Care Home: Fenton Lodge

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What the care home does well The home manager has the required qualifications and experience and is registered with the CQC. She is highly competent to fulfil her role and responsibilities and meet the service aims and objectives. Feedback from staff confirmed the home manager communicates a clear sense of direction to the team and ensures delivery of quality care based on best practice principles. Operational and management systems ensure continuous improvement, service user satisfaction and effective quality assurance. Staff follow the home`s policies and procedures and there is strong evidence of an open and transparent ethos. A high level of commitment to staff training and professional development was demonstrated. A staff member commented, "Each member of staff is trained to a great standard. Service users are our main priority and their well-being is always ensured by following care plans, guidelines, policies and procedures. When I first joined the team I was really impressed with standards at the home. Service users appeared happy with their care, which was nice to see".People considering using this service and their representatives have access to information in accessible formats, enabling an informed choice of home. Prospective service users have comprehensive needs assessment before admission to ensure their individual needs and expectations can be met. The care planning process starts with the individual and not services, taking account of individual needs, wishes, goals and aspirations. Staff assist and support the progression of communication skills, using suitable communication tools. Examples of these are pictorial and PEC formats, objects of reference and basic Makaton signs and symbols, which enable people using services to express themselves and make choices in their daily lives. Robust risk assessments and working protocols ensure people using services have the level and quality of support they need, promoting their safety, health and wellbeing. Policies and procedures and staff training promote equality and diversity and nondiscriminatory practice.The diverse needs of people using services are identified and met. Physical disabilities are managed by adapting the environment and obtaining suitable aids and equipment,in collaboration with external professionals.Examples include loan of an adjustable height profiling bed, installation of handrails and provision of a dining chair slider. The home`s good staff retention record leads to positive outcomes for people using services. Team stability enables continuity of care and steady, incremental service improvements, as staff become more experienced, knowledgeable and skilled.There is an ongoing staff training programme and the home exceeds the NMS ratio of staff with National Vocational Qualifications in health and social care. The health, safety and welfare of service users and staff is promoted and protected by a comprehensive range of policies and procedures which staff are trained to consistently follow. Self monitoring systems for infection control and health and safety and fire safety exist. A number of developments in the past twelve months demonstrate continuous review and improvement and effective, inclusive quality monitoring and quality assurance systems. What the care home could do better: It was positive to note plans to upgrade the kitchen units which are showing signs of wear and tear. Random inspection report Care homes for adults (18-65 years) Name: Address: Fenton Lodge Hazel Road Ash Green Surrey GU12 6HP three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Patricia Collins Date: 0 7 0 5 2 0 1 0 Information about the care home Name of care home: Address: Fenton Lodge Hazel Road Ash Green Surrey GU12 6HP 01252317211 F/P01252317211 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Rosemary Judith Diana Wykes Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Pamela Mary Eales care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 3 The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home The provider of Fenton Lodge is Mrs Mary Eales, trading as Just Homes. Just Homes operates a small group of care homes in Berkshire and Surrey. Fenton Lodge is a large, detached, wheelchair accessible bungalow owned and maintained by the Thames and Chiltern Trust (TACT). Situated in a quiet residential cul-de-sac in a semi rural location, Care Homes for Adults (18-65 years) Page 2 of 10 Brief description of the care home the home is near local shops and other community facilities of Ash Green village. It is also a short drive from Farnham, Guildford, Camberley, Aldershot and Farnborough. Service provision includes a five seater vehicle. The accommodation comprises of three single occupancy bedrooms, lounge, kitchen and dining area, bathroom, wet room, toilet, utility area and office. There is a well maintained garden at the rear of the building and limited car parking space on the drive at the front. At the time of this inspection weekly fees ranged from £1505 to £2191. Included in fees costings is some funding for people using the service to have a holiday of their choice, though there may be additional charges for holidays and personal items. Care Homes for Adults (18-65 years) Page 3 of 10 What we found: This unannounced inspection was carried out by one inspector from 11:00 hrs to 12.45 hrs. The short focused visit was part of a random inspection for the purpose of monitoring compliance. The random inspection does not affect the existing quality rating made on 10th may 2007 of three stars, excellent service. The report will say what we found as it is written on behalf of the Care Quality Commission (CQC). At the time of the visit the home manager was on leave. The support worker in charge of the shift was commended at the time for her efficient, professional management of the inspection process. This was facilitated at the same time as dealing with a kitchen fitter on site in connection with plans for the kitchen to be upgraded; also the formal induction of an agency worker who had not worked at the home before. The support worker in charge calmly fulfilled these responsibilities whilst ensuring continuity of routines and the well-being of the people using the service. The inspection process incorporated contact and conversations with all three service users and both members of staff. We toured the home and carried out focused direct and indirect practice observations. Records sampled included those specific to personal and healthcare support, the complaint and compliment procedure, safeguarding procedures and staff recruitment, induction and training. Judgements about service quality and how well the home is meeting the national minimum standards for younger adults (NMS) have been made, based on all available information. This includes accumulative assessment, knowledge and experience of the home since its last major inspection (we call this a key inspection). We have taken into account feedback in survey questionnaires received from three staff also from all the people using the service, completed by staff with their involvement. Also information supplied by the registered manager in the homes Annual Quality Assurance Assessment (AQAA). This self-assessment focuses on how well outcomes are being met for people using services and provides some numerical information. The AQAA was received on time,supplying excellent, quantitative information and validated by evidence. Its assessment of services against NMS outcome areas demonstrated both areas of strength and where improvements can be made. The physical environment was observed to be appropriate to the lifestyles and needs of the people using the service. It is domestic in scale, layout and character, decorated and overall furnished to a good standard, clean, safe and comfortable. Bedrooms all reflected the individuality and interests of their occupants.Investment in the property is ongoing, including replacement of old under-ground water pipes, new smoke detectors, redecoration of the kitchen and new fridge/freezer. The wet room has been updated with a new shower curtain and coordinated bath towels and mats, other communal areas have new curtains and cushions.The garden is well-maintained, affording an attractive outlook from the lounge and has a new large gazebo providing additional sun-shade. The homes pet rabbits, cat and her new kitten were noted to bring pleasure and interest to the lives of people using this service. A service user feeds the cat and others are involved in cleaning the rabbit hutches with staff. The planned structure of the homes operation was observed to support a lifestyle that Care Homes for Adults (18-65 years) Page 4 of 10 people using the service appear comfortable with. They each have a designated key worker and receive personal and healthcare support using a person centred approach. This is underpinned by value principles respecting rights to privacy, dignity, equality, fairness, and autonomy. Staff practice at the time of the visit showed respect for the wishes and personal autonomy of people using services, for example, offering choice in the times people got up and dressed, in the clothes they wore, their choice of breakfast and how they spent their time. Good attention was given to their personal appearance and intimate personal care delivered in private. The people using the service were cheerful and one person said, I like it here, I like the staff. Staff promote independence and service users participation in the daily living activities of their choice through their understanding and methods used to meet individual communication needs. This was evidenced by use of a pictorial staff rota displayed to informs service users of the staff on duty each day, pictorial menus and pictorial system enabling their involvement in menu planning, records of key worker and monthly house meetings. New developments include pictorial formats produced for hospital appointments and admissions, doctor and dental appointments. A pictorial format recipe file has enabled a service user to participate more independently in a weekly supported baking session, which she enjoys doing. Care plans include individualised weekly time-tables of activities. These programmes support service users in leading stimulating, purposeful lives, enabling social inclusion and further develop social skills. People using services maintain a community presence by using community facilities, for example library and shops and walking in the local area in fine weather. Through house meetings they are informed of community leisure and social activities which include theatre trips and social events. Individuals were also noted to attend day services and two evening social clubs. Staff frequently use the house car when supporting people in the community, though unavailable at the time of the visit owing to being in the garage for repair. The support worker in charge said this was not a barrier to accessing community resources as individual service users use accessible taxis and public transport when out shopping with staff. The home can also share the vehicle belonging to the nearby care home operated by the provider. Staffing levels were observed to support individual activity programmes.Service users have personal diary spread sheets to which they attach pictures of the following days activities, with staff assistance, which helps them to prepare and plan their routines. Examples of the wishes of service users influencing operational decisions were observed. These included the choice of new television in the lounge which has a free-view box with sports and music channels. Also arrangements accommodating holiday preferences. One individuals wish to travel on holiday by air was fulfilled. For another, his wish was realised to celebrate his 50th birthday with family and staff at his favourite restaurant. Clear guidelines are followed by staff which ensure safe delivery of appropriate care. A high standard of record keeping was evidenced.A comprehensive, inclusive six-monthly review process ensures care plans and assessments reflect current needs. Records also evidenced collaborative working relationship between staff, relevant professionals and relatives, in the best interest of people using services.Staff are trained and competent in healthcare matters. There is an efficient medication policy and procedure and daily medication audit system for ensuring policy is put into practice. Medication was suitably stored, administered and recorded at the time of the visit. Staff records were confidentially stored, the key to the filing cabinet held by the registered manager of the providers nearby care home, who promptly facilitated access for the purpose of inspection. We sampled staff records and evidenced robust recruitment,vetting and induction procedures;also a programme of relevant staff training which ensures a skilled Care Homes for Adults (18-65 years) Page 5 of 10 and competent workforce. The support worker in charge demonstrated good understanding of the individual needs and preferences of all people using the service. She acted as a good role model for the new agency worker, ensuring effective direction, guidance and support.Both staff were caring in their approach, listening to and valuing people using this service.The atmosphere of the home was friendly and appropriately stimulating. We have not received any concerns about the home since the last key inspection. There is a clear complaints and compliment policy and procedure, available in an accessible format to meets the communication needs of service users. An open culture and ethos was evident, welcoming suggestions for improvements and learning from complaints. Records are prominently displayed by the visitors book for visitors use, encouraging constructive feedback. Staff also carry a small card with head office details when in the community, to give to members of the public if they witness an incident involving service users and are concerned with how staff dealt with it. The complaint record showed there had been one complaints investigated by the home in the last twelve months which was not upheld. The outcome was communicated to the complainant, a service user, in a pictorial format to aid understanding. A number of complementary cards and letters from visitors about the home were viewed, evidencing good levels of satisfaction with service provision and staff. The homes policies safeguard service users and staff are trained in the local multi-agency safeguarding procedure and to recognise and respond appropriately to indicators of abuse. There have been no referrals under the local safeguarding adults procedures since the last inspection. Observations confirmed the home manager and staff are aware of their obligations under the Mental Capacity Act deprivation of liberty safeguards. A programme of staff training in this subject noted to have commenced. We were informed that none of the people using the service were subject to a deprivation of liberty authorisation or application.A referral was made to the health and learning disability team to support a service user with a pictorial format in making informed decisions at a Best Interest meeting under the Mental Capacity Act. What the care home does well: The home manager has the required qualifications and experience and is registered with the CQC. She is highly competent to fulfil her role and responsibilities and meet the service aims and objectives. Feedback from staff confirmed the home manager communicates a clear sense of direction to the team and ensures delivery of quality care based on best practice principles. Operational and management systems ensure continuous improvement, service user satisfaction and effective quality assurance. Staff follow the homes policies and procedures and there is strong evidence of an open and transparent ethos. A high level of commitment to staff training and professional development was demonstrated. A staff member commented, Each member of staff is trained to a great standard. Service users are our main priority and their well-being is always ensured by following care plans, guidelines, policies and procedures. When I first joined the team I was really impressed with standards at the home. Service users appeared happy with their care, which was nice to see. Care Homes for Adults (18-65 years) Page 6 of 10 People considering using this service and their representatives have access to information in accessible formats, enabling an informed choice of home. Prospective service users have comprehensive needs assessment before admission to ensure their individual needs and expectations can be met. The care planning process starts with the individual and not services, taking account of individual needs, wishes, goals and aspirations. Staff assist and support the progression of communication skills, using suitable communication tools. Examples of these are pictorial and PEC formats, objects of reference and basic Makaton signs and symbols, which enable people using services to express themselves and make choices in their daily lives. Robust risk assessments and working protocols ensure people using services have the level and quality of support they need, promoting their safety, health and wellbeing. Policies and procedures and staff training promote equality and diversity and nondiscriminatory practice.The diverse needs of people using services are identified and met. Physical disabilities are managed by adapting the environment and obtaining suitable aids and equipment,in collaboration with external professionals.Examples include loan of an adjustable height profiling bed, installation of handrails and provision of a dining chair slider. The homes good staff retention record leads to positive outcomes for people using services. Team stability enables continuity of care and steady, incremental service improvements, as staff become more experienced, knowledgeable and skilled.There is an ongoing staff training programme and the home exceeds the NMS ratio of staff with National Vocational Qualifications in health and social care. The health, safety and welfare of service users and staff is promoted and protected by a comprehensive range of policies and procedures which staff are trained to consistently follow. Self monitoring systems for infection control and health and safety and fire safety exist. A number of developments in the past twelve months demonstrate continuous review and improvement and effective, inclusive quality monitoring and quality assurance systems. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 7 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 8 of 10 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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