CARE HOME ADULTS 18-65
Fair View Croft Mitchell Troon Camborne Cornwall TR14 9JH Lead Inspector
Paul Freeman Announced 8 August 2005 14:00 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 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 Stationary 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. Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Fair View Address Croft Mitchell Troon Camborne Cornwall TR14 9JH 01209 831662 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Elaine Muriel Stuart Kearney N/a Care Home 2 Category(ies) of Learning Disability (2) registration, with number of places Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 8 February 2005 Brief Description of the Service: Fairview is a care home that is registered to provide care for two younger adults who experience learning disabilites. It is owned by Mr and Mrs Kearney and is their principal home. Mrs Kearney is the registered person and manages and runs the home with the assistance of her husband. The care provided is of a family style. The home is located in a rural setting on the outskirts of the village of Troon and within easy access to the town of Camborne where a wide range of amenities are available.The home was first registered in 2002 and is a large two storey detached property with outbuildings.The two residents bedrooms are single but ensuite facilities are not provided. The honme has limitations in regard to disability access and is not suitable for a wheelchair user. Extensive communial space is located on the ground and the residents also have own dedicated sitting room. One bedroom is located on the ground floor and one on the first floor.The home has extensive grounds and Mr and Mrs Kearney have a range of pets within the home and keep horses in a stable at the rear of the property. Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The planned unannounced inspection took place over two afternoons 8 August and 9 August 2005. The opportunity was taken to tour the premises, speak with the resident and Mr and Mrs Kearney as well as looking at the records and documents about the care home. The Commission also received written comments from a resident, a relative and the provider before the inspection occurred. This is a well run care home that has good standards of care and residents are fully consulted about all aspects of service provision. What the service does well:
Prospective residents and their relatives or representatives are invited to visit the home to help them decide if it is a suitable setting to live. The visiting arrangements are flexible and reflect the prospective residents preference and choice. Each resident has a care plan that outlines the care and support they require. The plans are regularly reviewed with the resident to make sure their needs are being met and their choices and preferences accommodated. Residents are also encouraged and supported to make their own decisions about daily life. Any situations that could place the resident at risk are assessed and where necessary additional care or support are provided. This helps to make sure that every reasonable step us taken to protect the person concerned. Residents are provided with regular opportunities to participate in the local community and activities of their choice. Flexible visiting arrangements are in place at the care home and the providers positively welcome and encourage family links and relationships. Residents’ health needs are well managed and health services are promptly accessed when required. Arrangements are made for residents to have annual health checks to make sure their health needs are well met. The providers also take every reasonable step to ensure that residents receive the health services they are entitled. Medicines at the home are well managed and the providers have undertaken appropriate training in the administration of medication. The providers or the Commission over the last year has received no complaints. Satisfactory arrangements are in place to deal with any complaints or concerns and the providers regularly check with residents and their relatives or representatives if they have any issues of concern. Residents and relatives indicated they have confidence in the providers and also feel confidant that any issues raised would be dealt with promptly and in a satisfactory manner. A homely environment is provided for residents in the principle home of the providers. The environment is well maintained and decorated to a good standard. A regular programme of maintenance and redecoration is in place.
Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 6 Residents’ bedrooms are situated on the ground and first floors. Toilet facilities are near to both bedrooms and a bathroom is situated on the ground floor. A resident and a relative indicated they are very satisfied with the accommodation provided. A good standard of care and support is provided by Mr and Mrs Kearney in a flexible manner that meets the needs, choices and preferences of the residents. A resident and their relative indicated they are very satisfied with the way in which the providers run the home. The providers regularly consult with them about all aspects of the services and facilities provided and their views are taken into account. A good standard of records are maintained that detail the care and support required and the daily events that occur at the home. There are no barriers to residents accessing their records. 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. Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 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 standard(s) 2 and 4. Satisfactory arrangements are in place to assess the needs of prospective residents to make sure the care home is able to provide the care and support required. EVIDENCE: No new residents have been admitted to the care home since the last inspection on 8 February 2005. The providers currently have one vacancy and have improved the format for recording their assessment of prospective residents needs, preferences and choices. The assessment will take account of the views of relatives or representatives and any professionals involved with the prospective resident. When completed it will assist the providers to satisfy themselves they are able to meet the needs of the person concerned. It is recommended the assessment also takes account of any nightime arrangements or needs the individual may have. Prospective residents and their relatives or representatives are invited to visit the home to help them decide if it is a suitable place to reside. The visitor’s arrangements are flexible and according to the prospective residents preference and choice. Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 6, 7 and 9. The providers have a good understanding of residents needs and with the residents have established satisfactory care plans that detail the care and support the individual needs. EVIDENCE: Each resident has a care plan that details their needs and the support and care required. Given the family style care provided sufficient information is included in the care plan to summarise the care needed. The care plan is reviewed with residents on a regular basis to make sure their needs are met and the services and facilities provided are satisfactory. Residents are aware of their care plans and indicated they are satisfied with the support available. Residents are provided with a range of opportunities to make decisions about their lives and on a day to day basis. Where a resident experiences difficulty in communicating the providers establish additional methods to help the person express their views and make decisions. Satisfactory arrangements are in place to manage any risks that occur within the environment. If any situations arise that could potentially compromise the Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 10 safety and wellbeing of a resident a risk assessment is completed and a suitable action plan established. Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 13 and 15 The arrangements for contact with relatives are good and visitors are welcomed at the home. Links with the community are also good and residents are able to regularly participate in a range of community activities of their choice. EVIDENCE: The records show the resident has regular opportunities to participate in a range of activities in the local community on a regular basis. The providers actively support the resident outside of the home. The resident indicated they were very happy about their community participation and the range of activities they undertake. The records also show the providers have a flexible approach to visitors and are committed to helping residents maintain contact with their relatives. Family members are welcomed at the home and there are no barriers to resident visiting family or friends’ providing it is safe to do so. The resident indicated they regularly have contact with their family at the family and care homes. Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 12 Relatives commented they were very satisfied with the care and support provided and said the resident was “very happy” at the care home. Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19 and 20 The health needs of residents are well met with evidence of good multidisciplinary working taking place when required. Medicines are well managed and promote good health. EVIDENCE: The records show that health services are promptly accessed when required by residents. On the day of the inspection a resident was taken to visit their general practitioner given they were experiencing a minor ailment. The providers also take appropriate steps to make sure that residents access the health services they are entitled. Annual health checks are also arranged for residents to make sure that all of their health needs are met. Satisfactory arrangements are in place to administer medication. The providers have undertaken suitable training in this area and medication is stored in a safe place. Good records are maintained and any medicines that are not required are disposed of in a safe manner. A satisfactory policy and procedure is also in place and residents are able to administer their own medicines when it is safe to do so. Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 22 The arrangements for dealing with complaints and concerns are satisfactory and residents and relatives are regularly consulted about any issues of concern they may have. EVIDENCE: No complaints have been made to the providers or the Commission following the last inspection on 8 February 2005. The providers have established a satisfactory policy and procedure for dealing with complaints. Where residents experience difficulties in communication the providers regularly check with them if they have any complaints or concerns in order that any issues can be dealt with promptly. The residents and their relatives indicated they have confidence the providers would deal with any complaints or concerns promptly and in a satisfactory manner. Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 15 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 standard(s) 24 and 30. The standard of the environment is good providing residents with a homely place to live. EVIDENCE: The residents reside in the principle home of the providers which is maintained to a good standard, offers a range of communal facilities and extensive grounds to the rear of the property. Residents have their own sitting room and have personalised this area. There are some limitations in respect of disability access and the environment would not be suitable for a person who requires a wheelchair. Toilets are located on both floors and a bathroom is situated on the ground floor. The laundry is located in an outbuilding and it is recommended that the flooring be improved. Both residents have single bedrooms. One is situated on the ground floor and the second on the first floor. Plans are being made for one of the bedrooms to be redecorated and certain furniture will also be replaced. The residents’ sitting room is also in the process of redecoration. Residents indicated satisfaction with accommodation provided and the evidence indicates the residents have been involved in the planning about redecoration and have chosen the new furniture.
Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 The providers are the principle carers and a good standard of care is provided in a flexible manner that meets the needs and preferences of residents. EVIDENCE: Mr and Mrs Kearney are the principle carers and no staff is employed at the care home. Family style care is provided to the residents and a resident and their relative indicated they are very satisfied with the care and support provided. Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 and 41. The home is well run and residents and their relatives or representatives are regularly consulted to make sure they are satisfied with the services and facilities provided. Good records are maintained to make sure residents needs, preferences and choices are met and they are not placed at risk. EVIDENCE: The providers run the home in an open manner and make every effort to consult and include the residents and their relatives or representatives. The home is well run and a relative indicated they are kept fully informed of events and are satisfied with the overall care provided. The records at the care home are maintained to a satisfactory standard and there are no barriers to residents accessing their records if they wish. The residents records detail the care and support they require and a daily record is also maintained that states the events of the day, any concerns or issues that have arisen and the action taken.
Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 18 Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 19 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 x 3 x 3 x Standard No 22 23
ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x x 3 x 3 x x Standard No 31 32 33 34 35 36 Score 3 x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Fair View Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 x x 3 x x D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 20 no 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. 1. 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. 2. Refer to Standard 2 30 Good Practice Recommendations The assessment of prospective services users should include their nightime needs. The laundry room should be provided with an impermeable floor covering. Fair View D52-D04 S9021 Fair View V231343 080805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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