Inspection on 09/11/05 for Fairfield House

This inspection was carried out on 9th November 2005.

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

Fairfield House 21/06/06

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Fairfield House Bleathwood Nr Ludlow Shropshire SY8 4LF Lead Inspector Jean Littler Unannounced Inspection 9th November 2005 03:15 Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 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 DS0000064842.V265761.R01.S.doc Version 5.0 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. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fairfield House Address Bleathwood Nr Ludlow Shropshire SY8 4LF 01584 711878 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) Winslow Court Limited Mr Stephen Macdonald Nicolson Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Fairfield House is registered to accommodate six people with learning disabilities who may display occasional challenging behaviour. All residents have a single bedroom and there are reasonably sized communal rooms. The Home is situated on the outskirts of the village of Bleathwood in a very rural location. There are attractive views and a spacious garden that contains a detached wooden building providing additional space for activities and meetings. The Home was opened and registered in August 2005. It is owned by Winslow Court Ltd. a company that comes under the umbrella organisation of Senad. The Home retains close links with Winslow Court which is a larger Care Home in the area. The company training, health and saftey, and human resources departments are based at Winslow Court. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection was carried out on a weekday afternoon between 3.15pm and 5pm. Four of the six residents were at Home for part of the inspection and two spent some time with the inspector. The manager assisted with the inspection and a permanent support worker was interviewed. The information obtained about the service during the registration process and communications between the Home and the Commission since the Home opened were also considered as part of the inspection process. What the service does well: What has improved since the last inspection? What they could do better: Work is being continual to develop individual residents support and activity plans as well as the daily routines and culture of the Home. The practice of wedging open fire doors in communal areas needs to stop but approved devices would be beneficial so the doors can be opened allowing residents to move freely about. The information in the Residents Handbook could be developed into a format that each person can more easily understand. One area of recording on the medication system should be addressed. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 6 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. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 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 Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 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, 4 and 5 Information about the Home has been developed and made available to residents and their representatives. Arrangements would be further improved if basic details were presented in a personalised manner for each resident. Contractual arrangements are in place but these had not been formally confirmed following the trial period. The needs of the new residents were carefully assessed prior to their admission to ensure the Home was a suitable placement for them and the group would be compatible. EVIDENCE: Four of the six residents moved from Winslow Court and their needs were already well known to the providers and the manager. One resident moved from elsewhere so a full assessment was completed prior to the trial admission taking place. One resident moved from the school that is on the same site as Winslow Court. As part of the assessment process the manager had visited this young person at school on different occasions, met with his parents and attended his leaving school review meetings. The young man had visited the Home with his family and chosen which bedroom he wanted. The residents were admitted in stages so their anxieties could be kept to a minimum. All residents seem appropriately placed and the group is compatible. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 9 A Statement of Purpose and Service User’s Guide were developed prior to the Home being opened. These were made available to the residents’ representatives as part of the admissions process. A version of the Guide, called the Residents Handbook, was also developed using Widget symbols and simple text. Now the residents have moved in their keyworkers should consider if the relevant information about the Home e.g. their rights, how to complain etc, can be presented in a format suitable for each individual. A Terms and Conditions document is in place and this had been issued to the residents’ representatives. Individual contracts with the funding authorities are also in place for each resident. After the trial three months the placements had not been formally confirmed with those involved. This seems to have been an oversight because all placements were going well. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 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): EVIDENCE: These standards were not fully assessed, however all residents have a care plan that has been agreed with their representatives. Detailed daily records are being maintained to provide evidence of each residents well being. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Residents are being actively encouraged and assisted to have appropriate personal relationships with friends and family. EVIDENCE: One resident has been spending private time with her mother in the activities building in the garden. They have used the kitchenette facilities to prepare a meal to share together. Efforts from the team have resulted in one resident seeing a relative again after being estranged for a long period. This is very positive for the resident concerned. These standards were not fully assessed, however each resident has a personalised activity plan and all are leaving the Home regularly to access the community and partake in college classes or sessions at Winslow Court. A relaxed Homely routine is being developed where freedom and choice are being promoted. Where restrictions have been implemented these have been on the basis of a risk assessment e.g. for her own safety one resident has been prevented from leaving the grounds without staffs’ knowledge. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 12 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, and 20 Suitable arrangements are in place to meet the assessed health and care needs of the residents, and they have access to a range of health specialists if required. Medication is being safely stored and managed. EVIDENCE: Links with local health professionals are being established. All residents are registered with a GP. One resident had just returned from the dentists at the start of the inspection. Support for health needs such as annual checks is provided by the site nurse based at Winslow Court. Additional health support can be accessed through the team of specialists based at Winslow Court e.g. psychologist, speech and language therapist. External links with health professionals are also in place e.g. consultant psychiatrist. The two care plans sampled showed that detailed guidance is in place to guide staff in how to meet residents’ care needs. Same gender staff are provided for assistance with personal care tasks. Intervention strategies are in place to assist staff to respond positively to the residents’ behaviour and methods of communication. For some residents staff have the option of using a specific sanction at appropriate times e.g. a resident may be asked to go to their bedroom to calm down if they become agitated. On these occasions an incident report is completed and a record made in the sanctions book. This book showed that sanctions are not being used excessively. Staff meeting minutes Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 13 showed that residents’ needs are being kept under review and that staff are trying to ensure their approach is consistent. The medication is being stored securely in an appropriate cabinet. The administration records showed that doses are being given as prescribed. A system is in place where a second worker signs a separate record to show they witnessed the medication being administered to each resident. This system effectively demonstrated that one dose had been given when the worker had forgotten to sign the main chart. Some hand written entries had been added to the pre-printed administration charts. These entries had not been signed by the worker completing them and there was no evidence that another worker had checked the accuracy of the instructions. This is recommended to help avoid administration errors. The storage cabinet was sufficiently large for the medication to be organised in an orderly way, with oral and topical medication separated. A medication policy is in place and staff are not permitted to administer medication until they have received training from the site nurse based at Winslow Court, who then observes them giving medication before deeming them competent. Staff are also provided with a formal accredited training course in medication administration. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not fully assessed, however no complaints or adult protection concerns have arisen since the Home was opened. Suitable procedures are in place. EVIDENCE: Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 15 The Home is well suited to its purpose and is comfortable and homely. One shortfall was noted in regards to fire doors. The residents are being supported to personalise their bedrooms. EVIDENCE: The Home has been specifically purchased and refurbished for the purpose of providing a calm and comfortable Home for people with complex needs. The location is very rural and so does not facilitate the residents becoming part of a local community or give them the option of using public transport for outings. Good initial efforts have been made to make positive links with neighbours and several staff drive the vehicle provided to allow residents to access planned activities and community facilities. The exterior of the home is in very good condition and the spacious grounds have been landscaped. Internally the house has been decorated and furnished to a high standard and work is continuing to create a homely feel. Two residents showed the inspector their bedrooms, which were nicely decorated and full of personalised possessions. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 16 To create a homely and relaxed atmosphere where residents can move freely around the building while staff discreetly supervise them the doors to some communal areas are being propped open during the day. These are fire doors and should be kept closed. As closed off rooms will not benefit the residents it is recommended that fire safety advisors are consulted about the installation of automatic release closure mechanisms. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 17 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): 33 Appropriate staffing levels are being maintained to meet the assessed needs of the residents. EVIDENCE: At least four staff are on duty during the day and when the manager is on duty there are five unless he is covering a gap caused by sickness etc. Having five staff on duty provides flexibility for residents to access their activities, outings or health appointments. Several of the staff have already been working for the organisation and transferred from the two other Homes in the area. This aided the residents who moved from Winslow Court to settle as they were with staff who knew them and their needs. The manager has worked hard to recruit locally over recent months. There is a part time vacancy, however a current worker may increase her hours by taking these on. If this is the case then the Home will be fully staffed. This is a major achievement for a new service and will provide important stability for the residents whilst the routine and culture of the Home is further developed. Staff training arrangements were not assessed in full, however the training is being accessed through Winslow Court where there is a well established induction, foundation and on-going training programme. Some staff were at Winslow Court during the inspection working on their NVQ awards. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 18 The member of staff spoken with reported that the Home is running smoothly and that she is being supported to develop the knowledge and skills needed for her role. She found the staff meeting she had attended open and constructive and finds the manager approachable. She felt she would benefit from receiving epilepsy training and said she would request this at her next supervision session. Both members of staff seen interacting with residents during the inspection demonstrated an awareness of their needs and any agreed boundaries, whilst showing them kindness and respect. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 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 and 38 The registered manager is suitably qualified and experienced. The Home is effectively running the service and focusing on the best interest of the residents. EVIDENCE: The manager was registered with the Commission as part of the overall registration of the service prior to it opening. The manager has relevant experience from working at a senior level within Winslow Court, he has attended managers’ training courses such as staff supervision, and is due to complete the NVQ Registered Managers Award shortly. The manager’s hours are not officially included in the care element of the Home’s rota. Despite this he was clearly involved in providing care support, having just returned from taking a resident to the dentist as the inspection started. He reported that he was only just managing to complete his management and administration duties within his hours. As there is no deputy post the providers need to monitor the expectations they are placing on the manager who was clearly Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 20 working whilst unwell. Despite this he took on a shift the following morning because the floods had damaged one worker’s car. The feedback gained during the inspection indicated that the manager is approachable and helpful. Health and safety arrangements were not fully assessed, however essential safety checks were taking place e.g. the fire alarm, hot water temperatures. As detailed above the arrangements for holding fire doors open need to be addressed. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 4 4 4 3 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 4 X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 4 16 X 17 Standard No 31 32 33 34 35 36 Score X X 3 X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fairfield House Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 X X X X X DS0000064842.V265761.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? N/a 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 YA42and YA24 Regulation 13, 16. Timescale for action Fire doors must be kept closed at 10/11/05 all times unless held open by an approved automatic closure device. (confirmation that these devices have been ordered was received from the manager on 23/11/05). Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA1 YA20 Good Practice Recommendations Consider if the relevant information about the Home e.g. their rights, how to complain etc. can be presented in a format more suitable for each individual resident. Any hand written entry on the medication administration charts should be signed by the worker completing it and then checked for accuracy, against the GP’s instructions, by a second worker who also signs the chart. Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN 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 Fairfield House DS0000064842.V265761.R01.S.doc Version 5.0 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!