Please wait

Care Home: Fernihurst Nursing Home

  • 19 Douglas Avenue Fernihurst Nursing Home Exmouth Devon EX8 2HA
  • Tel: 01395224112
  • Fax: 01395224117
  • Planned feature Advertise here!

This home provides a service for people whose main needs relate to their mental health, and whose needs are such that they require 24-hour supervision by nurses. The great majority of the people living at the home have dementia related care needs. The manager is a nurse trained in the mental health field, as are some of the other nurses, and one of them is usually on duty at the home or on call. 22009 The home was purpose built in 2000, with an 11-bed extension added in April 2004. The 50 single bedrooms are spread over three floors (although only 49 are currently in use), served by two passenger lifts. All bedrooms in use have an en suite lavatory. There is a lounge / dining area on each floor, with a ground floor conservatory and level garden at the rear of the home for anyone at the home to use. There are on-site parking facilities. Information relating to fees are available direct from the home. Fees do not include hairdressing, chiropody, toiletries, newspapers/magazines, telephone calls, relatives/visitors meals, or routine hospital transport costs. Staff escort time for hospital appointments is charged for if more than two hours (at the hourly rate of pay for staff). Fees do not include outings of any sort; people can pay for extra staff time (at the hourly rate of pay for staff) if they wish to go out accompanied by staff, by arrangement in advance, through the manager. The most recent report relating to the home is kept in the reception area, with copies available from the home on request or through CQC`s website.

  • Latitude: 50.615001678467
    Longitude: -3.3980000019073
  • Manager: Mr Andrew Douglas Mack
  • Price p/w: ~
  • UK
  • Total Capacity: 50
  • Type: Care home with nursing
  • Provider: Sanctuary Care Ltd
  • Ownership: Private
  • Care Home ID: 6424
Residents Needs:
Dementia, mental health, excluding learning disability or dementia

Latest Inspection

This is the latest available inspection report for this service, carried out on 7th January 2010. CQC found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

For extracts, read the latest CQC inspection for Fernihurst Nursing Home.

What the care home does well Each person who considers coming to live here is assessed to ensure that their needs are known and to ensure that the home can meet those needs. These needs are further assessed following admission to the home and are contained within a plan of care which all staff have access to. People are helped to stay healthy by seeing for example their GP , and referrals are made to specialists as needed. They are also helped to stay healthy by ensuring they have nutritious meals and have enough fluids to drink. They get the medicines they need as prescribed by the doctor, and these are stored safely. Staff are described as helpful, cheerful and patient. They receive training and are supervised by nurses. They showed a particularly strong commitment to the people they care for during the recent bad weather, ensuring that there were always sufficient staff on duty to meet their needs. People and their belongings are safeguarded from harm or abuse by ensuring that all staff having training in how to protect people from abuse. Complaints received are dealt with effectively. The home is clean throughout and the laundry, kitchen and control of infection are well managed. This is a well managed home which demonstrates a strong commitment to continual improvement. What has improved since the last inspection? Since the last inspection the manager has recruited a deputy. Together they have devised a plan to further improve the care delivered at this home. This plan includes revising all care plans, training staff in care planning and training staff in delivering person centred care for people with dementia. We saw improvements in how some care is planned and delivered. We also saw that the management team have a clear understanding of where further training and support in this area of care is needed. Further improvements have been made to the way medicines are managed. The system for helping people to have their social needs met has been revised and has currently undergone a review which will result in some changes. This particular area of care has been given a much greater priority in recognition that this type of care can help people with dementia to experience well being. This includes meeting people`s religious preferences and needs. The manager has restarted the relatives meetings as a way of trying to involve them in the running of the home. Redecoration and refurbishment is ongoing. What the care home could do better: Although the requirements from the previous inspection in 2009 have been repeated, it is clear that although not fully met, these requirements are partially met and work continues to bring about the required improvements. This service has already started a comprehensive training programme. This should help to address the shortcomings identified in some care planning and in delivering improved person centred care. This should also help staff to develop skills in understanding how dementia affects people and how they can contribute to helping these people experience well being and improved interactions. Key inspection report Care homes for older people Name: Address: Fernihurst Nursing Home Fernihurst Nursing Home 19 Douglas Avenue Exmouth Devon EX8 2HA     The quality rating for this care home is:   one star adequate 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: Teresa Anderson     Date: 0 8 0 1 2 0 1 0 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 34 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 34 Information about the care home Name of care home: Address: Fernihurst Nursing Home Fernihurst Nursing Home 19 Douglas Avenue Exmouth Devon EX8 2HA 01395224112 01395224117 andy.mack@sanctuary-housing.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Sanctuary Care Ltd care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Registration allows for the admission of five people aged between 55 and 65 years of age The maximum number of placements, including that of the 5 people aged between 55 and 65 years, will be 50 The terms of the staffing level agreement made on 17/05/04 must be met. Date of last inspection Brief description of the care home This home provides a service for people whose main needs relate to their mental health, and whose needs are such that they require 24-hour supervision by nurses. The great majority of the people living at the home have dementia related care needs. The manager is a nurse trained in the mental health field, as are some of the other nurses, and one of them is usually on duty at the home or on call. Care Homes for Older People Page 4 of 34 Over 65 50 50 0 0 0 9 0 2 2 0 0 9 Brief description of the care home The home was purpose built in 2000, with an 11-bed extension added in April 2004. The 50 single bedrooms are spread over three floors (although only 49 are currently in use), served by two passenger lifts. All bedrooms in use have an en suite lavatory. There is a lounge / dining area on each floor, with a ground floor conservatory and level garden at the rear of the home for anyone at the home to use. There are on-site parking facilities. Information relating to fees are available direct from the home. Fees do not include hairdressing, chiropody, toiletries, newspapers/magazines, telephone calls, relatives/visitors meals, or routine hospital transport costs. Staff escort time for hospital appointments is charged for if more than two hours (at the hourly rate of pay for staff). Fees do not include outings of any sort; people can pay for extra staff time (at the hourly rate of pay for staff) if they wish to go out accompanied by staff, by arrangement in advance, through the manager. The most recent report relating to the home is kept in the reception area, with copies available from the home on request or through CQCs website. Care Homes for Older People Page 5 of 34 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: one star adequate 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 unannounced key inspection was undertaken as part of the normal programme of inspection. It was undertaken by one inspector over two days. During this visit we (the commission) wanted to gain peoples views on the service they receive. However, as the majority of people living here have communication difficulties we could not do this by speaking directly with them. Instead we observed people, their interactions and how they were engaged with. We looked closely at the care and accommodation offered to three people living here. We did this to help us to understand the experiences of people using this service. This is called case tracking. We looked at peoples written assessments and plans of care, the environment in relation to their needs and at how their health and personal care needs are met. We spoke with the manager, with the deputy manager, with two member of care staff and with some housekeeping and administration staff. We looked Care Homes for Older People Page 6 of 34 at the communal and service areas in the home and at some bedrooms. We also looked at records including those relating to medication, staff recruitment and training and the management of peoples personal allowances. Prior to the inspection the manager provided us with information about this service in the Annual Quality Assurance Assessment (AQAA). We sent surveys asking for feedback to ten people living here, to ten relatives, to eight staff and to five health and social care professionals who visit the home. We received replies from twelve people living here or their relatives, from five members of staff and from two health care professionals. Their feedback and comments are included in the main body of this report. Care Homes for Older People Page 7 of 34 What the care home does well: What has improved since the last inspection? What they could do better: Although the requirements from the previous inspection in 2009 have been repeated, it Care Homes for Older People Page 8 of 34 is clear that although not fully met, these requirements are partially met and work continues to bring about the required improvements. This service has already started a comprehensive training programme. This should help to address the shortcomings identified in some care planning and in delivering improved person centred care. This should also help staff to develop skills in understanding how dementia affects people and how they can contribute to helping these people experience well being and improved interactions. 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. 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 34 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 34 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. People have enough information about this service before they move in and have their needs assessed to ensure those needs can be met. Evidence: In surveys all of the people who replied said they had enough information about the home before they came to live here. We could not speak with people about how they came to live here because they have dementia. However, one relative told us that they had come to see the home, been shown around the home and had been given written information to take away. The information given to peple tells them about the company who own the home, as well as information about the home itself. It provides details about activities, including information that this home does not provide activities or outings outside the home, together with information about meals and the staff structure. This document also advises people about who to contact if they are not happy, or wish to make a Care Homes for Older People Page 11 of 34 Evidence: complaint. We looked at some peoples records and saw that the manager assesses each persons needs before they came to live at the home. This helps the manager to determine what each persons needs are and how those needs can be met. We saw that the manager identifies risks such as the risk of the person developing a pressure sore and their moving and handling needs. Care Homes for Older People Page 12 of 34 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Plans to further improve the way that care is planned and delivered have very recently been put into action. These are yet to have a significant impact for people. Medicines are well managed meaning that people receive their medicines safely. Evidence: In surveys people told us that they always or usually get the care (including medical care) and support they need. Relatives say that staff work hard to ensure people are clean and wear well presented clothing. This is an important element of care for people who cannot do this for themselves. We found that each person living at this home has a plan of care that is written and evaluated by a Registered Nurse. We saw records showing that staff make referrals to healthcare professionals such as the GP and chiropodist, which helps to keep people healthy. We saw that care plans have very recently been revised as a result of training received. We saw that some of the new care plans are written in a way that is person Care Homes for Older People Page 13 of 34 Evidence: centred, takes into account the persons preferences and staff knowledge about that person. These care plans identify the persons physical needs and the risks to their health and welfare. They describe clearly the actions that need to be taken to meet these needs and to prevent deterioration. Some of these care plans identify peoples strengths and abilities. Staff told us that the intention is to work with these strengths and to maintain them for as long as possible. In one care plan for example, there is a record that the person can eat with assistance. It went on to describe in detail the assistance that staff should provide. In this way the nurse is recording the limits to the support that should be given, so that this person can continue to use the skills they have and to experience independence. We observed this person eating and saw that the care plan in relation to supporting this person to eat was followed and was successful in that staff provided just enough support so that this person could eat independently. This care plan also described this persons preferences for the clothes they wear, for footwear and for seating. We saw that the this person was dressed and seated in exactly the way it is described in the care plan. We also saw that the care plan contained information about what this person likes to eat and what they do not like. On the day of the inspection mashed potato was being served with lunch. This persons plan clearly states they do not like mashed potato. We saw that this person was given boiled potatoes to eat. This shows this person is treated as an individual and is given support to make choices. This care plan also contained a well written plan about this persons mental health. It describes that this person can call out repeatedly. It describes the possible causes of this and instructs staff about the actions to take to help prevent this person from feeling uncomfortable or distressed. This is very good practice as it clearly relates a behaviour to an expression of a feeling which, due to the persons illness, cannot be expressed in words. It also supports staff to provide comfort and assistance. We saw that since coming to live here one person has lost a lot of weight. We spoke with staff about this. They were able to tell us that this person is at risk of malnutrition, but that they eat well. They say that for a while this person was quite physically ill, and since this health issue has been dealt with that this person has started to gain weight. This shows that staff are monitoring people effectively and taking appropriate actions to keep people well. We saw in one care plan that this people had been identified as being at risk because of swallowing problems. They had been referred to the Speech and Language Therapist for assessment. Recommendations made by this person are contained within the care plan. We talked with staff about how this risk is managed and they had very Care Homes for Older People Page 14 of 34 Evidence: good information about how to support this person and prevent problems. We asked a member of nursing staff to identify who was at risk because of swallowing problems, and they were able to tell us. However, the carer who was giving them their lunch was not aware of all the people at risk. In addition, the way that care staff are thickening some drinks does not comply with the instructions in the care plan, which means that this person remains at risk. Although we saw some well written care plans, others were not as well written or were not so well followed by staff. We are aware that this is because the training programme in relation to this new way of recording and delivering care has only very recently been delivered. For example, when the manager carried out an assessment of one recently admitted person, he identified that this person is at risk of developing pressure sores. It was also identified that before they came to live at this home that this risk was managed by this person sleeping on an air waves mattress and sitting on a pressure relieving cushion. Following admission a risk assessment relating to their risk of developing pressure sores was repeated. This indicated the person was at risk of developing pressure sores. However, records show that they were not provided with an air waves mattress until more than a month after they had been admitted and, according to records, after they had developed skin damage. In addition, this care plan does not include a plan of care which instructs staff about how to prevent this person from developing pressure sores. This care plan also states that this person can become agitated and wants to walk around although they are at risk of falls. The plan of care states that when needed, and in this persons best interests, that this person can be restrained in a chair. The plan of care states that this should happen for periods of no more than 15 minutes. We saw records that show this person was restrained in a recliner chair for 30 minutes to help to settle this person. This included an entry that this person was banging their head on the back of the chair, which indicates that this course of action was not effective in settling them and should have been stopped. We also saw in this care plan that staff have taken a detailed history about this person. This includes their background, interests and problems with hearing. However, we did not see this information being put into use by staff. Staff also told us that this person is in the early stages of dementia and has times when they can understand and when they have insight into their illness. We saw staff speaking with this person from the side of their deafness so that they could not hear or understand what was Care Homes for Older People Page 15 of 34 Evidence: being said to them. We saw staff ignoring this person when they asked for information or clarification. We saw this person becoming increasing agitated at times and at other times they appeared resigned and withdrawn. We saw other people being ignored by some staff when they called out. We asked a senior member of staff to sit with us during part of our inspection. We did this to show them that two people who do not have dementia were getting a lot of attention from 4 members of staff. Another person was getting some attention and others were not engaged or interacted with, or their calls of distress were ignored. We also saw that staff did not challenge a resident who mocked one person with dementia. We saw that some staff gave assistance with personal care in a very detached and business like way. Two carers we observed supporting people to eat did not speak with them at all. We watched one carer assist someone with their lunch in a way that did not show respect for this person and which put them at risk of choking. We asked the nurse on duty to intervene and have written to the manager to describe this event so that appropriate action can be taken. We also saw staff being very patient and caring. One member of staff very kindly and discreetly replaced the empty glass one person was drinking out of with a full glass of juice. One person was agitated and was reacting angrily to staff who were trying to offer something to eat. One member of staff sat with this person and talked calmly with them about events and people that this person understood. After a very short time this person became calm and the member of staff offered them something to eat and drink which they accepted. This was exceptionally skillful. We saw that people wear their own clothes which are kept clean, and that these are appropriately warm and co-ordinated. People wear clothing and jewelry of their choice which helps to maintain their dignity and independence. One person told us that people are always well turned out. We looked at the way medicines are managed and we saw that there is a good system in place for ordering, storing and returning medicines. We looked at records and saw that they are up to date and well kept. All hand written prescriptions are either signed by the prescribing doctor or by 2 people, as is good practice. Medicines that need to be kept in a fridge are kept in fridges designed for this purpose and which are kept locked. Care Homes for Older People Page 16 of 34 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some people living here would benefit from improved engagement and interactions, and from more flexible routines. People enjoy a nutritious diet although the way they are supported to receive this could be further improved. Evidence: In surveys three people told us that there are always activities that people can take part in, one said there sometimes are and one said there usually are. We looked at the types of activities offered and how people who cannot take part in organised activities are engaged. This home has a dedicated activities co-ordinator who works full time. This person arranges activities such as skittles, magnetic darts, dominoes and bingo. They also help to arrange the church services and the distribution of newspapers. In addition, they run a trolley shop from where people can choose items such as sweets and toiletries. The manager tells us that the home does not provide activities or outings outside the home, as these are not funded. Staff told us in surveys that they see the engagement of people as part of their role and not just the function of the activities coordinator. One member of staff told us that Care Homes for Older People Page 17 of 34 Evidence: they are beginning to use every opportunity to have a social interaction with the people who live here. However, they also told us that this is in the very early stages of development. We observed 4 members of staff using an activity to engage with a group of 9 people. Of those people 3 engaged with and enjoyed the activity. 3 people slept, 1 person shouted out and was ignored and another person was very confused by the game being played and became upset and agitated. One member of staff kept telling this person to relax. However, this person could not understand what the member of staff was saying and this caused further upset. We saw in care plans that staff obtain a lot of information about people, their backgrounds, work, families and interests and pastimes. However, when we spoke with some staff they did not seem to understand how this would help them to communicate and engage with people. One member of staff we spoke with told us that this information is very important and demonstrated on numerous occasions how this could be used to communicate with individuals. On the whole, staff did not appear skilled in helping people to engage positively. We asked the manager if staff have received training in this and he told us that they had not. He also told us that the new training programme would help staff to be better able to engage and interact with people. People who visit the home say that staff are always very welcoming and keep them up to date. They say that it is lovely when coming into the home to be greeting in such a friendly manner by the receptionist, manager, deputy and/or the administrator. People say they are always offered refreshments and that staff have time for them. They can visit when they like and if they are taking their friend or relative out, the person is always ready to go at the arranged time. We looked at how people are helped to make choices in their daily lives. We saw that this could be improved. For example we heard two people on two separate occasions asking for drinks. Both were told what time tea would be served, and were not offered a drink at the time they asked for it. We asked the cook about how she knows who has chosen to eat what. She told us that there is no choice offered at meal times. She said that if someone is a vegetarian they have a none meat meal, otherwise everyone gets the same. We saw one person, when lunch had started to be served to others, become active and try to move from their chair. Staff continued to prepare other people for lunch working from the front of the room to the back of the room, not taking notice of this persons movements. After about 15 minutes of moving and Care Homes for Older People Page 18 of 34 Evidence: nearly upsetting the table in front of them a nurse said I bet youre hungry and served dinner to this person. This person then settled. This suggests that the routine of serving lunches had prevented this person from making a choice to have their lunch earlier than the staff had planned. We observed how lunch time is managed. We found that the home has limited seating spaces, so many people cannot sit up to a table to eat their meals. For this reason mealtimes are not very sociable. The way staff manage these times is quite business like, with little conversation or engagement taking place. Some staff, whilst supporting people to eat, did not talk to them at all. We saw that some people who spilled their food from the side of their plate did not have plate guards which would help to prevent this. Care Homes for Older People Page 19 of 34 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 listened to and kept safe from abuse. Evidence: In surveys people say they know who to speak with if they are not happy and the majority say they know how to make a formal complaint. The commission have not received any complaints about this service since the last inspection. The home has received one complaint which the manager reports has been dealt with to the satisfaction of the complainant. Relatives and supporters are made aware of how to make a complaint through the information given to them when someone is admitted to the home. In addition, the manager is very accessible. His office is situated at the entry to the building and his door is nearly always open. People say he is easy to talk with and very approachable. In addition to the above a programme of training is about to commence which will help staff to better understand dementia and what someone with dementia might be trying to communicate, which might be a form of complaint. All staff receive training in safeguarding people. We spoke with staff and they show a good understanding of what abuse is. They say they would report anything they were worried about to the manager and say they are confident he would take action. The manager tells us he has recently had cause to take action due to one staff members Care Homes for Older People Page 20 of 34 Evidence: inappropriate verbal behaviour. He took advice from the safeguarding team, followed this advice, and the homes disciplinary procedures. This person has been dismissed and has been placed on the list which prevents them from working with vulnerable adults in the future. This is good practice. It is also good practice that the manager has ensured that referrals have been made under the Deprivation of Liberty legislation, where he thought this was appropriate. Staff have not yet received training relating to the Mental Capacity Act (MCA), and this shows in the way they are recording that restraint is being used. For example, some people, in their best interests, have bed rails on their beds to help prevent them falling out. This is a form of restraint, the use of which must be recorded as stated in the MCA guidance. We also noted during the inspection that one person was restrained using two tables. We looked in their care plan and this type of restraint did not form part of their care plan. We spoke with the nurse about this. She said that at times this person, in their best interests, needs to be restrained to keep them safe, and that work is ongoing to find a form of safe restraint for this person. However, the nurse agreed that the method used on this occasion was not appropriate and could cause injury to this person. Care Homes for Older People Page 21 of 34 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 benefit from living in an environment that is homely, clean and safe. Evidence: In surveys people told us that the home is usually clean. We found the home to be clean and odour free. We found that all communal areas and private bedrooms are clean and well furnished. We saw staff tidying, clearing away used cups and glasses and wiping down tables. This not only helps to ensure the home is tidy, but also helps to prevent the spread of infection. We saw staff following infection control procedures by for example washing their hands and using protective clothing. We looked in the laundry and found it clean and tidy. One person commented that clothes sometimes get lost but other people said this had not happened to them. Clothes are marked with each persons name. We looked in some drawers in bedrooms and found that the clothing in them belonged to the person occupying that bedroom. Work is ongoing to ensure the standard of decor and soft furnishings is maintained. Things which may pose a risk to people around the home are identified and actions are taken to address this risk. For example, upstairs windows have restricted openings Care Homes for Older People Page 22 of 34 Evidence: and bathing water is delivered at near to 42C, as it should be. Care Homes for Older People Page 23 of 34 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. The training planned will help staff to further develop the skills needed to care for the people living here. More attention to detail in recruitment and induction is needed to help ensure that people are protected from potential harm. Evidence: We looked at the duty rota and saw that each day and at night there are 2 nurses on duty. In addition there are usually 8 or 9 carers on throughout the day and 3 at night. Staff are divided into 3 groups who work on separate floors. There is usually a nurse and 3 carers working on each of the top and middle floors, and 2 carers working on the ground floor. In addition the home has a manager, a deputy manager, administrator, receptionist, cleaners, laundress, maintenance and cooking/kitchen staff. In surveys people and their relatives say that people usually or always get the care and support they need. Some people thought that at times 4 carers instead of 3 are needed as the majority of people need the assistance of 2 people and have high needs. The information supplied by the manager prior to the visit to the home tells us that of the 48 people living at the home 32 need the help of 2 staff, and 38 are doubly incontinent. He feels that staffing levels are sufficient to meet peoples needs and keeps this under review. We observed that people did not appear to be up late and did not appear to wait a long time to be attended to. Care Homes for Older People Page 24 of 34 Evidence: People told us they thought that staff had varying skills in relation to caring for people with dementia. One person commented that the majority are very kind and patient, but that they thought some people needed more training. Our observations as detailed in Health and Personal Care and Social Life and Activities, would support this. The management team are also aware of this. They are about to introduce a system of training which will help staff to develop skills in caring for people with dementia. We looked at the current training system. We were told that staff training is currently delivered by them watching DVDs, and having their knowledge checked afterward through a written test. However, the manager tells us that some of this training will soon be replaced by a new training package aimed at increasing staff skills in caring for people with dementia. We looked at the induction training. The manager told us that this is not based on Skills for Care training as is recommended. However, the manager reports that over 50 of care staff working at this home hold a National Vocational Qualification (NVQ) in care to level 2 or above. We looked at the records of one member of staff who has never worked in a care setting before. We were told that this person had one days training, consisting of watching DVDs. We looked at their induction training record and saw this was focused on the routines and procedures in the home. We looked at the duty rota and saw that after this one days training, this carer worked as part of the care team. We looked at this persons supervision record and saw that their lack of knowledge or experience had not been addressed during these sessions. We looked at the recruitment files of two staff members. We found that two references and a police check had been received for each person prior to them starting work. This is good practice. However, we found that both members of staff had gaps or discrepancies in their employment history which had not been checked out as they should be. As this is a nursing home, the nurses working here must be registered with the Nursing and Midwifery Council. This home has a computerised system in place which alerts the manager when a nurse is due to re register. This is good practice as the manager can ensure this is done, meaning that people are only cared for by nurses who are registered. Care Homes for Older People Page 25 of 34 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. People benefit from living in a home where the management team strive to bring about improvements, helping to ensure that people live in a safe home that is run in their best interests. Evidence: The Registered Manager of this home has many years experience of working in health and social care, with people with mental health needs and in management. He holds the Registered Managers Award as well as nursing qualifications. Staff and visitors to the home say the manager is approachable, listens to them and that he continues to lead improvements. A deputy manager has recently been appointed, after a long time of the home not having one. Together the manager and deputy have devised a plan to better equip staff with the skills they need to provide care for people with dementia. This includes completely revising the care plans and providing training for staff in how to do this. In addition, a programme of training in dementia care is about to begin for all staff in the Care Homes for Older People Page 26 of 34 Evidence: home. Since the last inspection the manager has restarted meetings with relatives and supporters as a way of trying to involve them in the running of the home. In addition the manager carries out satisfaction surveys which are analysed at the companies head office. The results and comments are passed to the manager who will produce an action plan if needed. Staff report that staff meetings take place regularly and that the manager and deputy are always available to them. We looked at how monies are managed on peoples behalf and found this to be in order. We looked at two peoples accounts. We found that each credit or debit is checked and signed by a two people as is good practice, and that all receipts of monies spent are retained. Staff say there is enough equipment, such as hoists, for them to do their job safely. They say they receive training such as moving and handling, food hygiene and fire training. Records seen confirm this. In the AQAA, the manager reports that servicing, equipment testing and maintenance works takes place, and that all policies and procedures are regularly reviewed and are up to date. Care Homes for Older People Page 27 of 34 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 7 15 Each person should have a 30/06/2009 plan of care which identifies their needs and which shows how these are to be met. The plan of care should be reviewed in a way that shows how the intervention is working and the plan amended when needs are not being met or new needs are identified. Each plan of care should be tailored to individual needs and preferences. This will help to ensure that risks identified are addressed and health is promoted. Reviews of how the plan is meeting the need identified will help to ensure that the plan is tailored to each persons needs and meets those needs. Tailoring the plan of care to each persons needs and preferences will help to ensure that each person receives care that is person centred and which supported each persons capacity for self care and autonomy. 2 8 13 The health and welfare of each person living here should be promoted and maintained as far as is possible. This includes 30/06/2009 Care Homes for Older People Page 28 of 34 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 meeting needs relating to preventing and treating pressure sores, meeting nutritional and continence needs and maintaining and where possible improving peoples psychological health. This will help to ensure that people are kept as healthy as possible for as long as possible. 3 10 12 Each person living here should have their dignity protected and promoted. This will help to ensure that each person is treated with dignity and in a person centred way. 4 12 16 Each person living at the home should have their needs relating to activities, engagement and social interaction met in a person centred way. This will help each person to have their need to be social and to be interacted with met in a positive way which suits each persons ability and preference. 5 14 17 Each person living here 21/08/2009 should have their ability and capacity to make choices and to exercise autonomy maximised. In this way people who are Care Homes for Older People Page 29 of 34 30/06/2009 21/08/2009 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 disabled will be enabled to make choices and to have flexible routines. Care Homes for Older People Page 30 of 34 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 1 7 15 Every person living here must have a plan of care which identifies their needs and which describes how these needs should be met. The plan of care must be reviewed in a way that shows how the intervention is working and the plan amended when needs are not met or new needs are identified. This will help to ensure that risks identified are addressed and that peoples health is promoted. Reviews of how the plan is meeting the need identified will help to ensure that the plan is tailored to each persons needs and meets those needs. 26/03/2010 2 8 13 The health and welfare of every person living here must be promoted and maintained as far as is 26/03/2010 Care Homes for Older People Page 31 of 34 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 possible. This includes (but is not exclusive to) meetings needs relating to preventing and treating pressure sores, ensuring people are not put at risk of choking and ensuring peoples mental health needs are met. This will help to ensure that people are kept as health as possible for as long as possible. 3 10 12 Every person living here should have their dignity protected and promoted. This will help to ensure that each person is treated with dignity and as an individual who is respected. 4 12 16 Every person living at the 30/04/2010 home must have their needs relating to engagement and social interaction met in a way that addresses their well being. This will help to ensure that people experience positive feelings and have their individual needs met. 5 14 17 Every person should have their ability and capacity to make choices and to exercise autonomy maxims ed. 30/04/2010 26/03/2010 Care Homes for Older People Page 32 of 34 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 In this way people who are disabled will be enabled to make choices and have flexible routines. 6 18 13 Where physical restraint is 26/02/2010 used this should be of a kind that is the safest and the most appropriate for that persons well being and is carried out in their best interests. Where restraint is used, the type of restraint to be used should be clearly recorded and reviewed. This will help to ensure that restraint is only used in a persons best interests and is the most appropriate and safest form of restraint available. 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 29 Recruitment procedures should be robust and include exploring gaps or discrepancies in someones employment history. Induction training/programmes should be based on Skills for Care recommendations and should be tailored to each member of staff training needs, to ensure they deliver appropriate care. 2 30 Care Homes for Older People Page 33 of 34 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 34 of 34 - 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!

The Provider has not yet updated their profile and added details of the services and facilities they offer. If you are the provider and would like to do this, please click the "Do you run this home" button under the Description tab.

The Provider has not yet updated their profile and added details of the services and facilities they offer. If you are the provider and would like to do this, please click the "Do you run this home" button under the Description tab.

Promote this care home

Click here for links and widgets to increase enquiries and referrals for this care home.

  • Widgets to embed inspection reports into your website
  • Formated links to this care home profile
  • Links to the latest inspection report
  • Widget to add iPaper version of SoP to your website