Inspection on 19/04/07 for Fernmount House

This inspection was carried out on 19th April 2007.

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 17/11/05

Fernmount House 28/04/05

Fernmount House 12/01/05

Fernmount House 12/05/04

Fernmount House 16/07/03

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Hillview Farm

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Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

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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 Beverley Rand Unannounced Inspection 19th April 2007 10:45 Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 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.V336555.R01.S.doc Version 5.2 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.V336555.R01.S.doc Version 5.2 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.V336555.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th November 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. On the day of the inspection the manager advised the inspector that service users funded by Hampshire County Council would undergo a financial assessment to determine the charge made to an individual. For service users who are self-funding or being funded through another local authority the weekly fee is £798. Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection. On the day of the inspection there were two service users in the service and the inspector spoke with one. A staff member started to show the inspector around the home whilst the manager was otherwise engaged, before the manager completed the tour. Two staff were on duty but the inspector was unable to speak to them more fully as they took the service users out for the day. The inspector looked at records such as training files and support plans. The inspector received comment cards from four relatives of service users which were all positive. The previous inspection report was also looked at before the inspection. What the service does well: What has improved since the last inspection? What they could do better: There were no areas for improvement identified during the inspection. Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 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.V336555.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager ensures that potential service users’ needs are assessed before they are offered a service. EVIDENCE: The manager said that all new referrals for respite care are made by the local authority. The manager looks at the potential service user’s care management assessment on the local authority computer system and uses this to see if the service can meet an individual’s needs. The manager will then discuss further with the care manager to agree how contact will be made. Potential service users are invited to the service for one or more visits for an amount of time which suits them to enable everyone to gain more information which is used in the care plan. The manager gives potential service users a copy of the terms and conditions and general information about the service. Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager ensures that support plans include relevant information about individual preferences and that service users can make choices and take appropriate risks. EVIDENCE: On the day of the inspection there were two service users staying in respite beds and one in the emergency bed and the inspector looked at the support plans for all of them. The plans were thorough and included details of individual preferences and routines. Where necessary, there was evidence of support being provided by health and social care professionals. The inspector saw written evidence that service users can decide how to spend their break at Fernmount. The manager also gave verbal accounts about how service users can continue their daily routine as usual or treat the stay as a holiday and take part in different activities. Service users make everyday choices such as what to eat or to look after their own money. Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 Page 10 Risk assessments were on file to enable service users to undertake activities with a level of risk, such as keeping their own medication. Risk assessments for activities such as going to the shops were completed on a daily basis as the group can change on a daily basis as can individual abilities. Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is run in a way which ensures daily life is flexible and service user focussed. Service users can continue their daily activities and participate in new ones. Menus are not set in advance which means service users can request food they like and can help to make meals. EVIDENCE: Some service users choose to continue their daily activities, such as going to a day centre, whilst having a short stay. This is supported although the service cannot provide transport unless funding is provided. Others choose to treat the short stay as a holiday. Service users go out with the support of staff, either in groups or alone as appropriate and as staffing allows. On the day of the inspection the service users went out for lunch and a drive. The previous day service users had gone to Poole for the day. Other activities include shopping, going to the beach, forest, pubs or eating out as well as games, videos, jigsaws, manicures and facials. One of the comment cards mentioned that their relative ‘enthused’ Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 Page 12 about the trips out. The manager said that service users could be supported to vote if they happened to be using the service at polling time. The service user who spoke with the inspector said they could have visitors anytime. The terms and conditions state that service users may invite people to visit them during their stay and the registered manager confirmed that this does happen. The manager also said 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 daily routine of Fernmount is flexible and service users can choose how to spend their time. Evidence for this was seen on the day of the inspection and in written records. All the bedrooms can be locked and some service users choose to keep their own keys and lock their room. The manager respected service users’ privacy by not showing the inspector into rooms which were currently in use. If service users receive post it is given to them unopened. The manager said there is not a fixed menu, as food is decided upon by individual service users who are staying at the time. Service users can go shopping with staff or request particular foods which are then bought. The service ensures that personal food preferences are followed so that service users can feel at home during their short stay. The manager said the service currently supports service users with diabetic and vegetarian diets. Equipment such as lipped plates is provided for those who need it and staff support those who need assistance with eating, as is appropriate on any particular day. The manager also gave an example of maintaining a service user’s dignity by cutting their food in the kitchen as they do not like it cut up in front of other service users. The service user who spoke with the inspector confirmed that staff followed his mainly vegetarian diet and that he helped to make cakes and bread pudding. The manager confirmed that service users use the kitchen and one had made breakfast for the staff member that morning. The kitchen has an adjustable sink and cooker which means service users who use a wheelchair can use them independently. Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service ensures that service users’ personal and healthcare needs are met in a way which best suits them. There are good systems in place for the storage and administration of medication that enable service users to self medicate safely. EVIDENCE: Support plans showed how individual service users liked to be supported and the routines which needed to be followed. Staff were observed supporting service users in an appropriate way. The service supports visits to medical practitioners such as doctors, dentists and nurses as necessary. The manager said the service user’s own doctor would be called where possible, if the person was unwell. However, this was not always possible due to where the service user lived so a local doctor would be called. The service has lockable storage for medication, including a fridge. Service users who are able keep their own medication in a locked place and administer it themselves. Risk assessments are in place and reviewed for self medication. The drugs cupboard only contained medication for current service users and Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 Page 14 staff sign appropriate records if they administer drugs. If a service user has prescribed controlled drugs these are kept in suitable storage and two staff sign. The service has policies and procedures in place and staff sign to say they have read them. The service is supported by district nurses if a service user requires insulin injections. The manager has undertaken a specific course which enables her to provide medication training to the staff. Records showed staff had received this training. Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place for service users to give their views if they wish to complain. Robust policies and procedures ensure service users are protected against the risk of abuse. EVIDENCE: The service has a complaints procedure with the 28 day timescale for responding. The procedure is in pictorial and written format to ensure more service users can access it. The manager felt that as the service is a respite service, service users could also show their concerns by not using the service. If this were to happen she would contact them to discuss the reason they had not had a stay for a while. The four comment cards received by the inspector showed that relatives knew who to talk to if they were not happy with the service. The service has not received any complaints in the last four years. The service has the local authority adult protection procedures in place and all staff have received adult protection training. The manager was able to demonstrate that she was aware of what she should do if there was an allegation or suspicion of abuse. Service users look after their own money if possible, but a safe is available. If the service looks after money on behalf of service users during their stay, records are kept and signed by the service user and two staff members. The inspector found the money and records for the current service users to be correct. Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users stay in a comfortable, safe and clean environment. EVIDENCE: The service provides five single bedrooms. One is on the ground floor and has been adapted to accommodate a wheelchair user and has an en-suite bathroom: the others are on the first floor. All have lockable doors and storage space. Communal space comprises a lounge and dining room and service users can use the kitchen. Since the last inspection a new bedroom carpet has been fitted and the ensuite bathroom has had new flooring. A new bath has been fitted to meet the needs of some service users who could not climb out of the old one easily. Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 Page 17 All radiators are fitted with covers to prevent service users being scalded and window restrictors are fitted on windows. Water temperatures are taken on a weekly basis to ensure the water is not too hot when running a bath. Each room has a call bell which can be used to call staff and at night the bell rings in the staff member’s sleeping in room. The service is based in the large grounds of a local authority day centre. The manager told the inspector that some service users did not like to use the grounds as they were too big. Staff and service users have now created a garden area, with furniture and plants close to the house, which has been successful. The service has a contract cleaner on a daily basis throughout the week and the cleaning is done by staff at the weekend. The laundry was suitable for purpose and staff told the inspector about the procedures to follow regarding soiled laundry. Staff also said that gloves in different sizes and aprons were always available. Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has robust recruitment procedures to ensure staff are suitable to work with service users. Service users are supported by well trained staff. EVIDENCE: The service has not recruited any new staff since the last inspection and the standard was met when last inspected. The manager explained the recruitment process which she was due to undertake. She has asked service users if anyone would be interested in sitting on a service panel to assist in the recruitment of new staff. She plans for service users to meet with prospective employees during a visit to the service and then seek feedback from them. She has thought about service users being involved in formal interviews but understands that this is not possible due to recruitment procedures which must be followed. The manager was clear that staff would not be recruited if service users felt they were not suitable. The manager would undertake the necessary recruitment checks before new staff started work. The service user who spoke with the inspector said he liked staying at Fernmount. Comments from relatives included, ‘he gets on very well with the staff. They are very kind to him and welcome him every time he is there’, ‘the Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 Page 19 staff create a social atmosphere as well as being helpful and friendly towards all’, ‘she gets on well with the staff’ and, ‘staff are always helpful’. New staff undertake an in-house induction as well as the local authority’s induction within the first six weeks. The 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 National Vocational Qualification, (NVQ) 2 training. The service employs seven support staff and of these two have NVQ3 or higher, one is currently studying for NVQ2 and two are on the waiting list. The manager is aware that these figures do not meet the minimum standard of 50 , but explained that two staff with NVQ2 had left the service. Other measures are in place to increase the number of qualified staff. Staff receive ongoing training in areas such as Moving and Handling; First Aid; Infection Control, Medication, Adult Protection, Challenging Behaviour and Food Hygiene. Records were kept which confirmed that training does take place regularly. Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well managed for the safety of service users. There are systems in place to enable service users to make their views known but some service users may benefit from a more regular and direct approach. EVIDENCE: The registered manager has managed the home for ten years. She is qualified with the Diploma in Social Work and NVQ4 in management. She updates her training as necessary and recent training has included a Moving and Handling refresher course, Introduction to Challenging Behaviour and Train the Trainer in Medication. The service has a quality assurance system in place. When a booking for a respite break is taken, the confirmation letter is sent which includes an invitation to offer the service ways in which they might improve. There is an Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 Page 21 annual carers meeting and the agenda is sent to participants prior to the meeting to ensure they have time to consider issues. Each service user has a key worker which enables a one to one point of contact for service users to discuss any issues regarding the service. However, the service has not routinely sought the views of all service users since a survey was conducted about three years ago. The manager thought she might repeat the survey in the near future. Everyday issues such as the menu are discussed on a daily basis which means service users can raise issues on an informal basis. The inspector saw records which showed that fire equipment, hoists and thermostatically controlled valves are serviced at appropriate intervals. Staff have regular Fire Safety training. Food was stored appropriately and the fridge temperatures were monitored daily. Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 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 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 4 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 Page 23 N/A 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.V336555.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 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 © 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 Fernmount House DS0000037201.V336555.R01.S.doc Version 5.2 Page 25 - 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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