Inspection on 23/03/06 for Fernica

This inspection was carried out on 23rd March 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fernica 24/09/07

Fernica 30/08/06

Fernica 20/04/05

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 Fernica 18-20 Kings Road Prestwich Manchester M25 0LE Lead Inspector Lucy Burgess Unannounced Inspection 23rd March 2006 09:15 Fernica DS0000044739.V284693.R01.S.doc Version 5.1 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 Fernica DS0000044739.V284693.R01.S.doc Version 5.1 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 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. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Fernica Address Fernica 18-20 Kings Road Prestwich Manchester M25 0LE 0161 773 6603 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) Mr Neil Laventiz Miss Marguerite Clark, Mrs Miriam Elizabeth Laventiz Miss Marguerite Clark Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14) of places Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 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. 20th April 2005 Date of last inspection Brief Description of the Service: Fernica is a small care home providing accommodation and support for up to 14 people with mental health needs. The home is located within the Prestwich area and is close to all local facilities. Public transport may be easily accessed for Bury, Prestwich Village and Manchester City Centre. The home is made up 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. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced inspection and took place on over one day. The inspector arrived at 9.15am and left the home at 3.00pm for a period of 5¾ hours. Time was spent time talking with residents to see what they thought of the staff support and general routines within the home. Time was also spent talking with the manager/owner and staff member on duty to discuss what they do for residents. Records were also looked at. Those key standards not looked at during this visit were addressed at the last inspection in April 2005. What the service does well: What has improved since the last inspection? Training is provided, this has included anxiety and depression, challenging behaviour and risk assessments. More recent courses have included infection control and adult protection. On going redecoration of bedrooms as well as new carpets, bedding and curtains have been bought. This continues to improve the appearance of the home providing comfortable, private accommodation for the residents. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 6 What they could do better: Changes are being made with regards to the Registered Providers of the home. This is being addressed with CSCI. Checks are needed to the small appliances and gas safety. been done copies of the certificated are to be placed on file. Once they have The manager is also to make arrangements for one resident to have a replacement bed and for the damp in one bedroom to be looked at. Further training is still being sought with regards to 1st aid, this is to be provided to the team. 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. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Fernica DS0000044739.V284693.R01.S.doc Version 5.1 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 the following standard(s): None EVIDENCE: The key standards were assessed at the previous inspection carried out in April 2005. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 6 and 9 Care plans outline the needs and support of residents providing staff with clear information with regards how these are to be met. EVIDENCE: Individual files are held for each of the residents. This includes assessment and reviewing notes, care plan, risk assessments, correspondence and diary notes. The care plan covers areas in relation to individual physical and emotional wellbeing as well routines, religion/culture and finances. Plans detail needs, goals, support requirements and risk assessments. Information continues to be orderly and easy to read. Plans are reviewed regularly or as needs change. This was evidenced on those files seen. Formal reviews are also held with mental health professional as part of the discharge programme and information is held on file. It is suggested that plans are signed by each of the residents to evidence their involvement and agreement. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 10 Additional records continue to be completed. These include a communication diary for each of the residents, which are completed by the staff. This enables information to be passed within the team of individuals’ daily activities, if any issues have arisen or for monitoring purposes. Where concerns are noted in relation to the mental health of a resident the mental health professionals involved would be notified. The Community Psychiatric Nurses (CPN) and hospital consultants continue to provide on-going support and advise to the team. Risk assessments have been completed and address particular needs around mental health needs and vulnerability. Where additional needs are identified these too would be assessed. Residents 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. Residents follow various activities, attending college or therapeutic employment opportunities. These are based on individual preferences and wishes and enhance lives and skills. Feedback received from those residents spoken with was very positive. Individual felt very settled, one resident expressed that ‘this is the best place I have lived’, another stated he was ‘very comfortable and they look after us’. Through discussion with staff it was found that they had a good understanding in relation to the needs and wishes or residents. Interactions were good, open and friendly. Resident meetings are also held where decisions affecting the group/home can be discussed, enabling them to share ideas. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 11, 12, 13, 14 and 15 Individuals pursue a variety of activities both in and away from the home enabling them to develop skills and increase their independence. Regular contact is made with family and friends. EVIDENCE: Fernica is situated close to a main road. Easy access is available for public transport between Bury and Manchester. Those individuals using public transport have the provision of a travel pass. The home is also situated close to all amenities including shops, take-away, post office, church and synagogue. Routines at the home vary. This is very much dependant on the needs and wishes of individuals. Whilst some are actively involved in college courses, doing computers and maths or therapeutic employment others choose to spend more time at home. A variety of activities are followed and include attending drop-in centres, theatre outings, local pub, library, music lessons as well as tasks within the home or relaxing watching the television or videos and listening to music. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 12 Some of the residents also have additional staff support provided from the local mental health services who provide 1-2-1 sessions, which includes accessing community facilities and developing practical skills. Residents also maintain contact with family and friends. One resident had previously been on holiday with family members and arrangements are made for individuals to have overnight visits away from the home. Visits also take place at the home from family, friends and members of the local Jewish community, particularly around festival times. During the inspection it was observed that two of the residents are currently on a ‘rehabilitation’ programme, which involves them menu planning and purchasing items so that they can prepare their evening meal twice a week. This enables them to develop practical skills and independence for when they are able to move to alternative accommodation. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 18 and 19 Resident’s health and personal care needs are consistently met at the home, ensuring their mental well-being. EVIDENCE: Residents have access to health and social care professional as and when they are needed. These include GP’s, psychiatrists, dentists, continence advisor, dietician, nurse clinics, social workers and consultants for aiding mobility. A clear record is made of all appointments and support is provided. The mental health needs of residents are also closely monitored by both staff at the home and those that offer support from the mental health team ensuring the well-being of residents is maintained. Where concerns are identified the appropriate action can then be taken. Formal reviews continue to be held and minutes recorded detailing the stability/changes of each resident’s mental health. Generally each of the residents are able to manage their own personal care needs and this is encouraged so that individuals maintain some level of independence. Where necessary residents are prompted or support by the staff ensuring they maintain their own care and general well-being. Where support is provided this has been detailed within the care plan. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 14 Due to the needs of the residents regular support continues to be provided from the mental health professional including support staff who visit the home regular and provide some 1-2-1 input with individuals enabling them to accessing places within the community as well as developing new skills. These visit enable staff to monitor resident’s well-being, which is then discussed within the formal reviews. These are held on a regular basis as outlined within individual plans and monitor the stability of individual’s health, behaviours and medication. As outlined further within the report the manager must ensure the information as required under regulation is forwarded to the CSCI where this may affect the well-being of residents. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 22 and 23 Clear procedures regarding the investigation of complaints and adult protection issues are in place, ensuring that residents were listened to and protected. Training has recently been undertaken in this area ensuring staff are aware of the procedure to follow. EVIDENCE: Information is provided with regards to the complaints procedure. A copy of the document is displayed within the sitting/kitchen area. Copies are also held within the residents’ information pack, which is available in each of the bedroom. Residents spoken with had no concerns. No issues have been raised at the home or with CSCI. In relation to adult protection, the home holds a copy of the Inter Agency Procedure. Recent training has also been undertaken by the team with regards to the adult protection procedure ensuring they are aware of the procedure to follow should this arise. Additional policies continue to be held in relation to ensuring the rights and safety of residents are protected. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 24 Fernica continues to provide a comfortable, clean and homely environment for those living in the home. EVIDENCE: Fernica is a large detached property, originally two houses, which have been made into one. Accommodation is provided on 3 floors and comprises of 2 lounges, one of which is the designated smoking area, dining room, sitting area and kitchen. There are 14 single bedrooms and 4 full bathrooms, one of which provides assisted bathing enabling further support to be provided for residents in managing their personal care needs. A separate laundry room is also available on the 1st floor. Over the last year the owners have undertaken refurbishment and redecoration of the home, which has enhanced the property providing welcoming and comfortable accommodation for those living there. Extensive work had also been carried out within the basement rooms, these were being redecorated and re-carpeted during the visit. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 17 One resident stated, ‘they have spent a lot of money making the home nice, it’s very comfortable, I’m happy here’. Residents are able to move around the home freely and spend time relaxing in both their own rooms as well as communal areas. Whilst looking at the environment 2 bedrooms had recently been redecorated, re-carpeted and new bedding purchased. Rooms were attractive. Other bedrooms currently occupied had been personalised with individual belongings. It was noted in one room that the bed had collapsed therefore needs replacing. Another room had damp around the window on the external wall. The manager is to ensure that these issues are addressed. The home continues to employ a housekeeper who undertakes a majority of domestic tasks. However the care staff also undertakes tasks. The environment was found to be clean and odour free. A separate office and facilities are available are staff on the ground floor. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 18 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 32, 34 and 35 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 and 35 Sufficient staffing levels and recruitment checks were in place ensuring the safety and protection of residents. On going training is provided so that staff are equipped with the knowledge and skills needed in meeting the needs of residents. EVIDENCE: As the team is small all staff are aware of their role and responsibilities. Staff communicate with each other on a day-to-day basis, therefore have a good understanding in relation to the needs of the residents and events, which have occurred each day. Staffing currently comprises of 3 owners, carer, 2 bank staff and domestic. Previously each of the owners have provided support within the home. Due to recent changes alternative cover has been required. At present the Registered Manager is undertaking the majority of cover with some shifts being covered by bank staff. Alternative arrangements are to be made ensuring the manager has sufficient breaks between shifts as well as providing adequate cover within the home. Support workers from the local hospital also provide additional support. Support is offered to residents in accessing activities within the community as well as attending appointments. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 19 Recruitment files were not examined during this visit as no new staff have been employed. Previous examination of files found that relevant information and checks had been carried out. Further recruitment is being considered due to changes in staffing. Staff training has also been provided. Previous training has included Operating Safely, Risk Assessment, Dealing with Challenging Behaviour and anxiety and depression. More recent training has included adult protection and infection control. Outstanding training is still needed with regards to 1st Aid. This must be addressed. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 Effective management of the home is in place ensuring residents are consulted with and involved in the development and plans made for the home. EVIDENCE: Fernica is a family owned home. Changes are being made with regards to the Registered Providers. This is being dealt with by the CSCI. In relation to the day-to-day management of the home the Registered Manager who is also one of the owners undertakes this. The Manager is a qualified nurse and had worked at the home for many years prior to becoming the owner/provider. Training is also being completed with regards to the NVQ Level 4/ Registered Managers Award, it is hoped that this will be completed in June 2006. Residents are regularly consulted with in relation to the development of the home. Feedback is gathered in a number of ways. Residents are actively involved in residents meetings on a regular basis, minutes are taken. Further feedback is sought from residents and families through review meetings, which Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 21 are held with social workers and mental health professionals. Staff feedback is also sought from the staff during the periodic team meetings and supervisions. Regular checks have been carried out ensuring the safety of staff and residents. Up to date certificates were in place for • 5-year electric checks, • fire appliances and alarm, • emergency lighting An up-to-date annual check is due in relation to the gas and testing of small appliances. The manager must ensure that these are undertaken and a copy of the certificates held on file. Further in-house checks are also made with regards to fire safety. Weekly checks are carried out to the alarm and means of escape. Fire drills are also undertaken on a monthly basis. Clear records are held. Coshh assessments had been reviewed and updated as identified at the previous inspection. Those staff responsible for cooking meals ensure that records are completed with regards to food and fridge/freezer temperatures. The accident/incident book was seen, no recent issues had occurred. The manager is however reminded of the procedure to follow with regards to Regulation 37. Information should be forwarded to the CSCI with immediate effect with regards to any issues, which may affect the well-being of residents ensuring they are protected. Fernica DS0000044739.V284693.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 3 32 X 33 2 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 2 X X 3 X X 2 Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard YA24 YA24 YA33 Regulation 23 23 18 Requirement That damp found in one of the bedrooms identified during the inspection is addressed. That arrangement is made for a replacement bed for the resident identified at inspection. That arrangements are made with regards to staff cover ensuring the manager has sufficient breaks between shifts. That evidence is provided of staff completing up to date 1st aid training (previous timescale of 31st December 2005 not met) That a gas safety check and the testing of small appliances are carried out and certificates held on file. That a notification is forwarded to the CSCI with regards to all incidents that may affect the well being of residents. Timescale for action 30/06/06 30/04/06 30/05/06 4. YA35 18 30/06/06 5. YA42 23 30/04/06 6. YA42 37 30/04/06 Fernica DS0000044739.V284693.R01.S.doc Version 5.1 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 YA7 Good Practice Recommendations That service users are encouraged to sign care plans to evidence their agreement Fernica DS0000044739.V284693.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office 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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