Care Home: Fernbank Retirement Home

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well A great deal of positive feedback was received regarding the staff team and the care and support provided. The 14 surveys returned by residents, which included some comments from relatives, all confirmed that a good quality service is provided. Comments included; "Cares very much so help is there when needed" and "Fernbank does a great effort to help us in any way, day by day, in all respects." Qualification training for staff is given a high priority, with all care staff having achieved an NVQ (national vocational qualification) at level 2 or above. This means that care staff have had their work practice assessed and have been deemed competent in their work role. There is also a good rolling programme of health and safety related training, such as moving and handling, which helps to keep the skills of staff up to date. There are very good opportunities for those living at the home to raise any issues, ideas or suggestions. Staff were seen taking time to talk and listen to people, and residents meetings also take place. The atmosphere is warm, friendly and relaxed. It is clear that the all those involved in the running of the home want to provide a good service and work hard to maintain high standards. What has improved since the last inspection? Six monthly management meetings take place, where plans for improvement are agreed. This shows that there is a strong commitment to ongoing improvement. There is an ongoing programme of redecoration and maintenance, which ensures that the home remains a pleasant and safe place to live. The last key inspection showed that qualification training for staff was seen as very important. All of the team of care staff have now achieved an NVQ (national vocational qualification) at level 2 or above. People living at the home are therefore supported by a capable and competent staff team. What the care home could do better: Most medication is supplied in blister packs by the pharmacist. It is recommended that any medication not in blister packs such as liquids, is dated when it is first opened. This will help to reduce the chance of it being administered past it`s use by date and will also help to provide an audit trail of medication administered at the home. Although staff meetings take place and the manager works alongside care staff, formal recorded supervisions should take place at least six times a year, with one of these being the appraisal. This will help to ensure that all staff have opportunity to discuss their work in private and will help to ensure that the good standards at the home are maintained. Key inspection report Care homes for older people Name: Address: Fernbank Retirement Home 346 Heysham Road Heysham Lancashire LA3 2BW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Lesley Plant     Date: 1 1 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Fernbank Retirement Home 346 Heysham Road Heysham Lancashire LA3 2BW 01524854936 01524851787 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Deluxemain Limited care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only: Code PC, to people 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: Code OP. The maximum number of people who can be accommodated is: 18. Date of last inspection Brief description of the care home Fernbank is situated on Heysham Road in Heysham and is registered to provide accommodation and personal care for up to 18 older people. All bedrooms are for single occupancy and although none have ensuite facilities, all bedrooms do have a wash basin. Accommodation is split over two floors, with a stair lift providing access to the first floor. There is a good range of communal rooms, comprising of two lounges, a conservatory and a dining room. There are small garden areas at the front and rear of the home, with seating for people to use during the summer months. There is a car park at the rear of the home. Care Homes for Older People Page 4 of 28 Over 65 18 0 Brief description of the care home Details of the current fees can be obtained by contacting the manager of the home. Care Homes for Older People Page 5 of 28 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 key inspection focused on the outcomes for people living at the home and involved gathering information about the service from a wide range of sources over a period of time. The site visit for this inspection was unannounced. There were 14 people resident at the home at the time of the visit. All of the key national minimum standards, plus the standard relating to staff supervision were assessed. Time was spent talking to people staying at the home and observing staff as they went about their duties. Discussion also took place with the manager, kitchen staff and a visitor to the home. Staff views were gained from Care Quality Commission surveys. Records were viewed and a tour of the building took place. Care Quality Commission surveys, inviting feedback about the service provided at Fernbank were received from 14 people staying at the home, with some relatives also providing feedback on these surveys . The AQAA (annual quality assurance Care Homes for Older People Page 6 of 28 assessment) completed by the manager of the home, also provided some useful information. This is a self assessment focusing on how well positive outcomes are being achieved for people using the service. A service review took place in August 2008, with the last full key inspection being conducted in August 2007. Care Homes for Older People Page 7 of 28 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 8 of 28 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 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 10 of 28 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. Assessments take place prior to anyone being admitted into the home, helping to make sure people are only admitted to Fernbank if their needs can be met.. Evidence: The Annual Quality Assurance Assessment completed by the manager, describes the assessment and admission process for new residents. Assessments are only carried out by experienced management staff. Information from other health and social care professionals is taken into account and relatives are involved in the information gathering process. People admitted for short periods of respite care also have a full assessment of their needs prior to admission. CQC surveys completed by those living at the home confirm that people received enough information to help them decide if this home was the right place for them, before they moved in. People admitted for short periods often come back to the home for further respite stays and then choose Fernbank as their home when permanent Care Homes for Older People Page 11 of 28 Evidence: residential care is needed. Assessment documentation was viewed. This gathers information regarding a wide range of needs such as, mobility, communication, personal care, continence, medication, sleep, activities and safety. Care plans are then put in place, to show how any identified needs are to be met. Moving and handling risk assessments also take place. It was noted, that for one person who had previously stayed at the home for respite care, a new moving and handling assessment had been carried out prior to her recent admission. This meant that any changes in the support required could be identified and a new care plan put in place. Fernbank does not provide intermediate care. Care Homes for Older People Page 12 of 28 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. Health and personal care needs are met and the privacy and dignity of residents is promoted. Evidence: The care plans for three people were viewed. All were being regularly reviewed, with any changes being recorded. This means that staff have up to date information regarding the support required. It was seen that changes are also made outside of the monthly reviews if there has been a change in circumstance. For one person the care plan had been changed to reflect a change in their personal care needs due to having a dressing on her leg. Care plans address a variety of needs, including mobility, communication, sleep and social activities. Staff write care reports for each person and a key worker system is in place. Records are kept of the personal care given to each person. During discussions with people living at the home it was confirmed that staff come quickly when the call bell is used. The CQC surveys completed by those living at the home contained many positive comments about the good level of care people receive. These included; Cares very Care Homes for Older People Page 13 of 28 Evidence: much so help is there when needed and Fernbank does a great effort to help us in any way, day by day, in all respects. Staff keep good records of any visits by health care professionals such as district nurses and GPs. This means that health problems can be tracked and progress more easily monitored. Moving and handling assessments are carried out to determine what support, if any, is required from staff. Records are kept of each persons weight, with any significant changes being responded to. A relative spoken to during the visit confirmed that the GP is contacted when required and went on to explain that his relative had put on weight since moving into the home and that her general health had also improved. Prompt access to medical care when needed was also reflected in the CQC surveys completed by those living at the home. The manager and the deputy manager take responsibility for ordering medication. Medication is securely stored at the home. Staff who administer medication have undergone training, which includes a questionnaire to test their knowledge. Some people at the home are able to take responsibility for their own medication or in some cases for part of their medication such as creams. This approach supports people to maintain their independence. Most medication is supplied in blister packs by the pharmacist. It is recommended that any medication not in blister packs such as liquids, is dated when it is first opened. This will help to reduce the chance of it being administered past its use by date and will also help to provide an audit trail of medication administered at the home. The medication administration records for two people were viewed and these had been appropriately completed by staff. Specific storage and recording arrangements are in place for any controlled drugs held at the home. A check was carried out for one such medication which showed that the record of the amount of medication in stock was correct when checked against the actual medication held. The importance of promoting the privacy and dignity of those staying at the home is emphasised during the induction period of new staff and is also addressed within National Vocational Qualification programmes, which all care staff have undertaken. There are no shared rooms, which means that people can spend time alone in their room if they wish to and can also receive visitors in private as well as in one of the communal lounges. During conversations with people staying at the home it was made clear that staff are kind and respectful. Staff were observed speaking to people in a respectful manner and taking time to listen and chat with those staying at the home. Care Homes for Older People Page 14 of 28 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. Arrangements to meet the social and recreational needs of residents are good. Good quality, nutritious meals are enjoyed by those living at the home. Evidence: Care plans address peoples support needs regarding social activities and the care reports completed by staff record participation in various activities. Hairdressing, musical entertainment and tai chi sessions are regular activities. A card game took place on the afternoon of this inspection visit. Church ministers also visit the home and during the inspection visit a church representative came to the home to provide communion to one of the residents. Several people spoke of how much they had enjoyed a recent trip to the Lake District followed by afternoon tea at a hotel. People are also encouraged to continue with activities they enjoyed prior to moving into the home. One person spoke of how she is able to continue to attend a weekly social club and so keep in touch with old friends. The majority of CQC survey responses show that people are satisfied with the activities which are arranged at the home. Visitors are made welcome at Fernbank, as observed during this visit. People are able to bring their personal possessions into the home with them and so make their bedroom more homely and have their favourite things close to them. This Care Homes for Older People Page 15 of 28 Evidence: is a relatively small care home, meaning that staff have been able to build up close relationships with those staying at the home and have got to know their preferences and how they like to spend their time. Decision making is supported as was observed during this visit. Staff were seen encouraging individuals to make their meal selection, providing opportunity for people to sit outside if they wished and offering a variety of hot and cold drinks for people to choose from. The regular residents meetings encourage opinions to be voiced. It was noted that at a recent meeting a particular dish had been requested and the menus had been changed to incorporate this. There are two part time cooks employed at the home, with rotas showing that one is on duty each morning to prepare and serve breakfast and lunch and to prepare food ready for the tea time meal. The main meal is served at lunch time, when there is a choice of two hot meals available. A four week menu acts as a guide for the cooks and helps to ensure that meals are varied. Birthdays and special events such as bonfire night are celebrated, with party food or a themed menu. Those spoken to during the visit and feedback from CQC surveys confirmed that people enjoy the meals provided at Fernbank. One person spoken to said how much she enjoyed having a cooked breakfast and another spoke of the special deserts which were provided for her as she has diabetes. A person who was visiting the home, commented that his relative had put on weight and was now in better health since moving to Fernbank and eating regular nutritious meals. Care Homes for Older People Page 16 of 28 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 are able to raise any concern they may have in the knowledge that this will be responded to. Policies, good practice and staff training help to ensure that people are protected. Evidence: Fernbank is a relatively small care home, with 14 people resident at the time of this inspection visit. This means that staff get to know the residents and their relatives and can build up close relationships. Staff spend time talking to and listening to people, providing natural opportunities for any issues or concerns to be raised and dealt with informally. There is however a formal complaints procedure and details of this is displayed in the hallway of the home. During the last 12 months no formal complaints have been received by the home or by the CQC. Residents meetings also encourage people to air their views. One to one discussions mean that people with hearing problems, who may find group discussions difficult, are also able to express their opinions. CQC surveys completed by people staying at Fernbank confirm that staff listen to and respond to comments from residents and that the majority know about the formal complaints procedure. The responses stating that people did not know about the formal complaints procedure also contained positive feedback about the home, indicating that these people have no reason to raise a complaint. To the question Is there someone you can speak to informally if you are not happy? all those who Care Homes for Older People Page 17 of 28 Evidence: completed CQC surveys responded yes. Written policies providing guidance for staff regarding whistle blowing, abuse and protection are kept in the staff room available for all staff to read. Issues of abuse and protection are addressed in National Vocational Qualification programmes which all staff have undertaken. On the day of the inspection visit some staff were attending training regarding the Mental Capacity Act and Deprivation of Liberty Safeguards, with another group of staff due to attend this same course in the near future. This will help staff to understand and respond to issues such as capacity to make decisions, rights and restrictive practices. Care Homes for Older People Page 18 of 28 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. The home is clean and well maintained, providing a good standard of accommodation and a homely place to live. Evidence: Fernbank is situated on Heysham Road in Heysham. All bedrooms are for single occupancy and although none have en suite facilities, all bedrooms do have a wash basin. Accommodation is split over two floors. The home has two staircases, with one having a stair lift. There is a good range of communal rooms, comprising of two lounges, a conservatory and a dining room. This means that people are able to choose where to spend their time. There are small garden areas at the front and rear of the home, with seating for people to use during the summer months. A number of people enjoy sitting outside the front of the home, as seen during this visit. New garden furniture has recently been purchased. There is a car park at the rear of the home. The home is well maintained, with a programme of redecoration in place. Some of the unused bedrooms are currently awaiting redecoration. A call bell system is in place. The bathroom on the ground floor has a walk in jacuzzi bath, with the first floor bathroom having a hoist, to assist people with mobility problems. The home appears well maintained. A maintenance worker is based at the home on one day each week, with a system in place for staff to record any jobs that need Care Homes for Older People Page 19 of 28 Evidence: doing. The manager confirmed that the provider organisation is responsive should any bigger repairs be needed. A gardener is also employed. The home appeared clean and fresh. Care staff must be working very hard to carry out cleaning tasks as well as their caring and support role. Night staff have regular cleaning jobs to do during quiet periods in the night. The staff team training matrix shows that staff undertake food hygiene and infection control training, with further courses in infection control planned for the near future. This training, along with written guidance and policies helps to ensure that staff are aware of good practice in the prevention of infection. Care Homes for Older People Page 20 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good recruitment procedures are followed and staff training, including qualification training is given a strong focus. This means that those living at the home are supported by competent and capable staff. Evidence: On the day of the inspection visit there were 14 people resident at the home. There were two staff providing care support, which included the manager. A cook is on duty each morning and a handyman is based at the home one day each week. At night time there is a member of staff sleeping in and a member of staff on working duty. The manager explained that the minimum staffing would be to have two staff on duty. On three half days each week there are two care staff plus the manager and on these days the manager is able to complete necessary paperwork and focus on the management of the home. Care staff also carry out domestic cleaning duties, with night staff also having some cleaning tasks to do. There is four hours a week of domestic work allocated to one of the care staff. Staff are clearly working very hard to carry out their care and domestic tasks to such a good standard. The manager explained that staffing levels are kept under review and gave an example of when the staffing ratio had had to be increased. It is important that the continual review and assessment of staffing takes place. Many of the current residents require moderate levels of support, but should this change, then staffing Care Homes for Older People Page 21 of 28 Evidence: arrangements would need to be altered. 12 of the 14 people who completed CQC surveys responded always to the question; are staff available when you need them?, with 2 people responding usually. This indicates that the staffing arrangements are meeting the needs of those currently residing at the home. The records for a recently appointed staff member show that appropriate checks take place, helping to ensure that only suitable staff are employed. Documentation includes a completed application form, two references and confirmation that a check against the nationally held list of people who have been deemed unsuitable to work with vulnerable people has taken place, along with gaining a criminal records bureau disclosure. New care staff work through an induction checklist, which covers important information such as fire safety and the expectations of the employer. Completed induction checklists were viewed on staff files. An induction pack is then used, which addresses the agreed induction standards for care workers. New staff also commence the rolling programme of training, which addresses health and safety matters such as moving and handling. Staff are enrolled onto NVQ programmes at the earliest opportunity. Qualification training for staff has continued to be given a high priority, with all care staff having achieved an NVQ (national vocational qualification) at level 2 or above. This means that care staff have had their work practice assessed and have been deemed competent in their work role. Individual training records are held on staff files and there is also a training matrix for the staff group showing all the key courses and who has completed them. This matrix shows that most of the team have completed training regarding moving and handling, first aid, food hygiene, medication and fire safety. There is a rolling programme of these training courses, meaning that staff can update their knowledge and skills. The noticeboard in the staffroom showed details of forthcoming training, which included moving and handling, Mental Capacity Act and Deprivation of Liberty Safeguards and infection control. Care Homes for Older People Page 22 of 28 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 managed and has effective quality assurance systems in place, which allow for residents and staff to put forward ideas or suggestions. Policies, procedures, good practice and staff training all help to promote the health and safety of those living at Fernbank. Evidence: The manager of the home is registered with the CQC and has gained the Registered Managers Award and a National Vocational Qualification at level 4 in care. The Registered Managers Award is the recommended qualification for anyone who is managing a care service. A deputy manager and senior care staff also carry out certain management duties at the home, and support the manager in her role. Management meetings take place and involve senior personnel from the provider organisation. Minutes from the most recent meeting were viewed. The home has achieved an externally validated quality award and also has internal quality assurance systems in place. A senior representative of the provider Care Homes for Older People Page 23 of 28 Evidence: organisation conducts a monthly monitoring visit and produces a report of the findings. Management meetings, staff meetings and residents meetings all take place and give good opportunity for people to share their views or put forward suggestions. At a recent residents meeting a menu suggestion had been made and it was seen that this had been acted upon, with the menus being altered to accommodate this suggestion. Surveys are given out, mainly as people leave after a short stay. Recently returned surveys were viewed and showed a good level of satisfaction with the service provided, however some of these surveys were not dated. It is advised that all surveys are dated and that consideration also be given to providing surveys to those living permanently at the home. Many prefer to give their views at the residents meetings, however a printed survey may be preferred by some people. The manager regularly works alongside care staff and is therefor able to lead by example and demonstrate good practice, all of which helps to maintain good standards within the home. Spending money is held on behalf of some people who live at the home and this is securely kept. The records of income and expenditure for two of these people were viewed and the cash held balanced against the amount recorded. For other people a relative or representative handles their finances, with the manager keeping a record of expenditure, such as for hairdressing and then issuing a bill. The manager was advised to keep any cash held, separate from the records, as in case of a theft at the home, the records would still be available to show what money had been taken. An appraisal system is in place for care staff. The manager aims to carry out two appraisals each year with each member of the team. The appraisal format includes a self appraisal, which helps staff to reflect on their work practice and take some responsibility for their own personal development. Although staff meetings take place and the manager works alongside care staff, formal recorded supervisions should take place at least six times a year, with one of these being the appraisal. This will mean that all staff have opportunity to discuss their work in private and will help to ensure that the good standards at the home are maintained. The health and safety of those living and working at the home is given good consideration at Fernbank. Records show that there is a gas safety certificate in place and that electrical appliances are checked. A copy of the fire procedure is displayed in the hallway and fire equipment is regularly checked and maintained. Monthly fire drills take place and the emergency lighting at the home is also regularly checked. All radiators are covered to prevent any accident occurring from hot surfaces and water temperatures are also monitored to prevent accidental scalding. Care Homes for Older People Page 24 of 28 Evidence: The training matrix for the staff team shows that most staff have completed health and safety training addressing; moving and handling, first aid, food hygiene, medication and fire safety. There is a rolling programme of these training courses, meaning that staff can update their knowledge and skills. Further infection control training is soon to take place, with dates arranged. Care Homes for Older People Page 25 of 28 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 26 of 28 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 1 9 It is recommended that any medication not in blister packs such as liquids, is dated when it is first opened. This will help to reduce the chance of it being administered past its use by date and will also help to provide an audit trail of medication administered at the home. Formal recorded supervisions should take place at least six times a year. This will mean that all staff have opportunity to discuss their work in private and will help to ensure that the good standards at the home are maintained. 2 36 Care Homes for Older People Page 27 of 28 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!