Inspection on 25/08/06 for Feryemount Residential Home

This inspection was carried out on 25th August 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

Feryemount Residential Home 21/01/06

Feryemount Residential Home 19/10/05

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 Mr Stephen Ellis Unannounced Inspection 25th August 2006 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 DS0000031154.V307441.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000031154.V307441.R01.S.doc Version 5.2 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 DS0000031154.V307441.R01.S.doc Version 5.2 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. 21st January 2006 Date of last inspection Brief Description of the Service: Feryemount is a long established care home situated in the town centre of Ferryhill. Durham County Council provides the home. It is registered for 29 beds: 29 Older Persons (OP) plus 9 in the category of Physical Disability aged 55yrs or over. The home has an intermediate care service for up to 9 persons, for the purpose of short-term, multi-agency, intensive rehabilitation, designed to get people back home within 6 weeks of admission. Intermediate care service users are accommodated in a unit on the ground floor, and permanent residents are situated on the first floor, all in single occupancy bedrooms. There are a good number of communal rooms throughout the home, including a separate visitors lounge and two dining rooms on the ground floor. Stairs and a vertical lift connect both floors. Gardens to the rear of the home are well cultivated, with good access for service users. The home also provides up to 3 day-care places for service users in the community. The weekly residential charge is £432.32, although the actual amount people pay depends on individual circumstances. This covers accommodation, personal care and all meals and beverages. The only additional costs concern voluntary purchases such as newspapers, toiletries and hairdressing. People using the intermediate care service do not pay any charges. DS0000031154.V307441.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 25th August over 8 hours. It included a tour of the building, examination of records and discussions with service users, staff and manager. Before the inspection visit, information had been received from a number of sources, including service users, relatives and visiting staff to the home. In total, comments were received from 9 service users, 2 relatives, one health care professional and 6 staff. What the service does well: 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. DS0000031154.V307441.R01.S.doc Version 5.2 Page 6 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 DS0000031154.V307441.R01.S.doc Version 5.2 Page 7 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): 3 and 6 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Service users move into the home only after having had their needs assessed and having been assured that these will be met. Service users who use the intermediate care unit are helped to maximise their independence and return home. EVIDENCE: Written assessments of need in service users’ plans of care confirmed comments received from service users, relatives and staff: that comprehensive assessments of need were carried out prior to admission. These were kept under review and adjusted accordingly. Documentary evidence showed that in the past year, 60 clients had used the intermediate care service, with 49 of those going home (81.7 ) and 3 returning to hospital. The remainder had moved into some other form of care, such as a residential care home. Comments from people who had had experience of the intermediate care service were particularly positive and DS0000031154.V307441.R01.S.doc Version 5.2 Page 8 complimentary. As one service user said: “the staff are so caring and dedicated and absolutely lovely…the meals are excellent, beautifully made and I’ve requested smaller portions!” DS0000031154.V307441.R01.S.doc Version 5.2 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, 9 and 10 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The health and personal care, which service users receive, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Comments received from service users, relatives, one visiting health care professional and staff based at the home, confirmed documentary evidence in care plans of good arrangements for the delivery of health and personal care. Typical comments from service users included: “I can talk to staff…staff are good…staff listen and act on what you say.” A typical comment from a relative was: “A lovely, friendly home. The way the staff deal with my mother is wonderful. When dealing with me they are always helpful. Personally, I can’t fault it”. A visiting health care professional said: “I always find the staff caring and they share information that is necessary for patient care.” On the intermediate care unit there is intensive, multi-agency input, including staff providing personal care, occupational therapy and physiotherapy. There is also intensive input from General Practitioner and Community Nursing Services. The aim is to rehabilitate the service user back home within 6 weeks. DS0000031154.V307441.R01.S.doc Version 5.2 Page 10 There are good arrangements for the safe handling of medication. A monitored Dosage System is used, in which most medication is dispensed by the pharmacist in blister packs. There are lockable facilities in service users’ rooms should they be required by service users for the storage of medicines. In practice, most medicines are stored in special lockable cabinets in a medicine room and specially trained staff take responsibility for administering medicines as prescribed. DS0000031154.V307441.R01.S.doc Version 5.2 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, 13, 14 and 15 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Residents are able to choose their lifestyle, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet residents’ expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: Comments received from service users were positive about the lifestyle and range of activities enjoyed. A typical comment from a resident was: “Usually there are activities available that are organised by the home that service users can take part in.” These included individual and group activities, such as reading, television, shopping, board games, bingo, religious services, recall and reminiscence, crafts and occasional outings to places of interest. Resident consultation meetings are held monthly so that service users can discuss issues of concern about the life of the home and make suggestions about improvements. Individual choice is respected and staff try to ensure people’s preferences are acknowledged in daily life and activities. Several staff members said it would be helpful to have a member of staff dedicated to organising activities, because the personal care duties of care staff have to take priority, and this sometimes prevents the commencement or completion DS0000031154.V307441.R01.S.doc Version 5.2 Page 12 of an activity. Comments received concerning the quality of catering were very positive. A typical comment from a resident was: “The meals I get are very good with a good variety, and enough on my plate.” A varied appetising menu is provided, with good choice, including a cooked breakfast for those who want one. A variety of hot and cold drinks are available throughout the day. DS0000031154.V307441.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Residents have access to a robust, effective complaints procedure and are protected from abuse. EVIDENCE: Service users said they were confident about raising any concerns or complaints with staff at the home. A typical comment from one service user was “I can speak to any staff member if I am not happy. I don’t usually have anything to complain about but if I did I would see the manager.” The home’s complaints procedure is readily available in the service user guide. Staff and manager were described as being approachable and helpful. Staff confirmed that they had undergone training in adult protection, including ‘whistle blowing’, and were confident about their role in protecting vulnerable people. DS0000031154.V307441.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The physical design and layout of the home enables residents to live in a safe, wellmaintained and comfortable environment, which encourages independence. EVIDENCE: Service users said they were pleased with their accommodation, describing it as comfortable, homely and accessible. Good decorative standards were evident. The small and large dining rooms have recently been redecorated. Bedrooms are all well equipped singles, although many are not large (about 10 sq m) and none with en-suite facilities. However, toilets and bathrooms are well distributed and plentiful (16 toilets, 4 bathrooms and 2 showers). There are 7 communal rooms, including one visitors’ room, which help promote choice and dignity. The premises were clean and well maintained, as confirmed by records and the registered manager. It was noted that the laundry floor had been renewed since the last inspection. The dining room window has been referred for repair and is awaiting action. The rear garden was well looked DS0000031154.V307441.R01.S.doc Version 5.2 Page 15 after and accessible by residents. The front door was observed to require repainting as the blue colour was badly faded. DS0000031154.V307441.R01.S.doc Version 5.2 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, 28, 29 and 30 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of residents. EVIDENCE: Comprehensive staff training and development programmes were evident, addressing all essential training. For example, 63 of care staff have achieved National Vocational Qualifications (NVQ) in care at level 2 or above. The registered manager has achieved NVQ level 4 in management and care. Individual staff-training records are maintained and training needs are continually assessed in staff supervision. At the time of inspection, there were 22 service users, including 6 in the intermediate care unit. This unit is situated on the ground floor and can take up to 9 service users. The remaining 20 beds for permanent residents are situated on the first floor. At night (10 pm to 7 am) there are 2 care staff on duty, with the option to increase that to 3 if required. During the day (7 am to 10 pm) there are, normally, at least 2 care staff on each floor. There is additional input on the first floor from a residential supervisor, and one of the care staff from the ground floor (if possible), at times of peak demand, such as early to mid-morning. Staff expressed concern about their ability to meet the needs of increasingly dependent service users, although acknowledged that they manage most of the time. One health care professional observed that there was a lack of staff at times, but added: “I always find staff are caring and they share information that is necessary for patient care.” This issue has been raised with management and is being kept DS0000031154.V307441.R01.S.doc Version 5.2 Page 17 under review. On the intermediate care unit, there is multi-agency involvement from the local General Practitioner (Dr Willis), Community Nursing, Care Managers, Occupational Therapists, Physiotherapists and peripatetic support staff, as well as care staff from the home. Because of uncertainty about the home’s future (it was scheduled to close in 2006) it has been difficult to recruit new staff. Consequently, considerable use of agency care staff is being made. The manager tries to ensure continuity of agency staff wherever possible, so that disruption in the continuity of care is kept to a minimum. However, staff morale was reported to be very low because of the uncertainty. It would be helpful if clarification about the home’s future could be given soon. DS0000031154.V307441.R01.S.doc Version 5.2 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, 33, 35 and 38 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. EVIDENCE: There are sound arrangements for the management and administration of this home, including comprehensive policies and procedures and a registered manager with NVQ level 4 in management and care. There is always a residential supervisor on duty during the day, to provide support both to the manager, who normally works weekdays, and to care staff. There are good financial procedures for safeguarding residents’ monies, including individual bank accounts into which service users’ monies are paid, and from which standing orders are set up to pay charges direct to the County Council. All financial transactions involving residents’ monies and the care home are DS0000031154.V307441.R01.S.doc Version 5.2 Page 19 subject to 2 signatures and receipts wherever possible, so that there is a clear audit trail. The home has a clear statement of purpose, including aims and objectives and statement of values concerning ‘promises’ made to service users by the home about quality of service. Service users and their representatives are regularly consulted about their experience of the service and any suggestions for improvement (e.g. monthly residents’ meetings that are recorded). The home is subject to regular health and safety checks, including a comprehensive maintenance schedule. Staff are well trained in health and safety matters, including risk assessments, fire safety and moving and handling. There are sound arrangements for staff supervision (every 3 months) and appraisal (annually), plus regular staff team meetings. DS0000031154.V307441.R01.S.doc Version 5.2 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 x x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 DS0000031154.V307441.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP27 OP27 OP32 OP19 Good Practice Recommendations An activities organizer is desirable, to take pressure off care staff. Additional care hours may be required to cover peaks of demand, such as early to mid morning, and should be kept under review. Early clarification about the home’s future is desirable, not least because of the effect of uncertainty on staff morale. The front door would benefit from being repainted. 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