Inspection on 12/07/05 for Fernlea Care Home

This inspection was carried out on 12th July 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fernlea Care Home 22/04/08

Fernlea Care Home 10/04/07

Fernlea Care Home 10/10/06

Fernlea Care Home 09/01/06

Fernlea Care Home 21/02/05

Fernlea Care Home 28/06/04

Fernlea Care Home 13/01/04

Fernlea Care Home 10/02/03

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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 Fernlea Care Home Sway Road Brockenhurst Hampshire SO42 7SG Lead Inspector Roy Bega Unannounced 12/7/05 09:30am 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. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Fernlea Care Home Address Sway Road, Brockenhurst, Hampshire, S042 7SG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01905 795 088 Park Care Homes (No 2) Ltd Mrs Frances Enid Gilles CRH 10 Category(ies) of LD- Learning Disability: 10 registration, with number MD- Mental Disorder: 10 of places Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21/2/2005 Brief Description of the Service: Fernlea is managed by Parkcare Homes No: 2, which is a trading subsidiary of Craegmoor Group Ltd, a national company providing residential and nursing care. The property is a large detached house set in a large garden. It is located in the New Forest village of Brockenhurst within walking distance of local amenities. Fernlea provides care for up to 10 residents with a learning disability and/or a mental disorder. All residents are accommodated in single bedrooms. The age range of the current service users (eight male and 1 female) is 22-62 years. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report summarises the assessment of the extent to which the National Minimum Standards for Care Homes for adults 18-65 were being met at the time of the inspection. Standards not inspected on this occasion will be assessed during future visits. This inspection took place over one day, a total of six hours between 9-30 a.m. and 3-30 p.m. Opportunity was taken to look around the home, view records and talk with, residents an staff. Three requirements were raised resulting from this inspection. What the service does well: What has improved since the last inspection? What they could do better: The inspector noted the following external maintenance requirements • • • Paintwork to the guttering, facia and soffit boards is flaking Paint work to window frames and sills is flaking. In places bare wood showing and rotten. Masonry paintwork grubby and flaking in several places. This inspection took place on a hot day. It was noted that ventilation throughout the home has been reduced by the installation of window opening restrictors. Suitable ventilation is to be provided in all parts of the home which are used by residents. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 6 The lounge carpet is stained and requires cleaning/replacing. Lounge chairs are torn and require replacing. 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. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 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 Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 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 and 4. Prospective residents individual aspirations and needs are assessed prior to admission. Prospective residents have the opportunity to visit and “test drive” the home to make an informed choice as to whether the home can meet their needs and aspirations. EVIDENCE: The organisation has a comprehensive admission policy in place which includes full assessment of needs, aspirations and planned introductory visits. Discussions and a sample of three residents files records indicated that appropriately competent persons, residents and their representatives were involved in the assessment process. Observations, discussions and available training records indicated that staff have the skills and experience to deliver care effectively. Information and discussions indicated that prospective residents are invited to visit the home initially for lunch, an over night stay then a week- end before deciding whether the home will meet their needs and aspirations. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 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 standard(s) 6, 7, 8, 9, and 10. Residents are assessed and supported to take risks with regards to their daily living needs and make informed choices and decisions to fulfil their aspirations. Residents and their representatives know that information about them is handled appropriately and confidentiality maintained. EVIDENCE: A sample of 2 comprehensive personal centred care plans were seen which included the following information • • • • • • • • • • Social history. Residents aspirations and how they are to be achieved. Social interests/hobbies Social skills and “steps” how to be achieved. Community access and “steps” how to be achieved. Educational aspirations. Behaviour management and how to be achieved. Development of relationships. Physical health needs. Mental health needs H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 10 Fernlea Care Home • • • • • Communication needs. Mobility needs. Domestic abilities. Daily time table. Daily report log. It was acknowledged that the care plans are to be presented in formats appropriate to individual residents level of understanding in order to be completely personal. Risk assessments were include in documentation seen and form an integral part of the care plans, covering activities participated. Discussions indicated that staff and residents are fully involved in the care planning process. It was noted during the visit that residents, supported by staff were encouraged to participate in domestic duties. Information about residents is handled appropriately and confidences kept. The home has a policy on confidentiality. Staff spoken with portrayed a good awareness and understanding with regards to the importance of this issue. Residents’ files are kept securely. The inspector had the opportunity to talk with a nurse visiting from the “Community Learning Disability Team” who is providing advice and support in devising an appropriate care plan for a resident who recently moved into the home. Discussion indicated that the home operates in partnership with the service. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 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 standard(s) 11, 12, 13, 14, 15, 16, and 17. Residents’ rights are respected and responsibilities recognised in their daily lives. They are also provided with opportunities of personal development and participation in chosen activities including the community which demonstrates their rights are respected. Meals are nutritious and balanced offering a healthy and varied diet. EVIDENCE: See also the previous section, Individual needs and Choices, Standards 6 –10. A random sample of 2 residents daily activity programmes were seen. Activities include college courses, day services and sporting interests. For example – community access, cookery, life skills and horticulture. Residents readily informed the inspector of what they choose and like to do and that how staff are very helpful. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 12 One resident has completed the National Vocation Qualification (NVQ) level 2 in catering and informed the inspector that they are hoping to complete the NVQ level 2 in care. Discussions and available records indicated that community access forms an integral part of residents care plans. Two residents are part of the “Gardening Project” which serves both a “Sister Home” in New Milton and private contracts within the local community. One resident is being assisted in preparing to move into supported living accommodation. The inspector was informed that there are good community links with local retailers and banks. At the time of the inspection two residents were out un-accompanied visiting the local shops. Discussions and records indicated that where applicable, residents are encouraged to maintain links with family and friends. Past holidays have included, Paris, Majorca and camping on the Isle of Wight. The inspector was informed that holidays for 2005 are being planned. One resident discussed the desire of going to a holiday camp this year. Residents are involved with menu planning, shopping and food preparation. The available menu indicated a varied and balanced diet is provided. During the visit and where appropriate, staff were observed to support residents in preparing their own lunches. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 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 standard(s) 18, 19 and 20. Residents receive personal support in an appropriate manner and their physical and emotional health care needs are met. EVIDENCE: See also the previous sections, Individual needs and Choices, Standards 6 –10. and Lifestyle, Standards 11 – 17. Observation and discussions indicated that staff provide sensitive and flexible personal support to maximise residents privacy, dignity, independence and control over their lives. Care plans seen and discussions indicated that the healthcare needs of residents are assessed, and procedures in place to address them. One resident has been assessed as being able to manage their own medication. Medication records were well maintained and up to date. Medication was stored as required. Evidence of staff having received training in the management of medication was seen. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 14 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. There is a clear and effective complaints procedure which includes the stages and times-scales for the process. Comprehensive procedures are in place to ensure residents are protected from abuse neglect and self harm. EVIDENCE: A clear and effective complaints procedure, which includes the stages of, and timescales for the process was seen. Residents informed the inspector that they are aware of how to and have made formal complaints. A record of complaints and outcomes was seen. The Commission has not received any complaints in respect of the home in the preceding year. The home has a clear policy and procedure to ensure service users are safe guarded from abuse. Evidence of staff having completed adult protection training was seen. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26 and 28. Residents live in a homely environment that is well maintained internally. At the time of the visit the home was clean and hygienic. EVIDENCE: Fernlea provides a homely environment. The atmosphere is relaxed and residents said that they enjoyed living in their home. The organisation employs a maintenance engineer to carry out routine maintenance between Fernlea and the “sister home” in New Milton. The inspector noted the following external maintenance requirements • • • Paintwork to facia and soffit boards flaking Paint work to window frames and sills is flaking. In places bare wood showing and rotten. Masonry paintwork grubby and flaking in several places. Mrs Gilles informed the inspector that quotations for the necessary external repair/replacement and redecoration work have been obtained and forwarded to the regional office. Until completed these matters will remain a requirement. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 16 This inspection took place on a hot day. It was noted that ventilation throughout the home has been reduced by the installation of window opening restrictors. It is acknowledged that this practice has been introduced as company policy and subsequent to risk assessments in meeting safety needs of residents. However, the current device of rubber “door stops” screwed into window sills requires to be checked as to whether it meets the relevant health and safety legislation. Ventilation could be improved by using portable air condition units or electric fans. Adequate ventilation also includes staff working environment. The lounge carpet is stained and requires cleaning/replacing. Lounge chairs are torn and require replacing. The inspector was informed that an order has been submitted to replace the dining room chairs but this remains a requirement until new chairs are in place. Staff have suitable administration and sleeping facilities. The home was clean, hygienic and free from offensive odours. Laundry facilities are of a domestic type and meet requirements. Systems are in place to control the spread of infection. Evidence was seen to confirm that staff have received “infection control” training. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 35. Residents are supported to meet their individual and joint needs and aspirations by appropriately trained staff. EVIDENCE: Observations and discussions indicated that staff on duty had the competencies and qualities required to meet residents’ needs. They portrayed knowledge of individual residents disabilities, needs and aspirations. Observation and discussions with residents indicated that they view staff as being approachable. Staff training records indicated the following • 2 staff have completed the National Vocational Qualification (NVQ) level 3 in care. • 5 are currently completing NVQ level 3. in care. • 2 staff have completed the NVQ level 2 in care. • 1 currently completing the NVQ level 2. in care. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 18 Other courses completed include – • • • • • • • Learning Disabilities Frame Work training. Moving and handling. Control and restraint. First aid. Infection control. Health and safety. Adult protection. The inspector was informed that the training programme for the remainder of the financial year consist of • • • • Makaton. Autism. Mental health. Crisis prevention intervention. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 19 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, 38, 41 and42 Residents live in a home that is well run with an open management approach. The health, safety and welfare of residents are positively promoted within the home. EVIDENCE: During the visit, the inspector had the opportunity to speak with 3 staff and communicate with several residents. It was evidenced through these discussions and observations that good working relationships exist between the staff group and residents and staff. From observation and discussions it was also possible to assess that the management approach of the home creates an open, positive and inclusive environment. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 20 The atmosphere was relaxed indicating an environment where residents’ abilities and aspirations are being promoted. Records seen were well managed up to date and kept secure. Staff training in Fire Safety, First Aid, Food Hygiene and Infection Control is up to date. Staff have received appropriate training with regards to Care of Substances Hazardous to Health. Hazardous substances are kept in a locked cupboard to promote the welfare and safety of residents. The home has up to date maintenance certificates for the boiler, fire equipment etc. Accidents/incidents that affect the wellbeing of residents that occur within the home and whilst on activities are well documented. The Commission of Social Care Inspectorate have been fully informed of such incidents. Fire drills and required fire safety precautions are carried out and recorded. Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. 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 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 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 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fernlea Care Home Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x 3 3 x H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 22 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 24 Regulation 23 (2 b) Requirement Timescale for action 22/08/05 2. 24 23 (2 c) 3. 24 23 (2 p) Repair/replacement and redecoration as described in standard 24. An action plan is required by the stipulated date. The repair of the windows was a requirement raised resulting from the previous inspection dated 21 Feb. 2005. Lounge chairs are to be replaced. 22/08/05 Lounge carpet is to be cleaned/replaced. An action plan is required by the stipulated date. Suitable ventilation is to be 22/08/05 provided in all parts of the home which are used by residents.An action plan is required by the stipulated date. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 23 Commission for Social Care Inspection 4th Floor- Overline House Blechynden Terrace Southampton Hampshire National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Fernlea Care Home H54 S37572 Fernlea V238213 120705.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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