Further good practice recommendations were made to ensure that nutritional screening is undertaken, records should detail the person’s name for identification purposes, nationality should be recorded and risk assessments should detail the mobility aids that people use. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 15 Medications records for the three people case-tracked were found to be accurate and up to date. Medication that had been administered at different times to that directed by the doctor was being recorded on the reverse of the medication records. This had been recommended at the last inspection. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 16 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. People using this service are provided with healthy diets according to their preferences and regular activities that provided interest and stimulation. EVIDENCE: Significant improvements had been made in providing people living in the home with stimulating and interesting activities as recommended at the last inspection. This included trips out of the home on a regular basis. Two people made the following comments in satisfaction surveys, “It was lovely at Hollingworth Lake. I had the time of my life” and “We go out when we can. I like to go to Hollingworth Lake.” A person spoken to during the inspection visit also said that she had been on trips in the home’s minibus. Conversations with staff provided evidence that the religious needs of people accommodated were respected and met. The three care plans examined did not contain details of the individuals’ nationality. Consequently, there was no written evidence that cultural needs had been assessed or were being met. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 17 Activity schedules had been prepared monthly in advance and forwarded to relatives with a copy of the monthly newsletter. The schedules were noted with an invitation to visitors to join in with activities. This provided evidence of good practice in encouraging relatives of the people accommodated to become involved with their care. Morning activities mainly consist of current affairs discussions, exercise sessions, Beetle drives, bingo and gardening. Afternoon activities included massage, manicures, tactile boards, memory games, skittles and arts and crafts. Separate one-to-one sessions were held in the mornings with people who chose not to join in with group activities. This ensures that all people living in the home receive stimulation, which is further evidence of good practice. These sessions were observed during the inspection visit and a game of skittles was underway with a group of people before lunchtime. Social care plans needed improvement by recording individuals’ preferred daily activities and how these preferences would be met. Additionally, daily records should detail the outcome of the person’s experience of activities undertaken. A discussion was held with the chef about how the ‘Nutmeg’ system, introduced by Southern Cross, worked with people living in the home. This system is designed to provide a nutritionally balanced diet. The chef said that she adapts the menus to provide regional dishes that the residents prefer. She talks to individuals regularly so that she can understand their dietary needs and to get feedback on whether she is meeting their preferences. The chef had a thorough understanding of peoples preferred diets, particularly in relation to special diets. She said that she wanted to offer more choice of desserts to people suffering from diabetes and was currently researching how she could achieve this. Three people spoken to confirmed that they enjoyed the food and were satisfied that their choices and preferences were being met. The following comments were made in satisfaction surveys returned to the Commission, “Quite often when I ask for a cup of tea they get one. They are very kind. I am quite satisfied”, “Don’t get enough toast for supper. I like oldfashioned meals, not pizzas” and “Staff go the extra mile to make my sister sandwiches when she says she is hungry.” A recommendation made at the last inspection had been addressed by ensuring that people getting up early were given some toast and a cup of tea in addition to a cooked breakfast later in the morning. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 18 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, 17 and 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff take concerns and complaints seriously and the welfare of people using the service is afforded protection. EVIDENCE: A recommendation was made at the last inspection to provide a user-friendly complaints procedure and to ensure that the procedure for making complaints was on display in the home. This had been achieved by providing a large print version and by displaying the complaints procedure in the home’s reception area. People using the service and their relatives made the following comments in satisfaction surveys returned to the Commission, “I can speak to any member of staff at any time if I am not happy. If I had a complaint I would ask for the person-in-charge”, “I know who to speak to if I have a complaint”, “Any complaints have been dealt with sincerely and quickly” and “I know how to express concerns and make a complaint. The service always responds well to this.” The three people whose care plans were examined said they were confident that staff would take action to address any concerns they had. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 19 At the last inspection it was recommended that safeguarding procedures be obtained from Rochdale and Calderdale local authorities. Copies of these policies and procedures had been obtained and were held in the office should staff need to consult them. Staff on duty confirmed that they had received training in abuse awareness and they were knowledgeable about the action they should take if abuse was alleged or suspected. People living in the home spoken to during the inspection visit confirmed that they felt safe. It was particularly pleasing to observe during the inspection visit, staff unconditionally offering comfort and reassurance to people experiencing confusion and distress in relation to the dementia they suffered from. This provided evidence of good practice in dementia care. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 20 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. People using this service are provided with a safe, clean and pleasant living environment that has been adapted to meet their assessed physical needs. EVIDENCE: Significant improvements had been made to the environment as recommended at the last inspection. The garden area had been landscaped and suitable garden furniture had been provided. The manager said that a sensory garden was planned for this year and residents would be encouraged to become involved in planting tubs and baskets. It was previously noted that television reception was poor in the lounge area. This had been investigated with the outcome that the location of the home surrounded by the moors prevents good television reception. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 21 The recommendation relating to the laundry had been addressed by fitting shelves and providing each resident with a named basket for sorting their clothes. The laundry was clean and tidy on the day of the inspection visit. Rochdale contracts department has recently accredited the home to admit people to two of the three floors available. Consequently the top floor was not currently in use. There were twenty people accommodated at the time of the inspection visit. From a tour of the building the home was found to be clean and hygienic and equipment, décor, furniture and fitting had been maintained in good order. Suitable adaptations were in place to meet the physical needs of people accommodated and toilet and bathing facilities were located close to bedrooms and communal spaces. Satisfaction surveys sent to the Commission contained the following comments, “There are so many people here, it’s amazing how clean it is. They do a wonderful job”, “The home is always clean. I am perfectly happy with everything” and “The home is always fresh and clean.” Throughout the inspection visit the people accommodated were observed to have access to all parts of the home. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 22 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. People using this service can be confident that staff will be trained and qualified to meet their assessed needs. EVIDENCE: An outstanding requirement from the last inspection had been addressed by ensuring that sufficient staff were deployed to meet the needs of people living in the home. The manager said that she felt the requirement related specifically to how staff were deployed at the time, as staff were in the habit of taking their breaks together. She said that staff now take turns in having breaks. This was observed during the site visit. Since being accredited by Rochdale contracts department the number of people accommodated has increased giving rise to the need to employ more care staff. Three staff are currently on maternity leave and approximately seven vacancies need to be filled. Once this has been achieved the manager intends to recruit a bank of staff so that agency staff are not needed. Currently the home is employing the same three agency staff to provide continuity of care for people using the service. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 23 All care staff employed to work in the home had been enrolled on National Vocational Qualification (NVQ) courses as recommended at the last inspection. Four staff were currently doing NVQ level 2 in care with the remaining staff studying for this qualification at level 3. Staff on duty confirmed this. Records provided evidence that staff had received mandatory health and safety training, including infection control. The manager had applied to the Alzheimer Society to become a trainer in dementia so that she could offer inhouse training in good current practice in this field. The personnel records for one member of staff contained evidence of a Criminal Record Bureau disclosure and two written references. A new member of the care team confirmed that these documents had also been obtained for her, prior to her appointment. This person said that she had substantial relevant experience and had achieved NVQ level 3 in care. Appointed to the post of deputy manager she had been shadowing the manager for three weeks and during that period she had taken time to get to know people living in the home. She added that an induction had been provided and she had been issued with a staff handbook and relevant policies and procedures. Since being in post she has been on care plan training and has been booked on medication training. The deputy manager was aware that improvements were needed in the area of care planning. She said she was keen to support the manager in achieving this. Satisfaction surveys completed by people accommodated and their relatives contained the following comments, “I get on very well with the staff. You can have a laugh with them. I get confused and forget things, but the staff are wonderful at helping me to remember”, “I am happy with the staff and all their care for me. They treat me with respect and care. When I am upset the staff comfort and reassure me. If I need them urgently they always come, but I understand and am willing to wait if they are busy” and “Several of the care staff have been on courses in connection with dementia, which helps with the care of the patient.” Staff made these comments in satisfaction surveys returned to the Commission, “Any training which helps me in my work is given to me i.e. moving and handling, food hygiene, fire etc.”, “Never had so much varied training in such a short time; food hygiene, fire training, lifting, COSHH (The Control of Substances Hazardous to Health) and dementia”, “We have daily handovers, monthly meetings and at these meetings we discuss resident welfare”, “I wasn’t allowed to start at Ferngrove until my references and CRB were back” and “My induction was really in depth.” Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 24 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, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home is managed well and improvements are made in the best interests of people using the service. EVIDENCE: A recommendation was made at the last inspection for the manager to submit an application for registration with the Commission for Social Care Inspection. No application had been made. The manager explained that she had interpreted the recommendation to mean that she had up to two years in which to register with the Commission. She said she had started the process and was just awaiting a medical reference from her general practitioner. She expected to be able to submit her application to the Commission within two weeks. A requirement was made to this effect. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 25 The manager had almost completed the Registered Manager’s Award and was nearing completion of NVQ level 3 in care. She was aware that she would also need to achieve NVQ level 4 in care to be suitably qualified as the registered manager. She added that Southern Cross had agreed to sponsor her on a course of study to achieve a degree in dementia with Bradford University. The home’s quality assurance and monitoring system had been further developed since the last inspection. Systems were in place for the manager to undertake regular audits and this process will be strengthened by the appointment of a deputy manager to assist in this. Southern Cross issues satisfaction surveys to people using the service and their representatives and the feedback received is collated and used to improve the standards of the service provided. People spoken to were confident that their views were taken seriously and that this would make a difference to their quality of life in the home. Comments received from people returning surveys to the Commission included the following, “I feel the whole team, from domestics throughout really care about the people they are looking after”, “This is a newly developed home for dementia but everything is being done to involve the patient’s relatives” and “Communication doesn’t always get through, but the manager works within this area to improve when needed.” Staff views expressed in their surveys were, “We are specialists in dementia care”, and “I feel part of a team and part of a family. Work has its ups and downs, but I enjoy working here”, “Teamwork is what works best, especially for the care of the residents”, “We specialise in dementia and provide high standards of care”, “We care for the residents and treat them with respect” and “Residents are looked after well.” Suitable accounting procedures were in place to record transactions made in managing the personal finances of people living in the home. As mentioned elsewhere in this report, improvements should be made to the way information was recorded and stored. In particular, all personal care records should detail the individual’s name for identification purposes and personal information should be recorded and stored confidentially, in line with the requirements of data protection legislation. A sample of health and safety records was examined. This provided evidence that records required by health and safety legislation were accurate and up to date. This affords protection to the health and safety of people living and working in the home. Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 26 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X 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 2 X 3 X 3 X 3 3 Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 27 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 OP31 Regulation 8 Requirement The manager must submit an application to become the registered manager of this home. Timescale for action 10/03/08 Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 28 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 OP7 Good Practice Recommendations Care plan reviews should highlight changes in needs and care plans should be updated with this information. This will provide staff with up to date information on what tasks they must undertake in meeting individuals’ needs. Doctors and other healthcare professionals’ visits should be recorded and care plans should be updated to reflect their advice. This will provide written evidence that the current needs of people living in the home are being met. Daily records should detail the actual care that has been provided along with the outcome of the person’s experience of receiving that care. Risk assessments should specify the actual mobility equipment that people use to keep them safe. Staff should ensure that the nutritional screening tool is completed for each person admitted to the home to provide evidence that people are diets determined by their assessed needs. Care plans should detail the person’s preferred daily activities and specify how these will be met. Daily records should contain sufficient detail of the outcome of a person’s experience of the activities they are involved in. Decisions taken on behalf of people who lack capacity should be recorded in care plans. The record should contain sufficient detail to provide evidence that decisions are taken in the best interests and for the purpose of meeting the assessed needs of people accommodated. Personal care records should be noted with the person’s name for identification purposes. Personal care information should be held confidentially and securely in line with current data protection legislation. This will comply with a person’s legal right to access information held about them. 2 3 4 OP7 OP8 OP8 5 6 7 OP12 OP12 OP17 8 9 OP37 OP37 Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Ferngrove House Care Centre DS0000025471.V360369.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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