Inspection on 15/11/05 for Fairfield Residential Care Home

This inspection was carried out on 15th 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fairfield Residential Care Home 09/02/09

Fairfield Residential Care Home 21/02/08

Fairfield Residential Care Home 30/08/07

Fairfield Residential Care Home 18/12/06

Fairfield Residential Care Home 28/07/06

Fairfield Residential Care Home 09/06/05

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Maple Lodge

Heathlands

Aston Court Nursing Home

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Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Fairfield Residential Care Home 27 Old Warwick Road Olton Solihull West Midlands B92 7JQ Lead Inspector Debby Railton Announced Inspection 15th November 2005 09:30 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 Residential Care Home DS0000063831.V256573.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 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 Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fairfield Residential Care Home Address 27 Old Warwick Road Olton Solihull West Midlands B92 7JQ 0121 706 2909 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) Mrs Santok Mayariya Mr Dilip Mayariya Ms Eileen Winters Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The current registered double room is to remain as a permanent single room for as long as the existing service user chooses to remain in that room. During this period the effective capacity of the Home will be seventeen service users. Service users in the six upstairs bedrooms located in the original part of the house may continue to live there as long as their needs can be met. Until such time as the difficulty of split level floors is solved to the satisfaction of CSCI all future service users residing in this area must be ambulant. In the event of the Registered Manager leaving, a fulltime care practice consultant must be retained until such time as a replacement manager is actually registered. This arrangement to exist for a period of two years and applies to any reoccurrence of a registered manager leaving within that period. The current minimum staffing levels must be maintained until such time as agreement is reached with CSCI on the basis of service user needs, environmental factors and staff competency that these may be changed. 9th June 2005 2. 3. 4. Date of last inspection Brief Description of the Service: Fairfield is a large extended detatched house providing care for up to 18 older service users. The home is located in the Olton area of Solihull and is readily accessible to amenities such as shops, places of worship and public transport. The home comprises of 16 single bedrooms, thirteen of which have en-suite facilities and there is one double bedroom. Accomodation is provided on two floors. There are two lounges separated by glass doors, which when opened creates one large lounge area. A dining room and conservatory are also provided. There is a shaft lift to the upper floor. One small area of the home on the first floor is reached by a further small staircase and therefore is only accessible by those that are ambulant. The gardens to the rear of the property are accessed via a ramp from the conservatory enabling access for service users in wheelchairs or with a disability. Handrails are also provided. Limited parking facilites are available at the front of the building, however on-road parking is readily available outside the home. Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector was at the home for 6.5 hours during the day. The inspection consisted of a tour of the building, observation of daily life within the home, inspection of a sample of daily records and care plans and the administration of medicines were assessed. A dinner was sampled. The views of four service users and one relative were sought during the inspection. Three members of staff were interviewed in addition to the provider and registered manager. The pre-questionnaires were filled in by the registered manager. Four service users comment cards, four relative/visitors comment cards and one General practitioner comment card views were taken into consideration in the writing of this report. What the service does well: What has improved since the last inspection? What they could do better: The staff fail to review the service users care plans on a monthly basis. The information recorded on the daily records are not reviewed or reflected in current care plans and sometimes appropriate action is not sought. Staff do Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 6 understand the service users needs but these are not supported by written documentation. All accidents are recorded but the home has failed to report all of these to the Commission. The home has no Quality Assurance system. Installation of such a system would benefit the home and further improvements to the home could be achieved through this. 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 Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 Service users are able to make an informed choice using the service user guide. They are assessed prior to entry into the home and are encouraged to take advantage of a trial period. Each service user has a clear concise contract with the provider. EVIDENCE: The service user guide was clear and concise. Each service user has a written contract/statement of terms and conditions. All service users are assessed by the manager prior to entry and can stay for a trial period of one month. The registered manager uses the social services assessment in addition to her own assessment. She ensures that the home can meet the service users needs before admission. Prospective service users and their relatives and friends are able to visit the home to assess the quality, facilities and suitability. Care plans are written upon entry to the home. Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 The staff have a good understanding of the service users needs. These are not always fully supported by regularly updated care plans. The systems for medicine management have improved to a good standard since the last inspection. Clear comprehensive arrangements had been installed to ensure service users medication needs are met. All service users were treated with respect and empowered to maintain their independence where possible. External healthcare professional services are regularly received in the home. EVIDENCE: Care plans had been well written in the first instance but these had not been updated on a regular basis and so did not reflect the dynamic needs of the service users. Staff have improved the daily report notes and these contained more information about the service users daily lives than at the previous inspection. These had not been utilised to rewrite and update the care plans. All the service users were weighed on a regular basis, but it was noticed during the inspection that one service user had lost a lot of weight over a 12-month period. The dietician had not been informed. In this instance the staff did not reflect on information gathered and act appropriately. Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 10 The manager was keen to improve practice further and following the previous inspection had allocated service users with key workers. All the staff present during the inspection demonstrated a high level of understanding and respect for the service users and worked well as a team. Medicine management had vastly improved since the last inspection and all requirements from the last inspection fully implemented. Audits demonstrated that all the medicines had been administered as prescribed. Regular staff drug audits are undertaken to confirm staff competence in medicine management. Service users are encouraged to self medicate their own medicines and help offered to maintain this level of independence. A Controlled Drug cabinet and register had been purchased. Service users have regular dental check ups in addition to eye tests. Physiotherapist advice is provided in addition to good a good pharmaceutical service. A private chiropody service is offered for a small fee. All the service users clean and tidy in their appearance and their clothes well laundered. A hairdresser visits the home on a regular basis. Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Visitors are made very welcome into the home and staff understand the individual service users preferences and needs. Regular service user forums are held to discuss life within the home. Relatives and staff are welcome to these. Activities are regularly held and service users are encouraged to go on organised trips outside the home. The food has improved and was well presented and nutritious. EVIDENCE: Staff understand the service users preferences and needs. Breakfast times were flexible to enable the service users to get up when they want to. Each day various activities are available. These are varied and service users are able to make their own choice whether to participate. The home has numerous games and books for service users to choose from. A weekly exercise class in addition to a weekly and a “sing-a-long” event are held. Staff organise fundraising events for the homes social fund. Money was raised at the summer barbeque that was attended by the staff, the service users and their relatives. Service users were taken by coach to Bridges Worcester that was paid for by the social fund and the service users spoke highly of this trip. Shopping trips are encouraged and the home utilises the local “ring and ride” service. Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 12 All family and friends are made very welcome by the staff. Relatives spoken to during the inspection were pleased with the care provided by the home. This was supported by comment cards independently sent to the Commission from both the service users and their relatives. Religious needs are met and the manager is actively seeking a local vicar to undertake a Church of England service within the home. Links with the local Catholic Church have been maintained. The standard of the food was high. This has improved considerably since the last inspection. The provider and the cook now work as a team. The cook offered a choice of balanced meals that were well presented and tasty. She catered for individual dietary needs. A four weekly menu was observed in the dining room offering a good choice for breakfast, lunch and tea. Snacks, biscuits and fruit were also provided and freely accessible for the service users to eat. Drinks were offered regularly throughout the day. Various feeding aids were provided to help the service users maintain their independence. Discreet help by the staff was observed and the staff empowered the service users to feed themselves where possible. Service users who did not wish to eat their meals in the dining room were able to choose and alternative venue. Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 The home had received no formal complaints. The staff and manager regularly address issues raised either individually or at service user forums. The service users legal rights are protected. EVIDENCE: The home has had no formal complaints. The manager is approachable and service users and staff are able to address any subject with her. All the service users and relatives spoken to during the inspection had no complaint regarding the home and this was supported by comment cards sent to the Commission. Seven service users have an advocate or representative to act on their behalf. Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 The home is meticulously clean and free from any offensive odours. A redecorating programme is underway. All the requirements from the last inspection have been met and this has improved the home. The garden is pleasant and well used by the service users during the summer months. EVIDENCE: Since the last inspection the kitchen has been repainted and a new non-slip floor laid. The sink unit has been changed. The kitchen was very clean and tidy. Some easy chairs in the lounge have been replaced. Three bedrooms have been redecorated in addition to the dining room and the hall and stairway. An en suite floor covering has been replaced in one bedroom. The shower had had a pre set temperature regulator valve fitted and a sluice was to be installed upstairs at the end of November. Flooring had been replaced in the upstairs bathroom. The laundry floor had been replaced. The garden was well maintained and had been well used during the summer months. Staff and service users liked the food cooked on the barbeque. All the bedrooms were well presented, personalised and very clean. Not all bedrooms had two chairs available in the room, but additional seating was Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 15 available on request. furniture. Service users are encouraged to bring in their own Specialist equipment is sought to help service users maintain their independence and staff have been trained to use the hoist. The rooms suit the majority of the service users needs. One room is approached by some stairs and this may be inappropriate for one service users due to high risk of falls. This was to be discussed at the inspection. A possible room change was to be discussed with the service user and relatives in line with The Conditions of Registration 2. All the communal toilets and washing areas had liquid soap and paper towel dispensers. Full hand washing facilities were not available in the laundry. Transferral of soiled clothes and linen from the home to the laundry was poor and must be improved. All new Control of Substances Hazardous to Health (COSHH) information had been updated and displayed in the COSHH cupboard for easy referral in the event of an accident. Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 The staff and skill mix matched the service users needs. All the staff worked well as a team and this was recognised by some service users. The homes recruitment policy and practices are now adhered to in all instances. The manager has installed a training programme. EVIDENCE: The home has a relatively low turnover of staff and agency or bank staff are not used. All shifts are covered by the staff employed in the home. Rotas are well written and reflect the needs of the service users. 62 of staff have achieved NVQ level 2 in care. The remaining staff have been enrolled and are currently undertaking the course. Three members of staff have achieved NVQ level 3 and the registered manager has achieved NVQ level 4 and is currently undertaking the Registered Manager Award. Half the staff have received first aid training and six staff currently administer medicines and have successfully undertaken accredited training in the safe handling of medicines. All staff that wish to handle medicines in the future have been enrolled in the course. The manager has installed a training programme that identifies the staff needs and also summarises courses successfully undertaken. Staff have recently received training in Manual Handling, as identified to meet the service users and staff needs. The programme was ongoing. Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 17 All newly recruited staff have the relevant police check before they start work and references are sought. Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 38 The manager has flourished with the extra responsibility given to her by the relatively new providers. Staff and service users spoke very highly of her and her ability to successfully run the home. EVIDENCE: The registered manager has installed many improved systems within the home as well as maintaining a hands on approach. A deputy manager is to be employed to help with the written work for the care plans and daily reports. The office was well organised and all information needed to complete the inspection was readily available. The home is well run and all the staff work well as a team. All staff and service users interviewed during the inspection praised the manager. The service users needs were felt to be always the priority and this was commended during the inspection. Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 19 The home has no external Quality Assurance system, but service users and relatives views are regularly sought. The manager now undertakes regular supervision with her staff every two months and acts appropriately if needed to. Career developments are discussed and training needs identified and courses sought. The home recorded all accidents that had occurred in the home, but had failed to inform the Commission in all instances. Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 20 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 2 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 3 3 2 X X 3 X 2 Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 21 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 OP7 Regulation 15(2,b,c) Requirement All service users must have their needs regularly assessed and care plans written and implemented each month to reflect their dynamic needs. This was a requirement from the last inspection. Staff must reflect on information gained from weight charts for the service user and seek appropriate help if necessary Improved systems must be sought to transfer soiled clothing and linen from the home to the laundry Effective quality assurance and quality monitoring systems must be installed and must be based on the views of the service users in the home. All accidents, injuries and incidents of illness or communicable disease are recorded and reported to the Commission in a timely manner Timescale for action 22/11/05 2 OP8 14(1a)(2) Sch3(3m) 12(1a) 13(3) 24(1a,b) (2)(3) 22/11/05 3 OP26 15/12/05 4 OP33 15/12/05 5 OP38 37(1)(2) 16/11/05 Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Fairfield Residential Care Home DS0000063831.V256573.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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. 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