Care Home: Feryemount Residential Home

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What the care home does well What has improved since the last inspection? The corridors have been redecorated with light wallpaper, which has brightened these areas of the home. There are more planned improvements to bedrooms and kitchen this year. Fewer agency staff are used at the home and more permanent staff have been employed. This helps the home to provide better continuity of care for the people who live here. What the care home could do better: There should be clear information for people about the intermediate (rehabilitation) service so they would be able to make an informed decision about the service and what to expect if they stay here.Care plans about people`s specific needs, such as nutrition, should show how staff will support the person to keep at a healthy weight. It should also include monthly weight records and guidance for staff about what they should do if someone loses weight. The rotten window frames and woodwork to the outside of the home should be repaired or replaced. Other things that could make the home better include: having information on cassette for people who cannot see well; records could be kept on individual sheets so they can be checked more easily; protective gloves could be stored discreetly so they are not in view; everyone could be given a key when they come to stay or live here, unless they cannot manage one; and staff training records should be kept up to date. CARE HOMES FOR OLDER PEOPLE Feryemount Residential Home North Street Ferryhill Co Durham DL17 8HX Lead Inspector Andrea Goodall Key Unannounced Inspection 16th September 2008 9:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Feryemount Residential Home Address North Street Ferryhill Co Durham DL17 8HX Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01740 651667 01740 653633 chris.johnson@durham.gov.uk www.durham.gov.uk Durham County Council Manager post vacant Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29), Physical disability (9) of places Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That 1 place be maintained for a current service user in the category of DE(E) until that service user no longer requires this accommodation. 25th August 2006 Date of last inspection Brief Description of the Service: Feryemount is a long established care home situated in the town centre of Ferryhill that opened in 1972. The service is provided by Durham County Council. The home is registered to provide residential and personal care for up to 29 people. The registration includes 29 places for older people, of which up to 9 places can be for people with a physical disability. The home has an intermediate care service for up to 9 people on the ground floor. The people who stay here receive a short-term, multi-agency rehabilitation service designed to get them back to their own homes following either illness in hospital or in the community. People using this service stay here for up to 6 weeks. There are 20 permanent residential places on the first floor. All the bedrooms are single occupancy. There is a good range of lounges, dining rooms and bathrooms throughout the home. Stairs and a passenger lift connect both floors. Gardens to the rear of the home are well maintained and there is good access for the people who live or stay here. The weekly residential charge is £432.32, although the actual amount people pay depends on their individual circumstances. This covers accommodation, personal care and all meals and beverages. The only additional costs are for personal purchases such as newspapers, toiletries and hairdressing. There is no fee for the people using the intermediate care service. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Before the visit: We looked at: • information we have received since the last visit on 10th January 2007 and annual service review on 21st January 2008 • how the service dealt with any complaints & concerns since the last visit • any changes to how the home is run • the provider’s view of how well they care for people. The Visit: An unannounced visit was made on 16th September 2008. During the visit we: • talked with people who use the service, relatives, staff, the manager & visitors • joined residents for a meal and looked at how staff support the people who live here • looked at information about the people who use the service & how well their needs are met • looked at other records which must be kept • checked that staff had the knowledge, skills & training to meet the needs of the people they care for • looked around parts of the building to make sure it was clean, safe & comfortable • checked what improvements had been made since the last visit. We told the manager what we found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations – but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: There should be clear information for people about the intermediate (rehabilitation) service so they would be able to make an informed decision about the service and what to expect if they stay here. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 7 Care plans about people’s specific needs, such as nutrition, should show how staff will support the person to keep at a healthy weight. It should also include monthly weight records and guidance for staff about what they should do if someone loses weight. The rotten window frames and woodwork to the outside of the home should be repaired or replaced. Other things that could make the home better include: having information on cassette for people who cannot see well; records could be kept on individual sheets so they can be checked more easily; protective gloves could be stored discreetly so they are not in view; everyone could be given a key when they come to stay or live here, unless they cannot manage one; and staff training records should be kept up to date. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 6. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People who use the intermediate service do not get sufficient information so they are unable to make an informed decision about whether to come to stay here. EVIDENCE: Feryemount care home has been open for around 30 years and is a well-known resource in the local community. People who come to live here permanently are usually from the local area. They are given an information pack, called a Service Users’ Guide, which includes useful information about what they can expect from the service. This is easy to read and is placed in every bedroom so that residents can refer to at any time. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 10 At this time there are two people who live at the home who have significant visual impairments so they cannot read the information pack. Currently information is not available in another format for resident with diverse needs. The people who come to use the intermediate service provided at Feryemount may live outside this local area and so would not be familiar with this care home. When they arrive they also receive a copy of the Service Users’ Guide, but it does not clearly outline the intermediate service they will receive. Many people come directly here from hospital and they currently receive no written or photographic information about the intermediate service. Some people may decline to use the service because they do not have information about it. (The manager is aware of this shortfall in information and is currently developing a brief pamphlet that may provide a general description of the purpose of the intermediate service.) One person said, “It’s a very good service. I was in hospital after a fall before coming here, but I had no idea what this place would be like and I don’t know how long I’ll be here.” The intermediate service is for older people who are recovering from illness, either from hospital or from home, who no longer need medical care but need support to regain daily living skills so that they can return home. This service involves the Occupational Therapists, Physiotherapists and support staff. The period of stay for this service is up to 6 weeks. Between May 2007 to June 2008 there were 91 people who used the intermediate service. It is good practice that the intermediate unit is on the ground floor so the transience of new service users does not impact on the permanent residents who are accommodated on the first floor. One of the criteria for receiving such services would be that the person must be assessed as being potentially able to achieve rehabilitation. Potential service users are assessed by health and social care professionals, and a referral is made to the home. They are then assessed by the manager of Feryemount to ensure that their needs could be met at the intermediate unit, and to ensure that they want to use the service. In discussions a visiting health care professional said, “They provide a very good service within the funding and capabilities they have, but there are still sometimes inappropriate placements, probably due to hospitals wanting a quick discharge. This is an area for better understanding and training for hospital staff.” From statistical information it seems that the assessment process is improving so that there are fewer inappropriate placements where service users are not medically fit to be here. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Overall, good staff practices and access to heath care means that residents have good support with their personal and health care needs. EVIDENCE: Care plans are records that are used by all care services to show what sort of help each person needs and how staff will provide that care. Feryemount has different care plan systems for the two different services provided here. Care plans for permanent residents identify their primary, long-term care needs such as mobility, nutrition and personal care needs. It is good practice that a copy of the care plan is kept in each person’s bedroom so that they, and staff, can refer to it at any time. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 12 In the small sample examined most were brief but up to date. However one resident’s care plan included nutrition as a primary need, but the evaluation records did not correctly identify their significant and progressive loss of weight. The person’s weight records were sporadic and had not been considered when recording the monthly evaluation. In this way staff had not been prompted to take any action, e.g. referral to dietician and communication with catering staff about fortified meals. There is a different care plan system for people using the intermediate service which is designed by physiotherapy and occupational therapy staff. This ensures that the main short-term, rehabilitation goals of service users is the focus of the support that staff provide. For example goals might include joint exercises, mobility and daily living skills. Understandably, these plans are very technical in content, and staff commented that they would benefit from some training from therapy staff in understanding them. The people staying here get good health care during their stay by the relevant health care professionals. There are occupational therapy staff on site most days and physiotherapy services twice a week. People who come to stay here have access to local GP practice as temporary patients. One person said, “I would recommend this place to anyone who needed to get better before going home.” It was also evident from care records that permanent residents have support to access relevant health care services as and when they require them. A health care professional who was visiting during this inspection said, “I have no concerns about the care and practices here. It’s a good service.” The intermediate service aims to promote peoples’ continued independence, however service users are not assessed on admission for their ability to manage their own medication. Such an assessment would determine whether they can fully self-medicate, or need verbal prompts only, or need full support. Some pre-admission assessments showed that people had previously managed their own medications at home, and many people may need to keep up these skills for their return to their own home. Instead service users are asked to sign a consent form that allows staff to take responsibility for their medication. At this time the medication of all service users and residents is managed by the residential supervisors (the equivalent of deputy managers) who have had training in safe handling of medication. Medication for each resident is delivered to the home by a local pharmacist in easy-to-use blister packs. Medication is securely stored and records of the administration of medication are in good order. All the people who took part in discussions felt that their dignity and privacy is respected by staff. During this visit staff talked about people staying and living here in a respectful way. Throughout the inspection visits there were Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 13 many instances of good practice where staff supported people in a sensitive and encouraging way. For example, support at mealtimes, and helping people with their mobility at the resident’s own pace. People had many positive comments to make about the service. One person said, “They are lovely staff – they can’t do enough for you.” Another person said, “You could never get a better service. They do everything you ask and more.” A visiting relative said, “She is very pleased with the care she gets here- so are we. My brother is so pleased with Feryemount that he wrote a letter to the local paper about how good it is.” Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 – 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Residents have good opportunities to make choices about their own daily routines so that they lead a lifestyle that matches their individual preferences. EVIDENCE: People are encouraged and supported to choose their own daily routines. For example, some people prefer to dine in their own rooms, and some people enjoy a lie-in when they want. Residents described how they lead their own lifestyle, such as going to bed when they want, and spending time in the privacy of their own rooms. Care staff try to provide some activities when time allows, usually card games, quizzes or table top games. An arts and craft team also visit every fortnight and residents commented positively on their enjoyment of those sessions. One person said, “There aren’t many activities, but there’s enough for us. They do their best for us.” Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 15 There are two people living here who are celebrating their 100th birthday this year. At the time of this visit the large dining room was being specially prepared for a forthcoming 100th birthday party in a couple of days. One person said, “Well I’ve got to 100 while I’ve been living here – so they’re doing something right!” People staying in the intermediate unit also have therapeutic activities such as physiotherapy exercises, and daily living skills tasks, as part of their individual rehabilitation programme. People from both the intermediate unit and from the residential unit enjoy sitting outside in the pleasant patio area at the back of the home which has fantastic views across the Durham countryside. One person said, “We can sit out at the back whenever we want. As soon as you ask, staff help us with this and bring us back when we want.” Permanent residents do have some contact with their local community either through religious services that visit the home, or going out to local shops and weekly market with staff or relatives. Visiting relatives described the home as “friendly” and “very comfortable”. Activities and menus are advertised around the home so that residents have good information to make informed choices about these things. The menu for each day is written on a whiteboard in dining rooms, and there is also a copy of the weekly menu. Residents are also asked what they would like from the two main choices a couple of hours before each meal so that they can discuss their choices with staff. The dining rooms are bright and cheerful, and tables were well presented with tablecloths, napkins, condiments, milk and sugar. Meals are nicely presented and very appetising. Residents and service users described the meals as “always very good“, “we always get lovely meals”, and “they are always trying to feed us up!”. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 – 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Residents have clear information so they would know how to make a complaint. The staff team is receiving suitable training so they know how to protect residents from abuse. EVIDENCE: All residents have information in their service users’ guide which refers to the complaints procedure. There is also information about the complaints procedure on display around the home for visitors to see. All residents and their relatives who took part in discussions said that they would feel very comfortable about talking to the manager or staff if they had any “grumbles” or concerns about the service. There have been no complaints received by the home or by CSCI over the past year. The home endorses the local authority Safeguarding Adults protocols, and the manager is aware of the safeguarding team’s contact details for advice. (Although at this time there is not a copy of the Safeguarding Adults procedure in the home for reference.) Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 17 About two thirds of the staff team have had training in Safeguarding Adults procedures, and the remainder will have this in the future. In this way staff would know how to make an alert in the event of suspected abuse. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is clean, warm and comfortable but some communal areas are worn so residents do not live in a well-maintained environment. EVIDENCE: Overall the home remains warm, comfortable and clean. There have been some areas of redecoration since the last inspection, particularly to corridors, and the light coloured wallpapers have really brightened these areas. However some corridor carpets are marked and worn. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 19 The external woodwork to the building is becoming perished and the paintwork is faded. Many window frames are now rotting and if left in this state it will present a health & safety hazard. Most bedroom are reasonably furnished, comfortable and cosy, but some showing signs of wear and tear such as torn wallpaper and scuffed paintwork. The manager stated that there are plans for bedrooms to be redecorated this year. Many residents enjoy spending time in their rooms and many bedrooms have been highly personalised by the residents. At this time people are not automatically given a key to their bedroom on admission unless they request one, and the manager acknowledged that everyone could be offered a key. There is a very good range of sitting areas and lounges for people living or staying here. There are plans for one lounge to be fitted with a new carpet. There are small kitchens around the home next to dining rooms. These are to be fully refurbished so that people can keep up their daily living skills and for staff to have better access when serving meals. The standard of cleanliness and odour control in the home is very good. There is a small but well equipped laundry. Staff practices showed a good awareness of infection control and residents commented that the home is always “spotlessly clean”. However there are boxes of protective gloves on display in corridors throughout the home which does not support peoples’ dignity. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Overall the home provides competent, suitable staff to ensure that the people who live here are protected and that their needs are met. EVIDENCE: The staff team comprises the manager, three residential supervisors, care staff, catering staff, housekeeping staff, an administrative staff and a part-time maintenance staff. At the time of this visit there were 2 care staff allocated to support the 14 residents on the residential unit. This is currently sufficient staff to meet the number and needs of people living on the residential, although any change in need would require a review of staffing levels. There are two care staff on duty in the home at night. Each day there are 2 care staff and a support worker (to assist with therapy plans) allocated to the 8 people staying in the intermediate unit. It is accepted that people receiving a rehabilitation service require greater input over a short period to enable them to relearn their daily living skills and mobility in order to return home. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 21 It is decided each day which staff will be allocated to the intermediate unit. This means there is no planned continuity of staff to support the progress of people receiving this short–term service. Staff feel it would be helpful to spend continuous periods in this unit and the manager agreed this is to be considered. Discussions were also held with the manager about the ‘enabling’ role of staff working in the intermediate unit. The manager confirmed that staff need training in stepping back and allowing people to regain their own skills. Staff have also requested training from therapy staff in the therapy plans and exercises. In this way it is clear that the staff team are committed to providing an appropriate service to the intermediate unit, and have recognised the need for developing their training to support this. Since the last inspection there has been a slight increase in the number of care hours allocated to the home. Also new staff have been appointed to replace two posts that were previously subject to long term sick leave. There has been reduced number of care hours provided by private agency staff. In discussions an agency staff said, “It’s a very friendly place to work. They try to keep the same agency staff for continuity for the residents. I find all the staff work well as a team.” The last inspection report commented on the low staff morale due to the home’s uncertain future at that time. Staff commented that the future of the home is still uncertain, but that it has continued to operate over the past two years. One staff said, “We are all committed to this service. We want it to be as good as it can be for the people who live here or stay here.” The provider, Durham County Council, is an equal opportunities employer, and this is evident from the good mix of age, experience, gender and ethnic background within the staff team. The recruitment and selection process used by the provider continues to ensure that only suitable people are employed. No new staff can start work here until satisfactory references, checks and police clearance (called a CRB disclosure) have been received by the home. All new staff receive “skills for care” induction training within 12 weeks of starting their work here. All care staff are offered training to achieve a professional qualification in care called NVQ. At this time 65 of care staff have achieved NVQ level 2 and 20 more are working towards this award. Staff also receive training in appropriate areas such as moving & assisting and food hygiene. However at this time the training records do not demonstrate all the training that staff have achieved nor what further training they require. In this way it is not possible to determine whether all staff have received the mandatory training that they must have. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is well-managed so it is run in a way that upholds the best interests of the people who live or stay here. EVIDENCE: The manager has been responsible for the day to day operations of this home for over a year. He has many years experience of working in residential care services for older people. He was formerly the registered manager for six years of another care service operated by Durham SSD, and was initially transferred to this service on a temporary basis. It has now been decided that he will Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 23 remain at Feryemount, and he has now begun the process of applying for registration in respect of this home. Residents have opportunities to comments on the service, either individually or at Residents’ Meetings. The minutes of the most recent meetings are displayed on noticeboards around the home so that all residents can see the suggestions made. Minutes show that residents continue to make positive comments about the social events and menus in the home. The home also uses questionnaires to gain the views of people who have used the intermediate unit, and the manager intends to collate those responses as part of the quality review of that service. An operations manager visits the home on behalf of the provider. The outcomes of his visits are recorded on a monthly basis (this is called a regulation 26 report) but copies of the reports are not currently kept at the home for review. The home will support people to safely store small amounts of personal monies, if they request, and the home’s administrator takes responsibility for this. Records of this were clear, up to date and in good order. Peoples’ monies are kept in individual wallets in a secure place, and any transactions are clearly recorded and signed by two staff. In this way, residents’ monies are safely managed on their behalf. All staff have statutory training in health & safety matters, including moving & assisting. All staff are to receive updated fire safety training in the next few weeks. However at the time of this visit the in-house fire instruction records for staff were not completed. The maintenance staff carries out routine health & safety checks in the building, and overall the accommodation was safe. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 2 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 X X X X 2 X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 OP4 Regulation 5(1) Requirement There must be a Service Users’ Guide that describes this specialist service, including the accommodation, aims and objectives, and staffing. This is to ensure that people being assessed for intermediate care have good information so that they can make an informed choice about the service and can know what to expect from their stay here. Where nutrition is a primary care need there must be a specific care plan that set out the nutritional needs of that resident. There must be detailed guidance for staff in how to support those needs including a clear, co-ordinated approach involving care staff and catering staff. Monthly evaluations must report a meaningful assessment of the progress or change in need. This is to guide staff in how to support people with their significant needs in a consistent, Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 26 Timescale for action 01/12/08 2. OP7 15(1) 01/12/08 3. OP19 23(2)(b) planned way, and to ensure that any changes in need are identified and acted upon. The perished woodwork and rotten window frames to the outside of the building must be repaired or replaced. This is to ensure that the external premises are kept in a reasonable state of repair and to prevent a potential health & safety hazard. 01/01/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1 Good Practice Recommendations Consideration should be given to providing information (such as the service users’ guide) in an accessible format for residents who have visual impairments or reading difficulties, for example on cassette or CD. It would be better if each care need was set out on a separate care plan sheet, so that each specific need could be individually monitored for changes and progress. Weight records of all residents should be completed on at least a monthly basis (or more often if identified within a nutritional risk assessment). People should be assessed on admission for their capabilities towards managing their own medication and, where applicable, supported to do so within a riskassessment framework. The manager and the remainder of the staff team should have training in Safeguarding Adults, and a copy of the procedures should be available in the home for reference. Everyone should be provided with a key to their bedroom on admission, unless a risk assessment determines otherwise. Boxes of latex protective gloves should be stored discreetly in toilets and bathrooms to protect the dignity of the people who live here and to support control of DS0000031154.V372762.R01.S.doc Version 5.2 Page 27 2. 3. 4. OP7 OP8 OP9 5. 6. 7. OP18 OP24 OP26 Feryemount Residential Home 8. OP28 9. 10. 11. 12. OP30 OP32 OP33 OP38 infection. Consideration should be given to the deployment of dedicated care staff to the intermediate unit to allow for continuity of care, and training in intermediate care should be provided to those staff to develop their ‘enabling’ role. Training records should be brought up to date so that the training needs of each staff can be kept under review and their further development can be planned. As recommended in previous inspection reports, the provider should now clarify the future of the home and it’s services. Copies of the reports of regulation 26 visits carried out on behalf of the provider should be kept at the home for review. In-house fire instruction records should be completed and kept up to date. Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Feryemount Residential Home DS0000031154.V372762.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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