Inspection on 28/11/06 for Fairfield House

This inspection was carried out on 28th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Fairfield House 06/08/07

Fairfield House 19/04/06

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Fairfield House Charmouth Road Lyme Regis Dorset DT7 3HH Lead Inspector Alison Stone Unannounced Inspection 28th November 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 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 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. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairfield House Address Charmouth Road Lyme Regis Dorset DT7 3HH 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) 01297 443513 Fairfield House Healthcare Limited Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of four (4) bedrooms/suites measuring 15.5 square meters or more, may be used for double occupancy at any one time. 19th April 2006 Date of last inspection Brief Description of the Service: Fairfield House is a residential care home for older people. It is situated approximately ¼ mile from the seaside town of Lyme Regis. It was first registered as a care home for older persons in July 1986. The home is established in an early Victorian mansion set in its own grounds with panoramic views of Lyme Bay and Lyme Valley. The home is on a bus route to the town centre. The home is currently registered to accommodate a maximum of 34 service users in single and double bedrooms, available at ground and first floor levels. The communal facilities include a spacious lounge, smaller quiet lounge, dining room and two conservatories. A passenger lift enables access to the first floor of the home. The front entrance to the home comprises a large parking area, while the side and back gardens are mainly set to lawn with mature trees and seasonal borders. In November 2005 Fairfield House was purchased by Fairfield House Healthcare Ltd and Mrs Sue Heybourne was registered as the Responsible Individual, representing the Directors of the Company. Mrs Heybourne is also the Director of Personnel Solutions, the Management Company that oversees the day-today running of the home. An acting manager is currently in post. The home has a Service User Guide, which is available to all prospective service users or their representative. A copy is ordinarily located in the front hall, together with a copy of the most recent inspection report. Fees range from £425 to £550 per week for a single room. This information was given on the 29th November 2006. Readers of this report may find it helpful if they have any queries about fees to contact the Office of Fair Trading WWW.oft.gov.uk. The acting manager said that up to date inspection reports are available in the agency’s office and copies can be provided on request. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection of this care home by the Commission for Social Care inspection this year, the inspection year runs from 1 April 06 to 31 March 07. This was a key inspection. The key standards are identified in the main body of report in each outcome area. In order to obtain a fuller picture of the home the reader should refer to the earlier inspection report dated 19 April 2006. The inspector arrived at 9.30 am and left at 4.00pm the visit lasted six and a half hours. The inspector spoke with four service users, two relatives, the general manager, the acting manager and three staff members. The inspector joined service users for lunch, undertook a tour of the premises, observed practice and looked at medication supplies. They inspected records relating to service users’ care, staffing and other documentation relating to the running of the home. Preparation work included, reading the previous report, analysis of notifiable incidents reported to the Commission for Social Care Inspection, the body that regulates services like Fairfield and the analysis of comment cards and returned service user questionnaires. As part of this unannounced inspection the quality of information given to people about the care home was looked at. People who use services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service user’s guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk The Commission received three postal questionnaires from service users, four comment cards from relatives/friends and one comment card from health and social care professionals. Of the 38 National Minimum Standards, all 22 Key Standards and ten of the remaining 16 Standards were assessed. The general manager and acting manager were present during the inspection. The acting manager provided the inspector with all the relevant information relating to the inspection and any necessary background information. Feedback was given to the acting manager at the end of the inspection. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 6 This inspection found that substantial improvements have been made since the last inspection in all aspects of management of the home. There were many improvements noted in the quality of outcomes for service users living at Fairfield House. However the acting manager and the general manager will be leaving the home in the next few weeks. The organisation, Personnel Solutions and the owners have arranged for a temporary manager to run the home until such a time that they can recruit a permanent manager. The inspector would like to thank everybody who contributed towards the inspection process. . What the service does well: The manager ensures that service users are only admitted to the home after they have been supported with a comprehensive pre-admission assessment to ensure the home can meet their needs. Service users’ bedrooms were decorated to a good standard Staff treat service users with dignity and respect. Staff were observed to treat service users with kindness and consideration, taking time to support their needs, encouraging them to do as much for themselves as they were able. Service users made comments like, “ Staff are kind more than kind and very respectful, I can be a bit obstinate and the staff don’t mind this. They understand and respect this.” “The staff are very nice and very helpful.” Service users benefit from living in a nicely decorated and furnished home, where consideration is given to their physical needs, enabling people to have easy access both inside and outside the home. Relatives spoken to say that the home was excellent and that staff made them feel really welcome, one relative said “nothing is too much trouble for them”. A lot of thought is put into service users’ meals; they are of a good quality, nutritional and nicely presented. The menus at the home offer people choices of what they would like to eat. Service users are offered a wide range of activities to take part in. One service user said, “the thing about living here is, they try to keep your mind and body active”. The organisation positively supports issues around equality and diversity by; looking at accessibility issues inside and outside the home, adopting correct recruitment procedures and practices. They have a policy on equal opportunities and staff are supported to understand these issues through the induction programme. Service users are recognised as individuals within the home. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? The acting manager has been in post seven months and has worked hard to meet the requirements and recommendations left at the inspections of 19 April 06. There were 18 requirements and 19 recommendations made at the last inspection. 16 requirements and 18 recommendations have been met, a further two requirements and one recommendation has been partially met. Three requirements were made at this inspection. The home has improved in most of the areas identified in the last inspection, the areas that the inspector found improvements in are summarised in this section of the report. All aspects of record keeping have improved since the last inspection. Service users and relatives said that when they first moved in they were provided with lots of information about the home. Which included a copy of the complaints procedure. Service users are supported with introductions to the home to see what it is like before making decisions about whether they want to live there. Care plans are generally detailed and provide staff with up to date information about people. They were noted to have been completed with the service user and had been regularly reviewed. The home is well supported by the local GP practice and the district nurses regularly visit the home to support service users health needs. The home’s medication management is generally robust and protects the service users. Service users are encouraged and supported to make choices and decisions as far as they are able. Staff promote service users independence by encouraging them to do as much for themselves as they are able. The home now has a residents committee that involves some service users and relatives. Meals are of a good standard and people eat their meals in a pleasant area at times they choose. Service users are offered a choice of nutritional wellbalanced meals. Service users made comments like “the food is excellent”, “the food is lovely”. Staff are provided with regular training to meet the needs of the service users living at the home. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 8 Staff are generally recruited properly and service users can be confident staff are suitable to work with vulnerable adults. Service users said that they feel supported by the acting manager and they are able to approach her with any issues. The acting manager is experienced and runs the home in the best interests of the service users. 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. The summary of this inspection report can be made available in other formats on request. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 9 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 Outcomes Statutory Requirements Identified During the Inspection Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are supported with adequate information to make an informed decision about whether they want to live at the home. Service users can be confident that the home can meet their care needs prior to them moving in, because the home undertakes comprehensive assessments. Service users and their families/representatives are actively encouraged to visit the home and spend time assessing the quality and suitability of the home’s facilities, before making a decision about whether they would want to live there. The home does not provide any intermediate care. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 11 EVIDENCE: Four service users’ records were reviewed as part of the inspection. These indicated that in all cases where a service user was funded by social services a thorough assessment of their needs was undertaken prior to a referral being made to the home. Three service users said that they are told about any changes in cost because the organisation that runs the home writes to them to let them know about any increases. One service user said that they didn’t know about cost as their daughter deals with the money side of things for them. Three service users remembered signing a contract, one service users wasn’t sure. Service user’s files sampled showed that there were contracts in place. When a service user is referred to the home the acting manager visits the prospective person to carry out their own assessment of need. The review of these documents indicated that these were comprehensive assessments that included all the service users’ basic information as well as information about their physical, social and psychological needs. Service users and families spoken to as part of the inspection indicated that they had been given packs that included lots of information about the home prior to moving in; although they could not remember all the information included in the packs. The manager was able to demonstrate that all new service users were supported with packs of information relating to the home including a copy of the Service Users Guide, which included information like the Service Users Guide, aims and objectives of the organisation, the complaints procedure, and information about the home and the facilities provided at the home. Service users said that they had been able visit the home before having to make a choice about moving in. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ health needs are detailed in their care plans and service users can be confident they will receive the support they require to meet their care needs. Service users best interests are generally protected by the home’s policies and practices in relation to medication. Service users can be confident that they will be treated with respect and the staff will uphold their right to privacy. EVIDENCE: As part of the inspection four service users’ records were looked at, Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 13 these were found to be generally detailed. Care plans described the care to be provided and detailed service users’ preferences and the objectives staff were supporting service users to achieve. Work had been undertaken through the assessment process to identify a service user’s interests & hobbies, their life history and their friends and family relationships. Service users’ files demonstrated service users saw their GPs regularly and were supported to see the optician, chiropodist, and the dentist as required. The review of service users records indicated that detailed records of service users’ health were kept. Service users spoken to supported the fact that they regularly saw their GP and other health professionals as required. The acting manger said service users had the choice of accessing these services at the home or in their local community. It was noted during the inspection that the District Nurses attached to the local GP surgery were regularly visiting service users in the home. Service users’ files demonstrated that people were weighed regularly and the acting manager had undertaken individual nutritional and skin assessments, which were noted to be linked to their plans of care. Records of regular reviews were seen on service users files. Information relating to service users’ reviews was limited and did not provide any information about whether the service user and/or their family were involved. Care plans did not demonstrate what changes if any had been made following the review. However families spoken to during the inspection supported the fact that staff kept them informed about their relatives care. The homes medication management was reviewed as part of the inspection. It was noted that recommendations made at the last inspection had been taken on board and there were improvements. Improvements were noted in medication audits, staff training and better staff practices in relation to service users self-medicating. All the relatives that were involved in the inspection process made lots of positive comments about the standard of personal care their family members receive. Service users were observed to be well dressed and were smartly presented. People were noted to be wearing jewellery and dressed in clothes that reflected their individuality. It was noted service users had nicely styled hair. One of the service user’s spoken to said they enjoyed having their hair done with hairdresser who visits the home. Service users were noted to be wearing their glasses and hearing aids. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 14 Service users and families contacted as part of the inspection process spoke positively of the care and support they receive at the home. Service users said that they felt they were offered choices and staff respected their wishes. One service user and their family said that they could not speak highly enough of the support given to them after the death of their husband. They said the general manager, the acting manager and staff team had been hugely supportive making all the necessary arrangements with them. Direct observations made during the inspection noted staff discreetly encouraged service users to do as much for themselves as they were able. Staff were able to talk knowledgably about how they ensure service users privacy and dignity is respected particularly in relation to personal care. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Service users are supported to have access to a lifestyle in the home that meets their interests and preferences. The home encourages people’s social, religious and recreational interests, which promotes and encourages people’s individuality. Service users are supported to maintain contact with family and friends and be part of the local community. Encouraging service users to feel socially included preventing feelings of isolation. Service users are supported to have choice and control over their lives, promoting people’s sense of independence. Service users receive a choice of appealing, nutritional meals in pleasant surroundings. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 16 EVIDENCE: None of the service users who live at Fairfield belong to an ethnic minority and/or a religious group outside that of the Christian faith. The acting manager supports existing service users to be active in their faith by arranging a variety of Christian meetings at the home, which are open to all. The home also celebrates Christian festivals like Easter, The Harvest festival and Christmas. Service users and their families completed a profile in the assessment that details information about individuals cultural, social and leisure interests. The home has an activities co-ordinator who regularly visits the home. The acting manager also assigns members of staff to lead on service users’ activities during the day. The home benefits from having a large amount of space and one of the lounges is regularly used as an activities room. All the service users spoken to agreed that there were many activities offered at the home, including day trips. Two service users said that they really enjoyed going for a walk into Lyme Regis on a nice day. During the inspection there were a variety of activities going on, including the regular visits by the local church fellowship group. Two of the service users spoken to said there were always lots of activities over the Christmas period. The acting manager said that they had worked hard to provide a varied programme of activities over the Christmas period that including an entertainer. It was noted that the weekly timetable included a range of activities like exercises to music, newspaper debates, crosswords, and visits from a local church. One service user said they really enjoyed playing bingo. The home had recently redecorated and furnished the hairdressing room with lots of new equipment. This room provided people with a lovely area to relax and enjoy hairdressing appointments and other beauty treatments. The general manager said that more work was planed for the garden to provide service users with a further patio area to use in the summer. Service users said that the staff arrange have birthday parties there if they want. The home encourages regular contact from service users’ family and friends. One relative spoken to said that the staff team had been very welcoming to her and she had been able to stay in one of the spare rooms to be with her sister during a difficult time. The general manager said that relatives are always offered the opportunity to stay at the home if they have spare rooms and are encouraged to join their relatives for meals. The acting manager said Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 17 several families would be joining service users for Christmas lunch at the home this year. The manager said service users are supported to be part of the local community and they are always looking at ways to encourage more links. During the inspection it was observed that service users were encouraged to entertain their friends and relatives in the communal areas of the home. The facilities provided in service users’ rooms and the communal lounges offer people a pleasant, comfortable, nicely furnished environment to receive guests. Service users spoken to agreed that there were regular ‘residents’ committee meetings.’ This committee is independent from the management and the staff at the home. The meetings are used as a forum for people to put forward suggestions and make decisions about the home they live in. One mealtime was observed during the inspection. This was noted to be very pleasant social experience. Staff spent time encouraging service users to make choices for themselves and were seen to offer service users discreet support where required. Service users seemed to really enjoy their meal times, chatting amongst themselves. Meals were noted to be pleasant and unhurried. One service user said that they could have their meals at times, which were convenient to them and they choose whether to eat in their own room or in the dining room. The home benefits from a catering department and the chef ensures service users dietary needs are taken account of. Following a residents meeting and concerns raised there, the chef has ensured that all puddings are now available for people with diabetic needs. The general manager and the chef work together to offer people a wide selection of choices about their meals. They both said they felt it was really important to use good quality ingredients to ensure service users received high quality, well balanced and nicely presented food. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives can be confident that their complaints will be listened to and taken seriously. The home has a complaints process in place that supports the management of any complaints. Service users are protected from abuse and neglect through a process of staff training and the homes’ own polices and procedures. EVIDENCE: Review of the complaints file kept in the home demonstrated that all complaints were appropriately managed in accordance with the homes’ procedure. It was evident from the complaints file that the acting manager regularly encouraged service users to voice their concerns and took all concerns seriously. The home has a complaints procedure in place; this was made available to all service users in the Service User Guide. The service users and their families spoken to, were able to tell the inspector what they would do if they wanted to complain and said that they would feel confident in doing so. They all agreed that they had been given information about the complaints process when they first moved into the home. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 19 There haven’t been any complaints made to the Commission for Social Care Inspection in relation to the service the home provides. Services users spoken to during the inspection said that they would feel confident to make a complaint to the acting manager. They said they felt she was supportive and interested in their suggestions, concerns and/or complaints. Five staff records were reviewed as part of the inspection. These indicated staff had undertaken training in the areas of Protection of Vulnerable adults. Staff spoken to during the inspection were able to demonstrate a basic awareness of the different types of abuse service users may be at risk from and what they should do if they had any concerns. The manager was able to demonstrate that she had the appropriate polices and procedures in relation to Adult Protection on the premises. Both the local Social Care and Health’s policy and the organisations own policy were available at the home. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19.21, 23,24,25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a homely, nicely furnished and decorated home, which provides for their comfort. Service users bedrooms are pleasantly decorated and furnished reflecting their personal tastes and belongings and the rooms meet their needs. The home is clean, tidy and hygienic, this protects the health and safety of the residents. EVIDENCE: During the inspection a tour of the premises was undertaken. This included looking around all the communal areas including the dining room and lounges, bathrooms and toilets. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 21 The homes medication, kitchen and laundry rooms were also looked at. With the permission of the service users, two occupied bedrooms were looked at, a further two empty bedrooms were also looked at. It was noted that the homes certificate of registration was clearly displayed as well as the necessary insurance certificates. The owners of the home have recently undertaken a large refurbishment programme within the home. Carpets have been replaced, service users bedrooms decorated, communal areas redecorated and refurbished to a good standard. The general manager has taken on board accessibility issues within the home and has made changes to the environment making rooms more easily accessible to service users with physical disabilities. Accessibility issues within the home’s grounds are also being considered. More work is required before it can be stated the home is fully accessible and further refurbishment work is still required in the first floor bathroom. The general manager said that the owners have plans to make this into a fully accessible ‘wet room’. The general manager said there are also plans to make changes to the outside area, providing a heated conservatory area for those service users who want to smoke. Service users’ bedrooms were nicely decorated, each room reflected different styles of décor. The manager said that the staff work with service users and their relatives to find out people’s preferences and tastes and make sure rooms reflected a person’s individuality. Service users bedrooms included furniture and fittings they had brought from their own homes and it was noted that there were many personal effects around the rooms. Service users were able to have a television and telephone in their own bedrooms. The general manager said as part of the refurbishment programme an order of ‘cool touch’ radiator covers has been made in order of priority areas. During the inspection the home was noted to be clean and tidy and free from any unpleasant odours. The manager said that there are domestic assistants employed at the home; they work various shifts covering a seven day period. It is their responsibility to ensure the home is maintained to a good standard of hygiene and cleanliness. One relative commented, “The home is beautifully kept, very clean.” It was noted that all the bathrooms and toilet areas offered soap dispensers and paper towels providing staff and service users with effective hygiene facilities. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 22 The home has large attractive well kept grounds. The general manager said the grounds staff maintain the gardens. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 23 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28.29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are generally supported by skilled and trained staff, who are encouraged by the organisation to undertake regular training. Training in specialist areas would further support staff to be able to meet service users needs. Service users can be confident there are regularly enough staff on duty to meet their needs. Service users can be confident that the home’s recruitment practices are generally robust, ensuring staff suitability to work with vulnerable adults. EVIDENCE: Five staff files were reviewed as part of the inspection along with staff rotas. Staff files indicated staff were supported with mandatory training in areas like, infection control, health and safety, protection of vulnerable adults, fire, medication where appropriate, first aid and manual handling. Staff said that they are offered regular training and have an induction before commencing work with service users. The review of staff files indicated that Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 24 the induction was of a comprehensive nature over a three week period. The induction included regular reviews with staff to ascertain how things were progressing; it was noted the staff had signed these. As well as mandatory areas it was noted the induction covered areas like care of the dying, introductions to service users, getting to know the service users, equal opportunities. And issues around the value base of staff like dignity, respect, choice, privacy and individuality. The induction training is in line with the “Skills for Care” induction programme. The management team recognised the importance of supporting the staff team with regular training, supervision and staff meetings. The acting manager has systems in place to provide them with an overview of all staff’s statutory training needs and when refresher courses are due. The manger said that of the two senior staff, one has their NVQ 2 and the other has their NVQ 3. Out of the 14 care staff employed nine have their NVQ 2. It was noted that there were service users with diabetic needs living at the home. Staff training files did not indicate that they had been trained in this area. The acting manager is a trained nurse and takes a lead role in providing ‘hands on training’ to staff. Staff spoken to agreed that they were supported by the manager and had regular supervisions and meetings. Service users say that they felt staff were supportive of their needs and they had confidence in the care provided to them. They also said that there were enough staff on duty to meet their needs and they didn’t feel they had to wait long periods of time for help or that they were rushed during personal care. The review of rotas indicated that there were adequate staffing levels in place on a daily basis to meet the needs of the service users in all areas of the home including domestic support, service users activities, maintenance and catering staff. Having a live in management team of a General Manager and acting Manager further support existing staffing levels. The acting manager is on duty throughout the week and often works as part of the care team. The acting manager said that they have recently filled their current vacancies. The review of staff recruitment records demonstrated these are generally robust with all the necessary checks in relation to pre employment being undertaken. Including Criminal Records Bureau Disclosures, checks are made Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 25 against the Protection of Vulnerable Adult (POVA) lists prior to employment and there were two written references in place. However it was noted that where an overseas worker had been employed, a record of good conduct had not been obtained from their country of origin. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 26 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36, 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users benefits from having an experienced acting manager who is committed to improving their quality of life.and runs the home efficiently and in the best interests of the people who live there. The management style enables service users and their family and/or friends to feel confident about raising issues. Service users can be confident that staff are regularly supervised in relation to the work they carry out in the home. However service users and staff would benefit from a formal and regular supervision process. The home has the necessary arrangements in place to safeguard service users financial interests. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 27 EVIDENCE: The acting manager has been effective in their role over the previous seven months and has made good progress towards meeting the requirements and recommendations made at the last inspection on the 19 April 2006. However an application has not been received by CSCI, to register the existing manager. This is due to the general manager and acting manager shortly leaving their posts. Service users and staff raised their concerns about what another change in management would mean to them and said they felt uncertain about the future. Currently the organisation has not been able to appoint a permanent manager and has put interim arrangements in place. They have recruited a temporary manager on a three month basis until a permanent manager can be recruited. Representatives of Personnel Solutions management team in compliance with regulations make regular monitoring visits to the home and copies of reports made are sent to the Commission. The home operates a quality assurance process and has a policy in this area. The home was able to demonstrate the findings of Quality Audits are discussed with service users. Then follow up action is taken on the results of the audits to improve the quality outcomes for service users living at Fairfield. The manager was able to evidence that regular staff and service users meetings take place. Service users spoken to say that they felt they could approach the manager with any concerns. The staff spoken to also agreed that the acting manager was supportive. The home has polices and procedures that relate to the management of service users’ finances. Three service users’ financial records were looked at during the inspection and these were found to be in good order. Small amounts of cash and/or valuables can be kept in a secure place for service users. Records are kept of all transactions and receipts are retained. It was noted during the tour of the premises that lockable facilities are provided in service users own rooms. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 28 Staff records indicated staff were supervised on a regular basis. The acting manager put a lot of emphasis on the supervision sessions being carried out during training sessions, staff meetings and individual meetings. It was noted that little information was recorded from these ‘meetings’ other than the dates. Although staff are offered formal one to one annual appraisals, little work had been undertaken to offer staff formal recorded one to one supervision sessions, where individual performance issues could be addressed and staff are given the opportunity to raise issues/concerns. Accident forms were in place for staff and service users, these were properly completed and it could be seen that regular audits were undertaken of the service users’ accident forms. To comply with data protection legislation accident forms should be kept in locked facilities and correctly indexed to prevent loss. The inspection of fire records showed regular tests of the fire equipment and drills take place. The training needs summary demonstrated that staff have received fire training. However as mentioned in the last inspection more work is required to show, who attended training sessions and what topics were covered. Risk assessments are in place for staff, the premises and food safety. The acting manager said these are reviewed at least annually. As part of the inspection the kitchen area was looked at. This area was found to be clean and hygienic, with foodstuffs stored appropriately. The general manager said that they have regular visits from the environmental health officer. It was noted that there was an up to date portable appliance testing certificate in place, along with the appropriate five-year hard wiring check. An up to date gas landlord certificate was seen. Regular service checks where made to the stair lifts and passenger lift at the home. Water temperatures are checked each time service users have a bath to ensure that the water is at the appropriate temperature. Records relating to the testing of water indicated that all the appropriate checks and risk assessments had been undertaken. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 29 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 2 2 3 Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 30 Are there any outstanding requirements from the last inspection? Yes 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 OP25 Regulation 13(4)(a)( b)(c) Requirement Timescale for action 28/02/07 2. OP29 19(1) Sch 2&4 The registered person shall ensure that(a) all parts of the home to which service users have access are so far as reasonably practical free form hazards to their safety; (b) any activities in which service users participate are so far as reasonably practical free form any avoidable risks; and (c) unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. (This relates to the uncovered radiators) Outstanding from the last inspection 19 April 2006. Amended to take account of the progress made. The registered person shall not 28/02/07 employ a person to work at the care home unless(a) the person is fit to work at the care home; (b) subject to paragraph (6), he has obtained in respect of that person the information and documents specified in(i) paragraph 1 to 6 of Schedule 2; (ii) except where (7) applies, DS0000066189.V316729.R01.S.doc Version 5.2 Fairfield House Page 31 3. OP31 8 (1)(a)(b) & (2)(a)(b) 4. OP36 18(2) paragraph 7 of that Schedule; (iii) where paragraph (7) applies, paragraph 8 of that Schedule; and (c) he is satisfied on reasonable grounds as to the authenticity of the references referred to in paragraph 5 of Schedule 2 in respect of that person. (This relates to ensuring good conduct reports from staff’s county of origin are obtained for overseas workers.) Outstanding from the last inspection 19 April 2006. Amended to take account of the progress made. (1) The registered provider shall 02/01/07 appoint an individual to manage the care home where- (a) there is no registered manager in respect of the care home; and (b) the registered provider - (i) is an organisation or partnership; (ii) is not a fit person to manage a care home; or (iii) is not, or does not intend to be, in full time day to day charge of the care home. (2) Where the registered provider appoints a person to manage the care home he shall forthwith give notice to the Commission of- (a) the name of the person so appointed; and (b) the date on which the appointment is to take effect. (This relates to the organisation informing CSCI of what management arrangements they are intending to put in place in the absence of a registered manager.) The registered person shall 28/02/07 ensure that persons working at the care home are appropriately supervised. (This relates to staff being provided with formal recorded regular one to one supervision sessions.) DS0000066189.V316729.R01.S.doc Version 5.2 Page 32 Fairfield House 5. OP37 17(1)(a) &(b) Sch 3&4 The registered person shall- (a) maintain in respect of each service user a record which includes the information, documents and other records specified in Schedule 3 relating to the service user; (b) ensure that the record referred to in sub-paragraph (a) is kept securely in the care home the records specified in Schedule 4 (This relates to ensuring service users accident forms are kept according to date protection legislation.) 28/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations The registered persons should ensure a system of holding in-depth service users reviews at periodic intervals (e.g. every three or six months). Which include the involvement of relatives and professionals. To give all relevant parties the opportunity to thoroughly look at the care package that is being provided. This recommendation is amended from the last inspection 19 April 06 to demonstrate it is partially met. Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 33 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Fairfield House DS0000066189.V316729.R01.S.doc Version 5.2 Page 34 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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