Inspection on 11/02/06 for Fairburn

This inspection was carried out on 11th February 2006.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fairburn 22/10/06

Fairburn 10/09/05

Fairburn 20/03/05

Fairburn 05/01/05

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Fairburn 54 Kingsway Little Stoke South Glos BS34 6JW Lead Inspector Melanie Edwards Unannounced Inspection 11 February 2006 09:30 Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 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 Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 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. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Fairburn Address 54 Kingsway Little Stoke South Glos BS34 6JW 0117 9311069 0117 9311069 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) admin@aspectsandmilestones.org.uk Aspects and Milestones Trust Mrs Sarojini Subramanyan Care Home 8 Category(ies) of Learning disability (8), Physical disability (3) registration, with number of places Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate up to 8 persons aged 18 years and over with learning disabilities who are receiving nursing care and/or personal care only. Of the 8 persons accommodated up to 3 may also have specific nursing and/or Personal care needs arising from physical disability. Manager must be a RN on Part 5 or 14 of the NMC register Staffing notice dated 26/8/1999 applies Date of last inspection 10th September 2005 Brief Description of the Service: Fairburn is a care home operated by Aspects & Milestones Trust, to provide either respite nursing or residential care for up to eight adults aged between 18 - 64 years with learning difficulties. This can include up to 3 persons with physical disabilities accommodated on the ground floor. All service users admitted to the home have differing levels of learning and physical disability and the provision of respite care varies according to individual need. The home is situated in a residential location in Little Stoke and is close to local shops and amenities. It also has its own mini-bus to facilitate social and recreational activities. The home is a converted GP surgery, providing accommodation on two floors. This consists of six single and one double bedroom. Whilst none of the rooms have en-suite facilities, all have a wash hand basin. Communal areas include a lounge, dining room and conservatory, all of which are fully utilised. Bathrooms and toilets have been fitted with adaptations to meet the care needs of clients in the home. There is appropriate provision of equipment to assist staff and clients. However, many clients bring their own equipment into the home for the duration of their stay. The home is set in its own grounds and there is level access to the garden. Car parking is available, but this is limited within the homes own grounds. There is additional off road parking. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Part of the inspection was carried out on a Saturday as residents who stay at the Home attend day care services during the week. This enabled the inspector to meet residents. The second part of the inspection took place the following week. Please note that due to their disabilities, some residents cannot express their views verbally about the Home and their stay is for short breaks. In this report, the term ‘resident’ has been used to refer to people staying at the Home. As part of the inspection process, the inspector spent time sitting in the lounge observing residents being assisted staff. The registered manager, two care assistants and one registered nurse were consulted about their roles and responsibilities, training needs, and how they assist and support residents. A selection of records relating to the day-to-day running and management of the Home were inspected. A selection of resident’s care records and care plans were also reviewed. The environment was inspected. What the service does well: What has improved since the last inspection? What they could do better: Residents care plans must be reviewed and updated on a regular basis, to demonstrate resident’s needs are being monitored and reviewed. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 6 Residents would benefit if the Home carried out regular quality-monitoring audits of the care and service that is provided. Residents and their relatives need to be fully consulted about the Home to ensure their views are reflected in the overall running of the service. 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. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 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 Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 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 Prospective residents and their representatives are provided with the necessary information to make an informed choice about the Home. Also residents’ needs are met, and their individual assessment records support this. EVIDENCE: A copy of the service users guide to the Home was inspected to see what information is provided to residents and their representatives. The document contained a range of detailed, helpful information about life in the Home, the staffing structures and levels, and the service that is provided. There was information about daily life, as well as how they will be supported to meet needs while living at the Home. The document includes a range of colour photographs of the Home and surrounding community. This shows what type of service is provided, as well as the community facilities that are nearby. The information is also available in cassette tape format, for residents with differing needs. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 9 To find out how residents range of care needs are assessed, two assessment records were inspected .The assessments included information about each resident’s range of complex care needs. However assessments had not been formally reviewed or updated for over six months. Residents’ needs are assessed based on the idea of ‘person centred planning’ meaning staff will try and put the views and wishes of residents at the centre of all care provided. All the staff conveyed that they have a good understanding of residents needs. Residents were observed sitting in the lounge with staff. Residents and staff communicated in a warm and good-humoured way. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 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 Residents’ personal care needs are met, however this is only partly supported by their plans of care. Residents are well supported to take risks and make decisions about their life while at the Home, also there are safe systems in place for administering resident’s medication. EVIDENCE: Two residents care plans were inspected to monitor how the Home is meeting residents’ needs. There was a range of helpful and detailed information recorded about residents care needs. The care plans recorded in detail how residents’ needs are to be met while they stay at the Home. However residents care plans had not been regularly reviewed and updated. Care plans need to be regularly reviewed to demonstrate staff monitor their changing needs. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 11 Included with the residents care plans were risk assessments to support residents to maintain safety and minimise risks both in and out of the Home. Residents were also observed being supported by staff to go out for a drive into the community .On the second day of the inspection residents were being supported to either return home to their families or attend their day care activities. In discussion with the staff on duty they conveyed a sensitive approach as well as a good understanding of residents’ range of needs. Staff and residents were observed sitting in communal areas, and communicated with each other in a warm friendly manner. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 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): 11,13,17 Residents are supported to continue to be a part of the community whilst living in the Home. Also residents are supported and encouraged to take part in therapeutic activities and are offered a healthy and well balanced diet. EVIDENCE: Residents are supported during their stay to continue to attend the day care services that they go to when living in their own home. During the inspection, staff were seen spending time talking to residents. On the first day of the inspection a small group of residents and staff went out into the local community for a drive. As already referred to in the report on the second day of the inspection, the majority of residents were being supported to attend their day care activities or to return home to their families. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 13 There was also supporting information written in residents care records, which was confirmed by staff on duty that demonstrated residents regularly go to different community activities. This includes visits to the shops, the pub or different day care support groups. The resident’s menu was inspected to see if residents are offered a varied, well balanced diet. There was evidence that residents are offered choices of dishes and the menu choices were nutritionally well balanced, and varied. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 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): 18,19,20 Residents are supported to meet their needs in the way they prefer, and resident’s medications is handled, administered, and disposed safely. EVIDENCE: As already referred to in the report, residents stay at the Home for regular short breaks. It was apparent that staff and residents evidently enjoy warm trusting relationships, the staff that were on duty communicated among each other and were working well as a team. Residents also looked relaxed and comfortable when staff were supporting them with their needs. Care plans that were inspected detailed how to assist the residents with their range of care needs. Care plans also addressed the resident’s physical and emotional needs and what action needs to be taken to support residents. The procedures for the administration, storage and disposal of resident’s medication were inspected to monitor the systems in place for the handling of medication. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 15 The medication administration charts of two residents were inspected in detail. There was a photograph of the resident kept with each record, to ensure medication is dispensed to the correct person. The medication administration charts were legible, up to date, and contained the signature of the dispensing registered nurse, demonstrating resident’s medication is administered safely, the reasons for any omissions had also been written on the charts. There was also an up to date record of all medication being received into the Home, showing there are safe systems in place to monitor how much medication is kept. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 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): 22,23 Residents’ complaints are investigated promptly and residents are protected from the risk of abuse or harm EVIDENCE: Residents are able to access copy of the complaints procedure, which is on display on a wall in the hall. This area is well frequented by residents and visitors. The procedure has the contact address for Aspects Trust and the office of the Commission for Social Care Inspection, so residents can easily contact the Commission. The complaints record book was viewed to ascertain how the Home responds to complaints. There had been no new complaints recorded since before the last inspection, the record did include the details of how the complaints were to be dealt with. To help to protect residents there are policies and procedures relating to the issue of `protection of vulnerable adults from abuse’. Staff also attend training to ensure they are up to date in their understanding of the principles around protection of vulnerable adults. Staff had a good understanding of current guidance in relation to Protection of vulnerable adults from abuse issues, which should help to protect residents from harm or abuse. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 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): 24-30 Residents live in a safe environment that satisfactorily maintained, and they now have the specialist equipment needed to maximise their independence. EVIDENCE: Fairburn is a modern style converted residential property that is close to local shops and amenities, and a bus route into the centre of Bristol City centre making the home accessible to a range of community based facilities. The standard of decoration is starting to look ‘tired’ and it will be of benefit to residents when this work has been completed. The Home was clean and tidy and generally satisfactorily maintained. Since the last inspection an improvement plan has been undertaken for the Home. A new kitchen has been installed providing modern and spacious kitchen units and kitchen surfaces for food storage and preparation. There is a lift that residents can now use-giving access to the first floor. There is also a walk in shower room to assist residents who may need additional support with personal care. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 18 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): 32,33,35,36 Residents are supported by staff who are competent and well supervised in their work. Also there are sufficient numbers of staff provided to meet residents’ needs. EVIDENCE: To find out if sufficient staff are on duty at all times to meet residents needs the staff duty record for shifts worked for February 2006 was inspected. There is a minimum of one registered nurse and one care assistant on at any time on duty for a night shift, and between two and three staff on duty during core hours during the day between 10am and 5.30pm to work closely supporting residents both in and out of the Home. The staff team all work flexibly and adjust the hours and days that they work according to the dependency levels and numbers of residents who are staying at the Home. The training records of three registered nurses were reviewed. The training records generally demonstrated residents are supported by staff who have had attended a range of training courses and study days relevant to their needs. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 19 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): 37,39,42 The Home is well run and residents health and safety of residents is protected. However there needs to be more regular reviewing and overall development of the service. EVIDENCE: Mrs Subramanyan has been the manager of the Home for fifteen years and is shortly going to be retireing.All of the staff the inspector met, on this and past inspections, said how Mrs Subramanyan supportive and well regarded by residents and their families.Based on the evidence from this inspection and from previous inspections it is clear that she will be missed by residents and staff when she leaves. The Home has carried quality-monitoring audits of the care and service in 2004. However residents and their relatives need to be fully consulted about the Home on a more regular basis as part of the review and development of the Home. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 20 Their views need to be part of an action plan that has been devised to address suggestions made to enhance the service. The fire logbook was checked and showed weekly tests of fire alarms are carried out. The fire fighting equipment is also checked regularly, which helps to maintain the safety of those in the building. There was a record that staff had attended fire safety update training in the last twelve months to ensure they are aware of fire safety procedures in the Home. The kitchen was also inspected to check the systems in place to ensure safe food handling, storage preparation and serving. The kitchen environment was clean and reasonably well maintained. There were records kept to demonstrate that the cooks were temperature probing `high risk’ foods prior to being served to residents. There were also up to date records to demonstrate staff monitor the temperatures of the fridges and freezer. Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 21 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 Standard No Score 1 3 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X X X LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 x Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 22 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 2 Standard YA6 YA39 Regulation 15.2(b)(c) 24. (1) Requirement Timescale for action 15/04/06 Residents care plans must be reviewed and updated on a regular basis. Carry out a quality-monitoring 15/05/06 audit of the care and service that is provided to residents. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Fairburn DS0000020350.V276154.R01.S.doc Version 5.1 Page 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!