Inspection on 28/11/06 for Fernwood

This inspection was carried out on 28th November 2006.

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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fernwood 10/10/08

Fernwood 01/11/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Fernwood 30 Fern Road St Leonards-On-Sea East Sussex TN38 0UH Lead Inspector Jason Denny Key Unannounced Inspection 28th November 2006 10:00 Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 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 Fernwood DS0000060878.V320468.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 Adults 18-65. 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. Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fernwood Address 30 Fern Road St Leonards-On-Sea East Sussex TN38 0UH 01424 460689 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) Graham Robert Jack Graham Robert Jack Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Learning Disability (LD) not falling under any other category. The maximum number of service users to be accommodated must not exceed three (3). The people accommodated will be between the ages of eighteen (18) and sixty five (65) years of age on admission 1st November 2005 Date of last inspection Brief Description of the Service: FERNWOOD IS A LARGE DETACHED PROPERTY IN A QUIET SUBURBAN AREA OF ST LEONARDS. THE HOME HAS AN ACCESSIBLE AND LARGE BACK GARDEN. THE FRONT ENTRANCE TO THE HOME WOULD BE UNSUITABLE FOR WHEELCHAIR USERS. THE HOME HAS ONE BATHROOM AND ONE SHOWER ROOM/TOILET. ALL ROOMS INCLUDING THE KITCHEN, DINING ROOM, LOUNGE, AND BEDROOMS ARE LARGE AND SPACIOUS. THE HOME IS MODERN AND WELL APPOINTED. THE HOME IS CLOSE TO LOCAL TRANSPORT LINKS. EACH ROOM HAS SINK WITH A TOILET AND A CHOICE OF TWO BATHROOMS NEAR TO BEDROOMS. THE HOME IS REGISTERED TO PROVIDE SERVICES FOR UP TO 3 YOUNGER PEOPLE WITH A LEARNING DISABILITY. THE OWNER/ MANAGER OF THE HOME MR GRAHAM JACK OWNS A SIMILAR TYPE OF HOME IN HASTINGS. Information on the range of fees charged is within the homes current statement of purpose/service user guide and ranges from £930 to £1630 per week. Charge’s for extras includes personal items such as toiletries and clothes, part of the basic cost of annual holidays, and hairdressing. All Service Users have some kind of advocacy to assist the management of financial affairs. Inspection reports are not routinely sent out to families and advocates after each publication although a copy is kept on display in the reception area of the home and can be obtained via the manager. A service user guide containing the most recent inspection report is sent to any interested person [or their representatives] looking to move into the home. Fernwood DS0000060878.V320468.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, which included a visit to the home which took place between 10.00am and 3.45 pm on November 28, 2006. This inspection focused on the key areas such as care, Activities, lifestyles, environment, staffing and management of the home, and how concerns are dealt with. During this inspection process, which covers the period since the last inspection November 1, 2005 and the week of the home visit, a number of relatives along with social services have been spoken with . 1 of the 3 Service users returned survey cards, which indicated good levels of satisfaction with the home, especially the staff and the care. Relatives of the two other Service users indicated satisfaction in phone conversations with one describing the home as excellent. 2 Service users were spoken with and observed during the inspection, which included discussion with staff and observation of care. The focus of the inspection was looking at all 3 Service users and the newest one in some detail. Some diversity and equality areas were explored in relation to lifestyles. Care records for all 3 Service users along with health and medication needs were looked at. Discussions with management looked at progress since the last inspection. All communal areas of the home were toured. Meal arrangements were examined. A record of complaints was inspected. Staffing was looked at in detail along with the homes management, including measures to ensure quality for Service users. One [1] outcome area is assessed as Excellent, six [6] areas are assessed as Good overall, and one as Adequate. What the service does well: The home was found to provide good, attentive, and proactive care. Service users two of whom have severe learning disability have a good and improved quality of life since moving into the home, based on an active lifestyle suited to their needs and choices. The newest Service User is being well supported to settle in over the last two months with staff led well by the active manager with a clear approach in the best interest of all service users. The home has also acted quickly to reduce a person’s behavioural medication with positive effects. The exceptional size and quality of the building which the 3 service users share provides ample space for all to express themselves without affecting one another. This also avoids the temptation to overly medicate or unnecessarily control Service Users behaviour. The number of challenging and serious incidents remains very low. All relatives commented positively on the size of the home where some Service Users who had previously lived in more cramped environments which had affected them. The two established service users get on well together and do not interfere with the needs of the newest Service User. This compatibility is helped by Service Users having a high number of trial visits before moving in. Care-plans are useful with a stress on helping service users with their communication needs. Observations of staff Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 6 and records showed how well the home promotes choice and skill development for Service Users. One relative commented on how well the home is supporting someone who had a difficult time in a previous service and who was now described as “being back to his old and motivated self”. There is plenty of Staff, which means excellent attention for Service Users, staff are well chosen, experienced and dedicated with no staff turnover since the home opened. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4, & 5. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Prospective new service users benefit from a basic level of information which although improved requires some further work to be complete such as contracts [terms and conditions] The amount of time spent with, and assessing, prospective new service users including a number of trial visits is exceptional and ensures that such Service Users can make an informed choice before deciding to move in to the home. . EVIDENCE: The inspector examined the home’s service user guide and statement of purpose in the office of the home and which is in each Service Users care-plans folder and which, is given to prospective new Service Users before they move in. The Statement of Purpose looked at on the last Inspection was found to have been updated to reflect that 2 Service Users have moved in to the home and the type of staff team. The manager agreed that the guide/Statement of Purpose needed further updating to reflect the newest Service Users that has just moved in [September 2006] who does not have a severe learning disability but who is compatible with the others. Care-plans showed a number of assessments from social services given to the home prior to service users moving in. The manager discussed how he visited Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 9 these service users and worked shifts with them prior to offering them a place. On this Inspection the Inspector found that the home now records this process in respect of the newest Service User although some of the homes preassessment information needed dating. The manager was advised that trial visits should be recorded within daily notes or the assessment records and that socials services should be written to confirm that needs can be met. None of these shortfalls were found to be affecting outcomes. A diary showed a number of trial visits [2] by this service user. For the other Service Users trial visits included overnight and full weekends. This process is exceptionally well handled by the home with the newest Service Users and their relatives praising the manager who was fully involved and hands on during the move and settling in period. Those social workers spoken with indicated how well Service Users had settled into the home and made progress. Financial contracts are signed with Social Services when new Service Users move in which details the fee. The home has a sample contract/ terms and conditions within it is Service Users guide. Not all the required information was in this document such as room to be occupied and had not been signed by the service user or their representative on admission. The manager was also advised about changes to regulations effective from September 2006 in respect of the full range of information, which now needs to be in contracts. Service Users pay some costs of the annual holidays, which are classed as an additional charge of approximately £500. The manager was advised to be more specific about what this charge covers and what the home provides as part of the basic fee price. None of this was found to be affecting outcomes for Service Users and no concerns have been expressed. The full information is necessary to promote and protect Service User’s rights. Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, & 9. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Useful and sufficiently detailed care-plans, which are followed in practice, have been developed for all Service Users, supporting them to develop skills, maintain independence and promote choice. Service users are carefully risk assessed and given regular opportunities to access the local community. EVIDENCE: The inspector examined all 3 care-plans, which had developed from the original assessment information. A range of guidelines was found to be in place including detailed information on supporting personal care routines. A social services review carried out on one service user 8 weeks into the placement showed that needs were being met. Follow up reviews on the two established Service Users involving Social Services and relatives one in May 2006 indicated the home was still meeting needs and improving outcomes. Relatives of both established service users indicated in writing and in phone calls high levels of satisfaction with one described the home as “excellent from the word go”. Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 11 Relatives indicated how both Service Users were much happier since moving in the home and had opportunities to do what they preferred and to achieve their potential. Two service users have limited verbal communication with both plans showing a range of communication guidelines subject to regular review. Staff were interviewed as to their understanding of these plans, and how the service users had developed since moving in. Both service users were found to have weekly to fortnightly contact with families, with both being involved in care reviews. The newest Service Users has strong advocacy from his mother and a personal counsellor who acts as a advocate and who supported with the completion of the Commission’s comment card which indicates satisfaction with the home. All Service Users were found to have clear and comprehensive risk assessments in place, which, were observed to be followed in practice. Staff spoken with, were knowledgeable about risk assessing and how best to support Service Users such as one which has past issues with travelling in vehicles but who is better with smaller groups and known and predictable faces. The newest Service User is currently using the guidance from his last placement and from his weekly psychology input to assist the settling in process. This Service User was found to have comprehensive notes which staff access and discuss with a new care plan developing based on his new environment. Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16, & 17. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home is committed to active and meaningful lifestyles with routines carefully suited to the needs and choices of service users. Established service users have developed a higher level of motivation, independence, and more active lifestyles than had been the case previously. Service users benefit from both healthy and tasty meals at flexible times. EVIDENCE: Activity schedules were examined along with daily notes on service users. The inspection took place during normal business hours with only brief observation of service users due to them being out for most of that time. One was at a new day centre which he attends Monday to Friday and which in the opinion of staff, relatives, social worker and records, indicates an improvement with him enjoying the greater variety and space. Another Service Users went trampolining in the morning with 1:1 staffing and the newest Service User made his own choices and went out with the other Service User during the Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 13 afternoon for walk and a meal. It was evident through observation and discussion with staff and examination of records that each Service User has their preferred routines recorded and supported with all given space and time with unhurried routines. Breakfast times were observed to be flexible Relatives indicated their pleasure at how active the two established service users are in their new home and how previous placements had broken down partly due to issues with providing enough space and activities and enough staffing. The newest Service Users tried all activities during his first 2 weeks and is currently less motivated although staff steer a careful line between offering choices and respecting his rights. This service user indicated in discussions with the Inspector that he enjoys his large room and the views, along with the relaxed routines where he is not disturbed by other people. Relatives indicated how they are encouraged to be as fully involved as necessary as advocates in the lives of Service Users and how they received a warm welcome at the home and kept well informed. Records of meals served along with food stocks were examined. Two service users were observed to have full access to all parts of the home including the kitchen when staff are present. The newest Service Users who has been risk assessed to access the kitchen independently was found to have his own star key as the kitchen is locked for others when there are risks such as hot plates or staff are not present. The new Service User indicated pleasure with the menu and the choice he has. A relative indicated how another Service User has gained a healthy amount of weight since living in the home The home provides both in-house and mainly community based activities. Service users are encouraged to treat the home as their own with any restrictions based on careful risk assessment. Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19, & 20. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Service users receive personal support in the way they prefer and require. Service users benefit from having recorded routines and guidelines, which help staff to know how best to support them. Service users have minimal medication in their best interests, which is carefully reviewed, and securely stored by trained staff. EVIDENCE: Personal care guidelines were looked at for all service users this included looking at detailed bathing guidelines, which showed service users preferences, what they could do for themselves, and what support they required. One service user has his right to have a bath before breakfast respected. Care-plans itemised health needs with records kept of health appointments and follow up action. One service user has relieving anxiety guidelines. This service user now for the first time, has a meal with others. The newest Service User indicated how he is supported with personal care based on his preferences and skills. Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 15 A relative indicated how another service user who used to look pale and underweight in another placement was now much healthier. The home indicated how this person is encouraged to eat regularly and that a medication change helped when they quickly detected he was loosing weight again. The medication cupboard, medication stocks and records were examined along with staff being observed giving medication. Medication mainly consisted of over the counter remedies all of which were labelled and recorded on the administration sheets. All staff were found to have recent refresher training from a supplying pharmacist. The home was found to have acted proactively by quickly organising a medication review for the newest Service User where it was felt he had been unnecessarily overmedicated on arrival in to the home, which was making him lethargic. The home prefers that any behaviour be expressed with the staffing approach based on providing space and analysing the causes in order to improve guidelines. His relatives indicated pleasure that the home was taking this more proactive and empowering approach now that he was in the right environment and less of a risk to others. The service as expressed by the manager and staff, have taken the view that given the high staffing levels and amount of space that the possibility of challenging behaviour is reduced. Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, & 23. Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. The home operates in an open and inclusive way in the best interests of service users. There have been no upheld complaints made against the home since it opened with one concern thoroughly investigated with measures put in place. Staff are aware of how to both identify and report suspected abuse in conjunction with a clear policy and procedure. EVIDENCE: It was evident from records and discussions with the manger that no recorded complaints have been made to the home in respect of service users. One allegation has been made to the home by another service provider mainly about the conduct of staff with no evidence of this directly affecting Service Users. Social Services and the home manager investigated this concern with no evidence to support the allegation, which had come to light several weeks after the alleged incidents had been noted. The manager indicated that they had also received a part apology from the organisation making the complaint/allegation. It was not necessary for the Commission to be involved at all in the allegation made in November 2005 as a recent inspection had shown no evidence to support them. The manager demonstrated through discussion how any complaint would be dealt with and investigated including any complainant Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 17 being written to with the outcome. The home has introduced a complaint recording form to ensure that all staff would process a complaint in the same way regardless of who initially took the complaint as seen in the complaint file which showed no complaints since the last inspection. The manager also conducts more unannounced/unexpected visits to the home to ensure improved staff supervision in everyone’s interests. The manager confirmed that he had recently attended a Protection of Vulnerable Adults course. All staff have previously covered adult protection training in their previous jobs. The home was found to have adult protection prevention of abuse policy and reporting procedure. The reporting procedure was found to have been improved to make reference to Social services who take the lead role in adult protection investigations. Staff were interviewed as to their understanding of adult protection issues and again showed a good understanding. Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, & 30 Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. Service users live in an exceptional environment, which is homely, well equipped, and affords them plenty of space. A minor improvement to how staff use the home would be beneficial EVIDENCE: The Inspector toured the home and looked at the bedroom of the newest Service User. The newest service user stated that he likes the spacious home that also affords him his own room on the top floor where there are no other service users and with an en-suite shower room next to his room. All Service Users have large rooms, which are well equipped in a quiet suburban area with large garden within a detached property. The home was found to be clean and well maintained. All fire equipment is regularly serviced along with other equipment such as Electrical and Gas as seen in records and the home pre-inspection questionnaire. Although the Service Users treat the home as their own the manager was advised that staff need to show more care in respect of their personal Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 19 possessions and not leave them on display, as well as records, and other potential hazards. On arrival at the home the Inspector observed tobacco lighters and a used ashtray half-full of cigarettes buts in the dining room /conservatory near the back door. No Service Users were found to be unsupervised when moving around the home and did not approach these items. Staff stated that the ashtray had been brought in to the home due to rain and that staff only smoke outside the back door in line with the smoking and fire policy. The inspector advised that the impression was different although no smoke odours were detected with the situation quickly resolved. A mop bucket full of water was also found to have been in the dining room for several hours and after advice was emptied. The home was found to be well equipped with a range of good furnishings such as carpets, curtains and net curtains and highly personalised bedrooms based on the needs of Service Users. Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 33,34,35, & 36 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Service users benefit from good levels of attentive well selected staff, who are experienced, skilled and overall well trained and motivated. The rota would benefit from being clearer about management hours being worked in the home. EVIDENCE: The rota was found to be followed although it was not clear what hours were being worked by the manager with him on the rota 9-5 each week day except college days or when working a scheduled shift. The manager also covers some management hours in another nearby home during the week. The manager was advised to indicate when his hours were management time in relation to this home Fernwood to promote transparency. A service user who is funded to have 7 hours a day 1:1 staffing Monday to Friday was also found to have this plus 1:1 most weekends. Another service user was found to receive similar staffing ratios. With the arrival of new Service Users staffing levels are now 2 at all times along with the introduction of waking night staff. Service users were observed to have immediate access to staff and whilst the Service User Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 21 who attends a day centre 5 days a week [with a staff person provided at the centre], the other two Service Users who do not have day care receive 1:1 staffing provided by the home. Staffing files on the two newest staff were examined with Police CRB and references along with all other information in place. The manager now gets POVA firsts in writing before the person starts work in the home under supervision before the CRB is received. Both of the new care staff was found to have National Vocational Qualification at level 2 or equivalent. Overall 3 of the 7 care staff have at least this qualification with the manager working on National Vocational Qualification 4. The manager was advised that at least one other staff needs National Vocational Qualification. One senior did start a National Vocational Qualification 3 but has had to suspend this course for the time being. Both new staff were found to have an basic written induction with the manager which included care-plans. These staff are also very experienced and have done TOPPS inductions in previous jobs. The manager was advised about the new Common induction standards, which now need to be carried out on all new staff from October 2006. Most staff have done SCIP training based on preventing Service Users going into crisis and avoiding the risk of incidents. It was positively noted that there has been no turnover of staff since the home opened with relatives indicating the benefits of such continuity for Service Users. Supervisions records for all staff were looked at during the last Inspection, which showed that they were occurring at least every two months. Staff on this inspection confirmed that they are regularly supervised in a written manner and that the manger also turns up at the home unannounced to carry out inspections. The manager indicated that the two new staff that have started over the last month are booked in for written supervision. Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, & 42 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The way the home is managed ensures good outcomes for Service Users. The management of the home would benefit from being more up to date with changing law and policies. The completion of the necessary management course will also be beneficial. Minor improvements to administration are necessary in the best interests of Service Users such as written plans to improve upon quality. Service users are protected from harm by living in a well-maintained environment and by staff who are well trained in health and safety. EVIDENCE: The manager/owner has previously managed similar services. The manager was found to have now started a relevant management course. Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 23 [National Vocational Qualification level 4 and registered managers award]. This course is due for completion in July 2007 with the manager attending on a weekly basis. It was evident through discussions with all stakeholders, observations, and records, that the manager works hard and effectively to improve outcomes for all Service Users which are good. It was also evident that the manager will benefit the home further by keeping more up to date with changes in the care industry and to the care homes regulations. The home is managed is open way and as observed during the inspection the manager is easily accessible to staff and Service Users. Relatives also indicated that the home is well managed in the best interests of Service Users. Regular meetings take place in the home as evidenced in minutes. The manager is evidently committed to improving quality as shown in improved outcomes for Service Users. The manager indicated some plans to improve the service further but this has not been written and shared in the home. The manager was given 3 months to send this plan to the Commission. The staffing of the home is good although decision-making can improve. Staff were advised to ensure that Service Users confidential information is kept secure at all times and not left out in the kitchen. This was immediately addressed in the inspection. The manager is currently a registered nurse in learning disability. Some staff were found to have Moving and Handling, First aid, food hygiene, and health and safety training with all other staff booked on these courses over the next 6 months. All equipment such as fire, gas, and electrical, was found to be within its service schedule. The home have introduced a visitors book which showed on most but the current page the duration of each visit. New staff were found to have all necessary basic training, some existing staff have done refresher first aid training and currently the home are looking for a moving and handling trainer. Incident records showed that all necessary significant incidents over the last year had been reported to the Commission the last one being in October 2006. Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 4 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 3 2 X 2 3 X Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA5 Regulation Requirement Timescale for action 28/02/07 2. YA33 3. YA39 5 That the Registered person [a][bb][bc][bd] must ensure that the individual Terms and Conditions [Contract] is signed on admittance by the service user or their representative and contains all necessary information in standard 5 and as indicated in the amended regulation 5such as, detailing fee payable and by whom, and what is additional [extras] to what is charged for. 17[2] That the Registered person 28/12/06 Schedule 4 must ensure that the homes rota clearly indicates what management hours are being worked in the home. That a copy of the monthly rota is sent to the Commission by the date shown during the management hours also worked in the other home the manager/registered person covers. 24 That the Registered person 28/01/07 must ensure that Annual development plan is DS0000060878.V320468.R01.S.doc Version 5.2 Page 26 Fernwood produced and sent to the Commission by the date shown. 4. YA41 17[1][a][b] That the Registered person 28/11/06 must ensure that service user records are kept secure at all times. 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. Refer to Standard YA1 YA24 Good Practice Recommendations That the Registered person sends the Commission any update of the service user guide/ Statement of Purpose. That the Registered Person revisits guidance to staff on how to ensure that all areas of the home which service users have access to are free from hazards and respects the fact that it is there home. That sufficient numbers of care staff are enrolled on National Vocational Qualifications level 2 or equivalent as soon as possible and before April 2008 That the Registered manager completes his NVQ level 4 in Management and Registered managers award on schedule, and by 2008. That the homes visitor’s book must show the duration of each visit. 3. YA35 4. YA37 5 YA42 Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Fernwood DS0000060878.V320468.R01.S.doc Version 5.2 Page 28 - 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. 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