Inspection on 23/07/07 for Ferns Nursing Home

This inspection was carried out on 23rd July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Nursing Home 16/07/08

Ferns Nursing Home 10/10/06

Ferns Nursing Home 06/03/06

Ferns Nursing Home 24/05/05

Ferns Nursing Home 10/11/04

Ferns Nursing Home 28/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Ferns Nursing Home 141 St Michaels Avenue Yeovil Somerset BA21 4LW Lead Inspector Gail Richardson Unannounced Inspection 23rd July 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 Nursing Home DS0000003255.V342328.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 Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ferns Nursing Home Address 141 St Michaels Avenue Yeovil Somerset BA21 4LW 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) 01935 433115 01935 410536 ferns@almondsburycare.com HatherleyGrange@ALMONDSBURYCAREFSBUSIN ESS.CO.UK Almondsbury Care Limited Mrs Jackie Hufton Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to three places for personal care. The named Registered Manager to commence the Registered Managers Award by 1st February 2006. Date of last inspection Brief Description of the Service: The Ferns is a care home providing nursing care for up to 31 older people. The home also has up to 3 places available for older people who require personal care only. The home provides day care for a small number of people when required. It is a largely purpose built home in a residential area about one mile from the centre of Yeovil which has all the facilities of a small town. There is a lift to the first floor where six of the bedrooms are located, in the older part of the building. All bedrooms are for single occupancy and have the en-suite facilities of a toilet. The home has a large rear room, which is used to provide activities to both resident service users and those attending for day care as well as the main dining area. This room leads out to the rear garden area. The home also has a conservatory, which also looks out over the rear garden. The range of fees is from £550.00 to £650.00 this does not include all items including hairdressing and Chiropody Ferns Nursing Home DS0000003255.V342328.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 inspection, which took place over 1 day (6 hours) on the 20th July 2007 by inspector Gail Richardson. A tour of the home took place and a selection of the bedrooms and both communal areas were seen. There were 31 people currently residing at the home. The inspector spoke to 7 people using the service, 4 visitors and 6 members of staff, the Registered Manager was on annual leave and the Deputy Manager was available throughout the inspection. As part of this inspection the inspector surveyed the opinions of a random selection of people using the service and their representatives, GP’s, District Nurses and Care Workers. Surveys were sent to people using the service and 4 responses were received, relatives returned 3 surveys to the inspector. The inspector spent time talking to people within the home, visitors and staff and observed that on the day of inspection, residents appeared relaxed and comfortable in all areas of the home. It was evident from this observation that the people looked well cared for. All people using the service spoken to, and who were able, spoke of the staffs kindness and support, one person said, “ They treat me with dignity “. All people spoken with stated that they were happy with the care they received. Surveys from staff stated they felt supported by the management of the home. Staff were happy to tell the inspector that they enjoyed working at the home and felt that the standard of care given was high. Records relating to care including four care plans, staff files, finances and health and safety records were examined The focus of this inspection visit was to inspect relevant key standards under the CSCI ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are; - excellent, good, adequate and poor. What the service does well: One visitor commented when asked what the home does well replied, “The care they give here is second to none” and another stated, “This is a home from home”. Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 6 All surveys received and comments made, stated that the staff provide a good standard of care. It is clear from these comments that the home makes every effort to support both the residents and their relatives. One comment from a person using the service was “I feel lucky to be in a place like this “ and a relative stated, “I am always made welcome and kept up to date with any changes “. The manager has a positive leadership style, which reflects on the staff who stated they feel supported by the management of the home. People using the service spoken with, all confirmed that the quality, quantity and variety of food is always good, there was evidence that individual preferences are catered for. The ongoing building work taking place at the home has been managed in a manner which has not caused to much disruption to people using the service and in some cases they have felt involved in parts of the process. What has improved since the last inspection? The manager has changed the morning routine to ensure all residents are offered/receiving their breakfast earlier. The home have also reorganised the supper serving order, ensuring the food served is at an acceptable warmth. There has been an increased choice of suppers including hot choices and sandwiches People using the service requested to be involved in the new build and changes to outside grounds. They have been involved by preparing a scrap book of the different stages of these changes The home have made purchases including 4 net curtains to place at certain residents windows ensuring privacy whilst they have had changes in the grounds surrounding the Ferns. Also fans have been purchased for the occassional very hot days with residents. . The home have issued name badges to all staff to assist identification by people using the service,visitors and relatives. Slings for use in conjunction with hoists are now individually logged and inspected as fit for continued use by a competent person at least six monthly. The home has designed and built one garden area, with 2 further areas in the planning phase - flower boarders have been built at acceptable heights for people using the service, plus the addition of a wheelchair ramp for ease of access Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 7 The small dining room has been re-furnished, redecorated, re-carpeted. Hall ways on the ground floor have been redecorated with new curtains and new pictures. Some bedrooms have been redecorated, recarpeted and have upgraded funiture. What they could do better: The records relating to the identified needs of people using the service, which remain in the person’s room, are recommended to be reviewed to ensure that the information available does not compromise the dignity and confidentiality of the person using the service. Care plans are required to contain sufficient details of the plans of care for people using the service who have specific nursing and psychological interventions. This detail is required to ensure that staff have a clear plan of action for each person. Care plans are also required to be reviewed and updated regularly to ensure that the information contained is up to date and relevant The home is required to ensure that all oxygen cylinders stored in the home are stored securely in an upright position to prevent the risk of injury or explosion. The oxygen signage in the home must contain the details of the hazards identified, this is required to reduce the risk of injury /explosion. The policy regarding whsitleblowing is recommended to include the contact details for CSCI. The policies are also recommended to be reviewed regularly and signed to say that this process has been undertaken. The manager is recommended to contact the Fire Safety Officer and Health and Safety Executive, to seek advice about an unrestricted window on the second floor to ensure there is no risk of accident/injury. The manager is required to ensure that the cupboard containing cleaning solutions hazardous to health, is secured under the COSHH guidelines. This is required to reduce the risk of accidental ingestion. The systems at the home for the storage of people’s personal monies is recommended to be stored in individual envelopes to ensure that all people using the service have access to their individual money. The monthly checks made of the bedrails used in the home are recommended to be signed and dated to provide a clear audit of who and when the checks have taken place by a person qualified to do so. Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 8 Accident reports are required to be completed for all injuries sustained to people using the service to ensure an accurate record of accidents is maintained. 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 Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 9 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 Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 10 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 4 5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home continues to be able to provide prospective residents and relatives with sufficient information in the format of brochures, the Service User Guide and Statement of Purpose for them to make an informed decision about the home. All prospective residents receive a pre admission assessment by the registered manager to ensure the home can meet the assessed needs identified. EVIDENCE: The Annual Quality asurance Audit supplied by the manager states “The Manager considers carefully the needs assessment for each prospective resident before agreeing to the admission to the home. Prospective residents and their families almost always visit and spend time in the home prior to admission. The Manager or Deputy Manager are prepared to, and indeed very Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 11 often do visit the prospective resident and their family to get to know them and answer questions.” People using the service and visitors to the home, were happy to confirm that they had received an assessment visit from the home and relatives had visited the home prior to admission to view the room and facilities available. When asked by survey if the people using the service and relatives received enough information about the home prior to admission 5 in total said yes The home has a brochure and a website both of which outline the services and facilities the home provides. The Home provides a Statement of Purpose that clearly sets out the objectives and philosophy of the Home and also includes a resident’s guide, which provides clear information about the home. All residents are given a copy of the Statement of Purpose which is kept in their bedrooms. Contacts were not examined at this inspection. Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each service user has a care plan, the assessed areas of need were reflected in this plan of care but further detail is required to ensure staff are supported to meet all areas identified The management of medications systems is mostly good. Staff were observed to treat service users with dignity and respect at all times and residents fell well cared for. EVIDENCE: The care plan proccess comes in 2 parts. The carer plan which is updated monthly and sent to all relatives of residents is kept in the person who is using the services bedroom, to assist staff identify all needs. The content of this document is to be reviewed to ensure that the persons dignity and Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 13 confidentiality is not compromised. Some details relating to continence were personal and by leaving them accessible in the persons room, this may compromise their confidentiality. The reistered manager has advised that the documents will be reviewed promptly. The inspector examined 4 care plans. These records were stored securely in the nurses office and comprised of a kardex system of recording assessment, care plans, visiting health professional input, personal and social care recording and reviews. Another file is also used with supporting documentation for wound care and existing paperwork. Two care plans were noted to be lacking in sufficient detail to describe to staff how to provide the care needed and were not supported by other documentation used in the home to record accidents and ongoing observational behaviour assessment. Some assessments including nutritional and pressure relief assessments had not been completed. One care plan detailed that the person using the servive was to have monitoring of pain relief and regular review, no documentation was available of these observations or reviews. Another care plan highlighted that a person had sustained 2 injuries, these were not recorded in the accident books. A further care plan indicated that ongoing assessment of challenging behaviour was taking place. There was no indication in the daily record of a history of challenging behaviour to indicate that there had been any episodes of challenging behaviour to support this action taking place. The nurse in charge confirmed that this behaviour had been evident for some time prior, but no record was available to support this decision. Other areas of the care plans were completed and provided staff with enough detail to provide a good level of care, however,the reviews undertaken do not involve the people using the service and are not regularly reviewed. An updated copy of the care plan is supplied to each persons bedroom and is sent to the relatives and any changes are agreed. There is no signed record of this process or agreement by the people using the service’s permission for this to happen. Staff confirmed that they read the care plans and could contribute to them. People using the service were happy to confirm that residents meetings take place and relatives confirmed that they were also invited to meetings. All visitors said that they felt well informed of changes in their relatives condition. One relative commented that “ They rang me at night and kept me updated, I have stayed at the home overnight when I needed to “. People using the service were all happy with the service they received and thought highly of the staff. One comment was “ There is no better place, I feel respected”, another person commented that “It is good here, they take very good care of you”. Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 14 When asked if people using the service receive the care and support they need, 3 said always.When asked if staff listen and act on what you say, 3always One service survey commented “They look after us well” and another stated “They give complete care 24 hours each day”,another comment received was “More prompt attention has been evident recently” Call bells were left within reach of residents and these were noted to be responded to within a reasonable timescale. Records show that the home arranges for health professionals to visit people in the home. Medication systems within the home were mostly satisfactory. There was evidence of good recording in the Medication Administration Records, recording of blood sugar and pulse levels, recording of variable doses and all hand trancribed medications were signed by 2 staff to ensure no errors in recording. The records of controlled medications showed an error in calculation of one medication and the deputy manager put into immediate effect an auditing process to be undertaken weekly to re check the medication calculations. Dressings stored in the home were generally stored in each persons basket, however one box contained what the deputy manager described as emergency dressings of which some had originally been prescribed but had been removed from their boxes.This practice must be reviewed as all prescribed dressings are for that person only. Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 15 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): 12 13 14 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a wide range of opportunities for social stimulation and residents are supported to join in with organised activities or pursue their own interests. The meals in the home are of a good quality and a wide range of choice is available. EVIDENCE: When surveys asked if there were activities arranged in the home 2-always and 1-usually. One comment received was “Activities are Monday to Friday only” The inspector spent time talking with people using the service and observed people reading newspapers and chatting to staff. The planned activities are advertised on a newsletter which is produced monthly. Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 16 The people using the service advise the inspector that activities were available in the afternoons if you wished to participate, these included DVD’s, bingo and quizzes. One person explained that last year a calendar had been produced by the home to include pictures of people using the service and staff. The person had enjoyed this and was hopeful that the management would repeat this next year. The homes Annual Quality Assessment Audit states “The Home employs an activities co-ordinator who is responsible for creating activities and experiences both in the Home and the wider community. Sufficient staff resources are provided to allow time for activities and stimulation.” People using the service were happy to confirm this. On the day of inspection no organised activities were planned or seen. Three visitirs confirmed to the inspector that visiting was not restricted and they were made welcome at all times. People’s rooms were seen to be personally decorated and people confirmed that they were able to bring small items af furniture and personal belongings within the scope of the room size. The people using the service confirmed that within reasonable timescales they were able to get up and return to bed at a time of their choice. The staff deliver breakfast each morning to the people using the service rooms, the main meal of the day is at lunchtime and there is a large pleasant dining room. The tables were nicely laid with a choice of condiments and drinks to have with their meals. The cook in the home is qualified and experienced in cooking for older people, he explained that the menus are planned using the people using the service own preferences and he was aware of people’s particular likes and dislikes. Service users with specific dietary needs and preferences were catered for and contact with the Community Dietician is made as and when required. When asked if they liked the meals in the home 6-always and 1-usually. People using the service confimred to the inspector that the quality of the food is always good and that choice is made available. The inspector observed lunch being served both in the dining room and peoples bedrooms and it appeared to be enjoyed by all. The cook serves the meal and people who requested anything extra were provided with this immediately. People who required assistance were helped in a dignified and discreet manner. Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 17 On the day of inspection lunch was a choice of battered cod, smoked haddock or ham with chips/mashed potato and peas. Desert was a choice of apple and almond crunch, custard, rice pudding, jelly or mousse. All purée diet was served individually and the meal looked plentiful and appetising. Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 18 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 17 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff and people using the service are confident that the homes management team would deal appropriately with any complaints or concerns. Policies, procedures and training are available to staff to ensure they have the knowledge to prevent service users from the risk of abuse EVIDENCE: The Home has a Complaints Procedure that is clearly written and contains the contact details for CSCI. The manangement of the home confirmed that this can be made available in a number of formats (including other languages, large print, etc) to enable anyone associated with the service to complain or make suggestions for improvement. CSCI has not received any complaints about the Ferns and the home has no ongoing complaints. Three people using the service and visitors to the home confirmed that they would raise any concerns with the management of the home and felt confident to speak to any staff about any worries they may have.They were confident that any concerns would be dealt with promptly. The Home is able to offer people using the service information and telephone Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 19 numbers for contacting independent people who will act as advocates on the their behalf where the person prefers the help of an independent person.The home uses the age-concern advocasy services. All people using the service are registered to vote. The policies and procedures regarding protection of residents are of a good standard, which include complaints,recognising signs of abuse and whistleblowing. The policy regarding whsitleblowing is recommended to include the contact details for CSCI. The policies are also recommended to be reviewed regularly and signed to say that this process has been undertaken. All staff receive Criminal Record Bureau check proir to commencing employment as part of the recruitment procedures used at the home to protect people using the service from the risk of abuse. Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 20 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 20 21 22 23 24 25 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is a large building with some parts of the building suffering from wear and tear that would be typical of a building of similar usage. The area of garden completed was attractively laid out and suitable for people using the service. EVIDENCE: The home is a large building which provides accommodation on 2 floors and provides a spacious lounge/dining area and a further smaller lounge/dining area. Work is planned to update the kitchenette serving area in the large dining/lounge room. Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 21 Personal accommodation is located on both floors of the home and is accessible to people with all levels of mobility. Lift access is available to each floor. All bedrooms seen by the inspector were comfortably furnished and had been personalised to reflect the tastes of the individual people. Various aids and adaptations have been put in place to assist service users to maintain their independence. Specialist pressure relieving cushions and mattresses were seen where there was an assessed need. All wheelchairs were seen to be clean and maintained. Toilet and bathing facilities are provided in sufficient numbers and were clean and odour free, building work is currently taking place to extend the home and provide new laundry facilities and a new bathroom. This work has been undertaken without causing too much disruption to the people using the service. The home have developed a pleasant patio garden area with access for people using wheelchairs, further plans are underway to develop 2 more garden areas. The home was clean and appeared well maintained. One maintenance staff was seen working on the day of the inspection and it is clear that the home has an ongoing maintenance programme. 3 Service users surveys confirmed that the home is always clean and fresh. Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 22 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 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels at the home appear adequate to meet the assessed needs of people using the service and staff training is promoted to support people using the service. The induction process for staff has been developed to support new staff who commence employment. EVIDENCE: When service user surveys asked if staff are available when you need them,1always, 2-usually. On the day of inspection there was 1 qualified staff member and 6 care staff, 2 cleaning staff, 1 laundry tsaff, 1 chef and 1 kitchen assistant. There was also 1 handyman and 6 work men working in the building. Staff rotas examined established that this level of staff is consistent, there are systems in place for agency staff used to be the same staff to ensure continuity of care.Staff confirmed that they felt staffing levels were sufficient to provide a good level of care. Staff comment cards confirmed that 2 staff felt they had received adequate induction and were clear about what activities they must not undertake. Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 23 Furthermore staff confirm that they receive regular training updates and staff supervision. Staff induction is a programme of videos and supporting information with regular updates and staff confirmed that they were supernumerary for 3 days whilst this induction took place. This induction is in conjunction with the Skills for Care Common, Induction Standards. External training opportunities are also available for staff and staff explained that staff meetings are also used as a learning opportunity. Staff are also encouraged and supported to undertake NVQ qualifications. The recruitment procedures of the home are of a good standard and contain all the required information to support new staff and protect people using the service from the risk of abuse. Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 24 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 32 33 35 36 37 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is effectively managed and benefits from the positive and proactive management style of the registered manager. Systems are in place to ensure the health and safety of service users whilst encouraging and promoting independence. The management of the people using the service’s personal monies requires further development. EVIDENCE: The registered manager of the home is Jackie Huffton who has managed the home for a sustained period of time. Discussions with the staff confirmed that Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 25 Jackie has a clear understanding of the needs of the people living at the home and constantly strives to develop a team of staff to provide a high standard of care. Staff stated that she is “Firm, fair and direct”. Surveys are sent from the home to people using the service, relatives and visitors and the actions audited. This was not examined at this inspection The insurance cover in place ensures that the home is well able to fully meet any loss or legal liabilities. The management of personal monies of people using the service, requires further development. Currently all monies are stored in one tin which is stored securely. The home is recommended to ensure that people using the service’s moneys are stored individually within the tin. Records were maintained but could not be randomly checked by the inspector as all the money was stored together. The home maintains a running record of each persons finances and reciepts. The money is audited monthly and is currently only signed by one staff. The manager is recommended to ensure that 2 staff sign this audit and all transactions. The home maintains a record of accidents. It was noted that 1 accident noted during case tracking had not been recorded. All accidents are required to be recorded. The registered manager confirmed that an audit of these accidents takes place to look for trends and incidences which may be highlighted and action taken to reduce the risk of further accidents occuring. This was not available at inspection. Three staff at inspection stated that they were receiving regular supervision. The records available supported this, all topic set out in the National Minimum Standards are included in the supervision sessions. Maintenance records were well maintained and up to date., these included ; * * * * * * * * * * Fire Risk Assessment Hoist Servicing Weekly Emergency lighting checks PAT Tests Gas servicing Environmental Health Visit Hot water temperatures Weekly fire alarm tests Electrical Hard Wiring Fire System, maintenance and service records Further Health and Safety issues identified: Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 26 All substances hazardous to health under the COSHH guidelines are required to be stored securely. The cleaners store cupboard is required to be kept locked, this was discussed with the deputy manager who will deal with this issue promptly. The monthly checks on the fitting and use of bedrails are recommended to be signed and dated when completed by the person qualified to undertake the checks. An unrestricted upstairs window which leads to a flat external roof is required to be risk assessed and consultation with the Fire Officer and Health and Safety Executive is required regarding appropriate action to be taken to ensure that there is no risk of people using the service or visitors to the home sustaining injury. This is has been confirmed since inspection to be underway. The storage of oxygen in peoples rooms is required to be addressed to ensure that cylinders are secured in an uright position to prevent the risk of injury. The signage in use on some room doors to indicate oxygen is in use, also requires updating to ensure that the correct hazard indications are given. Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 27 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 3 3 X 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 2 3 1 1 Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? no 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 OP7 Regulation 15 (1) Requirement The registered manager is required to ensure that sufficient detail is available within the persons care plan to support staff to deliver the care needs identified. This is with reference to record keeping of pain relief levels and reviews and behavioural observation. Timescale for action 30/08/07 2. OP7 15(1) The registered manager is 30/08/07 required to ensure that the care plans are reviewed and updated at least monthly or as required in the interim period, to ensure all information is updated and correct. The home must maintain a record of all accidents occurring within the home which affects the person using the service. The manager is required to ensure that all substances hazardous to health are stored securely under the COSHH guidelines. The cleaning store cupboard must remain locked DS0000003255.V342328.R01.S.doc 3. OP38 17(1)(a) Schedule 3 12 (1)(a) 30/08/07 4. OP38 30/08/07 Ferns Nursing Home Version 5.2 Page 29 when not in direct use. 5. OP38 13(2) To protect people using the service from injury, the registered manager is required to ensure that all oxygen cylinders stored at the home are stored in a secured upright position. To protect people using the service, oxygen signage is required to contain all the appropriate hazard signs. 30/08/07 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 OP9 Good Practice Recommendations The home is recommended to review the use of emergency dressings to ensure they do not include prescribed dressings, which have been removed from their packaging and stored in the emergency box. The policy regarding whsitleblowing is recommended to include the contact details for CSCI and it is recommended that all policies are reviewed and signed regularly. The home is strongly recommended to ensure that personal monies are stored individually to ensure that each person’s money is accounted for individually. It is also recommended that 2 staff sign all transactions and audits. The registered manager is recommended to ensure that all bedrail checks are signed and dated by the person qualified to undertake the checks. 2. OP18 3. OP35 4. OP38 Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Ferns Nursing Home DS0000003255.V342328.R01.S.doc Version 5.2 Page 31 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!