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Inspection on 21/11/05 for 21 Fairfield Close

Also see our care home review for 21 Fairfield Close for more information

This inspection was carried out on 21st November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The organisational skills of the management are excellent, as evidenced in the comprehensive documentation maintained at the home. Good lines of communication ensure that everyone has the relevant information, in an appropriate format, to enable informed decisions to be made. The home is well maintained, and it is comfortable and secure. The needs of service users are anticipated, and responded to appropriately by staff, and a natural affinity is evident. The individuality of each service user is recognised, and the commitment of staff to their role in supporting and enabling service users is commendable. Staff work as a team, and they also `fight` for the rights of service users when necessary. High standards and values are maintained.

What has improved since the last inspection?

The admissions procedure has been implemented appropriately, both for a planned admission and also with an emergency. Staff have used the opportunity to concentrate on developing relationships with the new service users, to relieve the sadness caused by the deaths of two former residents. New staff have been welcomed to the team, and training courses continue to be organised. Some redecoration has been undertaken in parts of the home, and the garden has been greatly improved.

What the care home could do better:

There is an obvious commitment from the management of the home, to the ongoing improvement and development of the service, but staff should be continually aware that they need to monitor the possibility of becoming complacent. The management need to ensure that the staffing establishment is adequate for the assessed needs of service users at all times, to eliminate the need for agency staff to be used.

CARE HOME ADULTS 18-65 Fairfield Close, 21 21 Fairfield Close Worcester Worcestershire WR4 9TX Lead Inspector R McGorman Unannounced Inspection 21st November 2005 10:00 Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 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 Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 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 Adults 18-65. 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. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fairfield Close, 21 Address 21 Fairfield Close Worcester Worcestershire WR4 9TX 01905 616527 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) New Era Housing Association Limited Mrs Jeanette Mary McAllister Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. This service is primarily for people under 65 years of age with a learning disability. The Home may also accommodate a maximum of two named people over 65 years of age with a learning disability. The Home may also accommodate one named person under 65 years of age with an additional physical disability. The Home may also accommodate one named person over 65 years of age with an additional physical disability 22nd July 2005 Date of last inspection Brief Description of the Service: 21, Fairfield Close is registered to provide residential care for up to five adults who experience a learning disability, who may have a physical disability, and whose needs are diverse. The premises is a large, detached bungalow, situated in a residential area on the outskirts of Worcester, approximately a mile from the City of Worcester, with easy access to public transport and a range of amenities and facilities. The home is owned and run by the New Era Housing Association Ltd., and is part of The New Dimensions Group, which, as the parent Company, provides strategic direction and a range of functional support services. The stated purpose of the organisation is, to work with people with learning difficulties, supporting them to make choices and to exercise control over their lives, and the main aim of the home is, to deliver a person-centred response to the needs and aspirations of the people we support. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this routine unannounced inspection was to follow up previous requirements and recommendations, and to monitor the care provision at 21, Fairfield Close, Worcester, in relation to the stated aims and objectives of the home. The inspection took approximately 3 hours, when some time was spent with service users, and also talking with staff, who are all extremely positive about what it is like to work at 21, Fairfield Close. The care records of service users were inspected, and discussions held with the manager and staff about the content, as service users have limited verbal communication. The records kept in respect of the maintenance of equipment, and safe working practices were also seen. What the service does well: The organisational skills of the management are excellent, as evidenced in the comprehensive documentation maintained at the home. Good lines of communication ensure that everyone has the relevant information, in an appropriate format, to enable informed decisions to be made. The home is well maintained, and it is comfortable and secure. The needs of service users are anticipated, and responded to appropriately by staff, and a natural affinity is evident. The individuality of each service user is recognised, and the commitment of staff to their role in supporting and enabling service users is commendable. Staff work as a team, and they also ‘fight’ for the rights of service users when necessary. High standards and values are maintained. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: 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. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 & 5 Appropriate documentation is in place to enable prospective service users to make an informed decision about their future care needs. The admissions procedure is followed in detail, and all proposed admissions to the home are usually planned very thoroughly, over several weeks, to ensure an appropriate decision is made, both by the home and the service user. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 9 EVIDENCE: A Statement of Purpose has been produced, which together with the Service Users Guide, provides detailed information for residents and their families, on which to base decisions about their future care needs. The documentation is produced in an appropriate format if needed, and the Service Users Guide contains numerous photographs. Copies of these documents have been submitted to the Commission. The admission procedure includes extensive assessment by staff from the home, and a Community Care Assessment is undertaken by a social worker. A gradual introduction is made to the home following the initial referral, and a place is only offered if it seems likely that a suitable service can be provided for the prospective service user. Admission is agreed on a trial basis initially. There have been two recent new admissions to the home, only one of which was planned, but there is documentary evidence that the appropriate procedures were followed on both occasions. A statement of the terms and conditions of residence is provided for each service user. The details of these documents are discussed with each individual, and their family, or representative, and a contract is provided for each service user by the placing authority. The positive interactions observed during the course of the inspection between staff and service users, confirmed that staff are competent in the delivery of appropriate care, and are able to meet the differing needs of service users, who also have limited verbal communication skills. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 The service users plan of care is based on the initial assessment, which clearly identifies their assessed needs, and how these will be met. Service users living at the home are supported in making choices in all areas of their lives, although limitations are imposed by bureaucratic external agencies, over which staff have no control. Risk management strategies enable a responsible approach to the risks associated with the various activities of daily living. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 11 EVIDENCE: An individual plan of care is produced for each service user, based on the initial assessment undertaken during the admission process. The plans are very comprehensive, detailing the specific needs of service users and how these are to be met. The needs and individual preferences of every service user living at 21, Fairfield Close, are identified as far as possible, and their participation in the daily life of the home, is constantly encouraged. Risk assessments are completed, in relation to the premises, to the activities undertaken, and any restrictions imposed, and also in respect of every aspect of the life of each service user. The records of service users seen during the inspection, confirmed that this documentation is completed and maintained up to date, and to a high standard. Service users are not able to manage their own financial affairs, therefore staff provide the support to access accounts in the bank or building society. The care manager explained that it is almost impossible to open a new account, and this limits the autonomy of service users still further. In addition, dealings with various benefits agencies are also difficult, owing to the bureaucratic minefield that has to be negotiated. Further consultation with the relevant departments is currently being sought. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14,16 & 17 The opportunities made available to service users enable them to live as fulfilling a life as possible. The manner in which support is provided by staff ensures that the rights of service users are respected and their independence is promoted. There is a flexible approach to the provision of a healthy diet, and services users are encouraged to decide what to eat and when. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 13 EVIDENCE: Service users living at the home are encouraged to follow an ‘ordinary’ life style as far as possible, by using the same facilities as other members of the community, and being involved in a range of leisure activities. Social activities are available, and these may be undertaken in-house or in the community, and they may be group or individual arrangements, but they are varied and flexible, and reflect the preferences of each service user. Limited communication skills preclude involvement in paid employment or educational opportunities, although one service user regularly attends a local cookery session. The arrangements regarding the provision of food reflect the preferences of each service user, and a list of all likes and dislikes is made. General food stocks for the home are purchased each week, from which service users can choose, or an alternative can always be provided. Meals are discussed with everyone individually, and although service users are not always able to express their specific requirements, it is made very clear if something is not wanted. There may be four different meals, all provided at various times, although lunch is a light snack and the main meal is usually taken in the evening. Healthy eating is encouraged, and a record maintained of the food provided. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 & 21 Procedures are in place to ensure that the personal and health care needs of service users are appropriately met. The systems in place for the administration of medication ensure that the health of service users is promoted. Training for staff in regard to the development of dementia illness, will increase their awareness and enable the appropriate care to be provided. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 15 EVIDENCE: The personal and healthcare needs of service users are well documented, and there is evidence to show how staff understand and respond to them in an appropriate way. A talk on MRSA has been given to staff recently, by the Manager of the Infection Control Team in Worcester. Medication arrangements at the home are satisfactory. The Medication Administration Records are being maintained to a high standard. Following the recent death of a service user, issues relating to the ageing, illness and death of a service user, have been addressed by the management and staff at the home. The need for training to be provided, to increase the awareness of staff in relation to the care of a service user with dementia, was discussed with the Care manager. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 A satisfactory complaints procedure is in place at the home, and enables everyone to express any concerns, views, opinions, and compliments. EVIDENCE: These standards were not inspected in detail, but were met previously. A clear procedure for the investigation of complaints has been produced and any issues are dealt with immediately. The document has been produced in a format that is understandable to service users. There have been no complaints to the home, since the last inspection, although the repeated concerns of a relative of one service user were discussed. There is evidence to show that the responses made by staff at the home are appropriate. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,28 & 30 The premises are very suitable for their purpose. They are comfortable and clean, and ensure as far as possible that the safety and wellbeing of service users is promoted. The standard of the accommodation is excellent. The décor and furnishings are in good condition, and provide service users with an attractive and homely place to live. The location of the house is convenient to local services and facilities, and the layout provides adequate communal space for the needs of service users. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 18 EVIDENCE: The premises at 21 Fairfield Close is a large detached, purpose built bungalow, which is maintained to a satisfactory standard, and is suitable for its purpose. The communal areas of the home are spacious and airy, nicely decorated and comfortably furnished. Sensory equipment is provided for the benefit of service users. There is a kitchen/diner and two lounges, one with a door to enable access to the patio. The garden area to the rear of the property has been given some attention recently, although its potential is limited. The addition of pots and tubs for flowers has greatly improved the appearance of the patio area. There are five single occupancy bedrooms for service users, which are furnished to reflect the personality of their occupants, and some have sensory equipment, specific to the needs of the individual service user. One bedroom has been redecorated recently, with the wallpaper and colour scheme chosen by the service user. There are no outstanding requirements following the last visit of the Environmental Health officer, earlier in the year. The home has not received a recent visit from the Fire Safety Officer. The Fire Log Book was seen, and the appropriate checks have been undertaken with the required frequency. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 & 35 The management support and supervision given to staff, enables a clear understanding of their roles and responsibilities, and ensures the promotion of the aims and objectives of the home. The extensive training programme available to staff ensures that they are competent in their work, and therefore able to provide appropriate care and support to service users. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 20 EVIDENCE: The staffing arrangements at the home were not inspected in detail on this occasion, although some aspects were considered. New Era provides relevant information for staff on joining the organisation, and also keeps them updated on new developments and any changes that take place. Each member of staff is given a Welcome Pack that contains details about the organisation, and its aims and objectives, an Employee Handbook that provides information about terms and conditions of employment and policies and procedures, and an Induction Checklist covering the first three months of employment. The rotas indicate that staffing levels are satisfactory, ensuring many planned activities are undertaken with service users. There have been some staff changes in recent months, and this has necessitated the use of agency staff, although these are usually known to the home, and therefore some continuity of care is maintained. A training programme is in place at the home that includes Induction and Foundation training, the Learning Disability Award Framework (LDAF) accredited training, and the NVQ training. The training needs of staff are regularly reviewed, and care related courses are attended. A training record is maintained in respect of each member of staff. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,40,41 & 43 The management arrangements at 21 Fairfield Close are satisfactory, and staff and service users benefit from the positive leadership, and the person centred approach to the care they receive. The health, safety and welfare of service users is promoted and protected in respect of all safe working practices. The support provided to staff by the area manager, ensures the promotion of the aims and objectives of the home. The policies and procedures, and records maintained at the home, comply with legislative requirements and therefore help to safeguard the rights of service users. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 22 EVIDENCE: The Care Manager, Ms Jeanette McAllister has achieved the Registered Managers Award and the NVQ Level 4 qualification. She is also a NVQ Assessor. In addition she attends various care related training courses and ensures she is kept informed of the various developments relating to the care of people with a learning disability. The manager has many years experience working with this client group and has good communication skills, and a clear understanding of her role and responsibilities. The positive interactions observed between staff and service users are pleasing to observe. There is evidence of effective person centred care being delivered, and the home is being managed in an open and transparent manner. The records checked during the inspection have been completed to a satisfactory standard. Regular maintenance and servicing of equipment is done, and temperature checks are recorded. The accident records were seen to be in order, and Notifications under Regulation 37 are made to the Commission, when appropriate. Policies and procedures are produced by the Organisation, and staff confirmed they are familiar with the content. Specifically, an extensive health and safety policy and procedure is in place, and the Company employs an officer to advise on health and safety matters. Risk assessments in respect of all safe working practices are completed. A Business Plan is produced by the Organisation, which considers proposals for the next 5 years, and covers all aspects of the work of the New Dimensions Group. A copy of the Plan has been produced specifically for service users. Appropriate insurance cover is in place in respect of the business and the property. Regulation 26 reports are submitted to the Commission on a regular basis. Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X 3 X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fairfield Close, 21 Score X X 3 3 Standard No 37 38 39 40 41 42 43 Score 3 X X 3 3 X 3 DS0000018652.V262155.R01.S.doc Version 5.0 Page 24 YES Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action 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 YA21 Good Practice Recommendations Consideration should be given to the provision of dementia training for staff working at the home Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 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 Fairfield Close, 21 DS0000018652.V262155.R01.S.doc Version 5.0 Page 26 - 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. 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