Inspection on 01/12/05 for Fairfields House

This inspection was carried out on 1st December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Fairfields House 14/07/09

Fairfields House 24/07/07

Fairfields House 15/05/06

Fairfields House 21/07/05

Fairfields House 11/11/04

Fairfields House 03/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Fairfields House 21 Tuddenham Road Ipswich Suffolk IP4 2SN Lead Inspector Claire Hutton Unannounced Inspection 1st December 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 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. Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Fairfields House Address 21 Tuddenham Road Ipswich Suffolk IP4 2SN 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) 01473 213988 01473 785062 Fairfields House Ltd Post Vacant Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st July 2005 Brief Description of the Service: Fairfield House is a care home providing personal care and accommodation to up to 23 older people. It is a privately run home and is situated in a quiet area of Ipswich, not far from the town centre. The home is a two-storey building with bedrooms on the ground and first floor. The home has a shaft lift and stair lift. Twenty-one bedrooms are single and twelve provide en-suite toilet and wash hand basin. There is also one double en-suite bedroom. There are car-parking facilities at the front of the building and the rear provides an enclosed garden, which is well maintained and sheltered. Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place one afternoon in December and lasted approximately four hours. Both the two owners and the manager came to the home for the duration of the inspection. This report assesses the key standards that were not covered on the inspection from 21st July 2005 and reassesses those that were not entirely met. Three residents were met with and they discussed the care they received at the home. One relative, one member of staff and two professionals were also spoken with. Records either sampled or audited included assessments, care plans and associated records, medication, staff roster, and recruitment of one new member of staff. A tour of the communal areas was undertaken and three bedrooms were visited. Since the last inspection an application for the registered managers post has been received by the CSCI and is currently being processed. What the service does well: What has improved since the last inspection? Since the last inspection a programme of environmental improvements has continued. The laundry room and linen cupboard have both received a deep clean and a coat of paint. One bathroom and a hallway have also been painted. Flooring has been replaced in the downstairs bathroom, back corridor and entrance area. A new kitchen was said to have been purchased and consideration was being given to extension of the kitchen. The roster now shows that all shifts are now adequately covered, including a Sunday. Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 6 The manager had consulted with the local Health Protection Team regarding their policies on infection control. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 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 Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 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): 3 People who use this service will find that their needs will be assessed before they move into the home, therefore they can expect to have their needs met. EVIDENCE: Information was examined relating to three residents at the home. One resident was quite new to the home. There was evidence that the home had assessed the resident before they moved into the home and had obtained an assessment from the social worker and information from the family. Upon speaking to the individual they confirmed that the home knew what care they needed before they moved into the home. In one other case of a resident being at the home for sometime there was evidence of a review by social services and the revised care needs were in a report from the review. Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 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 and 9 People who use this service can usually expect to have their care needs documented and met, but more consistent recording and further development of instruction of how to care will ensure quality of care for every resident. EVIDENCE: The care plans and associated records, such as the daily statements, relating to three residents were examined. These were discussed with a staff member, the manager and the owners. Three residents were also spoken with about their care at the home. Each of the residents had a care plan in place; these had or were in the process of being revised on to a new format designed by the new manager. Each plan had approximately fourteen elements to the care plan including communication, being safe, personal care, dressing, eating and drinking, sleeping, mobility and recreation needs. On the whole these care plans were clear and easily understood. There was evidence of monthly review. However in one case the needs of a resident had changed and were changing still. The care plan did not appear to have kept pace with the health changes, e.g. catheter care, therefore the instruction to staff on care matters relating to the individuals catheter was not sufficiently evident. The visits of the district nurse Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 10 were not documented in a consistent way. There was evidence of accessing health care from the chiropodist and the optician. The plan in one case did not contain an assessment of mobility and use of a frame. There were no clear instructions to staff on how to move and handle the individual resident. One other manual handling assessment was not dated or signed. A discussion took place around the one individual’s night time arrangements and the manager and staff were not sure if the individual went to bed or slept in a chair. The daily notes made by staff could not clarify the issue. Upon visiting the individual resident they stated they liked to stay in the chair and this was probably for comfort. The home had ensured that a cushion to prevent pressure sores was in place, but the chair was possibly not the correct one for the size of the resident or the fact that the resident was probably spending most if not all the time in the chair. Therefore it was strongly suggested that an occupational therapist come and assess the individuals needs further. This was immediately actioned in the next few days by the manager. A district nurse was asked her opinion of the home. She stated ‘it’s not one of the better homes we go to in terms of how they care for people’. A social worker who visits the home was asked her opinion of the home. She stated that she has reviewed several residents needs at the home and they ‘are always happy about the food and the carers, but not so happy about the space available and their room’. The medication protocol was examined. A member of staff held the medication keys and the medication was kept secure. The home operates a monitored dosage system. There was a record of all medication coming into the home, a record of medication administered and a record of medication returned, therefore it was possible to audit one medication at random. The stock and administration was correct. Whilst auditing medication a tablet from a previous day was found in the blister pack. It had not been administered which was an error. The manager had a process in place for dealing with this and recording the event. There was a guideline in place for staff to follow in the event of prescribed as and when required medication (PRN). There was no list of staff specimen signatures and initials available to identify those who administered medication, if the matter required tracing. Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 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): People who use this service can expect to lead a lifestyle that they are happy with. EVIDENCE: The above key standards were assessed at the inspection in July 2005 and found to be met. At this inspection two residents stated that the food was of good quality and was to their liking. One person stated ‘the food is lovely here’. In terms of maintaining contact with family and friends three residents stated that their family and friends could visit at any time. One of the residents had several visitors per week. One visitor was met and briefly spoken with. The visitor was very satisfied with the home and felt they looked after the resident well. Explaining that if the resident was happy then they were happy. Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 12 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): EVIDENCE: The above key standards, (16,18) were assessed at the inspection in July 2005 and found to be met. Since the last inspection a complaint was received by the CSCI and referred to the home for investigation. This was duly investigated appropriately. The complainant then wished to retract the complaint. Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 13 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 and 26 Fairfield’s provides a small, comfortable family type home that generally meets the needs of older people. The plan of developments will ensure these needs continue to be met. EVIDENCE: A tour of the communal areas was undertaken and three bedrooms were visited with the permission of the residents. Since the last inspection the program of environmental improvements has continued. The laundry room and linen cupboard have both received a deep clean and a coat of paint. In the laundry room individual baskets have been introduced for returning fresh laundry to residents. There was a sink in the laundry room for staff to wash their hands after dealing with laundry, but there was no liquid soap or paper towels, therefore it is unlikely that staff did cleanse their hands in the laundry room after handling laundry. One bathroom and a hallway have also been painted. Flooring has been replaced in the downstairs bathroom, back corridor and entrance area. In the last inspection report it stated ‘the kitchen had a door hanging of and a worn Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 14 worktop. The ceiling had a crack and was very yellow from cooking’. The owner explained that repairs had taken place and a new kitchen has been purchased but consideration was being given to extension of the kitchen before this was fitted. The lounge and dining room were comfortable, clean and well used by residents and visitors. Currently not all residents could sit in the lounge as it did not have sufficient space. Plans to extend the communal area had yet to be finalised. All areas of the home were clean and without odour. The same cleaner from the last inspection was seen to be at work in the home. Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 15 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): 22 and 29 People who use this service will find that there are sufficient staff to meet their needs and that they are generally well recruited. EVIDENCE: The home have a weekly roster available for inspection that shows everyone employed at the home and in what role. Generally, there are three carers on in a morning and three carers on in an afternoon and two carers awake at night. This pattern was still followed. At the last inspection there was some concern that a carer was also the cook on a Sunday, this has now been resolved and a designated cook was seen on the roster for a Sunday. Residents spoken with stated that there were sufficient staff to meet their care needs. One resident said ‘the staff are very helpful and caring’. The recruitment files for one new carer recruited since the last inspection was examined. This was all satisfactory except the reference of the previous employer was not available for inspection. The manager had spoken on the telephone with the previous employer and had not recorded her findings. Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 16 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 and 38 People who use this service will find a service that is adequately managed with support from the owners and the health and safety of residents is protected, but could be further developed. EVIDENCE: Since the last inspection an application has been received from the manager at the home and is being processed by the CSCI. The owners of this home are involved in the running of the home and provide support to the staff and residents. The manager and owners was present through most of the inspection and contributed fully. One aspect of the manager’s fitness that the standard calls for is ‘a manager who is familiar with the conditions/diseases of old age’. At this inspection there have been two key repeat requirements relating to knowledge of old age. Therefore the manager should develop her knowledge further to ensure care plans reflect the correct up to date information on health and manual handling matters. Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 17 One resident spoken with spoke highly of the manager and found her helpful in solving matters. In terms of safe working practices at the last inspection records on training for first aid, abuse, fire and manual handling were assessed as satisfactory. At this inspection the manager confirmed that five staff had been trained in first aid. On the first floor all windows had restrictors to prevent falling and all radiators had nice coverings to prevent scalding. For one individual resident the expertise of the fall prevention officer had been utilised to ensure an appropriate plan was in place. The home must ensure all residents who need manual handling assessments have these in place. Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 18 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 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X 3 Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 19 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 13,(5) 14,15 Requirement All residents health and care needs must be set out in a plan therefore, plans must be updated as needs change. Manual handling must be assessed. The plans must have clear instructions to care staff on individual requirements. (This is a repeat requirement from 21/07/05) In order to demonstrate that resident’s health needs are fully met all medical intervention requested and provided must be recorded. Care plans must include a plan of support for medical treatment. e.g. District Nurse treatment. (This is a repeat requirement from 21/07/05) The recruitment process must follow the regulations – each member of staff must have two references before they start work. (This is a repeat requirement from 21/07/05) Timescale for action 06/02/06 2. OP8 13 (3)(4) 17 (1) 06/02/06 3. OP29 7, 9, 19sch2 06/02/06 Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP20 Good Practice Recommendations Daily care records completed by care staff should state the care given. The home is unable to accommodate all residents in the lounge, therefore a plan of how communal space will be increased should be provided to the CSCI with timescales, planning consent and budget identified. Fairfields House DS0000058630.V274218.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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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