CARE HOMES FOR OLDER PEOPLE
Fairfield Residential Home 115 Banbury Road Oxford OX2 6LA
Lead Inspector Jan Walsh Announced 2 June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fairfield Residential Home Version 1.10 Page 3 SERVICE INFORMATION
Name of service Fairfield Residential Home Address 115 Banbury Road, Oxford OX2 6LA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01865 558413 01865 513699 The Management Committee of Fairfield Alison Parry Care home 29 Category(ies) of Old age, not falling with any other category (29) registration, with number of places Fairfield Residential Home Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: none Date of last inspection 09 December 2004 Brief Description of the Service: Fairfield Residential Home is situated on the edge of Oxford and can be easily accessed by bus, taxi, or for the more enegetic on foot. It is also within walking distance of Summertown a small shopping area. The house is a large town house with a large well maintained garden. The house has been extended to provide the majority of bedrooms for the residents. The internal decor is of a high standard and the home provides spacious accommodation. The home is registered for 29 residents at the moment. They have applied to register a new room in the recently completed extension and refurbishment of the annex. The residents are accomodated in single rooms , 21 of these have en-suite facilities. There is a small lift to the first floor. There are several sitting areas and two dinning rooms. The residents also have the use of two small kitchens. Fairfield Residential Home Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Since the last inspection the home has refurbished the rooms in the annex and added a new room. One inspector made an announced visit to the home lasting 6 hours. During this time a tour of the building was undertaken. Water temperatures were taken in one bathroom and two wash hand basins in the annex. Four care staff, one kitchen assistant were spoken to plus the deputy manager and the manager. Five residents were spoken to and a visiting district nurse. Five records of care were looked at in detail plus one staff record. Records of accidents, medication were also seen. What the service does well: What has improved since the last inspection?
The rooms in the annex have been refurbished and now have en-suite facilities. The annex has been redecorated and looks bright and fresh. The residents are very pleased with their new rooms. One resident who spends some time in her own room as her mobility is poor was particularly pleased with the new facilities. Fairfield Residential Home Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fairfield Residential Home Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Fairfield Residential Home Version 1.10 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 4 and 5 Prospective residents are given the information they need to make an informed choice. Their needs are assessed before admission and they are assured these will be met and told how they will be met. Prospective residents and their family and friends are given an opportunity to visit to assess the home’s facilities and suitability. EVIDENCE: A pack of the information that is given to prospective residents was seen at the inspection. It contained the information needed for the person to make an informed choice. This will need updating to include details of the new room. All the information that is required is included but to make it more userfriendly it might be possible to expand this at the same time, to give the reader a more comprehensive picture of life in the home. The five resident records looked at in detail showed assessment of the resident’s needs prior to admission. The manager confirmed that all residents were assessed thoroughly before admission to make sure they will meet the specific criteria for residency. The resident always came for a visit before admission and usually had a stay for 2–3 days. The manager said she liked prospective residents to come in for a week and then return home to consider
Fairfield Residential Home Version 1.10 Page 9 with their family and friends whether the home would meet their needs. New residents always have a month’s trial. At the time of inspection five residents were on a month’s trial. The manager confirmed that if Fairfield is unable to meet their needs, help will be given to find a more suitable placement. Three residents confirmed that all their needs were met and one resident said that living in the home matched her expectations. Fairfield Residential Home Version 1.10 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 9 The residents’ care needs are recorded in individual care plans. The health needs of the residents are fully met. Residents who are able are selfmedicating and residents are protected by the home’s procedures and policies for dealing with medicines. EVIDENCE: Five residents’ records of care were seen during the inspection showing regular assessment and monthly reviews of the residents’ health, social and personal needs. Evidence was seen of visits of health care professionals, doctor, community psychiatric nurse and district nurses. Examples were seen of the way specific health needs are being met. District nurses from different GP practices were seen visiting residents on the day of inspection. One district nurse said she has visited Fairfield over a number of years. She confirmed that in her opinion the care at the home is very good. Staff reported things to her appropriately and would give the prescribed care as necessary. Medication records were seen and these showed evidence of the procedure for the safe administration of medication. The medicine cupboards were seen at inspection. Most medication is in dossett boxes received directly from the pharmacy and stored in this cupboard. On the day of inspection 2 bottles of
Fairfield Residential Home Version 1.10 Page 11 Lactulose were seen on top of this cupboard. The manager confirmed that the office is kept locked when no one is in there, and though this is a low risk medication it should be kept in the medicine cupboard. Four residents are self-medicating at the moment. Evidence was seen that the home orders the medication for them and returns it to the pharmacy if necessary. Records were seen of the medication that these residents have. The manager confirmed the residents keep their medication in a locked cupboard in their room. The manager confirmed all staff who administer medication have received training from the pharmacist and that this is regularly updated. A list of carers who administer medication and a specimen of their usual signature was seen. Fairfield Residential Home Version 1.10 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13, 14 and 15 Residents are happy with the home and feel all their needs are being met. Meals are wholesome and appealing, and are also a social activity taken in the attractive dining rooms or in their own room. Residents are encouraged to maintain control over their lives and to keep their previous contacts such as family and friends. Varied and stimulating activities are available in the home and in the community for those who wish to participate. EVIDENCE: Several residents said how happy they were with the living arrangements. They confirmed family and friends were always made welcome and there were often people dining with the residents, or having tea in the garden if the weather was suitable. One resident said the home lives up to her expectations and she is very happy here. She said she joins in the exercise group and is joining a local community group for more stimulation. At the time of the inspection the BBC was recording some residents telling parts of their wartime experiences. Members of the local community had also come to join in. Several residents said they had taken part. Other residents spoke of other activities that were available such as the bible study group,
Fairfield Residential Home Version 1.10 Page 13 which was arranged by the residents themselves. The manager showed some work by the art group and she said some of their work is going to be hung in the new annex. One resident said she had had visitors that morning and had entertained them in her room. She confirmed that she could go out to the shops, church and other meetings as she liked and that she had to sign in and out. The inspector joined some residents for lunch, which was nicely presented in a very pleasant dining room. The meal was wholesome and enjoyed by the residents. The residents confirmed that the food was usually good but they would enjoy more choice and more fresh fruit. The manager confirmed that if a resident did not like the meal on offer an alternative would be given and all people on diets would be accommodated. She said fresh fruit was served twice a week and dried fruit at suppertime. Small kitchens are also available for residents to make themselves a snack. Fairfield Residential Home Version 1.10 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed on this occasion. EVIDENCE: Fairfield Residential Home Version 1.10 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 24,25 and 26 The home is pleasant, hygienic and comfortable. However two areas raise concerns for the safety of residents. EVIDENCE: A tour of the building showed that the home was clean and well maintained. Several rooms were seen and they reflected their owners’ personality with their own possessions and furniture. The manager confirmed that residents were involved with choosing the colour schemes for their rooms, including carpets and curtains. Since the last inspection the annex has been refurbished. The residents have just moved back into their rooms and are delighted with them. They now have en-suite facilities and the rooms have been redecorated. A bath and shower room has been created from a block of 4 toilets. A separate shower room has also been created, thus allowing choice for personal hygiene. The large garden is well maintained with seating for residents to enjoy it. One resident said she likes to sit out when the weather is warm enough.
Fairfield Residential Home Version 1.10 Page 16 Two areas compromise the residents’ safety. • On testing the water temperature on the day of inspection the water to the bath was 63C, and water to two basins was 52C and 54C which is much too hot and puts the residents at risk of scalding. The manager confirmed that pre-set valves have been installed and she would contact the plumber to come and rectify the temperatures. • The drive into the home has several potholes and this is a risk to residents and their visitors walking out to the street. Fairfield Residential Home Version 1.10 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 Residents are cared for by adequate numbers of well-trained and competent staff. EVIDENCE: At the time of inspection there were three carers, one senior carer, a deputy manager and the manager on duty. Also on duty were a cook, a kitchen assistant and a domestic. The four care staff and the kitchen assistant all confirmed they had had all the mandatory training. The two carers were undertaking the national vocational qualification in Health and Social Care. The kitchen assistant has completed a four-ay course in food hygiene. Evidence was also seen of a comprehensive induction and training in a recent member of staff’s records. The staff confirmed most of them had worked at the home for many years and knew Fairfield and the residents really well. Fairfield Residential Home Version 1.10 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35 The home is run in the best interests of the residents with much resident involvement. The home’s policy is to have no dealings with the residents’ financial interests as this is a very able group of residents. EVIDENCE: Residents confirmed they are very involved with any decisions made about the home. They have 3 monthly questionnaires to help maintain the quality of the service. The residents confirmed they could always speak to the management or someone from the Trust’s committee. The manager confirmed that the policies and procedures are regularly reviewed in accordance with good practice. One resident confirmed that ‘the home is a lovely place to stay.’ The manager confirmed the residents are in control of their own financial affairs. In cases when the resident becomes unable to do this a family member or a solicitor has power of attorney. A resident confirmed that this
Fairfield Residential Home Version 1.10 Page 19 was so. The home has a safe but residents like to keep possessions safe in the lockable cupboard in their own room. Fairfield Residential Home Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 4 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3
COMPLAINTS AND PROTECTION 2 3 x x x 3 2 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 x 3 x x x Fairfield Residential Home Version 1.10 Page 21 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 25.8 Regulation Requirement Timescale for action immediate 2. 19.2 13(3)(4)a, Water provided to baths, c showers and wash handbasins must be maintained at 43 C and regularly tested and recorded 23(2)o potholes in the drive must be filled in and condition of the drive monitored and added to the maintenance system of the home 30/06/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 1 Good Practice Recommendations When homes statement of purpose and user guide are updated to show the new facilities, the manager also reviews them and expands on the information made available to prospective residents. All medication is stored in the medicine cupboard. Residents have a choice of menu at lunch time and more fresh fruit available to them 2. 3. 9 15 Fairfield Residential Home Version 1.10 Page 22 Commission for Social Care Inspection Burgner House Cascade Way Oxford Business Park South, Cowley Oxford OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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