Care Home: Fernbank

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What the care home does well People who use the service said they like living here. They felt the home was always clean and fresh and provided them with a comfortable place to live. They thought staff were attentive to their needs, responding quickly to requests for help. Comments included: `staff are patient, kind and polite`; `they are all lovely` and `they do everything they can`. The service provides a wide range of activities and people are able to choose whether to join in. People felt they were able to make choices about how they spent their day. Staff are well trained and morale is high in the home. People enjoyed the meals provided and said there was always a choice offered. What has improved since the last inspection? Improvements to the decor and furnishings are part of an ongoing program. Training has increased and staff commented they are now paid for this. What the care home could do better: No requirements have been made as a result of this inspection, however discussion regarding improving one person`s care plan and ensuring recruitment procedures are followed took place with the manager. Details are in the relevant sections of the report. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Fernbank 25-27 Gratwicke Road Worthing West Sussex BN11 4BN     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Liz Palmer     Date: 2 3 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 22 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 22 Information about the care home Name of care home: Address: Fernbank 25-27 Gratwicke Road Worthing West Sussex BN11 4BN 01903202821 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : fernbank@scnh.co.uk South Coast Nursing Homes Limited care home 32 Number of places (if applicable): Under 65 Over 65 32 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 32. 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: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Fernbank is a care home able to accommodate up to thirty-two service users who are over the age of sixty-five. The premises are situated in a quiet residential area of Worthing close to shops and other facilities. The accommodation is arranged on two main floors that are served by a passenger lift and a stair lift. There is also an additional mezzanine floor, which is accessed by a short flight of steps. The majority of bedrooms have en suite facilities. There is ramped access to the rear garden. Care Homes for Older People Page 4 of 22 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was an unannounced site visit by one inspector and took four hours. During the visit the inspector spoke to four members of staff on duty, five people who live in the home and one relative. Discussions with the manager also took place. Other information used to inform the inspection was the homes Annual Quality Assurance Assessment which they provided to us when we asked for it. We also received 5 staff surveys and 9 surveys from people who live in the home. Care Homes for Older People Page 5 of 22 Care Homes for Older People Page 6 of 22 What the care home does well: What has improved since the last inspection? 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 22 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 22 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A comprehensive pre admission assessment is completed that ensures people who use the service will only be offered a place if their identified needs can be met. Evidence: The AQAA stated that a pre admission assessment was completed for everyone wishing to move into the home, to establish what help they needed. The files for three people who had recently moved into the home were viewed. These had assessments completed, that identified what the person was able to do, what they needed support with, a medical and social history and details of emergency contact numbers. Care Homes for Older People Page 9 of 22 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information in care plans is sufficient to enable staff to consistently provide personal care in the way the person likes to receive it and that protects their rights to privacy and dignity. Health care needs are monitored so people who use the service are able to see health care professionals when there is cause for concern. The procedures for storing and administering medication protects people. Staff have the training and information they need to manage medication safely. Evidence: People who use the service felt staff were responsive to their needs and gave support in a way that respected their privacy and dignity. People commented that staff are lovely, cant find any fault and a relative commented that staff keep her mother beautifully clean. Each person had a care plan that described what help they needed with personal care. The plans seen were quite brief, but sufficient and were seen to be kept under regular review. More detail was needed in one care plan regarding someone who sometimes displayed some behaviours which might challenge the staff. Care Homes for Older People Page 10 of 22 Evidence: This was discussed with the manager who agreed to review this care plan and amend as necessary. People who use the service said they were able to see health care professionals such as doctors and chiropodists when they needed. Records showed the service worked well with health care professionals to meet peoples needs and made appropriate referrals. People are supported to visit health services such as dentists or may have visits arranged at the home. The administering of lunchtime medication was observed. Medication is supplied in a monitored dosage system and delivered to the home on a monthly basis. The storage was seen to be secure and the member of staff administered according to current best practice. They confirmed only staff who had received training in Safe Handling of Medications were permitted to administer medication. This training is updated annually and staff are monitored for competency through regular supervision. They had a suitable policy and procedure to follow. Records were sampled and found to be accurate. Residents are offered the option to look after their own medication on admission to the home and this is encouraged and supported by the home. This offers some independence to people. Care Homes for Older People Page 11 of 22 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about how they spend their time. They are offered a wide range of activities that provide mental stimulation and that they enjoy. The meals offered are well balanced and provide a varied choice that people like. Evidence: People who live in the home said they felt able to make choices about how they spent their time. Some liked to stay in their rooms, whilst others enjoyed socialising in the lounges and dining room. There are daily activities organised such as skittles, hoopla, quizzes, film and singing. Visitors were seen being made welcome to the home and one spoken with said they enjoyed visiting. Residents spoken to said the food was good and there were always two or three choices available. Specialist diets are catered for and, wherever possible, people are able to have the same options as everyone else. People were seen enjoying their lunch in the dining room. Others said they preferred to eat in their room and this was Care Homes for Older People Page 12 of 22 Evidence: respected. Care Homes for Older People Page 13 of 22 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have the information they need to make complaints and are confident the management of the service will investigate and take action about any issues they may have. Staff have the information and training they need to enable them to identify and report any safeguarding concerns. Evidence: Feedback from surveys completed by people who use the service, and from those spoken with during the visit, showed they knew how to make complaints and were confident they would be listened to. Information about the complaints procedure is included in the statement of purpose and the service users guide. One relative confirmed she had seen the complaints procedure and had every confidence in the management to sort out any minor grumbles as well as serious concerns, if she had any. The complaints log was looked at. Two complaints were looked at. These were responded to by the home and copies of the correspondence was seen. The manager stated that complaints are audited monthly. No complaints have been made to the Commission. The home has a policy and procedure in respect of safeguarding. All the staff spoken to had received training in this area and records showed most of the other staff have been trained. No referrals have been made. Care Homes for Older People Page 14 of 22 Care Homes for Older People Page 15 of 22 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in a clean, comfortable and safe environment. Staff have the training and guidance they need to promote hygiene. Evidence: During the inspection three lounges, the dining room, office, two bedrooms and two bathrooms were seen. All these areas are clean and homely and suitable for the people who use them. Residents said the home was always spic and span. A visiting relative said there were never any offensive odours and the home was always spotless. Staff are trained to ensure they promote hygiene and reduce the risk of cross infection. Care Homes for Older People Page 16 of 22 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A trained, competent and well supervised staff team ensures the smooth running of the service. The homes recruitment procedures must be followed at all times to ensure residents are protected. Evidence: The members of staff spoken to during the inspection were confident and competent. They said they enjoyed their work and showed sound knowledge of the individual needs of people who use the service. They spoke about people in a sensitive and positive manner. People who use the service said they liked the staff and got on well with them. One said its the staff who make it, they are lovely. The home has a rolling training programme for all staff. The manager ensures that all staff receive mandatory training, such as, Health and Safety, Manual Handling, Fire, Food Hygiene and First Aid. New staff receive a Skills for Care standard induction programme. The home currently has more than 50 of staff at NVQ level 2 or above. Three recruitment were looked at. All files were seen to contain all the required documentation, including, an application form, two written references and a Criminal Record Bureau check. One file showed that a member of staff had started work two days before their POVA first check had been returned. The manager was unaware of Care Homes for Older People Page 17 of 22 Evidence: this as the administrator deals with the recruitment paperwork. The manager stated that the member of staff was on induction during the two days and had not worked unsupervised with residents. The manager must ensure recruitment checks are carried out. Staff said they receive regular 1:1 supervision and records seen confirmed this. Staff also have an annual appraisal. Care Homes for Older People Page 18 of 22 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and the health and safety of people who use the service is promoted. The best interests and views of service users are part of the overall and day-to-day development. Evidence: The manager of the home has achieved National Vocational Level 4 and the Registered Managers Award and is registered with us in respect of this home. Regulation 26 monitoring visits take place monthly and the manager meets regularly with directors. Feedback from people who live in the home confirmed that they feel able to talk to the manager and staff at the home and expect their views to be listened to and acted on. Care Homes for Older People Page 19 of 22 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 20 of 22 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, Care Homes 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 Older People Page 21 of 22 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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