Inspection on 06/03/06 for Ferns Nursing Home

This inspection was carried out on 6th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Ferns Nursing Home 16/07/08

Ferns Nursing Home 23/07/07

Ferns Nursing Home 10/10/06

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 Barbara Ludlow Unannounced Inspection 10:15 6 March 2006 th 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.V278298.R01.S.doc Version 5.1 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.V278298.R01.S.doc Version 5.1 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@almondsbury.fsbusiness.co.uk 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.V278298.R01.S.doc Version 5.1 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. 24th May 2005 Date of last inspection Brief Description of the Service: 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. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken by B Ludlow for CSCI. The homes manager was the RN on duty at the start of the inspection and was present throughout. The home was generally clean and tidy. Staff were friendly and helpful. The morning routine was running late and service users were seen to be finishing their breakfasts at 10.30 am. There were 31 service users in residence. Observed staff and service user interactions were appropriate and kind. A tour of the premises was made and service users and staff were spoken with. Medications management was seen. Lunch was observed and looked appetising. Records were sampled during the afternoon these included the fire alarm tests. Major building work had commenced to add some further bedrooms to the home. The garden was being cleared and trees surrounding the perimeter of the rear garden had been cut back or cut down. Feedback was given to the Registered Manager, Mrs J Hufton at the end of the inspection period. The visit closed at 17:45 pm What the service does well: What has improved since the last inspection? Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 6 The homes Manager, Mrs J Hufton is now registered with CSCI and has settled into her new position. The requirements made at the last inspection have been addressed. What they could do better: 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. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 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 Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, NMS 6 does not apply The home provides a good level of information about the home to inform prospective services and their families when making their choice of care home. EVIDENCE: The home has produced a detailed Statement of Purpose, which was last revised in June 2005 with the addition of Mrs J Hufton as the Registered Manager/Matron. A copy of this document was received at this inspection and will be held on file by CSCI. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,10 Care plans were sampled these held a good level of health care information. Service users and staff interactions were observed to be respectful, friendly and caring. EVIDENCE: Care plans were sampled, there was evidence of health care needs being recorded and input by visiting professionals, the G.P, the district nurse and others for specific health care needs. These specialists included consultant input and the dietician. Five persons were identified that have pressure sores; one was described as small and three as superficial. Care plans were seen and wound care was recorded for all five. Supplementary diet had been introduced for one and specialist advice had been sought for another. Pressure relieving equipment is available and was seen in use. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 10 Bed rail use was documented in the individuals care plan and consent was obtained from the service user. There were areas where the care plan detail did not highlight a specific problem or did not document for example social care; one had no entries since December 05. All staff and service user interactions observed throughout the day were friendly, caring and appropriate. Service users commented that ‘staff are kind’. Where service users behaviour becomes unpredictable and difficult to manage the home should seek advice and develop a strategy to protect the service user and staff from harm. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14,15 Service users were satisfied with the social opportunities available to them. The food was described as ‘good’ and looked appetising. The kitchen required attention to cleaning and storage of refrigerated foods. EVIDENCE: Service users opinions were asked for with regard to the catering, the feedback was positive and service users reported that the food was good. The kitchen was seen mid morning. The floor was not as clean as would be expected from the cleaning rota, which indicated the floor had received attention on Sunday evening. Not all foods stored in the fridge were covered and one broken egg was on a tray in the middle of the fridge. The large sauce containers in the fridge door were very sticky and were cleaned by the cook when brought to his attention. The cook and assistant stated they had both attended a City and Guilds course at Yeovil College last September and their food hygiene training was coming up to renewal. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 12 The menu was beef casserole or omelette with a selection of vegetables and a choice of three puddings. The meals were nicely served and the food looked appetising. The dining tables laid in the large lounge, were adequately presented and 25 service users had lunch together. Service users can eat in their rooms if they wish; meals were nicely presented on trays. Drinks were served with the meal. Protective clothing is available and assistance was given sensitively. Service users asked commented positively about the food, ‘food is good’; ‘food is nice, plenty’. Service users were asked about their daily life and routine. The inspector heard that service users get up and retire when they choose. Service users commented that they had plenty to do, ‘always something doing after lunch’. One person said they were very happy at the home. One person was out at a day care centre and one other was free to attend if they wished to. A small number of service users prefer to stay in their rooms and watch television or read, some had hobbies and for example were busy knitting. Regular relatives meetings are now held 3 monthly. The time is rotated from Saturday to Sunday to an evening, to allow all relatives the opportunity to attend. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Service users are protected from abuse by the recruitment process and policies and procedures in place at the home. The home has a complaints policy and procedure. EVIDENCE: At the last inspection the recruitment process was satisfactory and all checks on new recruits had been made. The manager is very aware of her role in protecting vulnerable people in her care. Any concerns are taken seriously and would be acted upon. All concerns or complaints made to the home are logged and investigated. These records were not checked in detail at this inspection. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Accommodation is generally comfortable, clean and tidy. Bedrooms can be personalised. Communal facilities are comfortable and the home is suitably adapted for the client group. Infection control is managed fairly well but some areas that needed attention to cleaning were identified. EVIDENCE: Ferns is about to have an extension to the main building and the garden was out of bounds as the trees were cut down and the site prepared for the building works to commence. Ferns is purpose built and has level access. There are handrails, wide corridors and assisted bathing and toilet facilities. Health and safety adaptations include radiator covers and bath hot water temperature restriction to safe limits. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 15 Individual service user accommodation is comfortable and can be personalised. A tour of the premises was made and bedrooms were sampled. There is pressure relieving equipment available if required and overlays and cushions were seen in use. One cushion was identified for sufficient cleaning. The kitchen has a cleaning schedule that was completed up to date, however, the floor needed to be more thoroughly cleaned. See also NMS 15. The laundry process needs reviewing where laundry has to be dropped to the floor when removed from the tumble dryer, this requires a basket or suitable receptacle to be made available for use. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,30 Staffing numbers were adequate at this inspection. Staff receive induction and training. Staff supervision could to be developed. EVIDENCE: The home has a Registered Nurse on duty at all times, in the morning the home has six care staff, the afternoons have a minimum of four care staff rising to five in the evening, overnight there are two care staff with the Registered Nurse. No concerns were raised about the staffing levels at this inspection. The manager was the Registered Nurse on duty at the start of this inspection as she usually works one long day shift per week within her full time contracted hours. Another member of staff came on duty to relieve the manager to allow her to join in fully with this her first inspection since becoming the Registered Manager, this was most helpful. Two new staff have joined the home since the last inspection, both had induction and have supervision with the manager. The homes staff team is currently 36 in total, the inspector was in formed that staff receive supervision every 2 to 3 months, mostly carried out on an informal basis. Regular staff meetings are held. The supervision and meetings should be captured and recorded for individual staff. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 17 Staff training included, Principles of care, POVA, Fire training, Infection control and food hygiene. These training sessions are based around video and DVD information and training packages bought by the home. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,38 Mrs Hufton is registered as the homes manager with CSCI. Mrs Hufton is managing the home and all challenges arising in her duties, professionally and very well. Service user meetings are held to look at service user satisfaction and service improvement. Maintenance of the home was satisfactory and supports the health and safety of service users. The use of portable heaters must be risk assessed. EVIDENCE: Mrs J Hufton was approved by CSCI through the Fit Person Interview process. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 19 Mrs Hufton manages Ferns very professionally and has dealt with situations arising for her as the manager, very well. Mrs Hufton is approachable and has a quiet, firm management style. Service user and relative meetings are held and a service user satisfaction survey is carried out by the company. Accident records were seen, there is no regular accident audit being completed although action has been identified where patterns have been identified for example frequent falls. Accident audit is recommended. Fire records were sampled; there was evidence of a weekly fire alarm test being carried out on a regular basis. The alarm was tested on the inspection day. The six monthly servicing of the fire alarm was carried out on 31.08.05. The fire extinguishers had been serviced and were due again on 10.03.06. The emergency lights had also been checked on 06.02.06. Fire alarm records indicated an incident on 28.01.06 when a portable heater had been used to supplement the heating and fluff in the heater had singed and set the alarm off. This was clearly reported in the log, immediate action had been taken at the time and the handyman had since cleaned the heaters. The manager had not been alerted to this incident and it is recommended that a risk assessment supports the use of supplementary heating in corridors in cold weather. Audit of the alarm log entries and checks should also be made by the manager and the operations director carrying out the monthly Regulation 26 visit to the home on behalf of the company. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 20 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 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X X 2 Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 21 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. 2. Standard OP26 OP38 Regulation 13(4)(c) 13(4)(a) (c) Requirement The standard of kitchen cleaning must be improved. A protocol and risk assessment should be carried out for the supplementary heating of corridors in cold weather. Timescale for action 28/04/06 28/04/06 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 2 3 4 Refer to Standard OP26 OP38 OP38 OP8 Good Practice Recommendations A laundry basket should be used to transfer laundry from the tumble dryer. A regular audit check of the fire alarm log and checks should be made by the Registered Manager and Responsible Individual. Regular audit of accidents is recommended to identify any patterns that may emerge where preventative action can be taken to reduce the incidence and risk. Where a service users behaviour becomes difficult to manage advice should be taken and a strategy developed to support the service user and staff. Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ferns Nursing Home DS0000003255.V278298.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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