Inspection on 20/04/05 for Fernica

This inspection was carried out on 20th 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

Fernica 24/09/07

Fernica 30/08/06

Fernica 23/03/06

Fernica 04/10/04

Fernica 06/04/04

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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 FERNICA 18-20 Kings Road Prestwich Manchester M25 0LE Lead Inspector Lucy Burgess Announced 20 April 2005 th 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. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Fernica Address 18-20 Kings Road, Prestwich, Manchester, M25 0LE 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) 0161 773 6603 Mr Neil Laventiz, Mrs Miriam Laventiz, Miss Marguerite Clark. Miss Marguerite Clark CRH Care Home 14 Category(ies) of MD Mental Disorder registration, with number of places FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: The service should at all times employ a suitably qualified and experienced Manager who is registered with the NCSC. The matters detailed in the attached schedule of requirements must be completed in the timescales. Date of last inspection 4th October 2004 Brief Description of the Service: Fernica comprises of two semi-detached houses, which have been converted into one property. Accommodation is provided on three levels. There is no lift facility. The home is a family run home, offering accommodation for up to 14 adults with mental health problems and is staffed on a 24-hour basis. The home caters for both short and long stay service users. All bedrooms are single however no en-suite facilities are provided. Of the bedrooms, two do not meet the spatial requirements as stated within the National Minimum Standards. This information has been detailed within the homes Statement of Purpose. Over the past 12 months, refurbishment has taken place resulting in a number of areas being addressed. This has included new bathroom furniture, windows, radiators, wash hand basins in each bedroom and redecoration. The home is located within the Prestwich area and is close to all local facilities. Public transpot may be easily accessed for Bury, Prestwich Village and Manchester City Centre. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day for a period of nine hours. The inspector took the opportunity to look round the home, view records and policies as well as talk to manger/owners, staff and a number of service users. As the inspection was announced a completed pre-inspection questionnaire was received along with feedback surveys from 6 service users, 1 GP, 3 Care Managers and 5 relatives. What the service does well: What has improved since the last inspection? The owners have carried out work throughout the home, which has made a big improvement to the way the home looks inside. Further work is planned. The service users said they were pleased with the work undertaken. Comments included “the home is much brighter and cleaner” and “the bathrooms are in 1st class condition”. Since the last inspection improvements have been made in the range of activities for by some service users. Individuals felt more fulfilled and happy with the choices made. Improvements had also been made to the care plans and organisation of files. Information is clear and detailed outlining the needs, goals and support needs of each of the service users. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 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 FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 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) 2, 3, 4 and 5 Individuals admitted to the home are done so following introductory visits and completion of a comprehensive assessment process undertaken by both the staff and mental health professionals ensuring the needs of the service users can be met. EVIDENCE: One recent admission was being made during the inspection. Comprehensive information had been accessed from the current care providers and mental health reviews. Staff at the home have also been involved in the monthly review meetings in which progress has been monitored. Trial visits have been taking place as part of the resettlement process and observation made have been noted. This has also enabled the staff, service user and mental health professional to establish the suitability of the placement ensuring the identified needs are met. The service user expressed that she had been fully involved in the process and decisions being made. She felt satisfied that the placement was suitable and is eager to move however understood the process in line with mental health practice. Visits had also helped her to develop relationships with other residents as well as familiarise herself with the community. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 9 On admission to the home service users are issued with copies of the terms and conditions, which outline individual responsibilities. Documents had been signed and placed on file. Following assessment, needs and goals are clearly recorded within plans of care. Support provided is from a small team, who have many years of experience and knowledge of mental health issues. Those spoken with clearly demonstrated their understanding in changing needs, interventions and support levels. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 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 and 9 Care plans have been developed based on the assessed needs of the service users. Information set out is clear with regards to the needs of service users and how these are to be met. EVIDENCE: Care plans are in place for each of the service users detailing their needs, goals, support requirements and risk assessments. Information is orderly and separated into specific areas. Standardised documents have been introduced and information is reviewed with the service users twice yearly as well as formally with health professionals. Changes in needs, medication etc are clearly recorded. It is suggested that plans are signed by the service users to evidence their involvement and agreement. Risk assessment documentation has recently been amended covering individual mental health needs and vulnerability. Assessments should be completed where additional needs have been identified ie: risk of falls. Service users are able to make decisions about their lives enabling them to increase their independence. Each is able to come and go freely pursuing activities of their choosing and this was observed during the inspection. Service users follow various activities and therapeutic employment opportunities. These are based on individual preferences and wishes and enhance lives and skills. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 11 Where restrictions are in place, due to identified risks separate agreements have been drawn up and signed by the service users. From feedback received and through observations made service users are happy with the support provided and interaction with staff were seen to be open and friendly. Service users felt they could speak to members of the team in confidence. Staff were found to have a good awareness of individual needs. Resident meetings are also held where decisions affecting the group/home can be discussed, affording them the opportunity to offer their opinions and ideas. Clear and accurate records are maintained with regards to service users finances. A random sample was checked and found to be accurate. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 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) All Standards Individuals pursue a variety of activities both in and away from the home enabling them to develop skills and increase their independence. Activities are based on individual preferences and additional support is provided, where required. Regular contact is made with family and friends. EVIDENCE: Service users pursue a variety of activities both formal and informal, these included therapeutic employment, college courses, drop-in centres, library, gym as well as tasks within the home or relaxing with the television, video and stereo. Activities and routines are very much dependant on the needs and wishes of service users. Additional staff support is provided through the mental health services to facilitate some of the sessions, which include accessing community facilities and developing practical skills. Since the last inspection several service users have increased their activities away from the home enabling them to develop their social skills as well as make friendships. Feedback was positive about their experiences. Individual rights are promoted. Residents are given their mail unopened and those wishing to have keys for their own room. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 13 The cultural and religious needs of service users are also addressed. Provisions are made available for special diets and food items required for forthcoming festivals. This was noted during the inspection. One service user had recently attended the local synagogue for a festival dinner and visits by the Rabbi are made to the home. The home is also situated close to churches and individuals are supported in following their beliefs as they wish. Menus are in place offering a variety of meals with alternative options and special diets are also being catered for. The meal served was seen to be enjoyed with many having second helpings. The home also maintains health care records, which includes the monitoring of weight. Action would be taken with referrals to the dietician if a need were identified. Service users also benefit from regular contact with family and friends. Feedback was received from a number of relatives who expressed that ‘a home has been created for their relative’, ‘they are looked after brilliantly’ and ‘I’m well satisfied that they are being well cared for’. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 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 Service users health and personal care needs are consistently met at the home, ensuring their mental well-being. Appropriate medication systems are in place. EVIDENCE: Documentation is held with regards to individual mental and physical health. Relevant health care professional are involved ensuring sufficient support and monitoring is provided. Regular formal reviews are made and detailed the stability of individual mental health. Personal care support is provided in varying degrees depending on needs and information is recorded. In the main service users are prompted in maintaining their own personal care. Those working through the ‘rehab’ programme are encouraged to develop skills in maintaining their own care and general well-being, equipping them with the skills to live more independently. Regular input is made with mental health professional, which include formal reviews to monitor the stability of individuals health. Detailed information is recorded within the care plans outlining the needs of service users and how they are to be met giving clear direction to those offering support. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 15 Administration of medication was observed and considered to be safe. A recent audit had also taken place by the supplying pharmacist ensuring that a safe system of storing and recording was in place. Service users medication is also regularly reviewed with health professionals ensuring the stability of their mental health. Those individuals who self medicate do so following a risk assessment, which is agreed by relevant parties and monitored to ensure that the service user is able to manage. This gives service users further opportunities to learn new skills and take responsibility in maintaining their overall well-being. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 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 Satisfactory arrangements are in place in relation to the protection of service users as well as responding to their concerns. Polices are in place outlining the appropriate response for allegations of abuse however training is outstanding in this area. EVIDENCE: Clear policies and procedures are in place covering these standards. No complaints have been received either by the home or CSCI. A copy of the Local Authorities Vulnerable Adults procedure has been accessed. The team have some knowledge in relation to the procedure to follow however staff training in relation to Vulnerable Adults has yet to be undertaken by the staff. Feedback received through the CSCI questionnaires found that people were aware of the complaints procedure. Copies of the complaints procedures are also available in each of the bedrooms, therefore accessible to service users. General issues are also discussed at the residents meetings. The home also has further written policies and procedures for adult protection these include dealing with whistle blowing, aggression, service users finances and missing person. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 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) All standards Fernica meets the needs of service users providing single bedded accommodation for up to 14 people. The environment has been greatly improved with the on-going refurbishment taking place. Adequate communal space and bathing facilities are available and aids have been provided where required. EVIDENCE: Fernica is a large detached property that is in keeping with those around it. Each of the service users have their own bedrooms, however no en-suite facilities are provided. Several areas have recently been refurbished and redecorated, which have enhanced the environment. The owners have identified further work, which needs to be undertaken and have planned a programme of work. Service users have commented on how the work has improved the environment with it looking ‘cleaner and brighter’ and the bathrooms are ‘in first class condition’. The environment was looked at, bedrooms had been personalised with individual belongings. The home employs a housekeeper who undertakes a majority of domestic tasks. The environment was clean and odour free. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 18 Some service users are encouraged to undertake some tasks independently as part of their rehabilitation, guidance is offered from staff where necessary. Three bathrooms have recently been completely refitted and redecorated offering bright, clean and modern facilities for the service users. One of the bathrooms has an assisted chair, which provides further support for one service user when managing her personal care needs. Appropriate checks are carried out ensuring the health and safety of service users and staff. The home also has a dining room and two lounges one of which is the designated smoking area. Services were seen to spend time relaxing in all areas. A separate office is provided. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 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, 33,34 & 35 Staff at the home are very experienced and in sufficient numbers to meet the needs of service users. Further training opportunities have been identified in meeting service users needs. EVIDENCE: Staffing levels are sufficient to meet the needs of service users. Where specific support needs have been identified as part of the care management programme support staff are provided from the mental health services to assist in developing individuals social and emotional skills. As the staff team is small with little turnover, recent recruitment has not been undertaken. The Manager/Owners are aware of the information to be held on staff personnel files as well as Criminal Record Checks. Alternative arrangements are to be made to cover maternity leave for one member of the team, ensuring that the manager does not work excessive hours. Recent training in health and safety and risk assessments has been undertaken by four members of the team. Training records are held. Further training opportunities for the support and domestic staff were discussed during the inspection. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 20 One member of the team is also enrolled for the NVQ training and the bank worker has previously completed the training. The Registered Manager/Owner is a qualified nurse and is currently completing the NVQ Level 4 Registered Managers Award. The two other owners are registered mental health nurses. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 21 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) 37, 40 and 42 Each of the owners work within the home and have clear direction in the running of the home. Policies and Procedures have been developed covering all areas. Certificates and checks with regards to health and safety have also been completed. EVIDENCE: The home is managed and staffed by the 3 owners. Two are qualified registered mental health nurses and one a registered nurse. Each have extensive knowledge and experience in mental health and meeting the needs of service users. The Manager is currently completing the NVQ Registered Managers Award with completion by the end of 2005. Clear policies and procedures have updated covering all areas identified with the standards with additional ones specific to the home and the needs of the service users. Information offers clear direction for staff in ensuring the safety and well-being of service users. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 22 Checks have been carried in relation to electric, gas, fire, small appliances etc. A recent visit has also taken place by the environmental health. General risk and Coshh assessments are to be reviewed and updated. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 23 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 2 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 FERNICA Score 2 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x 3 x 2 x F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 24 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 18 Regulation 18 Requirement That risk assessments are completed in all identified areas ie: mobility/falls and show how the risk is to be managed That all staff undertake training in relation to Vulnerable Adults That additional staffing is arranged to cover for maternity leave That all support and domestic staff receive training in areas relevant to their role and responsibilities for example; infection control, health and safety, specific mental health needs That evidence is provided of staff completing up to date 1st aid training (previous timescale of 31st December 2005 not met) That the general risk assessments and coshh assessments are reviewed and updated Timescale for action 31st May 2005 31st July 2005 31st May 2005 31st July 2005 2. 3. 4. 23 33 35 18 18 18 5. 42 18 31st July 2005 31st July 2005 6. 42 13 7. FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 7 20 20 Good Practice Recommendations That service users are encouraged to sign care plans to evidence their agreement That a copy of the pharmacy report is forwarded to the CSCI That the self medication policy clearly explains the risk assessment process and mangement FERNICA F56 F06 S44739 Fernica V212101 200405 Stage 4.doc Version 1.20 Page 26 Commission for Social Care Inspection Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton, BL6 6HG 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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