Inspection on 25/09/07 for Fairfield Manor

This inspection was carried out on 25th September 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Fairfield Manor 10/02/10

Fairfield Manor 16/02/09

Fairfield Manor 20/02/07

Fairfield Manor 20/01/06

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Fairfield Manor Fairfield Road Broadstairs Kent CT10 2JU Lead Inspector Mrs. Susan Hall Key Unannounced Inspection 09:45 25 September 2007 th 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 Manor DS0000065787.V340162.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 Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairfield Manor Address Fairfield Road Broadstairs Kent CT10 2JU 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) 01843 860715 01843 868516 www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Post Vacant Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36), Physical disability over 65 years of age (3) of places Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Of the 36 beds 26 are registered for nursing patients and 10 for residential clients. All residential clients must be aged 65 years and over. Date of last inspection 30th April 2007 Brief Description of the Service: Fairfield Manor Nursing Home is situated in a residential area on the outskirts of Broadstairs, approximately one mile from the nearest shops and other amenities. It is owned by Southern Cross Healthcare, who are well known as providers for many nursing and personal care homes. It is adjacent to another care home (Woodlands), which is owned and run by the same company. There is ample car parking at the front of the building and garden areas where service users can sit out in good weather. Fairfield is an old manor house, which is not ideal for meeting nursing needs, as many corridors are rather narrow for wheelchair users. However, some adaptations have been made, and include a passenger lift, which provides access to all floors. Ramps are in place to facilitate wheelchair users. Accommodation for residents is provided on three floors (ground, first and second), and comprises rooms for single use only. Thirty rooms have en-suite facilities. The lower ground floor is used only for staff, and includes the kitchens. The building includes a five bedroom flat which is let to staff. These facilities are entirely separate, so that they do not encroach on residents’ facilities. Fees range from £584.37 to £664.98 per week, depending on the need for residential or nursing care, and taking into account residents’ dependency levels. Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection, which includes amalgamating all information gained about the service since the previous key inspection. This included obtaining survey forms from residents, relatives, health professionals and staff; assessing concerns or complaints made to the service or directly to CSCI; preinspection documentation completed by the manager; and a visit to the service. The inspector previously visited the home for a key inspection in February 2007,and had identified concerns regarding staffing levels for nurses and carers; and other concerns about medication management, and the environment of the home. She returned to the home in April 2007 to carry out a “random inspection”, which was a specifically targeted visit to look at the requirements given in February. She was pleased to find that all requirements were being attended to, and many had already been met. This included requirements about numbers of nurses and care staff. The random inspection report is not available on the web site, but can be obtained by specific request from CSCI or Southern Cross Healthcare, if the request is applicable. CSCI was contacted by relatives for two residents since April, who expressed some concerns about care issues. These concerns were dealt with directly by the home, and appropriate action was taken. The inspector received a number of survey replies, which assisted with the inspection process, and carried out a visit to the home lasting six hours. During this time she chatted briefly with ten residents, a resident’s friend, and several staff. The manager was present throughout the day, and the company’s Operations Manager for this home was also present in the home for a meeting. The inspector was able to give her some direct feedback. The manager informed the inspector that she had given notice of her resignation due to relocating to another part of the country. She was due to leave in ten days time. The company are in the process of recruiting a new manager, and in the interim period have put in a company “project manager” to oversee the running of the home. All staff, residents and relatives had been informed of the change of manager. Residents said they would be “sorry to see her go”. However, they were generally cheerful, and several said they were “happy in the home” and “liked living here”. Feedback from residents and relatives stated that the home is always clean and bright; nursing and care staff are always available to answer concerns; the staff are friendly; the food is good; and there is a variety of activities available. What the service does well: Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 6 The home has a relaxed atmosphere, and staff attend to residents with a caring and respectful manner. One relative commented they were pleased that it “is like a home, and not an institution”. Nursing staff keep up to date with their training and competencies, and carry out good basic nursing care. They are quick to contact other health professionals for advice if needed. The home has a good programme of activities in place, which includes the opportunity to go out of the home on a regular basis. Over 50 of care staff have trained to NVQ level 2 or 3. The manager has a visible presence in the home, and this promotes good contact with residents and visitors. Feedback is also obtained through regular residents/relatives meetings, and annual questionnaires. What has improved since the last inspection? What they could do better: Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 7 The providers need to ensure that an ongoing programme for upgrading areas of the building is completed. This includes: Redecoration and refurbishment of bedrooms; Replacement of worn carpets in bedrooms, corridors and communal areas; Redecoration for exterior paintwork; Upgrading of the second floor bathroom; Refurbishment of an unused first floor bathroom. There are recommendations to: Provide evidence in care planning that residents and relatives are involved in this process. To ensure property lists are accurately completed in care plans. To keep nursing hours under review at weekends, when there is only one nurse on duty in the mornings. To add local Social Services contact details to the complaints procedure. To ensure that a carpet cleaning machine is always available. To further consider making the second passenger lift available for use. To increase the number of fire drills. 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 Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 8 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 Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 9 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): 1-3 (Standard 6 does not apply in this home). People who use the service experience good quality outcomes in this area. The home provides good information for residents and relatives enquiring about the home. There are satisfactory pre-admission assessments to ensure that the home can meet the person’s needs. EVIDENCE: The manager stated that there had been no changes made to the statement of purpose and service users’ guide since the last (random) inspection in April 2007. This documentation was seen then to be up to date, and accurate in its contents. The inspector viewed a pre-admission assessment for a recently admitted resident. These documents are well completed with relevant information obtained about the person’s medical and family history, social lifestyle, and nursing/care needs. Joint assessments from hospital/social services staff are also obtained where possible, and the manager accesses additional information from relatives and carers. Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 10 The manager assesses the information against the room available, and ensures that it will meet the needs of the person in terms of equipment and moving and handling needs. All new residents are provided with a copy of the service users’ guide, which includes terms and conditions of residency, and the complaints procedure. There are a number of residents in the home with dementia/mental health needs, who have developed their symptoms since being admitted to the home (mostly several years ago). These are referred to the GP/Psychiatrist as indicated, and if the home cannot meet their needs, alternative placements are found. However, the home does not admit residents who already need this category of care prior to admission. Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 11 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): 7-11 People who use the service experience good quality outcomes in this area. Personal care is given satisfactorily, and attention is paid to obtaining health care and advice as needed. Medication storage and administration has been improved. EVIDENCE: The Inspector viewed three care plans – one in detail, and two others for wound management and pressure ulcer prevention/management. Care plans are stored in individual folders, which are kept in a locked cupboard in order to retain confidentiality. Nurses and carers have easy access to these. They are divided into indexed sections, which makes it easy to access the required information. Residents have comprehensive information recorded on admission, including medical history; past social history and family background; medication and any allergies; and an assessment of the activities of daily living (e.g. communication needs, personal hygiene management, mobility, nutritional needs, continence care, social preferences). Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 12 Care plans are drawn up on the basis of detailed assessments, and these are reviewed on a monthly basis. Ongoing assessments include moving and handling assessments, continence assessments, nutritional assessments and falls risk assessments. Residents and relatives are invited to take part in care planning, but the inspector did not see evidence of this in the plans viewed. This involvement could be confirmed with a signed sheet, showing when the resident or relative has been included in discussions and reviews. The inspector was pleased to see that a recommendation raised at the last inspection in regards to recording wound care, had been responded to positively by the company and staff. Two plans viewed showed that each area of wound is documented separately, and there is now a record written at each dressing change, showing the pathway of progress for that wound. The manager carries out a monthly audit for wounds and pressure ulcers. Care plans showed good records for contacting GPs, arranging out-patient visits, and referrals to other health professionals as needed (e.g. dentist, speech therapist, dietician). Daily records are written at the end of each shift. These are written by the care staff who have delivered the personal care; and nursing staff add any additional comments. Care staff complete a tick list each day to show the personal care which has been given, and who has carried this out. A record is kept throughout the night, showing that all residents are checked at least every 2 hours, and recording if they have been given a drink, positional change, helped to the toilet etc. The senior staff discuss management regarding death and dying as soon as possible, depending on each resident/family. This enables them to find out specific preferences, and if a resident would want a family member present with them. Residents said that staff are “very kind”, and one said that “the staff are wonderful”. The inspector observed that they interacted with residents with kindness and gentleness, and a respectful attitude. A relative commented that staff are “always available to answer any concerns, and that nursing staff are quick to contact the doctor or other health professionals as needed”. Medication is stored in a clinical room which was in good order. New washable flooring has been fitted, and there is a new controlled drugs cupboard, and a new drugs fridge. Storage cupboards were seen to be clean and tidy and not overstocked. Creams and lotions are kept separately from oral medication. The home uses a monitored dosage system for most drug administration. There are two medicine trolleys for drug rounds, and the inspector checked the medication in one of these. There was no out of date medication. Medication Administration Records (“MAR charts”) were examined, and had been well completed. Handwritten entries had been correctly signed by two nurses. Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 13 There are now two nurses on duty on weekday mornings, and medication is being given within the correct timeframes. There is only one nurse at weekends, and it is still a rush sometimes to complete the medication round within the correct time. However, nurses said there is less pressure at weekends, as there is not usually the same number of doctors and hospital visits to arrange, or other administration duties. There is a recommendation to keep this situation under review. Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 14 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): 12-15 People who use the service experience good quality outcomes in this area. The home provides a good range of activities, outings, and entertainment. Visitors are made welcome. The food is good. EVIDENCE: The home continues to employ an activities organiser who works 20 hours per week. He oversees a two-weekly activities plan, which includes in-house activities such as videos, mobile shop, bingo and quizzes; entertainment twice per month (singers etc); and outings every two weeks. There had been karaoke the day before, which several residents said they enjoyed. They sometimes go to other related homes to join in with parties. The home uses the “Dial a ride” bus service for transportation, and they go to places such as seaside towns, drives in the countryside, places of interest, and pubs/restaurants. A carer accompanies the activities organiser and residents on outings. One resident said she loved going out for pub meals. The activities organiser takes another out to her church once per month. There is also an inhouse church service held monthly. One to one times are allocated for those who do not wish to leave their rooms (or are unable to do so). Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 15 Visitors are welcomed into the home, and have the opportunity to speak to the manager or nurses at these visits. The manager has a visible presence in the home, and welcomes feedback from visitors. Residents are able to bring in personal items of furniture, ornaments, photos etc. with them, and many rooms were seen to be personalised according to their choice. The Inspector visited the kitchen, and this was generally in good order. There is an ongoing weekly/monthly cleaning programme. There is a new cooker hood, and new fly screens at the windows. Food and fridge temperatures are recorded. The chef is in the process of completing NVQ 2 in catering, and he said he had found this helpful, and it had given him more ideas. The chef dishes up lunches in the dining room himself, and he becomes familiar with residents’ likes and dislikes. The chefs use a system of nutritional guidelines called the “Nutmeg” system. There is a procedure in place for assisting residents who need feeding – ensuring that the food is at the right temperature, and that they are not rushed. There is always a choice of menu. The chef said he wanted to develop the menus further, and was waiting for computer access to assist with this. Residents said that food is well cooked, and there is enough. Additional variety would be welcomed at times. Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 16 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 People who use the service experience good quality outcomes in this area. Residents and visitors are able to voice any complaints, and know they will be listened to. Appropriate action is taken to deal with complaints. Staff are trained in the prevention of abuse. EVIDENCE: The inspector viewed the complaints log, and this showed there had been five in-house complaints since the last key inspection in February 2007. Complaints had been properly investigated, and taken seriously. The manager checks with the complainant that they are satisfied with the action taken, and the records showed that she had followed up complaints appropriately. The log does not allow much space for documenting outcomes. Additional records are retained for each complaint, including any letters, statements etc. The complaints procedure does not include details for the local Adult Social Services department, and this is recommended, as it offers the choice for another avenue for complainants if they do not wish to raise complaints inhouse. Relatives commented that they can easily voice any concerns with the manager or nursing staff, and know that they will be listened to. Staff training records include a staff training matrix. This showed that all staff have been trained in recognising different types of abuse, and understanding Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 17 the correct procedures if they suspect this. Training was carried out in March and April. The manager is trained as a trainer in the protection of vulnerable adults, and was able to deliver this training, and to ensure ongoing updates for staff. Staff recruitment procedures are well managed, with appropriate checks for staff carried out prior to confirmation of employment. Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 18 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): 19-26 People who use the service experience adequate quality outcomes in this area. There have been considerable improvements made to the premises since the last key inspection. It is important that the ongoing programme of redecoration and refurbishment continues. EVIDENCE: The inspector viewed all communal areas, bathrooms and toilets, kitchen and laundry, and some bedrooms. The premises generally looked much improved, and it was clear that the maintenance men had been working hard to carry out the redecoration programme. The lounge, dining room, quiet lounge and corridors were in a reasonable state of decoration, although skirting boards need constant attention from equipment damaging the paintwork. Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 19 There is a programme in place to redecorate the bedrooms, and the inspector viewed some which had been completed. The work was of a good standard, and new furniture and soft furnishings had been obtained as well. Eleven bedrooms have been redecorated, and four have new furniture. Other bedrooms still need attention to décor, and new carpeting. New carpets are on order for communal rooms and corridors, and this will significantly improve the whole appearance of the home. The programme needs to be continued until all areas have been completed. The home had 27 residents currently in occupancy. The home is registered for up to 36. One room is extremely small and is only offered for occasional short term respite care. Another room is inconsistent with fire regulation evacuation procedures, and cannot be used unless this situation is satisfactorily resolved. The home has four bathroom/shower rooms, one of which is out of use as it is unsuitable, in poor condition, and unusable for meeting these clients’ needs. Of the other three, a ground floor shower room (“wet room”) has been fitted on the ground floor, and a bathroom on the first floor has been refitted, and has an integral bathing hoist. This work has been completed to a good standard. The second floor has a bathroom with a Parker bath. This room is also in need of refurbishment, but is currently functional. There are plans to alter the design of the room, so that there is access to both sides of the Parker bath. This will provide better reassurance and assistance for residents. The recommended number of bathrooms is one for every eight residents, and it is recommended that the company continue to pursue altering the other first floor bathroom into a useable room. The gardens are well maintained, and residents said they enjoy sitting outside in good weather. A new sluice room is being fitted on the ground floor; and attention is being given to the laundry room to redesign this area. Some walls had been painted, and there are plans to remove wooden drying racks and replace them with better fitments. Another unused room, which is adjacent to the laundry, is being fitted as a drying room. Quotes have been obtained for carrying out painting to the exterior paintwork, and this work is scheduled in the ongoing programme. The home is equipped with pressure relieving mattresses and cushions. Some old hospital beds have been replaced with new nursing beds, and others are on order. Window restrictors have been fitted and are checked monthly. Hot water pipes - which were unsightly, and could have caused injury to residents or staff - have now been boxed in and painted. Radiators are covered; one of these was noted to have a loose fitting, and the manager said she would write this in the book for the maintenance man. Stairways have doors fitted with Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 20 keypad locks for the safety of any resident who is mobile, and may become disorientated. The premises were clean in all areas, which is a testimony to hard work by the cleaning staff, as they were currently without the use of a carpet cleaning machine. This had broken the week before and a part ordered, but the home was still waiting for the part. Additional cleaning hours and maintenance hours have been added since the last inspection. There are two cleaning staff on duty on most days, and usually three for one day per week. This enables additional work such as cleaning behind beds, and carpet cleaning, to be carried out. An additional number of maintenance hours is enabling the maintenance men more time to catch up with the enormous amount of redecoration, gardening and day to day checks. The inspector viewed maintenance records, which are very well kept, and confirm checks for things such as weekly visual wheelchair checks, and monthly records for hot and cold water temperatures. It would be of value to the home to have the second lift in working order. Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 21 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): 27-30 People using the service experience good quality outcomes in this area. Staffing numbers are now being maintained at a satisfactory level. There are good staffing recruitment and training procedures in place. EVIDENCE: The inspector visited the home in April after the last key inspection in February. This was specifically to check staffing levels. These had been increased at that time, and numbers have remained the same since then. The current levels are for 2 nurses in the mornings on week days (plus the manager); and 1 nurse for all other shifts. There is usually only 1 nurse at weekends, as the home is not so busy. However, this still means that it is sometimes difficult for the nursing staff to complete medication rounds on time, and this situation must be kept under review. For example, if a high number of residents need assistance with medication, 2 nurses may be required for weekend mornings as well. Care staffing levels are 5 in the mornings; 3 in the afternoons, and a 4th carer for the evenings until 10pm. This gives additional help at a busy time when many residents want to go to bed. There are 2 care staff on duty at night. Additional successful recruitment means that there has been a drop in the need for agency staff, and this clearly benefits the home. Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 22 Over 50 of care staff have now completed NVQ 2 or 3. The current percentage is 57 , and other care staff are in the process of training. The home has 7 staff from Bulgaria, who are adaptation nurses, or doctors, in their own country, and are currently working as care staff. All have had their qualifications checked by a registered body. These staff have enrolled at college for classes to improve their English. Residents said that they could talk with them satisfactorily, and that all of the staff are kind and caring. The home operates an equal opportunities policy. The home employs an administrator each day for Monday to Fridays. The inspector viewed 3 staff recruitment files. These are well produced with an index and checklist to ensure all aspects of the recruitment process have been completed. Staff files included application forms (specifying it must include a full employment history); interview records; proof of identity; current photograph; confirmation of qualifications; PIN number check for nurses; POVA first and CRB checks, and 2 written references. The deputy manager oversees all aspects of staff training, and there are ongoing courses to ensure all staff are updated as needed. The training matrix showed that all mandatory staff training is carried out (e.g. moving and handling). Some of the staff (including nurses and care staff) are trained as trainers in moving and handling, so that this training can be passed on to all staff. All staff have been trained in infection control, and all chefs, kitchen assistants and care staff in food hygiene. The chefs have nearly completed NVQ 2 in catering, and the housekeeper is carrying out an NVQ in housekeeping. A nurse said that they have the opportunity to keep their own training and practice updated with sufficient courses. Nurses in the home are able to carry out practices such as male catheterisation and venepuncture. Wound care updates are available, and nurses are checked for competency in managing medication. Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 23 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, 35-38 People who use the service experience good quality outcomes in this area. The home has moved forward under good management. There are good systems in place for auditing and recording purposes. EVIDENCE: The manager had completed Registered Managers’ Award training, and been registered as a manager with CSCI. However, she was leaving this post ten days after the inspection visit, due to moving out of the area. The company are in the process of recruiting a replacement manager, and in the meantime are providing a “project manager” from the company to oversee management in the interim period. The current manager has a good presence in the home, and is always available; a relative commented that they hope this will continue in the future. Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 24 The manager has provided a good lead to nursing and other staff, promoting a good work ethic, and training staff to be accountable for their responsibilities and behaviour. Staff meetings are held on a regular basis, and residents/relatives meetings. The minutes for the most recent residents/relatives meeting were displayed on the notice board. The home carries out their own survey system using questionnaires approximately once per year. The manager carries out monthly audits for all aspects of the home, such as the environment, medication, complaints, pressure ulcers, training requirements and care plan reviews. The home only deals with residents’ money in relation to pocket money, and only stores small amounts. The activities organiser showed the inspector that there is a comprehensive list drawn up for new residents/relatives, showing the charges for optional outings and other expenditure. These include hairdressing and chiropody costs, the price of outings, raffles, mobile shop costs, and specific entertainment (which is more expensive than regular arrangements). If a resident is unable to give consent, the next of kin is requested to choose from the available list to give consent for the items they think the resident would enjoy, and will then authorise the amounts which can be spent on the resident’s behalf. (e.g. £1 per week for mobile shop, average £9 per outing, hairdresser average £5-£7 per time). Records of all receipts and debits are retained, and can be viewed by the resident or authorised person at any time on request. Formal staff supervision has been implemented at all levels. This is delegated to different staff to carry out with staff for whom they are responsible. The inspector viewed supervision records. One to one supervision is carried out every two months. Records were seen to be well completed, legible, properly stored and up to date. The maintenance man oversees health and safety in relation to weekly/monthly checks of equipment and fire alarm records. These include checks for the fire alarm panel, alarm sounders, door closures, break glass units, and fire extinguishers. Fire records were well maintained, but the inspector only saw three fire drills documented since February, and would recommend that the number of fire drills is increased. The home had a visit from a Health and Safety Inspector from HSE in September 2007, and he had requested evidence for some servicing records (lift and hoists), which were not available on the day. The home has a health and safety meeting every month, and this is for all staff to attend. The inspector viewed some other servicing records and these were up to date. Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 25 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 2 3 2 3 3 2 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO 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 OP19 Regulation 23 (2) (b,c,n) Requirement To continue with the programme for refurbishing the home in respect of: Redecorating bedrooms and en-suite areas; Providing new bedroom furniture and soft furnishings; Replacing old, worn carpeting in corridors, bedrooms and communal areas as applicable; Redecorating exterior paintwork; Replacing old hospital beds with new nursing beds. 2 OP21 23 (2) (j) To ensure that the home provides sufficient numbers of bathing and shower facilities for the numbers of residents in the home. 31/03/08 Timescale for action 31/03/08 Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 27 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 Refer to Standard OP7 OP7 OP9 Good Practice Recommendations To provide evidence to show that residents and relatives are involved in the care planning process. To ensure that property lists are accurately completed, and kept up to date. To keep the number of nurses employed on weekend mornings under review, in respect of managing medication. To include the local Adult Social Services details in the complaints procedure. To reconsider the possibility of repairing the second lift and making it useable in the home. To complete the programme for refurbishing the second floor bathroom; and to make the unused first floor bathroom into a useable facility. To ensure that a carpet cleaning machine is always available for cleaning staff to use. To increase the number of fire drills. 4 5 6 OP16 OP19 OP21 7 8 OP26 OP38 Fairfield Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Manor DS0000065787.V340162.R01.S.doc Version 5.2 Page 29 - 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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