Inspection on 24/11/09 for Fairlawn

This is the latest available inspection report for this service, carried out on 24th November 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fairlawn 21/10/08

Fairlawn 22/10/07

Fairlawn 14/03/07

Fairlawn 20/12/05

Fairlawn 01/07/05

Fairlawn 08/12/04

Fairlawn 19/08/04

Similar services:

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Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

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Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Fairlawn 327 Queens Road Maidstone Kent ME16 0ET     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Wendy Mills     Date: 2 4 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 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 27 Information about the care home Name of care home: Address: Fairlawn 327 Queens Road Maidstone Kent ME16 0ET 01622751620 01622692161 fairlawnreshome@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Michael Andrew Lawrence,Mrs Mary Alexandra Lawrence care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 26. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Fairlawn provides residential care and support for up to twenty-six older people. The home is a detached property with accommodation on two floors. There is plenty of communual space and a summer house in the garden. There are twenty-five single bedrooms and one double room. The majority of bedrooms have en-suite facilities. The remainder have hand basins and each room has a call bell system with two call points. There is a television point in each of the bedrooms. Each room has the potential for individual telephone lines to be installed at the request of the service user and personal phone bills from a service supply company sent direct. Care Homes for Older People Page 4 of 27 Over 65 26 0 2 1 1 0 2 0 0 8 Brief description of the care home Outside the home has a large and pleasant garden to the rear and a good sized parking area to the front. In addition there are no current restrictions to on street parking near the home. The home is situated in a quiet residential area close to Maidstone town centre. There are good public transport links from Maidstone to London and the coast. The town centre of Maidstone provides a large variety of shops, restaurants, pubs and leisure facilities as well as places of worship for a number of different religions. The fees range from £335.00 to £510.00 per week. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This visit formed part of the annual inspection proceed of the Care Quality Commission under the Care Standards Act. This report uses information gathered before this visit and evidence gathered during this visit. The evidence we gathered before the visit includes information that the home is required to give us such as the Annual Quality Assurance Assessment and notifications of significant events that have occurred that adversely impact on the lives of the people who use this service. This evidence is then used to make a judgement about the quality rating for the service. During this visit we spoke to four of the people who use this service, two members of staff and the registered manager in private. We examined important documentation such as care plans, staff files and training records. We made a tour of the home and used direct and indirect observation throughout the time we were in the home. The people we spoke to said that they are happy living in the home and that the care Care Homes for Older People Page 6 of 27 they receive is very good. they also told us that the environment is pleasant and the food delicious. They also told us that they like to refer to themselves as residents in the home. therefore this is the term that is used to refer to then throughout this report. The registered manger, the staff and the residents are thanked for the welcome they gave and for their help throughout this visit. The quality rating for this service is 2 Stars. This means that the people who use this service experience good outcomes in all aspects of their care. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. 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 8 of 27 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 9 of 27 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. The home gives prospective service users and their supporters good information so that they can make an informed decision about moving into the home. Clearer details should be contained in contracts for existing residents when there are changes in care needs. Thorough pre-admission assessments are made to ensure that only those people whose needs can be met and who are suitable for the home are offered a place there. Evidence: The Statement of Purpose and the Service User Guide have been updated since the last inspection. They contain good information about the home that can help prospective residents and their supporters make a decision about moving into the home. There have only been a few admissions since the last inspection. Inspection of the Care Homes for Older People Page 10 of 27 Evidence: care plans of the most recently admitted residents showed that good pre-admission assessments were made. Likes and dislikes, health and care needs and cultural and religious needs were all identified and well documented. We found that the care needs of some existing residents had increased. The home had altered the terms of some of the contracts of some of these residents without being specific about the additional care needs for each individual and how these needs are now being met. The home should review individual contracts to ensure they tell the residents and their supporters exactly why the terms of those contracts have changed so that the additional increase in fees are properly justified. The home does not offer intermediate care. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home positively promotes the health and welfare of the residents in a way that protects their privacy and dignity. Evidence: Four care plans were examined in detail. Care plans are important documents because they are one of the means by which the residents and their supporters can tell that their care needs and wishes have been recorded and that the way those needs will be met are described in detail. In addition, they are an important source of reference for staff who must ensure that care is given in a consistent manner in line with best practice. Care plans can also be useful in helping to inform the decision making process for people with failing mental capacity. The care plans contain good initial assessments of need and are up to date and in order. A few entries were found to be unsigned and some were undated. This seems to be a sporadic problem and most entries were signed and dated properly. There was good evidence that local healthcare appointments and hospital Care Homes for Older People Page 12 of 27 Evidence: appointments are made and kept and that the advice given by visiting health care professionals is recorded and acted upon. The registered manager has undertaken a phlebotomy course so that blood tests can be carried out more quickly. One section of the care plans deals with ongoing needs. These needs are recorded under a number of headings, for example, personal care, nutrition, vision and hearing. Whilst staff have been diligent in completing these sections and there are clear aims and objectives, the way in which the aims and objectives are described lacks detail. For example, an entry might say, Assist with personal care, but does not state how this assistance is to be given. In addition, there is a column in the care plans for writing an evaluation of the care interventions but this has not been used correctly. Entries simply repeat the already stated aims and objectives. The registered manager and staff should review the way they are using the care planning documentation to ensure that entries help to inform the care planning process. The care plans contain a great deal of useful information and there was good evidence to show that these are reviewed by senior staff on a regular basis. However, we were told that care staff felt that they were having to tackle too much paperwork and were not very involved in the maintenance of care plans. We found little evidence to show that staff are using the care plans on a daily basis to inform their practice. This may be because they are overwhelmed by the complexities of a system that gives very good information but requires careful tracking from one section to another. The home should consider creating a simplified summary of each care plan that describes daily needs and is more accessible to both residents and care staff. We observed staff to be very respectful of the wishes of the residents and to treat them with kindness and patience. The residents we spoke to confirmed this and praised the staff for their kindness. There are sound policies for the management and administration of medicines in the home. Storage of medicines is safe and secure and there are facilities for storage of controlled drugs if necessary. There have been no recent medication errors and the Medicines Administration Record (MAR) is well maintained and up to date. The home recently provided end of life care for one resident. They worked closely with the palliate care teams and the district nurses to ensure that excellent support was given to allow a dignified death. the home received messages of thanks for the care they provided at this time. Care Homes for Older People Page 13 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a range of meaningful and varied activities to help residents maintain the independence and interest of the residents. Evidence: There is an activities co-ordinator who works in the home. The activities programme includes a weekly quiz, reminiscence, a monthly themed meal and baking. The home also holds a number of communal events such as garden parties and barbeques in the summer and Halloween and Christmas parties later in in the year. These events are very popular and collages made up from photographs of a variety of these events are hung in the hallways of the home. There is a programme of visiting entertainers and the residents are consulted on those that they wish to be booked again. There are regular residents meetings that are chaired by a resident with the home providing support to make notes at these meetings. Religious and cultural needs are identified in the care plans. Members of a local church visit to provide services in the home for who wish to attend. Visitors are made welcome to the home and can visit at any reasonable time. Care Homes for Older People Page 14 of 27 Evidence: The food at the home is very good. Residents and staff say that the food is really lovely. The home has managed to maintain consistency in food standards despite there having been three changes of cook since the last inspection. The dining room is pleasant and airy and the tables are laid attractively with napkins and flowers. Special diets are catered for and there is always a good supply of fresh fruit and vegetables in the home. Care Homes for Older People Page 15 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home listens to the views of the residents and acts upon them but more diligence is required when putting safeguarding procedures into practice. Evidence: There are regular residents meetings and staff meetings. The residents meetings are chaired by a resident and the home provides an administrator to take notes at these meetings. The registered manager does not attend but addresses any concerns raised at a later time. This gives the residents more freedom to openly express their views. Residents told us that their views are sought and listened to and that they feel happy in talking to the staff or the registered manger about any concerns. They said that they feel confident that she would act appropriately if there were any concerns. The home has sound policies and procedures for handling concerns and complaints. However, a recent safeguarding investigation into a serious alert found that the strict procedures for dealing with this alert were not followed correctly. The incident led to a Level three safeguarding alert being placed on the home. This meant that no new socially funded residents could be admitted whilst the alert was in place. The home also voluntarily suspended admissions of privately funded residents. This safeguarding alert had now been lifted. However, we found evidence to suggest that the registered provider and the registered manager have learned important lessons from this experience. Care Homes for Older People Page 16 of 27 Evidence: The staff we spoke to told us that they had received safeguarding training as part of their induction when they started work at the home. Senior staff have also received stage two safeguarding training recently. The registered manager told us that staff receive updates of safeguarding training on a regular basis. The staff spoken to were all clear about their responsibilities in respect of reporting any suspicions or allegations of abuse of residents to the manager. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is well maintained and very clean. This gives the residents a pleasant and homely place in which to live. Evidence: A tour of the home was made. The home is well maintained, very clean and odourfree. There is plenty of communal space with a large lounge and separate dining room. All but seven bedrooms are on the ground floor and all have en suite facilities. Outside there are well kept gardens with a large sun lounge that is situated a few yards from the house. The garden has been improved since the last inspection with the raised beds having been cleared. The home has contacted the Kent Wildlife Trust for advice about creating a wildlife area in part of the garden. There is an improvement plan for the environment. The home is well furnished and decorated and has a relaxed and homely atmosphere. Since the last inspection a new toilet flush handles have been fitted, following feedback from residents that these handles would be easier to use. At the time of this visit radiator covers were being fitted to all radiators following an incident where a resident received a burn, following a fall. The homes Annual Quality Assurance Assessment (AQAA) told us that all rooms are decorated when they become vacant. When new residents are admitted they are given Care Homes for Older People Page 18 of 27 Evidence: a choice of colour schemes and soft furnishings. The seven bedrooms on the first floor are accessed via a stairway that is fitted with a stair lift. Recently there have been several occasions when the stair lift has been either not working or unreliable but a new lift was due to be fitted on the day following this visit. On the day of this visit the stair lift was functioning intermittently but we have subsequently been told that a new lift has now been fitted and is working well. There are sound infection control measures in place and a new and more sophisticated washing machine has been installed to provide better protection from cross infection. Care Homes for Older People Page 19 of 27 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. Staffing levels, staff training and recruitment practice are all good. This means that the residents are cared for by a well qualified and carefully vetted staff team. Evidence: The home has good staffing levels but there has been a significant turnover of staff and long term staff sickness over the past year. A new team leader has been appointed and was spoken to during this visit. She demonstrated a good understanding of best practice in care. We spoke to two members of staff in private to seek their views on the home and the way it supports staff. Both told us that there is a good induction programme and plenty of support from the other staff and the manager. One said, This is my first job in care and its been wonderful. I have had plenty of training and lots of help from everyone, we all work as a team - its the best job Ive ever had. Indirect observation of staff interaction with residents showed that residents are treated with kindness and respect. The residents we spoke to said that the staff are kind and caring. The homes Annual Quality Assurance Assessment (AQAA) confirmed that over half the staff hold the National Vocational Qualification (NVQ) at level two or above and that Care Homes for Older People Page 20 of 27 Evidence: they are working toward all staff holding an NVQ award. Staff told us that there is plenty of training going on. The home has a training matrix and regular audits of staff training are carried out by the registered manager. The AQAA also confirmed that the home is fully staff and that recruitment practice meets the requirements. it told us that all staff are checked out with the Criminal Records Bureau (CRB) and that written references are sought for all prospective staff. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the best interests of the people who use the service. Evidence: The manager holds the National Vocational Award at level four (NVQ IV) in management and care and the Registered Manager Award (RMA) and continues to maintain her continuing professional development by attending relevant course. She has recently attended a course in phlebotomy so that blood tests can be carried out more quickly. She is now registered with the Commission as the manager for the home. The registered providers are now semi-retired but still keep a hands on approach to the running of the home. The AQAA told us that there are regular management meetings that are minuted. The registered manager confirmed this and told us that she meets on a weekly basis with the registered provider. She told us that she is well supported and that, although she is expected to manage within the financial budget, this budget is not restrictive. Care Homes for Older People Page 22 of 27 Evidence: There are sound quality assurance systems in place. there is a monthly residents meeting and an annual quality assurance questionnaire that is sent out to residents and their supporters. The AQAA told us that feedback from residents meetings is acted upon as soon as possible following receipt of comments and we found evidence to support this during our visit. For example, residents give regular feedback about visiting entertainers and the home either continues to book these, if they are to the residents liking, or do not book then again if they have not been well received. Several residents still choose to manage their own personal finances, others are helped to do so by their families and some by advocates. If the residents seek assistance with the management of their personal monies then these are kept safely and securely but the home and properly accounted for. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 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 18 13 13(6) The registered person shall make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. the home did not comply with the strict safeguarding policies and procedures in that the Kent and Medway safeguarding polices and procedures were not adhered to following a safeguarding incident. This hampered the investigation of the safeguarding team. The safeguarding policies and procedures to be reviewed and the registered provider to ensure that these are in line with those of Kent and Medway Social Services. 29/01/2010 Care Homes for Older People Page 25 of 27 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 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 27 of 27 - 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!