Inspection on 16/09/08 for Fernlea

This inspection was carried out on 16th September 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Fernlea 19/09/07

Fernlea 06/03/07

Fernlea 11/07/06

Fernlea 14/02/06

Fernlea 17/10/05

Fernlea 31/01/05

Fernlea 13/07/04

Fernlea 15/03/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Fernlea 59 Fort Ann Road Soothill Batley West Yorkshire WF17 6LS two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Catherine Howarth Date: 1 6 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Information about the care home Name of care home: Address: Fernlea 59 Fort Ann Road Soothill Batley West Yorkshire WF17 6LS 01924 470176 01924 470176 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): St Anne`s Community Services Mrs Sarah Grogan-Evans care home 7 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 7 0 learning disability Additional conditions: Seven service users with learning disabilities and four who also have physical disabilities. To provide accommodation and care for one named service user over 65 years Date of last inspection 1 6 0 9 2 0 0 8 A bit about the care home Fernlea is a care home registered to provide nursing care and accommodation for three adults with learning disabilities and four adults with learning and physical disabilities. The registration category also includes one person who is over 65 years of age. St Anne?s Community Services, a charitable organisation, operates the home. The home is located in a residential area close to the centre of Batley. There are shops, a post office and community facilities within 5 minutes? drive of the home. The property is a brick built, detached bungalow which was purpose built for use as a care home. Internally, the home is separated into two discrete units, one providing care and accommodation to adults with severe learning disabilities (red side), and the other providing care and accommodation to adults with physical and learning disabilities (blue side). All the service users have complex needs. Information about the home is available from the home and from St. Annes main office. Fees on 16 Septmeber 2008 ranged between 94 and 71 per weeek. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home The last inspection on this service was completed on 19 September 2007. This inspection was carried out by one inspector using information from a variety of sources. People who use the service and staff were sent surveys to elicit their views about it; the manager completed a self assessment and a dataset of information about the service; and the inspector carried out a site visit over a period of seven hours, which involved a tour of the building, meeting people living there and staff and examining documents relating to people’s care and management of the service. The inspector also had the opportunity to meet with two visiting relatives. What the care home does well People’s needs are assessed before they move into the home so that staff are aware of individuals’ needs and aspirations. The service supports people who use it well. People’s individual needs are considered and staff do their best to make sure that individuals can make their views and preferences known as far as they are able. Health needs are well supported. There are some individuals who need considerable support, and having a staff team with a high level of nursing support means that those needs are well met. People’s safety is high in priority within the service and staff work hard to make sure that people who live there are not put at unnecessary risk. People live in a homely and comfortable environment, which is kept clean. The staff team are well qualified overall and their training is updated regularly. The are well supported by the manager. The service is well managed by a committed and dedicated manager. What has got better from the last inspection Routine health checks are now up to date and we found that stocks of medicines were available for people who may need them. The floor covering in the kitchen on the red side has been replaced. The staff vacancies have been filled so consistency of care can be better provided to people living there. A new boiler has been fitted to make sure that water temperatures can be maintained at a safe and comfortable temperature for people living there. The person that was not getting out much last time has now returned to day services and is going out more frequently when well enough. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Catherine Howarth St Nicholas Building St Nicholas Street Newcastle upon Tyne Tyne and Wear NE1 1NB 01912333300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries.northeastern@csci.gsi.gov.uk or by telephoning our order line - Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are assisted to choose the home with the benefit of detailed assessments that make sure they can be supported properly. Evidence: One person has been admitted to the home since the last inspection. This person was unwell at the time in hospital so their involvement in the process was limited by this. However two of their relatives spoke with the inspector and said they had been fully involved and were happy with how the assessment and admission process had been carried out. They confirmed that they had been given information about the home and had visited beforehand. A good level of assessment detail was found on this persons file. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Peoples individual needs are well met and they are offered choices as far as they are able to make these with support. Evidence: Three peoples files were looked at as part of this visit. All three showed a good level of detailed and guidance for staff about meeting peoples individual needs, especially in relation to meeting health needs. For one person there was detail about how they communicate using makaton, a form of basic sign language, and staff were seen actively using makaton with this person. Some of the people living at Fernlea are very physically dependent as well as having a learning disability, mainly on the blue side. At the last inspection it was recommended that emotional and social needs should be focused on more as well as physical and medical needs. It was positive to note that this advice has been acted upon and there was evidence of more social interaction and leisure activity for one person than had previously been the case. Risk assessments showed that people are being supported to participate activities as safely as possible without limiting their choices. Most were up to date and relevant, with one exception which the manager agreed to address immediately. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Fernlea are supported to follow their interests and to have a good social life. Family and friend relationships are encouraged. People are offered a good balanced diet. Evidence: This area has improved at the home. There is now more of a focus on helping people to socialise and enjoy their lives. We found evidence that people are getting out more and also that people are being actively supported to make choices about daily living and participating in daily life activities such as cleaning and food preparation where they are able to. In particular one person who was not having much activity die to illness has now returned to attending day centre and goes out at least once a month on an outing, which can be difficult to organise because he needs a nurse with him and also drivers are in short supply at the home. Around the home people were seen to be occupied, one person was actively listening to his music and enjoying a new CD. Another person was looking at a magazine. One person went out for a walk to the park. It was noted that people are supported to have holidays and are involved in choosing these if they are able to do so. Even when this may be difficult, staff are making plans to provide holidays where staffing levels may need to be 2:1 to ensure that people still have that opportunity. One person has been to Cleethorpes and another was planning a trip to Blackpool. People receive good support to maintain family relationships. One person stays at home every week with their parents. Two relatives who were visiting on the day of this visit said they found that they are always welcomed by staff and kept informed of any news or problems. One person signed frequently for his sister, staff responded appropriately offering reassurance and told him when she would be visiting. On the red side, there are restrictions in place such as there is a gate on the kitchen to prevent people going in when staff are not present. Also there are combination locks on bedroom doors to prevent people going in uninvited. These can be left off the latch when there is no risk of this, and this was observed to be the case on the day of this visit where people were moving in and out of their rooms freely, as the person who is likely to do this was not present. The inspector observed one mealtime. This was relaxed and people were offered appropriate choices. One person was unwell and has not been eating. Staff offered encouragement and were patient in giving this person the time and space to eat and drink. Adapted cutlery and crockery was available for one person who needs this in order to be able to eat independently. Records of meals serviced showed a good variety of foods provided. Staff also keep a separate record of peoples intake of fruit and vegetables to try and monitor whether they are getting their five a day. Special diets are provided where needed. Two people were seen to have thickened drinks as they have problems with swallowing and one person is now being given supplements to make sure they are getting enough nutrients. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Fernlea are well supported with their health and personal needs. Evidence: People living at Fernlea require significant assistance with personal care. It was noted that there are details on files about how to do this in ways that people prefer and overall it was seen that assistance was offered with respect for peoples dignity, although some of the language used in referring to people was on two occasions rather patronising good girl for example is not appropriate language to use with a woman of 62. Some of the people living at Fernlea have significant health problems, and all need careful monitoring and evaluation to ensure they remain healthy. We saw from files that people receive good support with all aspects of health care. People are supported to attend regular appointments such as optician, dental, chiropody for example. Where people have significant health needs there are good relationships in place with other professionals to enable the staff at Fernlea to support them, for example tissue viability nurses, consultant psychiatrists and general nursing staff. There was detailed guidance found for staff about supporting two people who need considerable support with their health needs. The relatives who spoke with the inspector said that staff do a very good job with their relative who is quite unwell. The handling of medication was looked at as part of this visit. Records were found to be up to date and stocks in the cupboard balanced with levels on the records. Storage of medicines is appropriate. Medication is given by nurses. AT the last visit we found that some stocks were missing. On this visit there were stocks of all medicines that people were prescribed. For as required medicines there were clear protocols for when they should be given and each person has a photograph on their medication file to avoid the possibility of someone being given the wrong medicine. One mistake was noted when an agency nurse gave one person the wrong as required sedative medication to calm them before an appointment. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Fernlea are safegurded by the systems in operation in the home. Evidence: The home operates the corporate complaints procedure for St. Annes Community Services. No complaints have been received about the service since the last inspection. No complaints have been made to the CSCI either. The manager and staff take the safety and welfare of peole very seriously. There have been difficuties in the past between some individuals, which has led to assaults. In the past year these incidents have been few and far between as staff now follow a very strict protocol to maintain the safety of all involved. Where incidents have occurred these have been dealt with swiftly by staff, recrded fully and reported to the appropriate agencies. Staff have received support from St. Annes Positive Behaviour Support Group, which has offered advice and guidance on appropriate techniques to use with individuals to minimise the difficulties. All staff have received training in safegurding vulnerable adults and also in managing challenging behaviour including breakaway techniques. Finance records for two people were seen. These were recorded in page numbered books and receipts were kept. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The environment at Fernlea meets the needs of the people who live there, but some ongoing improvements are needed in some areas to maintain good hygiene. Evidence: The environment at Fernlea is generally homely and appealing. On the day of our visit it was clean and tidy throughout. There have been some improvements in the home, such as new non slip flooring in the red side kitchen and some areas have been redecorated. Staff have tried to put up wall paper in the red side lounge to make it more homely, but unfortunately this has not been successful as it has been ripped off. Each side has its own character. The red side is more open and somewhat stark although as mentioned staff have tried to combat this and do continue to make efforts to ensure that it is as homely as possible. This has been achieved more on the blue side as the group living there is quite different. On the blue side however, there is less space for the group especially as some people need to use wheelchairs permanently. They do have a conservatory however which offers a little extra space. Staff reported that the lack of space had been a problem earlier this year when one person had been agitated and needed to move around a lot. A new lock has been fitted to the front door on the red side as one person left the building unescorted earlier this year which could have been very dangerous for them. Both kitchen areas were found to be pleasant and well equipped. The bathrooms on both sides need some attention. On the red side the bathroom needs redecorating to make it a more appealing place to enjoy a bath. The radiator panel and the bath panel were both rusting and could therefore be a source of infection. On the blue side the flooring is worn and needs to be replaced. The homes laundry serves both sides and is equipped with appropriate facilities to meet the needs of this group of people. There is also a macerator to manage the clinical waste. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Fernlea are supported by a well qualified and competent staff team who are well supported by managers. Evidence: The home has improved in this area since the last inspection. More staff have been allocated to the staffing establishment. One new nurse has been recruited and will be starting soon. One person needs 1:1 staffing, and this is being achieved through using casual/agency staff. Otherwise staff are consistent and therefore the quality of care that can be offered is improved as staff know people well and this helps people to be more relaxed when personal care is delivered by familiar staff. Staff training is generally good. Half of the staff team are nurses so there is a high level of skill in the team. St Annes offers a wide range of courses to staff to supplement this and basic courses are updated regularly. Not much progress has been made with NVQ qualifications for non nursing staff however. Induction covers all basic courses such as food hygiene, moving and handling, emergency aid, safeguarding and physical intervention/breakaway techniques. In their survey responses, staff said they feel they got a good induction to the work. It was noted however that the process for this has changed recently. The manager was arranging an induction for a new starter while the inspector was present and it seems that the block training that people received has now changed to a process spread out over a period of weeks or months. This causes some concerns, for example one person will not be able to have moving and handling training until the New Year. In a home where there is a significant need for this, this is inconvenient as this person will not be able to assist certain individuals alone. This may have a detrimental effect on peoples privacy and dignity. There have been no new staff starting work since the last inspection so staff recruitment records were not examined. Staff supervision and team meetings are held regularly. Staff said they felt well supported by the manager to meet peoples needs. The team have been through a difficult time however and in their responses some staff said they felt that staff morale was an area for improvement. Generally however staff did say that they felt that they are a good team and provide a good level of commitment to the people who live there. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is well managed in the interests of the people who live there. Evidence: The manager of the home is a qualified nurse and is committed to providing a good service to the people who live at Fernlea. This is evident from the amount of input she has into the records for each person and evidence of her monitoring the quality of work within the home. She also has good relationships with the people who live there and leads the staff team by example. Relatives who spoke with the inspector expressed confidence in her. This is a critical factor in the improvements that have been seen in the service over the last two years and she is commended for this commitment. The service has some mechanisms for monitoring quality. Recently questionnaires have been sent out to stakeholders but have not yet been returned. The home has a Team Plan which outlines improvements that the team aspire to in this financial year. Unfortunately this remains an inadequate tool for measuring improvements as it is not written in such a way as to make this possible by using measurable goals. The home being part of St. Annes Community Services should be visited monthly with reports available arising from these visits. Only two reports were found on file for 2008, from April and May. This means that the service is not being properly monitored by the organisation. Health and Safety checks of equipment in the premises were found to be up to date, apart from electrical appliance tests.. The manager made arrangements immediately for this to be addressed. Fire safety checks, including equipment checks, were also all complete and up to date. Records of staff attending fire drill practices, showed that some staff have not done this within the last year. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 18 20 Staff should be reminded to use appropriate respectful language with people at all times. Staff need to be vigilant that they are giving as required medicines as prescribed and according the protocols in place so that people are not given inappropriate medicines. Improvements are needed in both bathrooms to improve hygiene. On the red side the radiator panel and bath panel should have impermeable surfaces so that they may be cleaned effectively. On the blue side new non slip flooring is needed. 50 of care staff should have NVQ level 2 or equivalent. Staff should ideally take part in a fire drill at least twice a year to ensure they know what to do should a fire break out. 3 30 4 5 32 42 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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