Inspection on 17/01/07 for Ferns

This inspection was carried out on 17th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Ferns 13/01/09

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Ferns 152 Longden Road Shrewsbury Shropshire SY3 9ED Lead Inspector Karen Powell Key Unannounced Inspection 17th January 2007 09:30 X10015.doc Version 1.40 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 Ferns DS0000020691.V297380.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 Older People. 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. Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ferns Address 152 Longden Road Shrewsbury Shropshire SY3 9ED 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) 01743 368039 01743 340901 Mr Lakin Lea Arrowsmith Mrs Pauline Jean Arrowsmith Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st December 2005 Brief Description of the Service: The Ferns is a private care home, registered to provide care and accommodation for up to 36 elderly 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 for service users, with en-suite facilities, in addition to ample communal space in the three lounge areas and a dining room. The Organisational Structure of the home is clearly defined. Mrs Arrowsmith has a Deputy, and also employs 20 care assistants, cooks and cleaners. Ferns DS0000020691.V297380.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. One inspector carried out the inspection. The visit lasted three and a half hours. It included talking with service users, visiting district nurses, the manager and members of staff on duty, case tracking service users, observing work practices, looking at a number of records and a tour of the home. All 22 key national minimum standards for older people except for standard 30 were assessed and a quality rating provided based on each outcome area for service users. These ratings are described as excellent/good/adequate or poor based on findings of the inspection. The service users, manager and staff on duty were welcoming and co-operated fully throughout the inspection. It was found that the National Minimum Standards assessed had been met, with a number exceeded, and that the overall quality of care provided was good. What the service does well: What has improved since the last inspection? What they could do better: There were no requirements as a result of this inspection. Ferns DS0000020691.V297380.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. Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 3. Prospective service users and their representatives have the information needed to choose a home that will meet their needs. There is a clear assessment procedure and all prospective service users needs are assessed prior to them moving into the home. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Significant time and effort is spent making admissions to the home personal and well managed. Prospective service users and their families are treated with dignity, respect and understanding for the life changing decisions they need to make. There is a high value on responding to individual needs for information, Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 9 reassurance and support. A variety of positive methods enable people to experience the home and what it has to offer. A prospective service user and their family had made arrangements to visit the home on the day of the inspection. They were greeted by staff with a warm welcome. The family member commented what a nice atmosphere the home had. They were given the opportunity to spend time over coffee meeting other people who live at the home and ask any questions they wanted to. The manager was observed talking to them, showing them the bedroom available and generally sharing information about The Ferns. Later on the inspector spoke with the individual’s concerned who said that all of the family members had made visits to the home to view it before their relative was going to move in and that the staff had all been helpful along with service users to address any questions they had. Other service users spoken to told the inspector that they had received written information prior to moving into the home and had found this useful. A needs assessment is undertaken for each prospective service user before agreeing admission to the home. Three service users were case tracked as part of the inspection process, one of which was a new service user. This individual had moved from out of area and the manager had obtained a copy of the previous care home assessment and further information had been obtained from a visiting family member. Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users have a plan of care. These are comprehensive and all include appropriate moving and handling and nutritional risk assessments. Care plans are individual and include all areas of the individual’s life including health, personal and social care needs. Care plans contained preferred terms of address and service user and managers signatures. All care plans and risk assessments are regularly reviewed. However, these do not involve the service user or their family where this has been agreed and would be welcomed by Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 11 some service users as established through the inspector speaking to service users. Service users have access to health and remedial services and records evidence this. Service users too frail to leave the home have their health care needs met by visiting health care professionals. Two district nurses visited the home during the inspection and were happy to talk to the inspector about their comments regarding the care management of individual’s by the care team. District nurses were confident about the quality of the care given to service users. They told the inspector that staff call them immediately they require district nurse involvement and the care team work well to follow guidance from the district nurses. Staff spoke positively about the support they receive from the nursing team and the benefits of being shown positive aspects of care to promote service user well being. Service users’ personal aids are well maintained and the home provides the necessary aids and equipment to support both staff and service users’ in daily living. Staff are trained and knowledgeable about the needs of older people and demonstrated this through discussion with the inspector. The home works to an efficient medication policy supported by procedures and practice guidance. Staff are aware of and understand the guidance set out. All staff that administer medication have had medication training. It is planned that those staff completing NVQ level 2 will be next to be put forward for medication training. Discussion with two members of staff on duty who regularly handle the medication demonstrated to the inspector that they work within safe practices. One service user’s medication was audited as part of the case tracking process. This was satisfactory and included controlled drugs. General storage, recording, receipt and disposal of medication is good. Service users who have the capacity are encouraged to keep and take their own medication. This was seen recorded on the care plan and is reviewed on a monthly basis. Service users spoken to were happy with the manner in which staff maintain their dignity and respect. The inspector observed staff knocking before entering service user rooms and being courteous to service users. Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Service users are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet service users expectations. Service users receive a healthy, varied diet according to their assessed requirement and choice. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are able to enjoy a full and stimulating life style with a variety of options to choose from. The home has sought the views of service users and considered their varied interests and abilities when planning the routines of daily living and arranging activities. One service user said about some activities that ‘they didn’t take to all activities provided, but then you have to accept that living in a care home’. Routines are very flexible and service users can make choices in major areas of their life. The routines, activities and plans are service user focussed. Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 13 Policies and procedures focus on service users being in control of their life. Examples of this were seen in service users electing to administer their own medication, deal with their own finances, managing their own bank accounts and calling the Dr when they wished. One service user who was happy to take the inspector to their room pointed out their own tea making facilities that they can access during the night without having to be dependant on calling night staff. Service users are actively encouraged to keep in contact with family and friends living in the community. Visitors are welcome at any time and facilities are available for them to have a drink or a meal with the service users. This was observed on the day of the inspection. One service user told the inspector that ‘you can choose to entertain visitors in your own room if you wish’. Staff give help when it is needed and have contacted advocacy groups and encouraged their involvement with individuals in the home. This was evident in a situation explained to the inspector by the manager. Advocacy schemes are well publicised within the home, with written literature for those who wish to take a copy. Food is considered to be highly important and meal times considered a social occasion. The dining room is always well presented with clean matching tablecloths and comfortable seating. The cook in the home is qualified and experienced in cooking for older people and is an important member of the care team. The cook is well aware of the recorded dietary and cultural needs of each service user. Service users told the inspector that their opinions on the quality of food and menu planning is sought from staff and feel their dietary needs are well catered for. The menu is varied, balanced and nutritious. It has a number of choices and special diets are catered for according to the individual’s assessment. Food is served to meet the need of all service users including those who have swallowing or chewing difficulty, these needs were recorded in the care plans. The menu along with the January newsletter and activities was seen on display in the hallway. Drinks and snacks are available during the day and morning coffee and biscuits were given to service users and visitors during the visit. Service users who enjoy being able to eat in their own room when they wish are supported to do so. There is a small kitchenette area available for service users and their visitors to use. Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. There is a clear and accessible complaints procedure in place. Policies, procedures and staff training are in place to protect the people living at the home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure that is up to date and clearly written. The home actively encourages individuals and their families/representatives to make complaints, comments and compliments. Leaflets relating to this are located in the hall. One service told the inspector that they had made a complaint some time ago and that they were happy with the way it had been handled and the outcome. There have been no complaints to the home or to the offices for The Commission for Social Care Inspection since the last inspection. There are clear policies and procedures regarding protection of service users. There have been no referrals to the adult protection team regarding allegations of any form of abuse. Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 15 Training of staff in the area of protection is arranged by the home and it was confirmed by the manager that all staff have undertaken adult protection training. Service users spoken to regarding protection said they felt safe and secure. The use of advocates has been referred to earlier and the home promotes individual service user rights. Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is excellent. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The management and staff encourage service users to see the home as their own home. This was apparent through discussion with service users and observations of their personal space. Service users were pleased that they are encouraged to bring with them personal belongings to enable them to personalise their rooms. The home is very well maintained, safe, comfortable and attractive. Aids and adaptations were seen around the home these included bed levers, ramps and pressure relieving equipment. Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 17 The rooms are well planned and all except one room has en-suite facilities. There is a selection of communal areas, this means that service users have a choice of place to sit quietly, meet with family and friends or be actively engaged with other service users. Service users were seen moving freely around the home during the inspection. Toilets and bathrooms are clean, tidy and sufficient in numbers. It was observed that the home follow strict infection control procedures and staff make every effort to minimise infection. Two requirements made by the environmental heath officer have been met. Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 29. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of residents. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager continues to support staff to undertake training relevant to their roles and responsibilities. Staff told the inspector of additional training being undertaken. It was stated by the manager and confirmed by staff spoken to that all mandatory training is up to date. The home undertakes to provide inhouse updates in topics such as medication. Two senior staff will be undertaking the NVQ level 4 in the near future. There has been one new member of staff recruited to a vacancy in the kitchen since the last inspection. The individual’s personal file was examined. This individual had been recruited by an employment agency. There was a clear job description on the file outlining the role and responsibilities of the post. There has been no new care staff therefore NMS 30 could not be assessed on this occasion. Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mrs Arrowsmith has been manager at the home since 1992. She has strong leadership skills and actively works in the home on a daily basis alongside staff. She has a clear sense of purpose and is committed to achieving very high standards within the home. The home works to a clear health and safety policy and ensures that as far as reasonably practicable the health safety and welfare of service users and staff is promoted at all times. It was reported by the manager that the fire officer visited the home the day before the inspection, fire safety was considered to be good. Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 20 There is always a first aider on site. The home has a good record of meeting health and safety legislation. The home has an annual development plan, which includes the redecoration of service user rooms when they are vacated. Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 x 4 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 x 18 4 4 x x x x x x 4 STAFFING Standard No Score 27 4 28 4 29 4 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 4 x x 4 Ferns DS0000020691.V297380.R01.S.doc Version 5.2 Page 22 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. 1 Refer to Standard OP7 Good Practice Recommendations Review of care plans involve service users who wish to take part in the review process. 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