Inspection on 28/04/05 for Fernmount House

This inspection was carried out on 28th April 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 17/11/05

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 Pat Trim Unannounced 28 April 2005, 14:30 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. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Fernmount House Address Forest Pines New Milton Hampshire BH25 5SX 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) 01425 611 558 Hampshire County Council Mrs Lynne Chessell Care Home 5 Category(ies) of Learning Disability (5) registration, with number of places Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12/01/2005 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. 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 H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection for the year 2004/2005. It was an unannounced inspection and took three hours to complete. It was carried out during late afternoon/early evening in order to see service users when they came back from their activities, as it is normal practice for people to be out during the day. During the inspection there was an opportunity to talk with three service users and two staff. A partial inspection of the environment was also carried out. No requirements had been made following the last inspection and none were made following this one. What the service does well: What has improved since the last inspection? What they could do better: The Statement of Purpose, service users’ guide and terms and conditions are currently being reviewed. They should be produced in a range of formats more suitable to the client group so that all the people who use the service may have access to them. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 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. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 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 Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 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) 1, 2, 4 and 5 Service users are given sufficient information about Fernmount to make an informed choice about whether they wish to stay there, but they would further benefit by this being in an accessible format. Comprehensive assessments completed prior to admission ensure that the service is able to meet service users’ identified needs. EVIDENCE: The Statement of Purpose contains all the information required by the Regulations, such as the number of rooms, number of staff and their qualifications. The service users’ guide is incorporated into the terms and conditions and includes the complaints procedure, the Commission for Social Care Inspection address and telephone number and the fee to be paid. All service users are given a copy as part of the admission procedure. Two signed and dated contracts were seen on two service users’ files. The registered manager confirmed the Statement of Purpose and other documents were being reviewed. The objective should be to produce them in a number of formats to meet the needs of all service users. Service users said they had visited the home prior to coming for a short stay and the admissions procedure stated that all prospective service users must make an initial visit. Service users using the unplanned admissions bed are often already known to the service as they have used it for short breaks. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 9 Two files seen had extensive pre admission assessments, completed by care managers. Only service users referred through the care management process may use the service and pre admission assessments must be completed as part of the procedure. The new protocol for unplanned admissions gives a timescale for the completion of an assessment of need. A planning meeting to identify short and long term objectives has to take place within 72 hours of admission. This protocol had already been used by the registered manager and the service user was being supported to move to permanent accommodation. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 10 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 and 7 Staff working in partnership with service users support them to make choices about how they spend their stay at Fernmount. The use of good communication and the sharing of information ensure that changing needs are identified and met. EVIDENCE: The registered manager was observed making sure that decisions were made by service users and not staff in the home or from other agencies. For example, someone telephoned to arrange an overnight stay for the service user looking for a permanent placement. The registered manager said she would pass the request to the service user for him to decide, and later, was seen discussing the invitation with him. The service user confirmed the registered manager was supporting him to decide where he wanted to live and staff ensured he was able to go and try out a number of options. Service users said they were able to decide how to spend their short break. Some chose to continue with their normal routine whilst others treated their stay like a holiday. The daily routine was decided each morning by the service users, as were menus and in house activities. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 11 Care plans were simple, as they were only required to compliment those already in place for the service user living in the community. Risk assessments were completed for anything identified in the assessment as a cause for concern. A care plan for service users admitted as unplanned admissions were completed by the care manager. These were drawn up after the planning meeting had been held. These identified objectives, timescales and persons responsible. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 12 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) 12, 14 and 16 Staff support service users to make full use of their stay at Fernmount by ensuring that their wishes are central to all planned activities. The deployment of staff enables service users to have the opportunity to try a wide range of activities during their stay. EVIDENCE: Service users having short stay breaks are able to choose how they spend their time. Two staff are available to accompany service users on trips out. On the day of the inspection they had chosen to go for a picnic. They had also been shopping. One service user said that Sunday was a ‘chill out’ day when service users chose to relax and have a traditional Sunday lunch. Some service users had chosen to go shopping on Saturday and were deciding what they wanted to buy. The daily log recorded a wide range of activities chosen by service users during their short stay. Opportunities available within the home included cooking, quizzes and puzzles. The layout of the home enables service users to spend time alone in their own rooms, to watch television in the dining room or spend time chatting in the lounge. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 13 Staff confirmed they were there to support but also to enable service users to try things they might not always be able to experience at home. For example, some service users said they liked to help with shopping and cooking. Service users on unplanned admissions are encouraged to continue with their normal routine, although they are also able to join in some of the activities. Two service users currently in the home continue to attend their day centre and work place. Transport has been provided to enable this to happen. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 14 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 and 19 Staff commitment to service users’ rights to privacy, dignity and choice ensure personal care is given in a way that service users’ choose. Staff ensure that service users’ health needs are met. EVIDENCE: Two service users said staff supported them only where required and gave examples of the type of help they might need. Staff were able to identify the assistance they gave these two service users which was exactly as described by the service users. Service users confirmed they were supported to attend health care appointments. One service user said he needed to go to the dentist and this was being arranged. He confirmed he would need someone to go with him and that this would be provided. Service users also confirmed they were able to see a doctor if required. One care plan identified that it had been noticed someone’s mobility had deteriorated since their last visit. The key worker confirmed she was passing this information on to the care manager to be included in the person’s review. The registered manager was observed discussing one service user’s emotional support needs with his care manager. She described how staff spent time helping him reflect on the outcome of some of his actions. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 15 Service users said how the registered manager was ‘always there’ for them and how she would support them to work through emotional problems. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 16 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 The ‘open door’ policy of the home ensures service users feel their concerns will be listened to and addressed. EVIDENCE: Service users said they felt confident they could take any concerns to staff and that they would be listened to. The complaints procedure is given to all service users on admission and contains sufficient information to support service users to use it. Regular feedback on the service is obtained from service users and their families. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 17 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 and 30 Service users’ needs are met by the comfortable environment and the cleaning schedule ensures the home is maintained to a hygienic standard. EVIDENCE: Service users said how much they liked the lay out of the home. They particularly liked having their own rooms and being able to lock the door. They were not concerned about not being able to bring items such as televisions and videos in with them as they said they enjoyed the social aspect of their short stay. The home provides five single bedrooms. One is on the ground floor and has been adapted to accommodate a wheelchair user. It has an en suite. All the others are on the first floor. They are simply furnished and have lockable storage space. Communal space comprises a lounge and dining room. Service users said they tend to watch television in the dining room, which is also furnished with a lounge area and to use the large lounge as a room to socialise in. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 18 The home is cleaned on a daily basis by contract cleaners on Monday to Friday. Staff are responsible for light cleaning at weekends. On the day of the inspection the home was clean and there were no unpleasant smells. Service users on short breaks, are not expected to help with domestic tasks, but may if they wish to. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 19 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) 35 Service users are supported by well trained and motivated work force. EVIDENCE: Following the departure of a number of staff the home has been short staffed. This issue is now being resolved with the appointment of two new staff. These appointments will bring the staffing complement back to normal. During the week two staff are available to accompany service users on outings with the registered manager remaining in the home to support anyone who does not go out. Staffing levels are adjusted to provide appropriate support for the number of service users accommodated at any one time. The registered manager confirmed she was just completing individual training needs for the year. This information is used to identify training needs for the unit. Staff will now be completing Learning Disability Awareness Framework training before NVQ 2 as this is more appropriate to meet the needs of service users. Staff confirmed they had completed a wide range of training and were aware that core training such as moving and handling needed updating. This had been identified as a training need. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 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 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) 39 A wide range of systems are in place to obtain information about the service to ensure the service provided meets the needs of the people who use it. EVIDENCE: Service users described the registered manager as ‘perfect’ ‘very nice to talk to’ and said she ‘sorts out any little problems’. Staff also confirmed she was very supported and that they felt very much part of a team. Information about the service is obtained by talking with service users during their stays. Regular meetings are held for service users and staff and once a year a carers meeting is held. Surveys are also used at least twice a year to obtain feedback on all aspects of the service. Service users said the registered manager listened to their comments and they felt very much that their opinions mattered. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 21 During the inspection it was noted that regular fire drills were carried out. These were for all the people staying in the home, staff and service users. Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 x 3 x 3 x Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fernmount House Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 23 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 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. 1. Refer to Standard Good Practice Recommendations Fernmount House H54 S37201 Fernmount House V222538 280405 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Hampshire Area 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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