Inspection on 28/04/05 for Fernhill Lodge Care Home

This inspection was carried out on 28th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fernhill Lodge Care Home 04/09/08

Fernhill Lodge Care Home 04/09/06

Fernhill Lodge Care Home 21/09/05

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 ADULTS 18-65 Fernhill Lodge 5 Fernhill Lodge New Milton Hampshire BH25 5JZ Lead Inspector Roy Bega Unannounced 28/4/05 10:00am 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Fernhill Lodge Care Home Address 5 Fernhill Road, New Milton, Hampshire, BH25 5JZ 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) 01905 459800 Park Care Homes No: 2 Miss Tracey Mundell CRH 13 Category(ies) of Learning Disability LD, Learning Disability over registration, with number age of 65 years LD(E), Mental Disorder MD, of places Mental Disorder over age of 65 years MD(E) Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1- Service Users are to be over the age of 45years. 2- One named service user in the category DE Dementia can be accommodated. Date of last inspection 13-12-2004 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. Fernhill Lodge is a care home registered to provide care and accommodation for 13 male and female service users with a learning disability and a mental disorder. Two double rooms are being used to provide single accommodation. Therefore the homes current operational level is 11 residents. At the time of this inspection there were not any vacancies. Four of the residents are over the age of 65 years. The home is located in a residential area on the north side of New Milton, close to local amenities. Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A week previous to this visit, the Commission for Social care Inspectorate (CSCI) were informed that the registered manager, Miss Tracy Mundell had resigned her post. At the time of this visit, Mrs Jan Cozens was acting manager. This inspection took place over one day. Opportunity was taken to look around the home, view records, talk with majority of residents, staff on duty and a visiting relative. Four of the seven requirements raised resulting from the previous inspection were assessed as being met. The outstanding requirements are in respect of the home’s Statement of Purpose, Residents Care Plans and Residents Risk Assessments. They are mentioned in the main body of this report. Due to the circumstances with regards to the change of management and nature of the outstanding requirements, CSCI have agreed to extend the timescale for completion to 30 June 2005. What the service does well: What has improved since the last inspection? The management of offensive odour. Staff have received training with regards to care giving in mental health. Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 6 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 H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 and 4. Prospective residents do not have the information they need to make an informed choice prior to moving into the home. Prospective residents individual aspirations and needs are assessed prior to admission. Prospective residents have the opportunity to visit and “test drive” the home to make an informed choice as to whether the home can meet their needs and aspirations. EVIDENCE: The statement of purpose and service user guide state different categories for which the home is registered. This requirement has been carried over from previous inspections. Mrs Cozens (acting manager) assured the inspector that this matter will be completed by 30th June 2005. A comprehensive pre admission assessment of a recent admission was seen. It included reports/information from professionals involved, the resident’s thoughts and family input. Discussions with the resident and family member during the inspection indicated that they were fully involved in the assessment process and kept up to date with its progress. Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 9 A requirement from the previous inspection was for staff to complete training in mental health. Information and discussions indicated that this has been met. Observations, discussions and available training records indicated that staff have the skills and experience to deliver care effectively. Staff were observed to relay what aspects of care they were going to do before carrying it out. Staff were also observed to be courteous, respectful, ensuring residents dignity and privacy at all times. Information and discussions indicated that prospective residents are invited to visit the home initially for lunch, an over night stay then a week- end before deciding whether the home will meet their needs and aspirations. This was confirmed by residents. Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9, and 10. Care plans require updating and related risk assessments need to be completed. Residents make decisions about their lives and are consulted in respect of life in the home. Records are kept secure and staff are aware of the importance of maintaining confidentiality. EVIDENCE: A sample of four residents care plans were seen. They were not up dated and appropriate risk assessments not completed. This was a requirement raised as a result of the previous inspection. Mrs Cozens assured the inspector that these requirements form an integral part of her action plan whilst at the home. Also training in respect of care/personal centred planning is being arranged to enable staff to become more involved. This will be reassessed during future inspection visits. Residents spoken with readily informed the inspector of the daily choices they make. For example, clothes they wear, time they get up and go to bed, what Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 11 they do and where they go, décor and soft furnishings in their bedrooms. Evidence of this was observed during the visit. For example, residents were getting up as they pleased, joining activities as they wished and whether they went out or not. Residents meetings are also held the minutes of which were seen. Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 15, 16 and 17. See also standards 6 to 10 of this report with regards to care/personal centred plans. Residents have opportunities for personal development and age related activities. Residents rights are respected and visitors made welcome. A varied diet is provided. EVIDENCE: Discussions indicated that residents are given the opportunity to attend college courses or day services as they wish. An external tutor visits the home once a week to provide literacy skills. Residents informed the inspector that they enjoy these sessions. Residents also readily informed the inspector with regards to individual and group excursions to places of interest and social activities. For example the Isle Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 13 of Wight and Blackpool. One resident enjoys commuting independently on local buses. Mrs Cozens advised he inspector that residents interests and aspirations are to be re assessed when redeveloping care/personal centred plans. This will be reassessed during future inspection visits. The available menu indicated a varied and balanced diet is provided. Residents informed the inspector that they are asked what they like to eat. The inspector had the opportunity to observe lunch. It was noted that residents choice was being respected. Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. 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. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20. See also standards 6 to 10 of this report with regards to care/personal centred plans. Residents receive personal support in the way they prefer but care/personal centred plans require reviewing. The health and personal care of residents is well managed within the home. EVIDENCE: Observation and discussions indicated staff provide sensitive and flexible personal support to maximise residents privacy, dignity, independence and control over their lives. Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 15 Care plans seen and discussions indicated that the healthcare needs of service users are assessed and recognised and procedures are in place to address them. All residents have been assessed as being incapable of managing their own medication. Documentation was seen. Medication records were well maintained and up to date. Medication was stored as required. It was acknowledged that it would be best practice for two members of staff to sign when administering diazepam. Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23. Residents views are listened to and acted on. Residents are protected from abuse. EVIDENCE: Residents informed the inspector that they are aware of how to and have made formal complaints. A record of complaints and outcomes was seen. A clear and effective complaints procedure, which includes the stages of, and timescales for the process was seen. Mrs Cozens informed the inspector that the format of the complaints procedure is being reviewed to be more suitable for residents. The home has a clear policy and procedure to ensure service users are safe guarded from abuse. Evidence of staff having compleed adult protection training was seen. Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26 and 28. Residents live in a homely comfortable and safe environment. Residents bedrooms promote their independence. Shared spaces complement and supplement residents individual rooms. EVIDENCE: Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 18 Fernhill Lodge provides a homely environment. The atmosphere is relaxed and residents said that they enjoyed living in their home. The organisation employs a maintenance engineer to carry out routine maintenance between two homes. The home was clean and well maintained at the time of the visit. Staff have suitable administration and sleeping facilities. A sample of 3 residents rooms were inspected. It was noted that residents can take their own furniture to the home and have personalised their rooms. Each resident’s bedroom seen had furniture and fittings sufficient and suitable to meet individual needs and lifestyles. Comfortable, safe and fully accessible shared spaces is provided both for shared activities and for private use. Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 35. Residents are supported by competent and qualified staff. EVIDENCE: Discussions and evidence seen indicated that majority of staff have completed the National Vocational Qualification (NVQ) level 2 in care and one member level 3. Observations and discussions indicated that staff on duty have the competencies and qualities required to meet residents needs. Staff on duty also portrayed knowledge of specific residents disabilities with an appreciation of and ability to balance particular and fluctuating needs of individuals. Residents spoken with and observations indicated that they view staff as being approachable and helpful. All new staff are required to complete an induction pack from the Learning Disabilities Award Framework (LDAF). A completed document was seen by the inspector. Staff on duty portrayed a positive attitude towards training. Mrs Cozens informed the inspector training is planned with regards to care planning, risk assessments and medication. Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. 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 home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38, 41 and 42. Residents benefit from the ethos, leadership and management of the home. The effectiveness of current fire door closures require reviewing. EVIDENCE: Mrs Cozens had only been in the position as acting manager for four days at the time of this inspection. Observations and discussions indicated however, that the management approach creates an open, positive and inclusive atmosphere. Staff confirmed the manager communicates a clear sense of direction and leadership. There was also a relaxed and peaceful atmosphere which indicated a safe and supportive environment where service users abilities and aspirations can be promoted. Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 21 The inspector had the opportunity to speak with all staff on duty and service users. It was evident that good working relationships exist between staff, and service users and staff. Apart from care plans, records were well maintained and up to date. All records are kept secure to maximise confidentiality. It was noted during the visit that the more frail residents found it difficult to negotiate fire doors due to the current closing devices. One resident had their bedroom door wedged open which is not acceptable. The closing devices on communal and bedroom fire doors require reviewing to ensure residents welfare, safety and independence. Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 22 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. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 x 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fernhill Lodge Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 x x 2 2 x H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA 1 Regulation 4 Schedule 1 Requirement Timescale for action 30/06/05 2. YA 6 15 3. YA 9 13 4. YA 42 13 (4 a ) The registered manager must produce an up to date statement of purpose and service user guide that accurately reflect the categories and services provided for in the home.This issue was raised as a result of the previous inspection. The registered person must 30/06/05 ensure that all care plans are dated, regularly reviewed and reflect the individual and changing needs of service users.This isue was raised as a result of the previous inspection. The registered person must 30/06/05 ensure that all risk assessments are relevant to the individual and reflect needs identified in care plans. This isue was raised as a result of the previous inspection. 30/06/05 The closing devices on communal and bedroom fire doors require reviewing to ensure residents welfare, safety and independence. An action plan regarding this requirement is to be forwarded to CSCI by the stipulated timescale. Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Fernhill Lodge H54 S37561 Fernhill Lodge V223618 280405.doc Version 1.30 Page 25 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton 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. 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