Inspection on 13/01/09 for Ferns

This inspection was carried out on 13th January 2009.

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

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

Other inspections for this house

Ferns 17/01/07

Ferns 01/12/05

Ferns 12/07/05

Ferns 10/01/05

Ferns 13/07/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ferns 152 Longden Road Shrewsbury Shropshire SY3 9ED     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Becky Harrison     Date: 1 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Ferns 152 Longden Road Shrewsbury Shropshire SY3 9ED 01743368039 01743340901 theferns.residential@virgin.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Pauline Jean Arrowsmith,Mr Lakin Lea Arrowsmith Type of registration: Number of places registered: care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The Ferns is a private care home registered to provide accommodation and personal care for up to 36 Older People. The home has operated since 1992 under the ownership of Mr and Mrs Arrowsmith, who live on site in a separate detached house. Mrs Arrowsmith is responsible for the day-to-day management of the home. The Ferns is conveniently located approximately two miles from the centre of Shrewsbury and enjoys easy access to all the towns main services and amenities. The building is set back from the Longden Road in attractively maintained grounds with ample parking space. It is a substantially extended large family house and offers single bedroom accommodation with en-suite facilities, in addition three lounge areas and a dining room. The home provides good access and a passenger lift is available for people with mobility difficulties. People can obtain information about this service from the home’s Statement of Purpose, Service User Guide or the providers web-site. Inspection reports Care Homes for Older People Page 4 of 27 0 Over 65 36 Brief description of the care home produced by CSCI can be obtained direct from the provider or are available on our website at www.csci.org.uk. Fees charged range from £440.00 - £475.00 per person per week. The reader may wish to obtain more information about the fees direct from the care service. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We were at the Ferns for five hours, we did not tell people that we were coming. A range of evidence was used to make judgements about this service to include discussions held with five people who use the service, 3 staff, a visitor and the proprietors. We looked at some parts of the home, reviewed the homes quality assurance processes and sampled a number of records to include complaints and protection, staff training, recruitment and health and safety records. Three visitors completed surveys for us during our inspection informing us of their views of the service. Before we did our inspection we asked the manager to complete an Annual Quality Care Homes for Older People Page 6 of 27 Assurance Assessment (AQAA) document for us. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for them to share with us areas that they believe they are doing well. By law they must complete this and return it to us within a given timescale, which the manager did. Three people who live at the home were case tracked this involves establishing individuals experience of using this service, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. We looked at the outcomes for people living at the home and information to produce this report was gathered from the findings on the day and also by review of information received by CSCI prior to the inspection date. What the care home does well: What has improved since the last inspection? The last key inspection of this service was undertaken on 17th January 2007. We did an annual service review on 18th January 2008. This did not involve a visit to the home but is a summary of new information given to us, or collected by us, since the last inspection. The report is available at the home. The home provides prospective residents and their families with an information pack, which has been updated to include photographs of the home, activities and facilities. The providers website now includes a video providing details about what the service Care Homes for Older People Page 8 of 27 offers. This enables people to make an informed choice as to whether the home is appropriate to their needs. There is now a designated member of staff who holds responsibility for planning and providing people with structured activities. People told us that more activities are available ranging from crafts to games and external entertainment such as singers. The home aims to extend the range of activities offered to include more outdoor activities. Several improvements have been made to provide people with a more homely place to live. A number of areas around the home have been redecorated, flat screen TVs have been installed in the lounge areas, new seat pads provided in the dining area and garden furniture replaced. There are plans to replace the floor coverings in the communal lounge areas over the next 12 months. Additional measures have been put in place following a medication error, which resulted in one person being hospitalised. Staff have been provided with additional training from the district nursing team and procedures have been improved to prevent it from happening again. People told us that they have been provided with a new menu with a range of choices including a vegetarian option. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People looking for a care home can be confident that the Ferns can support them. This is because information about the service is made readily available to help them make an informed choice about whether the home is able to meet their individual needs. A complete assessment of their needs is undertaken with them and others close to them, and people are given the opportunity to visit the home and to ensure it is appropriate to their needs. Evidence: The home provides prospective residents and their families with an information pack, which has been updated to include photographs of the home, activities and facilities and provides details about what the service offers. A statement of purpose and guide are made available and people may also access the providers website, which includes a video about the home. This enables people to make an informed choice as to Care Homes for Older People Page 11 of 27 Evidence: whether they would like to move to the Ferns and if the home is suitable to meet their needs. As part of our inspection we case tracked the person most recently admitted. This involved meeting and talking with the individual, looking at their care records, the admission process and speaking with the manager about the admission procedure adopted. The person told us that she and a relative had visited the home prior to admission and that she was very confident she had chosen the right place to move to. She stated The home is exceptional, I was very lucky they had a vacancy. Its a place I would recommend to anybody. We spoke with the manager about the homes admission process and looked at the persons care records, which showed that an assessment of need had been undertaken with them prior to admission. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have the information they need and have a clear understanding of how to offer care to each person, which ensures peoples health and personal care needs are met in a way that they prefer. Evidence: We spoke with 5 people who live at the home and their comments were very positive. Comments about the care that they receive include: The care here is very good Staff respect me The attention and care is exceptional, I cannot fault it We case tracked three people whose needs are very different. Their care records were detailed and evidence that they or their representative had been involved in Care Homes for Older People Page 13 of 27 Evidence: developing their care plans, which are reviewed and updated regularly. We spoke with 3 staff about the individual needs of the people we case tracked and they all demonstrated a clear understanding of the needs of the people they support. They considered that they are provided with sufficient information to ensure peoples needs are met and in a way that they prefer. We saw evidence that peoples health needs are well met and advice is sought from health care professionals as required. For example the person most recently admitted to the home was assessed by the district nurses to ensure the right piece of equipment was obtained for her. Records for the other two people we case tracked evidence that their health is closely monitored and any concerns are quickly referred to the district nurses or the general practitioner and outcomes recorded on their care records. People we spoke with told us that they are happy with how their medication is managed. We spoke with the member of staff who had designated responsibility for medication during our visit. She demonstrated a clear understanding of the procedure and was aware of the medication held on behalf of the three people we case tracked. Since our last visit there has been one medication error, which resulted in the person being hospitalised. Action was immediately taken by the manager and additional measures put in place to prevent it from happening again, to include additional training from the district nurses. The staff member responsible is no longer employed. Discussions with the resident and staff indicate that the additional safeguards put in place are effective. People told us that staff treat them with respect and that their privacy is upheld. Peoples preferred form of address was clearly stated on their care plans and staff interacted with residents in a professional manner and were seen to knock on peoples bedroom doors prior to entry. One care plan stated Mrs X does not wish to be disturbed please knock before entering her room. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the Ferns are provided with opportunities to experience a meaningful lifestyle that ensures their self-esteem and wellbeing. People are provided with healthy, well-presented meals according to their dietary requirements and choice. Evidence: People told us that routines are flexible, that they regularly see their family and friends and that the home provides a number of activities that they are able to opt in or out of. Care plans sampled identified peoples likes and dislikes and preferred routines. During the inspection a church service was provided in one of the lounges and people were asked if they would like to attend. A hairdresser was also at the home and many people accessed this service. A diary of planned events is displayed in the home and an activity file has been developed containing photographs of social activities that people have enjoyed participating in to include a garden party, harvest festival, poetry reading and flower arranging. People we spoke with were generally satisfied with the activities provided although one person said Theres not really enough to do during the day. A member of staff now has designated responsibility for activities and discussions with her and the manager evidence that the home aims to extend the range of activities available over the next 12 months to include more outdoor Care Homes for Older People Page 15 of 27 Evidence: activities, which is also stated in the AQAA for planned improvements. People are confident that they are able to maintain relationships with people important to them. They told us that their relatives and friends are made welcome and this was evident in observations we made during our visit and the positive feedback that we gained from discussions we had and surveys we received from visitors. Comments include: All the staff are cheerful and friendly and they always greet visitors cheerfully. Everyone is sympathetic when anyone is ill, they are caring and understanding The staff are very friendly and exceptionally helpful I have only been visiting since August 2008 and I have been most impressed with the Ferns in that time. People have been provided with a new menu, which provides a range of choices and also caters for specific dietary needs. The meals provided during our visit appeared balanced and nutritional and were well presented. People told us that they enjoy their food and never go hungry. People have a choice of where they take their meals and their preferences are documented on their care records. The catering manager demonstrated a clear understanding of the dietary needs and personal preferences of the people we case tracked, which was an accurate reflection of the information held on their care files. She also reported that she is not restricted to a budget, that food is so very important in peoples lives and that the home advocate a healthy diet. The lunchtime meal was observed and the dining room was welcoming with tables nicely laid and staff made the mealtime a social and enjoyable experience. Staff were sensitive and discrete in providing support to individuals who required assistance with their meals. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the Ferns have access to a complaints procedure, which is accessible and ensures the views of people are listened to. Staff receive training so that they have an understanding in adult protection to ensure people they support are protected from abuse, ensuring their well being. Evidence: People we spoke with told us they knew what to do if they were unhappy with the service they receive and reported they had no concerns or complaints about the home. People have access to a complaints procedure which states We would actively encourage any complaints or comments. The manager reported any niggles are dealt with immediately. Neither the home of CSCI have received any complaints or concerns since our last inspection, which indicates peoples continued satisfaction with the service the home provides. One visitor stated I have no concerns with the service, I visit the home twice a week and have never observed any poor practice. People told us that they feel safe and secure and those who require support to manage their finances were happy with the procedures in place to keep their money safe. Staff were aware of safeguarding and whistle blowing procedures and sign to say that they have read and understood these. One member of staff stated If I saw any poor practice I would report it. There have been no referrals made under local safeguarding procedures since our last inspection and staff receive training on adult Care Homes for Older People Page 17 of 27 Evidence: protection. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the Ferns are provided with an exceptionally clean and homely place to live which is equipped to meet their individual needs and makes them feel safe and secure. Evidence: People spoken with during the inspection told us that they enjoy living at the home and that their rooms are warm and comfortable. One person stated I am exceptionally happy with my own room, I was able to bring in some furniture from my own home. It is like home from home here. We looked at parts of the home and at the rooms of the people we case tracked. These were very personalised with family photos and ornaments and appropriately equipped to meet their individual needs. A passenger lift is provided to assist people with mobility difficulties in addition to ramps to access the grounds. 35 of the 36 rooms provided have en-suite facility and communal areas include two lounges, a study and a large dining room, which are all decorated and equipped to a high standard. Several improvements have been made since our last visit to include redecoration of a number of areas, installation of flat screen TVs in lounges, installed a new boiler to the central heating system, new seat pads in the dining area and updated the mains water supply throughout the home. There are plans to replace the floor coverings in the communal lounge areas over the next 12 months. Care Homes for Older People Page 19 of 27 Evidence: The AQAA states Our attention to cleanliness and infection control are exemplary throughout our environment which was an accurate reflection of how we found the home during this unannounced inspection. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for staffing, their support and development ensures that the needs of the people living at the Ferns are met. People have confidence in the staff at the home because checks are done to make sure that they are suitable to care for them. Evidence: People we spoke with were very complimentary about the care that they receive. One person we case tracked stated The staff are very good and its obvious that they are very well trained. Throughout the inspection staff were accessible, good listeners and communicated well with the people using the service. They appeared motivated and committed to their work. People considered there is enough staff on duty to meet their individual needs. Comments that we received in surveys completed by visitors include Staff are very caring and understanding and nothing is too much trouble. Staff we spoke with demonstrated a clear understanding of the needs of the three people we case tracked and reported that they are provided with good training opportunities. Each staff member has a training file in addition to their own set of policies and procedures, that they have signed. The manager stated that all care staff hold a nationally recognised care qualification Care Homes for Older People Page 21 of 27 Evidence: known as NVQ at 2 and are currently working towards levels 3 and 4. The deputy manager has obtained NVQ at level 2,3 and 4. The staffing structure consists of the registered provider who manages the home, a deputy manager, five senior care staff, ten care assistants, catering staff and a full time cleaner. One member of staff is due to leave the home shortly therefore providing one vacancy. We looked at the files of five staff employed since the last inspection. Most of these contained all of the pre-recruitment checks required to ensure people are safeguarded however shortfalls were identified on the file belonging to a member of staff who is not employed as a carer. This was immediately acknowledged by the manager who committed to ensure the necessary checks are obtained. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have confidence in The Ferns because it is effectively managed in the best interests of the people living and working there. Evidence: The manager has numerous years experience in working in the care sector and everyone we spoke with was complimentary about how the home is managed. The AQAA states The Proprietor/Care Manager has excellent leadership skills and is committed to working within the home full time alongside her staff, leading by example and committed to very high standards in all aspects of care. People we spoke with stated: The manager has high expectations, she is firm but fair The manager works hard and because she works alongside us she sees what goes on ensuring people get the best possible care. The home is effectively managed The manager is fair and very very efficient, I love coming here, nothing is too much Care Homes for Older People Page 23 of 27 Evidence: trouble and the staff are cheerful. Everyone works well together and things run very smoothly. People using the service are provided with opportunities to express their views about the service through residents meetings. Satisfaction surveys are available and the manager agreed to circulate these to people who use the service, relatives, staff, visitors and professionals and collate the responses on an annual basis to inform future planning. We asked people what they thought could be improved and people said I personally cant think of anything that could be improved here, the home is very well managed. A relative stated I cant think of anything the home could do better. Im sure if the staff do - they will do it. The home has received a number of compliments since our last visit to include a card from a relative stating We would like you to accept our very sincere thanks for the excellent care which X received whilst in the Ferns. The hospitality shown to all her family and friends. We often thought the Ferns was more like a hotel with excellent meals, varied activities and a pleasant environment... People who require support to manage their finances are safeguarded by the procedures in place. Records are available for finances held and two signatures are obtained for all transactions in addition to receipts. Detailed inventories of property held were available on all three files sampled. People we spoke with told us that they feel safe and secure living at the Ferns. The AQAA states We ensure that all Health and Safety practices are adhered to and address issues immediately as they arise. We looked at a variety of health and safety records and the checks that staff do to prevent people from being placed at risk of harm. We found that checks are undertaken at the required frequency and equipment serviced to ensure that it is safe and protects people. Staff told us that they receive training in safe working practices for example moving and handling, food hygiene, fire, infection control which helps to keep people safe. The manager stated that there are no outstanding requirements made by the fire or environmental health departments. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 29 All pre-recruitment checks must be undertaken on new employees before they commence work. This will ensure people living at the Ferns are better protected by the homes recruitment policy and practice. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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