Inspection on 06/10/05 for The Fearnes

This inspection was carried out on 6th 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

The Fearnes 17/03/09

The Fearnes 13/08/07

The Fearnes 25/07/06

The Fearnes 22/02/06

The Fearnes 18/01/05

The Fearnes 01/10/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Fearnes 26 Knyveton Road Bournemouth Dorset BH1 3QR Lead Inspector Rosie Brown Unannounced 06 October 2005 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 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. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Fearnes Address 26 Knyveton Road, Bournemouth, Dorset, BH1 3QR Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01202 296906 01202 310065 Care South Manager application in process for Margaret Tomlin Care Home only 40 Category(ies) of OP - 40 registration, with number DE(E) - 30 of places MD(E) - 10 The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 40 in the category OP (Old Age) including up to 30 in the category DE(E) and up to 10 in the category MD(E) Two named service users (as known to the CSCI) in the category LD (Learning Disability) may be accommodated. Two named service users (as known to the CSCI) in the category LD(E) (Learning Disability [Elderly] may be accommodated. Date of last inspection 18 January 2005 Brief Description of the Service: The Fearnes was built as a residential care home over 20 years ago by the local County Council. It is now part of Care South (formerly known as The Dorset Trust).The home is located in a residential area of Bournemouth close to the central shopping area and the travel interchange. It is registered for 40 older people and this includes 30 residents with dementia. The home is divided into four separate ‘houses’ – Oak Way, Beech Way, Willow Way and Lilac Way. The three ‘houses’ with residents who experience dementia have magnetic keypads fitted to the entrance to minimise the risk of wandering. Each unit has 10 bedrooms, a lounge, and a dining room and kitchen area. Assisted bathing and shower facilities are available and toilets are located close to residents bedrooms. The accommodation is available over two levels – ground floor and lower ground floor. Accommodation is provided in single bedrooms with vanity unit style washbasins fitted for use in room. The home is decorated in a homely way and is comfortably furnished. The home is being extensively refurbished and developed, currently to upgrade the laundry and improve some bathrooms. The spacious and inviting entrance hallway has additional seating and a piano and provides a useful central focus to the home. The home has a passenger lift to enable easy and level access to both floors. There are front and rear gardens with raised flower borders, mature shrubs and garden seating. A driveway to the front of the home provides off road parking. Margaret Tomlin is the appointed manager of the home on behalf of Care South. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 6th October 2005 and was undertaken by inspector Rosie Brown, it was the first of two statutory unannounced inspections planned to take place this year. The inspection commenced at approximately 10:45am and concluded by 4:45pm. This was the first time the inspector had visited this home and a favourable impression was gained. There were 37 residents accommodated in the home and 14 members of staff were on duty at the time. The inspector assessed 18 of the National Minimum Standards and reviewed progress made with the requirements and recommendations set out in the report of the previous inspection. The communal areas and the majority of bedrooms were viewed: residents’ care records, staff recruitment records and certain policies and procedures were also examined. The inspector spoke with the appointed manager, the deputy manager, one relative and six members of staff. Prior to this inspection, comment cards supplied by the Commission were returned. These included seven cards from service users, five from relatives/visitors, two from GP’s and one from a care professional; the views expressed within them have also been used to inform this inspection report. Most residents in this specialist home experience a high degree of confusion but the inspector spoke with six residents during lunch and one at their request later in the day. The interactions observed between staff and residents were considered to be caring, patient, polite and positive: a good standard of care is provided to residents in the home. What the service does well: The home has a comprehensive statement of purpose readily available in the hallway of the home accompanied by a copy of the previous inspection report and a quality assurance report documented by an independent consultant. A caring, friendly homely atmosphere is evident within the home. The care records demonstrate that other care professionals are consulted appropriately to ensure that residents receive the services they need. The home provides good quality specialist care to a large group of vulnerable residents. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 Page 6 Residents are supplied with good wholesome food in a congenial setting. One resident said, ‘we are lucky here we get four meals a day’ and ‘if you don’t want what is on the menu you are always offered something else’. 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 Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 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 standard(s) 1, 3 and 6 The home’s statement of purpose is presented in an attractive format and clearly describes the services available, the management and staffing arrangements so that prospective residents’ representatives can make an informed choice about the home. Each prospective resident has a pre admission assessment, which is undertaken by the home Manager or deputy home manager to ensure that the home can meet assessed needs. The home does not provide intermediate care. EVIDENCE: Since the previous inspection the home’s statement of purpose has been updated to reflect management changes within the home and a change in title of the business from The Dorset Trust to Care South. The manager explained that the service user guide in incorporated into the statement of purpose. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 Page 9 The pre admission assessment and records for one recently admitted resident were examined. These demonstrated that an assessment was undertaken prior to admission from hospital where the service user was cared for following a fall at home. A care plan was drawn up from the information obtained and a number of care related risk assessments also documented for staff guidance. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 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 standard(s) 7, 8 and 10 Each service user has a care plan that identifies the care being provided to meet identified needs. Service users’ health needs are monitored and responded to appropriately with support from community services. One service user confirmed their privacy is protected and their known wishes respected: this was also confirmed by relatives. EVIDENCE: Care records and care plans for four service users were examined. These evidenced that care plans are drawn up for each resident and that risk assessments concerning their care are also noted. Care plans in most instances provided adequate information and guidance for a staff to follow to ensure that identified care needs are met. It was noted that the care plans are not being regularly updated at significant times of change, following a fall or an incident that affects a resident’s well being. In one case daily care records referred to one resident’s fluid intake but there was no chart drawn up or record of fluids given recorded. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 Page 11 The home keeps records of accidents and incidents: these are subject to external management review on a monthly basis to establish any patterns, e.g. where and when, although it was not clear what actions are taken when patterns are repeated. Risk assessments are also reviewed in the home but the actions taken to prevent recurrence are not routinely transferred into the care plans. In addition there was no risk assessment drawn up for a service user concerning there propensity to fall and the fact that they were going out to the town on their own. An accident which resulted in a resident being taken to hospital was not reported to the Commission, as required but was dealt with appropriately. Another care record demonstrated good practice in that following an incident of particularly challenging behaviour a resident was sent for a mental health assessment and review in a local hospital. A discussion took place regarding challenging incidents and adult protection issues. Prior to this inspection a number of cards were received from residents, their relatives and representatives and all commented positively about the care provide by the home. They also noted that resident’s privacy is always respected. One resident said ‘privacy is never in doubt’ and ‘ this is a good home, I am treated well’. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 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 standard(s) 13 and 15 Residents and their relatives confirmed that visitors are always welcome in the home. The meals and food supplied by the home are very good offering both choice and variety and catering for special dietary need. EVIDENCE: The keeps a visitors book which demonstrates that relatives, friends and professionals call into the home on a regular basis. Comment cards received by the Commission from relatives and care professionals all confirmed that visitors are seen in private. During conversation with one relative during the inspection, it was evident that they regularly visit their relative and one service user said ‘I get plenty of visitors’. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 The home’s complaint procedure enables people to raise concerns/complaints and one resident confirmed that concerns are be put right. The organisations’ Adult Protection policy provides staff guidance to ensure that residents are protected from abuse while in the home. EVIDENCE: The home’s complaints record book indicated that there had been two received by the home since the previous inspection. These have been investigated according to Care South complaints procedure and satisfactorily resolved by the manager. One complaint was received by CSCI during this time and was referred to the Registered Individual (RI) for investigation. An investigation was undertaken and the Commission is satisfied that the complaint was not upheld. There are robust policies and procedures in place concerned with the identification of adult abuse and the protection of vulnerable adults: the adult protection policy should make reference to the POVA guidance. The manager explained that she had recently attended a ‘No Secrets’ training course concerning local procedures and the recognition of abuse: senior staff who are left in charge have yet to undertake this training. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 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 standard(s) 19 and 26 Residents live in an attractive and comfortable environment. While a refurbishment and improvement programme is taking place, individual risk assessments concerning each resident’s safety are in place. Residents live in a home that is clean and hygienic. EVIDENCE: The home is attractively decorated and comfortably furnished and is set in mature gardens. There is a large communal central hall, which leads to all four houses. Each house has a separate lounge/dining and kitchen area. The homes main kitchen is located in one lower ground house/unit. It was noted that two hot food trolleys are left to heat up in the lounge/ dining room and this situation must be risk assessed for safety reasons. A conservatory lounge is also available in this unit, providing an attractive view and access to the sheltered back garden. Each room has a call system fitted and staff have pagers that identify the source of a call. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 Page 15 The radiators in the home are not guarded and this remains a safety concern. Individual risk assessments concerning residents’ vulnerability are in place and subject to review. However, there was no evidence that these risk assessments are updated following a fall. One ground floor unit has a conventional bath with a bathing seat fitted and another has a ‘Parker bath’ and a wheelchair accessible shower room. However, the Parker bathroom was being used to store large items of equipment and did not appear to be used. The other ground floor unit has a conventional bathroom (which was being used to store large laundry bags) and a separate wheelchair accessible shower. One lower ground floor unit bathroom has been upgraded to a high standard to provide an assisted bath and the other has a shower facility, which is wheelchair accessible. The manager explained that there are plans to further improve the bathing provision in the home. Following a requirement in the previous inspection report Care South provided a plan of action regarding improvements in the home’s facilities and during this inspection it was evident that certain developments have taken place. For example, the lower ground floor assisted bathroom, redecoration of the majority of residents’ bedrooms, carpet and floor covering replaced, new curtains bedcovers, etc. The corridors in two units and the main stairs have been redecorated. Future plans include the development of a larger laundry, moving the home’s hairdressing room and improvements to the safety of the balcony gardens. The home was clean and odour free on the day of the inspection. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 The home is appropriately staffed each day by management, care and domestic workers to ensure that service users needs are met at all times. The home’s staff recruitment procedures ensure that residents living in the home are protected. EVIDENCE: Staff on duty when the inspector arrived at the home included the deputy manager, care team manager, five permanent care assistants, one bank care assistant and one agency carer. The domestic/ancillary staff include the chef, kitchen chef, kitchen assistant, two domestics and a laundry assistant. The staff rota was shown to the inspector and demonstrated that care and ancillary staff are on duty every day and from 10pm there are three wakeful care staff on duty with a care team manager who sleeps in on call. The manager and deputy manager currently work Mondays –Fridays. The manager explained that the senior rota arrangements are being reorganised, as is management grading and cover. The recruitment and employment records for one care assistant and one domestic staff were examined. The records detailed that all necessary checks and information was obtained before these persons commenced working in the home. Records showed that both new staff were subject to POVAfirst checks and were supplied with induction training, which meets NTO specifications. The manager said she is updating and developing the in-house induction training for all staff. She is also gradually building up a team of staff whose command of English and communication is good for the benefit of confused residents. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 and 35 The organisation have employed a new manager who is properly qualified and experienced to ensure that the home is effectively managed so that service users receive consistent care. The views of residents and others are obtained to help ensure the home is run in their best interests. Residents financial interests are protected by the organisation’s procedures. EVIDENCE: Care South have employed a new manager, Margaret Tomlin to replace the previous registered manager, who moved to another home. An application for M’s Tomlin to become registered has been received by the Commission and is currently being processed. She has many years of residential management experience, particularly in specialist elderly care, as well as the appropriate qualifications. In the past she has been the registered manager for other Care South homes. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 Page 18 The organisation had an independent quality assurance audit undertaken in August 2004 involving residents, family, staff, visitors, healthcare professionals etc. A copy of the published findings is available in the hallway of the home. The report identifies two main areas for development: staff speaking English language and associated communication issues and the development of social care provision. It was evident that the manager has started to make improvements in both areas. Senior staff at The Fearnes manage the personal allowances of many service users in the home. The systems for this are well established and help ensure that service users financial interests are safeguarded. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x 2 x 3 x 2 x The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 Page 20 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. 2. OP7 14 &15 Care plans and care related risk assessments must be updated monthly and at times of significant change. All incidents and accidients that affect the well being of a service user must be reported to the Commission. The improvements to the laundry and storage arrangements for linen must be undertaken as planned. (previous timescale not met in full). 30/11/05 Standard Regulation Requirement Timescale for action 3. OP8 13 (4) & 37 23 30/11/05 4. OP19 31/1/05 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 OP7 OP18 Good Practice Recommendations Service users and/or their representives are invited to sign care plans to demonstrate their involvement and a note made where this is not possible/taken up. The adult protection policy and staff recruitment procedures should be updated to reflect the POVA guidance issues by the Department of Health. D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 Page 21 The Fearnes 3. 4. OP18 OP33 Senior staff who are left in charge of the home should undertake No Secrets training so that they are familiar with the local guidance and procedures. The manager should continue to address and improve the issues highlighed in the quality assurance report. The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF 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 The Fearnes D55 S3905 The Fearnes V233426 061005 Stage 4.doc Version 1.30 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. 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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