Inspection on 19/10/05 for Feryemount Residential Home

This inspection was carried out on 19th October 2005.

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

Feryemount Residential Home 25/08/06

Feryemount Residential Home 21/01/06

Feryemount Residential Home 08/02/05

Feryemount Residential Home 20/07/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Feryemount Residential Home North Street Ferryhill Co Durham DL17 8HX Lead Inspector John Trainor Unannounced Inspection 19th October 2005 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 Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 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. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Feryemount Residential Home Address North Street Ferryhill Co Durham DL17 8HX 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) 01740 651 667 01740 651 667 Durham County Council Ms Christine Elizabeth Ann Johnson Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29), Physical disability (9) of places Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. That 1 place be maintained for a current service user in the category of DE(E) until that service user no longer requires this accommodation. 8th February 2005 Date of last inspection Brief Description of the Service: Feryemount residential care home has been long established in the town of Ferryhill. The home is owned by Durham County Council and is registered for 29 Older Persons (OP) of which 9 are in the category of Physical Disability aged 55yrs or over. The home provides an intermediate care service for up to 9 persons. Service users are accommodated on the ground floor and first floor in single occupancy rooms. Throughout the home there is a range of separate lounges including a separate visitors lounge. Meals are provided in the main kitchen. A vertical/shaft lift is provided to the first floor for those less ambulant. Gardens to the rear of the home are well cultivated and provide easy access for service users. The home provides 3-day care places for service users in the community. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and lasted 5 hours, during which there was a tour of the environment and several people who live at the home were asked their views on what it was like to live there. Three people had their care reviewed in detail to see how good the home was at providing for peoples needs. Documents and certificates were inspected including care plans. The homes representative on the day of inspection was the Residential Supervisor Angela Muir. What the service does well: What has improved since the last inspection? What they could do better: The manager was on holiday and the electrical installation safety certificate could not be found. The home was told to provide this to the Commission for Social Care Inspection to prove things were safe. On the day of inspection changes had been made to the staffing rota which meant that there was a period in the middle of the day when insufficient staff were scheduled to be on duty. Though the senior on duty managed to change this on the day and maintained a safe number of staff more attention was needed to the planning of this in the future to ensure safe and adequate staffing levels. The home regularly uses agency staff to meet the staffing requirement necessary and it was recommended this be reviewed so people receiving the care have consistent staff they can get used to and develop a relationship with. A review of the medication policy and recording practice was necessary to make sure people were not prescribed drugs they did not need and staff were recording in the monitored dosage sheets in line with recognised good practice. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 6 The frequency of fire safety training needed to increase in order to ensure all staff were trained in line with current guidance on fire safety issues. Record keeping needed to improve to avoid the keeping of communal record files and ensure each person living in the home had a working care file which held all of their personal care records including risk assessment and risk management plans. The home was given instructions to improve these matters and make things better for people. Relatives who visit from far away would like to have a guest room so they could stay overnight when wanting to visit their loved ones. 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. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 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 Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 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, 3 and 6 People had some information to help them to make a choice before they moved into the home but improvements were needed to ensure they could make an informed decision. EVIDENCE: Care management assessments were completed prior to admission using the single assessment care management process and documentation. The manager then reviews these and makes a decision on whether the home is suitable to meet people’s needs. Following this there is a six week assessment period to ensure it is appropriate for the individuals needs. The provider does not have personal effects insurance cover for people living in the home. The statement of purpose was checked to ensure this was made clear to people before they moved in and this was the case. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 9 People assessed for and admitted to intermediate care beds had rehabilitative input from community rehab staff (occupational therapists and physiotherapists.) People did not receive a letter confirming the home could meet there needs following assessment and before making a decision to move into the home as required by regulation 14 (1(d)) so there was no clear record of understanding that this had been confirmed with individuals to inform their decision making process. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Though people could be confident their health care needs would be met and recorded in a plan of care improvements to the record keeping process would enhance the continuity of care for people. EVIDENCE: The community nurse spoken to at the home on the day of inspection said the home was good and there were good relationships between home staff and primary care teams. People had access to both primary and secondary health services as evidenced in their care files. Hoists and equipment were available and maintained safely Staff received medication training. Controlled drugs records were maintained accurately and safely. Medication was stored safely. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 11 Recording on the medication sheets was not always completed in line with good practice with medication being prescribed by a G.P. and not given by staff sometimes with no record on the dispensation sheet. MARS sheets were filled in by hand with no signatures of who had completed them. It was also recommended the provider reviews it’s policy on PRN medication as the current position, in practice, where G.P.’s are prescribing paracetemol four times per day just in case and staff are omitting them when not needed still leaves staff making the decision on whether the medication is needed and is worse than having a clear PRN policy for staff. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People found the lifestyle in the home met their expectations and had things to occupy their time. EVIDENCE: Contact with family and friends was supported and encouraged. Relatives were visiting during the inspection and those spoken to said the home was, “very very good,” and their relatives were well looked after. Activities were organised on a daily basis with a programme to ensure something happened every day. Outings were organised and people went out with individual staff. People living at the home said they had enough to do during the day and that their personal care needs were met in a way which met their expectations. People said the food was very good and it looked and smelled appetising. The cook was aware of special dietary needs for people. Some relatives were visiting from far away and would like it if there was a guest room to be able to stay the night. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 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 and 18. People could be assured their views would be heard and responded to and that measures were in place to protect them from abuse. EVIDENCE: There was a copy of the multi agency strategy on adult abuse, which the home adheres to. Staff spoken to were aware of “no secrets” and the local policy on suspected abuse. They had also received training in this area. The home had a complaints procedure and leaflet explaining this for people resident in the home and their relatives. The statement of purpose included a summary of this which provided information on how to contact the Commission for Social Care Inspection if they wished to. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 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 and 26. Though the home was clean and tidy, people could not be confident all aspects of the home were maintained safely. EVIDENCE: The home was clean and tidy. People spoken to said they liked their rooms though one complained of cold at night and it was found that her window did let in a cold draught. Risk assessments were maintained and staff were trained in infection control. However the laundry floor seal had become compromised and needed repair to ensure adequate infection control measures. The home did not have a hard wiring certificate for the electrical installation and therefore could not evidence the safety for the people living in the home. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 15 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, 28, and 30. Though people reported the staff met their needs sensitively and competently some difficulties with personnel management meant that consistency of care was threatened. EVIDENCE: On the day of inspection staff were deployed in sufficient numbers to meet the needs of the people resident in the home and staff received training to enable them to meet those needs. Staff were observed to treat people kindly, with dignity and respect. However the rota for the day of inspection had left 30 minutes in the middle of the day when only two staff were scheduled to be in the building. Though the senior on duty managed to avert this situation from arising, this bad planning is unsafe and inadequate. Staff must be deployed to ensure safe levels at all times. The home also has a dependency on agency staff using them on a regular basis to meet the minimum staffing requirement. This means people cannot be guaranteed they will have their personal care needs met by staff they know and have developed a relationship with and is not best practice. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 16 It is understood the fluctuating occupancy in intermediate care beds necessitates the addition of some staff at short notice when agency may be the only option but evidence seen on the day of inspection suggested the use of agency was greater than this and is an issue which should be addressed by a review of the personnel management of the home. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 17 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, 33, 35 and 38. Though in the main, the home was being managed in a way which maintained the safety of the individuals living there, some management decisions in the home seem to be made based on the needs of the service rather than the needs of the people. EVIDENCE: Gas safety certificate was current to evidence the installation was safe and following the last inspection the boiler had been replaced to ensure safety. Portable appliance testing was completed December last year. It was noted the risk assessment for portable appliance tests advised three yearly checks but this was not felt to be frequent enough based upon the type of service, where annual checks are advisable and therefore testing will be due in December 2005. Service user finances were maintained safely and regularly audited. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 18 Lifts and hoisting equipment were checked regularly. Staff received training in first aid, food hygiene, moving and handling, infection control and fire safety. However the frequency of the fire safety refreshers needed to be increased and the provider must satisfy themselves that the level of training provided meets the needs of the home and accurately reflects the fire policy in the home. Health and safety files were in a state of disorder and disarray with old certificates mixed with current safety checks it is suggested an archive of health and safety information be maintained but current checks, certificates and evidence be maintained in a working file. Failure to provide adequate staff cover at all times when staff take time off in lieu or are sick was put down to saving the budget by staff in the home and staff felt the regular use of agency staff was exacerbated by a freeze on recruitment which meant they could not employ into permanent posts. Senior management in the authority have since confirmed there is no such freeze on recruitment. Staff were unable to locate the hard wiring certificate to evidence the safety of the electrical installation. The floor surface in the laundry was in need of repair to ensure adequate cleaning can be maintained for infection control purposes. Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 19 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 1 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 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 X 18 3 1 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 3 3 3 X 1 Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 20 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 OP3 Regulation 14 (1(d)) Requirement For all new admissions confirmation must be given to people in writing that the home is able to meet people’s needs before they make a decision to move into the home. The registered manager must review current medication recording practice to ensure the problems with recording on MARS sheets are rectified. There should be no gaps on the recording sheet if someone is prescribed a medication there must be either a record of administration or a code to explain why it is omitted. The electrical hard wiring certificate was not available for inspection and must be made available to the Commission for Social Care Inspection before 28th October 2005 to evidence the safety of the installation. The laundry floor requires repair to ensure a waterproof seal. The registered provider must ensure all staff receive fire safety training appropriate to the policy DS0000031154.V254296.R01.S.doc Timescale for action 28/10/05 2 OP9 13 (2) 30/11/05 3 OP19OP38 13 (4(a&c)) 28/10/05 4 5 OP19 OP38 13 (4(c)) 23 (4(d)) 31/01/06 31/12/05 Feryemount Residential Home Version 5.0 Page 21 for the home with refreshers 6 monthly for staff who work days and 3 monthly for staff who work nights. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations It is recommended that all care records pertinent to the delivery of care to an individual be stored in the individual care file this includes the daily record and moving and handling risk assessments. This will enable the care plan to be a working document and encourage consistency of care among all staff. It is recommended staff rotas ensure there are sufficient staff deployed for duty so there will be enough staff in the building at all times. The use of agency staff on a regular basis should be reviewed as it would be better for the people living in the home to have consistency in the staff team. 2 OP27OP31 Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Feryemount Residential Home DS0000031154.V254296.R01.S.doc Version 5.0 Page 23 - 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. 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