Fernlea, The Wishart Anderson (Care Home) Care Home Service Fernlea, The Wishart Anderson Care Centre Marrister Symbister Whalsay ZE2 9AE
Inspected by: Allan Barker (Care Commission Officer)
Type of inspection: Unannounced
Inspection completed on: 15 December 2005
1/10 Service Number Service name
CS2005097964 Fernlea, The Wishart Anderson (Care Home)
Service address
Fernlea, The Wishart Anderson Care Centre Marrister Symbister Whalsay ZE2 9AE
dummy Provider Number Provider Name
SP2003002063 Shetland Islands Council
dummy Inspected By Inspection Type
Allan Barker Unannounced Care Commission Officer dummy Inspection Completed Period since last inspection
15 December 2005 9 Months
dummy Local Office Address
Room 205 / 222 Charlotte House Commercial Road Lerwick Shetland ZE1 0HF
dummy
2/10 Introduction Fernlea, The Wishart Anderson Care Centre, was a purpose built residential centre with an adjoining day care facility. The building was situated in Marrister on Whalsay, overlooking the picturesque Linga Sound.
The service was registered to provide a care service to a maximum of ten adults, which included long term, respite and short term care.
All bedrooms had en-suite facilities, with rooms decorated, reflecting the Service User's likes, interests and individuality.
The provider also managed community care outreach services and a ' meals on wheels' service.
The care service, previously operated by Shetland Welfare Trust had recently been transferred over to Shetland Islands Council, social care department.
Basis of Report This report was based on consideration of the service's compliance with the regulations associated with the Regulation of Care (Scotland) Act 2001, as well as taking account any requirements, recommendations, or areas of development identified from the inspection of 1 March 2005.
The inspection focussed on the sections of The Regulation Care (requirements as to Care Services) (Scotland) Regulations 2002, Statutory Instrument 114, and took account of the National Care Standards for Short Breaks and Respite, Care Homes for Older People.
The inspection was an unannounced inspection visit.
Standard 1. Trial Visits. Standard 2. Your Environment. Standard 5. Management and Staffing Arrangements. Standard 8. Making Choices. Standard 13. Eating Well. Standard 15. Keeping Well - Medication. Standard 11. Expressing Your Views.
Action taken on requirements in last Inspection Report Not applicable.
Comments on Self-Evaluation Not applicable
View of Service Users The Care Commission Officer spoke with four staff during the inspection visit. Staff said they enjoyed their work and worked well as a team. Staff said they all 'supported each other and got on well'. Staff were able to access regular training including SVQ's in Care and received regular supervision.
3/10 View of Carers The Care Commission Officer spoke with three Service Users and three relatives during the inspection visit. Service Users and relatives spoke very highly of the staff and service. 'we couldn't hope for anything else', 'the staff are awfully fine', 'I have a laugh with staff they are really good', 'it really is a home from home'. The various comments made during the inspection visit followed a similar theme.
4/10 Regulations / Principles
Regulation 5: SSI 114 Regulation 5 (2) Personal Plans
Strengths
Five care plans were examined during the inspection visit. There had been an overall improvement with most of the documentation.
Some review minutes highlighted monitoring, evaluation and detailed outcomes. Documentation was current and up to date.
Most reviews were held on a regular basis and documentation had been enhanced.
Records and care plans examined highlighted involvement with health care professionals and other services.
Service Users who were on special diets had details of such diets or nutritional supplements documented within their care plans.
Care plans were appropriately stored in a locked cabinet, when not in Service User's rooms.
The provider kept appropriate records in accordance with the conditions of registrations.
Service Users care plans highlighted rights and responsibilities. Service Users also had contracts detailing service provision.
Areas for Development
Care plans could be further developed and enhanced to note unmet need.
Care plans could be developed and enhanced to record and highlight activities.
Regulation 10: SSI 114 Regulation 10 Fitness of Premises
Strengths
The premises satisfied the criteria for meeting the aims and objectives of the service. The premises satisfied the necessary criteria in terms of construction, repair, lighting, heating and ventilation in most areas of the house. The various rooms were colourfully decorated and in good repair.
Highlands and Islands Fire Services had carried out an inspection visit which recommended certain actions to be taken.
Areas for Development
The provider is required to update the Care Commission on which recommendations have been completed and an action plan detailing the date of completion for outstanding work.
5/10 Regulation 19: SSI 114 Regulation 19 (3) Records
Strengths
The provider was aware of the requirement to keep appropriate records where restraint of a Service Users was required.
The provider kept appropriate records and implemented policies and procedures relating to fire drills, alarm tests, recording of accidents and incidents and the maintenance of equipment.
The provider kept adequate records and documentation concerning the recording of accidents and incidents.
A complaints procedure was in operation which also highlighted the Care Commission and the service's conditions of registration.
A record of medication was highlighted in Service User's care plans. Documentation was accurately recorded and reviewed on a regular basis.
The provider was aware of the notification process defined within the conditions of registration.
Service User's money and valuables could be deposited for safe keeping with appropriate records maintained by the provider.
Procedures were in place for the administration of medication to a Service User without the consent of that Service User or of a person duly authorised to consent on the Service User's behalf.
Areas for Development
There were no areas of development discussed for this standard.
National Care Standards
National Care Standard Number 2: Care Homes for Older People - Trial Visits
Strengths
The provider welcomed visits to the care home by prospective Service Users and their carers or family. There were opportunities for trial visits before taking up a permanent place. A full review was held within a six week period of moving in.
Home and assessment visits were carried out by staff and other agencies which usually included social services and health visitors. Prospective Service Users and their carers / family had access to information brochures and could speak with staff at any time.
Prospective Service Users could also access an independent advocate where required.
6/10 Areas for Development
There were no areas of development discussed for this standard.
National Care Standard Number 4: Care Homes for Older People - Your Environment
Strengths
A high level of hygiene and cleanliness was maintained throughout the premises. Areas and rooms were personalised as much as they could be and Service Users were encouraged to bring in personal items when moving into the care service. Service Users had access to a locked drawer or area where they could store personal belongings. The decor, furnishing and fittings gave a home-like appearance.
The furniture and equipment was kept in good condition and well maintained. All relevant health and safety requirements were promoted and supported by the provider. Records were accurately recorded.
Rooms were well ventilated, had adequate lighting and Service Users could control the temperature or get assistance from staff if required.
The accommodation was large enough to allow enough space for individual and group activities. There were various areas throughout the care home where Service Users could go if they wished a quiet area or visit the communal areas.
Service Users had access to a kitchen area and could have assistance from staff if required.
Areas for Development
One bathroom toilet could not be used as a grab rail was not fitted.
National Care Standard Number 8: Care Homes for Older People - Making Choices
Strengths
The aims and objectives set out in Service User's care plans were supported by staff and reviewed on a regular basis. Service Users said staff were very helpful and 'always there for you'. Relatives also spoke highly of staff and the service delivered. Service Users said there were many choices available and chose what they wanted to do or where they went. Favourable comments were also made about the food, menus and choices.
Feedback from Service Users was very positive; this was echoed by points made by relatives.
Where Service Users were less able to make informed decisions the staff encouraged carers and family to assist or where this was not possible Service Users could access an independent advocate. Some Service User's had their own room keys; other's relied on assistance from staff.
7/10 Staff were aware of the Adults with Incapacity Act ( Scotland ) 2000 and the implications.
Service Users meetings were held on a regular basis and a minute was available. The provider took an active part in supporting and enabling choices for Service Users. This was evidenced via comments made by Service Users and relatives during the inspection visit and examining documentation.
Areas for Development
There were no areas of development discussed for this standard.
National Care Standard Number 11: Short Breaks and Respite Care Services for Adults - Expressing Your Views
Strengths
Service Users said they were able to discuss their views or concerns with staff at anytime. Service Users said that they found staff very helpful and kind. Comments such as ' staff always have time for you' and ' I have a laugh with staff they're really good' was the general theme made by Service Users
A complaints system was in operation, which highlighted the local Care Commission office. Service Users said they knew who to speak with if they had any concerns or complaints. It was noted that Service Users could also access an advocacy service if required.
Service Users were able to play a part in the inspection process. Their views have been recorded throughout this inspection report. The Service Users stated they welcomed the opportunity to express their views about the service and staff. Relatives also spoke positively about the openness of the staff and said they could approach the manager or staff at anytime if they had any concerns.
A copy of the most recent Care Commission inspection report was available to look through.
Areas for Development
There were no areas of development discussed for this standard.
National Care Standard Number 15: Care Homes for Older People - Keeping Well - Medication
Strengths
Service Users were encouraged to manage their own medication unless there were specific legal reasons preventing this.
Service Users had their own lockable storage area or, if required, medication could be held by the provider in appropriate storage.
8/10 Service Users could order or collect their own prescriptions or obtain help from staff.
Medication records and storage facilities were examined during the inspection visit. Staff were trained in how to administer medication. Refresher training courses were also held on a regular basis. Prescribed medication was monitored on a regular basis, with and on behalf of the Service User. Records examined were accurate and up to date.
Where required, support from community medical service was available. Service Users and staff said the local health centre staff were very helpful and supportive.
The provider had a policy and procedure if medication went missing and a procedure if Service Users were unable to give consent.
Areas for Development
It was noted during the inspection that the 'sharps' disposal bucket was full and without a lid.
9/10 Enforcement There was no enforcement action necessary as a result of this inspection visit.
Other Information The provider had appropriate insurance and public liability. Valid until 31 March 2006.
Highlands and Islands Fire Services had carried out an inspection visit which recommended certain actions to be taken. The provider is required to update the Care Commission on which recommendations have been completed and an action plan detailing the date of completion for outstanding work.
Requirements Requirement 1. The provider is required to update the Care Commission on which recommendations have been completed and an action plan detailing the date of completion for outstanding work. Timescale for implementation: Within two months of receipt of this inspection report. SSI 114 Regulation 10 Fitness of Premises.
Recommendations Recommendation 1. Appropriate action should be taken to install the required aid in the bathroom area. National Care Standard Care Homes for Older People 4. Your Environment.
Recommendation 2. Care plans could be further developed and enhanced to note unmet need. SSI 114 Regulation 5 (2) Personal Plans.
Recommendation 3. Care plans could be further enhanced to record the views and activities of Service Users. SSI 114 Regulation 9(2) Personal Plans.
Recommendation 4. The provider should take appropriate action in line with best practice to ensure sharps disposal are emptied on a regular basis. National Care Standard - Care Homes for Older People 15. Keeping Well Medication.
Allan Barker Care Commission Officer
10/10