Inspection on 20/10/08 for Fair Haven

This inspection was carried out on 20th October 2008.

CSCI found this care home to be providing an Adequate 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

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Fair Haven Fair Haven 102 Station Road Soham Ely Cambridgeshire CB7 5DZ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alison Hilton     Date: 2 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Fair Haven 102 Station Road Fair Haven Soham Ely Cambridgeshire CB7 5DZ 01353720916 01353624475 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Laura Ann McAleese Type of registration: Number of places registered: Mr Kanagasooriam Ravivaruman care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 19 The registered person may provide the following categories of service only: Care home only - Code 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 - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Fairhaven is a service for 19 older people some of whom have a diagnosis of dementia, and is situated in the town of Soham. The home is within easy access of the cities of Cambridge and Ely. Local resources are accessible for those who are able to go out independently. Members of care staff will escort people to the town where possible. Care Homes for Older People Page 4 of 24 Over 65 0 19 19 0 Brief description of the care home The registered manager is on maternity leave and the deputy manager is in charge until her return. The area manager is providing support to the home and staff. Accommodation at Fairhaven is on two levels, accessible by stairs or passenger lift. The majority of bedrooms are single, but there are some double bedrooms. The home is situated in a quiet road, with adequate parking and an enclosed back garden. On the same site is another residential service for three adults with learning difficulties. There are no shared facilities. Fees were confirmed as £395 - £424 per week. Extras are charged for hairdressing, chiropody and toiletries. The inspection report is available from the office at the home. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We, the Commission for Social Care Inspection (CSCI) carried out a key unannounced inspection of Fairhaven on Monday 20th October 2008 at 09:35 hrs using the Commissions methodology described below. This report makes judgments about the service based on the evidence we have gathered. This was the first inspection of the service under new ownership. Staff, people who live at the home and the deputy manager were spoken to. An Annual Quality Assurance Assessment (AQAA) was completed and returned to the Commission by the manager prior to this inspection. Care Homes for Older People Page 6 of 24 A number of records were seen, together with four staff personnel files and three files of people living in the home. There were eighteen people living in the home on the day of inspection and one bed was vacant. The deputy manager was present for the inspection, and the area manager was spoken to on the telephone at a later date. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 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 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have good information about the home so that they can make a decision as to whether the home is right for them. Evidence: There is a new statement of purpose and service user guide that gives people information they need to decide if the home can meet their needs. Deatils in the AQAA showed that comprehensive needs assessments are completed prior to any admission to the home together with reports from placing authorities. This was seen in the files inspected on the day. Care Homes for Older People Page 10 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The variable practice in recording medication does not ensure the health and wellbeing of people living in the home. Evidence: Three files were looked at as part of this inspection. They all had individual plans of care but there were areas that need to be improved. The area manager said that all files were being updated but the process was taking longer than expected due to her accident and the manager being on maternity leave. There were risk assessments on one file for dependency, falls, nutrition and tissue viability but these were not signed or dated. From the information on another file there should have been a nutritional risk assessment completed to ensure the well being of that person. People spoken to in the home were unclear if they had been involved in creating their care plans. Details in the AQAA showed that there is an intention to return to a key worker system so that individual members of staff take responsibility for the upkeep of care plans and undertake reviews. This has not yet been implemented. Care Homes for Older People Page 11 of 24 Evidence: The medication administration record (MAR) sheets were seen for two people living in the home. Staff must be consistent in the way they record refusal of medication. One staff member had used the correct notation of A but other staff had used F, which requires an explanation as it notes other as a reason for the medication not being administered, but this had not been done. Staff must record administered medication in the correct place. This was in relation to a medication supplied in a blister pack where two tablets had been given, however the recording of this had not been completed against that entry on the MAR sheet. Details of controlled drugs were seen and found to be correct. Medication is stored in appropriate facilities. Care Homes for Older People Page 12 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The limited choice of activities in the home means people do not have a range of opportunities to participate in stimulating and motivating activities. Evidence: Details in the AQAA showed that people living in the home have a choice of meals. Our observations confirmed this as well as talking to people living in the home. A new four week menu has been introduced and this provides greater choice, and includes the option of a cooked breakfast and two main choices at lunch and tea time. Home made cakes and puddings are provided. We observed a meal as it was prepared and served. People made their choice of meal and this, as well as the amount eaten, was recorded. Staff were available to serve the meal, which meant people did not have to wait and so the food was hot, however because all the staff were there it was slightly chaotic. People were asked about the food and they said it was good. On the main menu it showed that there was a choice between soup and fruit juice but in practice we did not observe this being offered. The mealtime was unhurried. Drinks were served through the day and one person said she was given drinks whenever she asked, and that included during the night. The cook said she had no overall responsibility for food budgets but was able to order as she wanted, sourcing local products. Care Homes for Older People Page 13 of 24 Evidence: The AQAA also showed that activities had improved but there is currently no activities co-ordinator and although staff have more time (as they no longer carry out domestic tasks) there is little in the way of organised activity. Staff do spend time with people and this is a positive experience for both parties. On the day of inspection we spoke to all the care staff on duty who said that more activities were taking place such as walks in the village, bingo and quizzes. The deputy manager confirmed that a minister comes once a week and someone who calls the bingo numbers. A hairdresser also calls regularly. A number of visitors were in the home during the inspection and they expressed their satisfaction with the home and said it was clean and well maintained. They also said they were made to feel welcome. We observed choice being offered in an appropriate way and staff spoken to had a good understanding of peoples needs. People spoken to did not feel their choices or preferences were restricted, but one person said there was a bathing rota, which denied them a real choice of when to bathe. The deputy manager said that anyone could have a bath when they wished, with the rota being a general guide, not a definitive list. Care Homes for Older People Page 14 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are formal processes to address complaints and concerns, and information is available to enable people to complain. Evidence: There is a complaints procedure in the home but it has not been tested as there had been no recent complaints. The Commission has received one concern about the service, which is addressed in the staffing area of this report. There have been no safeguarding issues brought to our attention. Staff have received training in protection of vulnerable adults (now called safeguarding) and whistleblowing; and they were able to demonstrate their knowledge to us during the inspection. Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a pleasant and homely environment which is well maintained. Evidence: Details in the AQAA showed that the home has a friendly and homely environment. Any maintenance issues are addressed quickly and the manager has health and safety policies in place. We walked round the home and spoke to people living there and staff. Staff said that equipment is supplied, when needed, by the new owners and that new furniture and carpets are going to be replaced. Staff said there was only one standing hoist and one other hoist but this was not enough. Service records for the hoists were seen. One door to the outside was blocked by furniture and wheelchairs, but the deputy manager said this was not a fire door. There are a number of domestic staff employed in the home who provide 60hrs of cleaning, laundry and ironing. Night care staff have responsibility to clean the lounges. All areas in the home were clean and free of odours. Staff confirmed they had completed training in infection control. There were aprons, disposable gloves and alcohol gel throughout the home. Toilets and bathrooms had soap dispensers and Care Homes for Older People Page 16 of 24 Evidence: paper towels. Domestic staff said they were responsible for doing the laundry, but care staff were observed putting washing in the machine. The new owners are planning to re site the laundry facilities, but we had concerns that the washing machines are in the same area as food is stored. There are no sluicing facilities and one member of staff said that soiled clothes were not always being washed at appropriate temperatures, although the machines have a pre wash cycle. The home was visited by the Environmental Health Service in February 2008 when a number of requirements were made. A follow up visit was made in May 2008 and a number of the requirements remained outstanding. Staff in the kitchen said they had not seen a copy of the report although the deputy manager said she had discussed areas with them. Care Homes for Older People Page 17 of 24 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. Staff receive the necessary training to ensure their practice is up to date to meet the needs of those living in the home. Evidence: Staff files seen as part of this inspection contained all the necessary documentation. We checked the files of four staff. These provided us with evidence that the home complete all the appropriate pre employment checks before staff work at the home. None of the files related to staff employed recently as there have been no new staff recruited. The acting manager confirmed that they had one vacant care post and were waiting for the criminal record bureau (CRB) check to come through. CRBs should be renewed as a matter of good practice. There was evidence of training but staff supervision has been minimal. There was no evidence of staff meetings being held although the deputy manager said there had been one since the new owners had taken over. This has left staff feeling that there is little communication between them and managers. Correction fluid must not be used on the staffing rota as this is a legal document. The rotas were checked and showed us that staff are being employed in sufficient numbers to meet the current needs of the people living in the home, but this must be kept Care Homes for Older People Page 18 of 24 Evidence: under review as needs can change. Some staffs hours and shift patterns have been changed to incorporate weekend work and slightly longer hours to meet the needs of those living in the home. Additional domestic and catering hours have been provided. The deputy manager said that the home does not currently have an activities coordinator, but staff do undertake some activities themselves as they do not have domestic chores. The registered manager and area manager are both off at the moment on maternity leave and sick leave respectively. The acting manager is being supported by the new provider through daily telephone contact. The administrator has left and administrative and maintenance tasks are now dealt with centrally. Staff meetings have not been held recently and any changes implemented, including the introduction of new polices and procedures and care plans are passed on through staff hand overs. We were told by staff that changes, such as the introduction of new menus, appeared to be a top down decision with little consultation with them or the people living in the home; although six staff said that most of the changes in the home had been positive. One such change was staff training. The new provider has used external training providers to refresh staffs training and uses work books to assess their skills and competence. Staff get paid for their time. There is a training matrix which showed the amount of training that has taken place in the last year. Most of the mandatory training was up to date and care staff had received dementia care training. Care Homes for Older People Page 19 of 24 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 temporary management arrangements (whilst the manager is on maternity leave) and support of the deputy have not been available as planned. The needs of those living in the home are being met but the quality of the service is not improving. Evidence: The AQAA showed that there are clear systems in place to ensure the efficient running of the home, including unannounced visits by the proprietor, training and supervision. Staff supervision, which up until the early part of the year, was being provided regularly has not been given. Some staff files showed that staff had not had supervision for six months or more. Fire and maintainance records were checked and were satisfactory. We asked to see an up to date fire risk assessment, and fire evacuation procedures we were told these were with the provider. The deputy manager confirmed that the fire risk assessment would be back in the home as soon as possible. The home has not been visited by the Care Homes for Older People Page 20 of 24 Evidence: fire safety officer to ensure compliance with changes in legislation, and we discussed this with the deputy manager. We were not shown any evidence that showed staff had been involved in evacuating the home, although staff were able to tell us about fire evacuation procedures. The deputy manager said that no money is held on behalf of any person living at the home, but a member of staff came to the office and asked for the money for someone in the home. It is understood that no money is generally held but the procedures for recording money coming into the home must be completed whenever it occurs to protect the staff and the person whose money it is. Care Homes for Older People Page 21 of 24 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 22 of 24 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 9 13 Staff must ensure the recording of administered medication is completed correctly. This is to ensure the health and wellbeing of people living in the home. 13/10/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The care plans and risk assessments need to be updated as soon as possible to ensure people who live in the home have their needs met. The procedure for recording money coming into the home must be completed whenever it occurs to ensure staff and the person whose money it is, are protected. Staff should receive appropriate supervision to ensure their practice is maintained and training needs discussed. 2 35 3 36 Care Homes for Older People Page 23 of 24 Helpline: 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 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 © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - 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!