Inspection on 21/09/05 for Fernhill Lodge Care Home

This inspection was carried out on 21st September 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fernhill Lodge Care Home 04/09/08

Fernhill Lodge Care Home 04/09/06

Fernhill Lodge Care Home 28/04/05

Fernhill Lodge Care Home 13/12/04

Fernhill Lodge Care Home 20/04/04

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Fernhill Lodge Care Home 5 Fernhill Road New Milton Hampshire BH25 5JZ Lead Inspector Mr Roy Bega Unannounced Inspection 21st September 2005 09:30 Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 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 Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 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 and Care Homes for Adults 18 – 65*. 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. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fernhill Lodge Care Home Address 5 Fernhill Road New Milton Hampshire BH25 5JZ 01905 459800 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) Park Care Homes (No 2) Ltd Miss Tracey Mundell Care Home 13 Category(ies) of Learning disability (13), Learning disability over registration, with number 65 years of age (13), Mental disorder, excluding of places learning disability or dementia (13), Mental Disorder, excluding learning disability or dementia - over 65 years of age (13) Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users are to be over the age of 45 years. One named Service user in the category DE Dementia can be accommodated 28th April 2005 Date of last inspection Brief Description of the Service: Fernhill Lodge is managed by Parkcare Homes No: 2, which is a trading subsidiary of Craegmoor Group Ltd, a national company providing residential and nursing care. The home is located in a residential area on the north side of New Milton, close to local amenities. Fernhill Lodge is registered to provide care and accommodation for 13 male/female residents with a learning disability and a mental disorder. Two double rooms are being used to provide single accommodation. The homes current operational level is 11 residents’. Four of the residents are over the age of 65 years. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report summarises the assessment of the extent to which the National Minimum Standards for Care Homes for adults 18-65 were being met at the time of the inspection. Fernhill Lodge also accommodates residents who are over the age of 65 years. This inspection therefore was also carried out in conjunction with the National Minimum Standards for care Homes for Older People. Standards not inspected on this occasion will be assessed during future visits. This visit took place on 21 September between of 9-30 a.m. and 2-30 p.m., a total of five hours. Opportunity was taken to look around the home view records, observe the working environment and speak with residents and staff. The four requirements raised resulting from the previous inspection were assessed as being met. One requirement was raised as a result of this inspection. Mrs J Cozens application as registered manager is pending. What the service does well: What has improved since the last inspection? Observations and discussions indicated that there is a more positive working atmosphere within the home. A draft of the home’s revised statement of purpose has been completed. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 6 Work with regards to the content and presentation of care plans has been completed. Risk assessments appertaining to meeting residents’ needs and wishes have been completed. Automatic closing devises linked to the alarm system have been fitted onto identified fire doors. 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. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 5. Prospective residents and their representatives are provided with information they need about the home. EVIDENCE: A requirement was raised resulting from the previous inspection for the home to provide an appropriate statement of purpose. The inspector was shown a copy of the revised document. Apart from minor amendments, the inspector assessed the document as meeting the standard. Copies of residents’ terms and conditions of residence on admission to the home were seen. They contained the required information. Copies are kept on residents’ files. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9. Residents assessed and changing needs including risk assessments and personal goals are recorded in their individual care plans. EVIDENCE: A requirement was raised resulting from the previous inspection for residents care plans to be reassessed, risk assessments to be completed and appropriately documented. The inspector looked at a random sample of two care plans. It was noted that the required information and documentation had been completed. Residents told the inspector that they are asked what they like to do and what help they need from staff. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 10 Mrs Cozens informed the inspector that an advocacy agency has been engaged to support residents who do not have any relatives/representatives. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 14. Residents are part of the community and engage in appropriate leisure activities. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 12 EVIDENCE: Records seen, observations and discussions indicated that staff assist residents to become part of and participate in the local community in accordance with assessed needs and wishes. Current activities both for individuals and group include, a local music club, snooker club/s, various sporting events, public houses, shopping and community events. The inspector was informed that a couple of residents plan to attend locally run college courses in art and craft and horticulture. Activity escorts are employed by the organisation in addition to regular care staff. Mrs Cozens informed the inspector that it is planned to further develop the areas of social inclusion and activities. The home has unmarked ‘family’ vehicles for transportation. Residents are also supported to use public transport. Discussions indicated that residents are supported to vote but declined to do so in the last elections. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21. Residents and their representatives are assured that ageing, illness and death will be handled with sensitivity and respect. EVIDENCE: The home has an appropriate policy and procedure to assure residents that at the time of illness and death, they and their family will be treated with care, sensitivity and respect. Discussions with staff indicated that this standard would likely be met. Residents’ cultural/requirements/ wishes upon death are recorded in care plans. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16, 18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 16, 18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards in this section were assessed on this occasion. EVIDENCE: Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, and 30. There are sufficient toilet and bathroom facilities that provide privacy and meet residents’ needs. The premises are kept clean. EVIDENCE: There is a ratio of six toilets, three bathrooms and one shower to thirteen residents. All facilities are fitted with suitable locks to provide privacy. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 16 At the time of the visit the premises were clean, hygienic and free from offensive odours throughout. Systems are in place to control the spread of infection. Laundry facilities are sited so that soiled articles, clothing and infected linen are not carried through areas where food is stored or prepared. Maintenance of the building was not assessed as part of this inspection. Mrs Cozens however, informed the inspector of the following planned alterations/repairs for which quotations have been obtained – • • • • • External repairs and redecoration including replacing remaining metal window frames. Internal redecoration, including refurbishment of bathrooms. New stair and hallway carpet. Replacement of vanity units in residents’ bedrooms. Providing an all season conservatory. These areas will be monitored as part of future inspection visits. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35 and 36. Residents benefit from stringent recruitment policy and procedure, staff being appropriately trained and having good awareness of their roles and responsibilities. New management have not implemented staff supervision. EVIDENCE: Two staff records were seen which included copies of detailed job descriptions and required documentation. Positive relationships and respect was evident between residents and staff on duty. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 18 New staff have completed “The Learning Difficulties awareness Framework” induction programme. Observations, discussions and available records indicated the home has an effective staff team with complementary skills and sufficient numbers to support current residents. At the time of the inspection three care staff were in duty. The rosta seen indicated this is the norm during waking hours seven days a week. A cook and domestic are also employed although at the time of this visit the domestic post was vacant. The inspector was informed that the staff compliment is being increased by the equivalent of three full time carers to promote meeting residents social/leisure activities. Discussions with staff indicated an awareness of their own knowledge and skill limitations. Three staff have completed the National Vocational Qualification (NVQ) Level 2 in care. Two further staff have been registered to commence the course. Two overseas staff’s training has been assessed to equate to NVQ level 3. The inspector was shown the home’s training schedule that detailed courses for individual staff that have been and need to be competed. Staff spoken with portrayed a positive attitude towards training. Mrs Cozens informed he inspector that since her appointment in April she has been committed to reviewing/restructuring residents care plans therefore, staff one to one supervision has not taken place. She agreed to ensure that it is implemented by 31 October. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42. Effective quality assurance and monitoring systems are in place to ensure the home is run in the best interest of residents. The health and safety of residents and staff is promoted. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 20 EVIDENCE: Observations and discussions indicated that management and staff are fully committed to ensure residents needs and wishes are met. Residents’ thoughts and opinions about what the home provides and how it is run are actively sought. Residents spoken with told the inspector that they prefer to verbally inform management of what they think than complete anonymous questionnaires. Views are also sought from relatives as part of the quality assurance procedure to ascertain if the service is achieving its goals. The standard covering health and safety was inspected in part. The requirement raised resulting from the previous inspection with regards to ensuring fire safety precautions are maintained has been met. Automatic Closing devises linked to the alarm system have been fitted onto identified fire doors. The effectiveness of the fire door to the bedroom located next to the staff office was discussed and needs to be assessed. Advice will need to be sought from Hampshire Fire and Rescue Service. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 3 2 X 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 X 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT 37 X 38 X 39 3 40 X 41 X 42 3 43 X Standard No 6 7 8 9 10 LIFESTYLES 11 12 13 14 15 16 17 Score 3 X X 3 X X X 3 3 X X X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X 3 Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 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 YA36 Regulation 18 (2) Requirement Management is required to ensure staff one to one supervision is implemented by the stated timescale. Timescale for action 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 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. Fernhill Lodge Care Home DS0000037561.V251878.R01.S.doc Version 5.0 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. 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