Inspection on 17/05/05 for Fairby Grange Rest Home

This inspection was carried out on 17th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

Fairby Grange Rest Home 26/03/07

Fairby Grange Rest Home 11/10/05

Fairby Grange Rest Home 25/10/04

Fairby Grange Rest Home 11/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

1 Marten Road

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Fairby Grange Rest Home Ash Road Hartley Dartford Kent, DA3 8ER Lead Inspector Elizabeth Baker Unannounced 17 May 2005 10:00 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 Older People. 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. Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Fairby Grange Rest Home Address Ash Road Hartley Dartford Kent DA3 8ER 01474 702223 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) Mr Gregory Brian Reeve Mr Gregory Brian Reeve Care Home 30 Category(ies) of Old Age - (30) registration, with number of places Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Care for one older person with mental health difficulties is restricted to a person whose date of birth is 15/07/1921. Date of last inspection 25 October 2004 Brief Description of the Service: Fairby Grange is a care home providing Personal Care for 30 Older People. Mr Gregory Brian Reeve is the Registered Provider. The home is a detached listed Grade II property built around 1685. A purpose built extension was added to the home in 1992. Some parts of the home still retain original features. The home is situated within well maintained gardens. There is also a smallsecluded patio area at the rear of the property. Bedroom accommodation is on two floors and comprises 24 single and three double rooms. Seven single rooms and one double room have ensuite WC facilities. The home does not have a passenger lift. Bedrooms on the first floor are accessed by a stair lift. Three bedrooms on the first floor mezzanine level have to be accessed by an additional four steps. All bedrooms are connected to the call alarm system. Communal rooms comprise a reception room, two day rooms and a dining room. One day room is designated for residents who smoke. A small quiet meeting room is adjacent to the Managers office. This room has to be accessed by one step. The home is situated near to the village of Longfield. Train services to London Victoria, the Medway Towns and Kent Coast are available from Longfield Station. Buses to the neighbouring areas of Dartford, Gravesend and New Ash Green, as well as the Bluewater Shopping Complex at Greenhithe pass nearby the home. The home is easily accessible by car from the main A2/M25 road junction. Car parking facilities are available. Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over six hours on the 17 May 2005. Lead Inspector Elizabeth Baker and Regulatory Inspector Fiona Holdway carried out the inspection. A partial tour of the home took place. Records were inspected for case tracking purposes. Some residents were spoken with including six who agreed to be formally interviewed. A number of staff were also spoken with. At the time of the visit 27 residents requiring personal care were residing at the home. The inspection was carried out with full assistance from the newly appointed manager Mrs C Brent. The proprietor Mr Reeve was also in attendance for part of the inspection. Assessment of progress on requirements and recommendations made at the previous inspection was also part of this visit. No complaints have been by the Commission. What the service does well: What has improved since the last inspection? A new Manager with the Registered Manager Award qualification has appointed. A number of the requirements and recommendations made at the last inspection have been completed. Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 6 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. Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Prospective residents cannot be sure all their assessed needs will be met as information obtained during the admission process is not always used to inform the care plan. EVIDENCE: The home endeavours to obtain comprehensive information about prospective residents’ needs, problems and abilities prior to a decision of admission being made. However pertinent medical information is not always transferred to the resident’s respective care plan. This practise could result in inadequate care being delivered. Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9 and 10 Residents are at risk due to limited progress being made on improving care records to ensure all health and personal care needs of residents are identified and met. Staff assist residents with their personal care in a manner, which assures their privacy and dignity. The home’s medicine procedures are not sufficiently robust to protect residents’ safety. EVIDENCE: Three care plans were inspected as part of the case tracking process. Care information obtained from residents during the inspection was not recorded in their respective care plans. A document described as a ‘care plan’ for a resident admitted in December 2004 was basic and made no mention of their medical condition and subsequent treatment. The care plan for another resident was not reflective of the deterioration of the residents’ physical condition. Although discussion with management suggested more needs were known and were being addressed, this was not recorded in the care plans. There is currently a reliance on verbal communication and staff memory. Where problems and needs had been stated there was no information as to Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 10 action and ultimate goals. Individual daily records are maintained and contained a mix of health and quality of day experiences. Visit details of Doctors and Health Care Professionals are kept in a communal book and are not always cross-referenced to the individual care records. This makes it difficult to obtain a complete and accurate picture of residents’ needs and problems. Medication administration record charts are maintained. Care staff administer medications to residents where support is required and evidence this by completing the charts. Some residents take variable dose medications, although staff do not always record the actual quantity administered, which could present a problem if an audit trail was required. There was no risk assessment for a resident who self-medicates to ensure their medicines are safely managed. Residents spoken with said they receive good care. Residents receive six monthly reviews by their GPs in respect of their medications, blood pressure and weight, or more frequently if required. District Nurses provide “nursing” input when the residents’ assessed needs require this level of care. If a resident’s assessed needs change and demonstrate 24-hour nursing care is required, the home arranges a multi-disciplinary re-assessment and assists the resident and their representative in finding an appropriate care home. Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Residents’ wishes to participate in occupational activities and recreation or not is respected. A choice of appetising meals is available and residents can choose where to eat. EVIDENCE: Some residents are encouraged and supported in continuing their links and associations with clubs and other community activities enjoyed by them prior to admission. Other residents said they would like to go out more for fresh air. Residents were seen resting in armchairs, talking amongst themselves, reading and watching TV. Religious services take place at the home twice a month. External entertainers provide activities on an occasional basis. Some residents have formed a card school and meet regularly for card games. A number of residents spoke enthusiastically about a game of bingo they had attended, but felt more notice would have prepared them better. Residents said the food is good and choices are available. Residents are asked for their views and opinions of the food provided and this information is used to vary the menus. Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 17 Reference to the former Commission may delay residents in accessing the regulatory authority. Residents’ are enabled to participate in the civic process if that is their wish. EVIDENCE: A complaints procedure is displayed in the reception room. The procedure sets out the home’s complaint’s route as well as providing contact details of the Commission. However the Commission is still referred to as the National Care Standards as opposed to the Commission for Social Care Inspection. Ensuring the Commission is identified by its current name could prevent residents or their representatives in experiencing any unnecessary delay should they wish to contact the organisation direct. Residents spoken with know who to speak to if they have a concern or complaint. A resident said she had gone to the Polling Station to cast her vote in the General Election. Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22 and 26 The standard of environment is good and provides residents with a clean and homely place to live. Additional aids in some corridor areas would improve residents’ safety. Residents and staff are at risk of cross infection due to lack of wash hand basins. EVIDENCE: The home is kept in a good decorative and clean state. rooms are always kept very clean. Residents said their Some corridor areas of the home are not easily accessible for residents with poor mobility. The provision of additional handrails and improved lighting would assist residents in mobilising safely, while maintaining their independence. Hand washing facilities in the laundry are poor and present a cross infection risk to staff. The one sink is used for the dual purpose of soaking contaminated continence aids as well as hand washing. This matter has been Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 14 identified at previous inspections. It was also noted at this inspection that the WC on the mezzine floor, does not have a hand sink. As this toilet is shared by a number of residents, this also poses a potential infection control risk. Residents’ clothes are appropriately laundered. Residents expressed satisfaction with the laundry service, although some have experienced items being lost or misplaced occasionally. Water thermometers are now available in all bathrooms. This enables staff to measure the water temperatures accurately to ensure residents are not scolded. Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 Residents are potentially at risk due to the current recruitment and vetting practice and inadequate training of staff. Rotas are reviewed to ensure appropriate skill mix of staff is available on all shifts. EVIDENCE: Staff were seen carrying out their duties in a calm and unhurried manner. In addition to care staff, staff are employed for catering, domestic and laundry duties. For residents’ safety, the rotas have recently been reviewed and revised to ensure a senior carer is on duty every day. The newly appointed manager has established training shortfalls and is now taking action to address the matter. Future training topics are to include moving and handling, adult protection, infection control, diabetes and medication administration. Systems are in place for recruiting and vetting staff. Details of Criminal Record Bureau checks contained in the files of two recently employed staff related to their former employment. As these checks are not transferable the home must immediately apply for clearance to ensure residents’ protection. Three carers are currently trained to NVQ level II care. At the previous inspection it was reported that six carers had this qualification. There is an Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 16 expectation that at least 50 of care staff are being trained to this qualification. Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 and 33 and 36 The newly appointed manager has a clear development plan and vision for the home, which she has effectively communicated to residents and staff. EVIDENCE: A new manager has been just been appointed. The manager is currently trained to NVQ level 4 Management and is now working towards attaining the requisite care qualification. The manager has a good understanding of what needs to be done to improve the home and together with the Provider and support from the former Matron is planning to instigate these improvements. Residents had been advised of the management changes. The new manager has just introduced staff supervision. This practice will ensure staff are trained and supervised to provide appropriate care to residents. Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 18 Meetings are facilitated for residents to attend and express their view and opinions of the service and facilities provided at the home. A quality monitoring questionnaire has recently been sent to all residents. So far 19 responses have been received. When the responses have been analysed the manager intends to publish and circulate the results to current and future residents. Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 2 2 x x x 2 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 x 2 3 3 x x 3 x x Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 20 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. 1. Standard OP22 Regulation 23 Requirement Visibility in corridor areas must be improved; additional grab/hand rails must be installed to aid residents moving safely around the home. (Timescale 31/12/04 not met) A separate handwash sink must be installed in the laundry. (Timescale 31/12/04 not met) Hand wash basins must be installed in toilets. Staff must receive infection control training. (Timescale 31/12/04 not met). CRB clearance must be obtained by the home in respect of new staff. All pertinent pre admission must be used to inform the care plan. All residents must be provided with a detailed care plan reflecting all their current needs and problems Timescale for action 30/09/05 2. 3. 4. 5. 6. 7. OP26 OP21 OP30 OP27 OP3 OP7 13 23 18 18 14 15 31/08/05 31/08/05 31/08/05 17/05/05 31/05/05 31/05/05 8. Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 21 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. 3. 4. 5. Refer to Standard OP28 OP31 OP9 OP16 Good Practice Recommendations Fifty percent of care staff must be trained to NVQ level II care. The Manager must attain NVQ level 4 Care. Details of actual quantities of variable dose medicines must be recorded on the medication administration record charts The current name of the Commission must be used on documents which residents and the general public access. Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone, Kent, ME16 9NT 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 Fairby Grange Rest Home H56-H06 S23941 Fairby Grange V226867 170505 Stage 4.doc Version 1.30 Page 23 - 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. 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