Inspection on 17/11/05 for Fernmount House

This inspection was carried out on 17th November 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 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

Fernmount House 19/04/07

Fernmount House 28/04/05

Fernmount House 12/01/05

Fernmount House 12/05/04

Fernmount House 16/07/03

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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 Fernmount House Forest Pines New Milton Hampshire BH25 5SX Lead Inspector Mrs Pat Trim Unannounced Inspection 17th November 2005 11:00 Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 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 Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 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. Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fernmount House Address Forest Pines New Milton Hampshire BH25 5SX 01425 611 558 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) Hampshire County Council Mrs Lynne Chessell Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th April 2005 Brief Description of the Service: Fernmount House provides a service for five adults with a learning disability. One bed is kept for emergency placements, but the other four offer short stay breaks. The home is owned by Hampshire County Council and managed by Mrs. Lynne Chessell. Accommodation is provided on two floors of a large family house. There are five single bedrooms, one of which may accommodate a service user who also has a physical disability. This room has an en suite bathroom and a hoist system. Communal space comprises a large lounge and dining room. The home is situated in the grounds of a Local Authority day service for people with a learning disability. It is close to New Milton, shops, local amenities and public transport. Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second statutory inspection for 2005/2006 and both reports should be read for an overview of how the home is meeting the standards. It was an unannounced inspection, completed by one inspector in three hours. The focus of the inspection was to assess core standards not covered on the previous inspection. There were no requirements to review from the last inspection. Information was gathered from speaking with one service user and the registered manager, and looking at a selection of records. Information was also obtained from the pre inspection questionnaire, completed by the registered manager. What the service does well: What has improved since the last inspection? The statement of purpose and service users’ guide have been prepared in a format that is more accessible to the client group and will enable service users to have information about the service prior to using it. A new care plan format is being introduced that is much easier to use with service users and will record their wishes and aspirations for their stay at Fernmount. A project was undertaken this summer with service users and staff to improve facilities in the garden. This has resulted in an area being provided with table and chairs so service users and staff have somewhere to sit outside in good weather. Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 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 Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 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): Standard 2 was assessed on the last inspection. EVIDENCE: Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 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): 9. Assessments are used to identify and minimise risk which enable service users to undertake the activities they have chosen even if they might involve an element of risk. EVIDENCE: The files for service users currently staying at Fernmount House were seen. These contained basic risk assessments such as moving and handling, where they were required. Risk assessments were also used to enable staff to support service users with more complex emotional needs. For example, a service user could become agitated if, from his perception, he was being ‘told off’ for something. This was identified as a risk and staff given guidance on how to address issues with this service user in a way that treated him with dignity and respect and did not make him feel he was being disciplined. During the inspection, the registered manager was observed dealing with a difficult situation by risk assessing it and making decisions based on treating the service user with respect, upholding her rights to make her own choices and minimising the risk involved in doing this. Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 Page 10 Risk assessments are completed on a daily basis, when the main activity for the day has been decided. For example, if it is decided that some service users wish to go out shopping, the risk assessment identifies any risk associated with that activity for each service user. Staffing levels are adjusted according to identified risk. For example, there was an identified high risk to one service user of epileptic seizures during the night. When he comes for a short stay, a waking night staff is employed. Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 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): 13 15 and 17. Service users have access to information about local facilities which enable them to make choices about what activities they go to in the local community. The policy of the home supports and enables service users to maintain their relationships. The system used for the provision of meals enables service users to be actively involved in choosing what they eat. EVIDENCE: Service users are able to plan what they wish to do during their stay and have information about a wide range of local activities. The service user in the home at the time of the inspection said she had been out for cake and coffee the day before at a local café. She also said she had been shopping and for drives to local beauty spots. The registered manager said that on the day of the inspection the service users had gone out with two staff to Boscombe. This trip had been chosen by one of the service users. Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 Page 12 The daily log recorded the various activities chosen by service users that accessed the local community, such as shopping, going out for meals and visits to the pub. The registered manager confirmed that the majority of service users have used Fernmount for short stays for a long time. Service users get to know each other and visits may be planned so friends may stay at the same time. The terms and conditions state that service users may invite people to visit them during their stay and the registered manager confirmed that family and friends may visit service users whilst they are staying at Fernmount. However, she said that some families and service users prefer to use the opportunity of the short stay to have a break from each other. As service users are usually at the home for a holiday, menu plans are completed on a weekly basis by those staying at Fernmount. These showed a wide range of meal provision. The registered manager said that service users took it in turn to choose the main meal of the day. She confirmed that service users could have an alternative main meal if they did not like what someone else had chosen. Packed lunches are provided for the majority of trips out and the main meal is served in the evening when everyone is home. The home had a good supply of fresh fruit and vegetables, and ample food stocks. During the inspection the registered manager was observed explaining to a service user that if she did not like the sandwiches that had been made for lunch, she could choose an alternative. She supported the service user to make a choice. Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 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): 20 There are good systems in place for the storage and administration of medication that enable service users to self medicate safely. EVIDENCE: Information provided by the pre inspection questionnaire showed that all staff responsible for the administration of medication had received appropriate training. All those who gave out medication were assessed by the registered manager as competent to do so and a written record of this assessment was kept on file. The service user present in the home at the time of the inspection said that she liked the staff to look after her medication and felt safer if they did so. The registered manager said that service users were asked whether they wished to self medicate. One service user was currently self-medicating. A risk assessment had been completed. There was evidence this was reviewed prior to each short stay to make sure it did not need amending. The home had a robust policy and procedure for the management of medication and all staff were required to sign a record to confirm they had read them. A new recording system had been introduced that the registered manager said staff were finding easy to follow. The record had been signed to confirm all medication had been given out that morning. All medication Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 Page 14 brought into the home was checked and a record kept of it. Medication was stored appropriately in a locked cupboard. Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 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): 23 Robust policies and procedures, and on going staff training, ensure service users are protected against the risk of abuse. EVIDENCE: Information in the pre inspection questionnaire identified that staff had received training in the use of restraint and the registered manager confirmed more was being arranged. New staff attend an introduction to working with challenging behaviour during their induction training. Training relating to the protection of vulnerable adults is also included in NVQ 2 training. The home had an in house policy and procedure that included a policy on whistle blowing. These were based on guidance from Hampshire’s Protection of Vulnerable Adults procedure. The registered manager and staff had experience of working with the procedure in relation to service users who had stayed at Fernmount. Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 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): 27. Core standards were assessed on the last inspection. The provision of a new bath and the redecoration of the upstairs bathroom will provide better facilities for service users. EVIDENCE: The registered manager said the upstairs bathroom was to be redecorated and the existing bath replaced. This will improve facilities for service users as at present the room is showing signs of wear and tear and the existing bath is very deep and could present a problem for service users when trying to use it. Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 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 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): 32 Staff are provided with the support and opportunities to obtain qualifications and training that enables them to meet the needs of service users. EVIDENCE: The registered manager said that new staff were able to undertake Learning Disability Award Framework (LDAF) training, which provided them with the basic skills and knowledge they needed to work with people who have a learning disability. Only when they had completed this, were they expected to undertake NVQ 2 training. The home had not yet achieved 50 of staff trained to NVQ 2, but the registered manager was aware of the requirement and two staff had already got this qualification or above. She said that all new staff were told at interview there was an expectation they would undertake this training and confirmed two new staff would be starting their NVQ 2 when they had finished their (LDAF) training. The inspector was satisfied the home was committed to providing opportunities for staff to complete qualifications that enabled them to meet the needs of service users. Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 Page 18 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 42. Service users may be confident the registered manager has the skills and experience needed to provide service that meets their needs. Systems are in place that ensure the health, safety and welfare of service users are protected. EVIDENCE: Ms. Chessell has been the registered manager of Fernmount for nine years. She had a diploma in social work (DipSW) and has the Registered Managers’ Award. Staff training records evidenced that staff are expected to undertake training and refresher courses in basic health and safety, such as food hygiene, first aid and fire training. Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 Page 19 Information obtained from the pre inspection questionnaire and records seen during the inspection evidenced that equipment and utilities, such as the gas central heating, were regularly serviced. The fire log book recorded that staff received regular in house training. The fire safety officer for the home had recently attended a refresher course in fire safety. Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 Page 20 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 X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fernmount House Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 X DS0000037201.V261799.R01.S.doc Version 5.0 Page 21 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Fernmount House DS0000037201.V261799.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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