Inspection on 14/11/06 for Fairholme

This inspection was carried out on 14th November 2006.

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

Fairholme 28/10/08

Fairholme 27/10/05

Fairholme 21/06/05

Fairholme 22/11/04

Fairholme 30/06/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Fairholme Morda Road Oswestry Shropshire SY11 2AP Lead Inspector Pat Scott Key Unannounced Inspection 14th November 2006 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 Fairholme DS0000020664.V296997.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. Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairholme Address Morda Road Oswestry Shropshire SY11 2AP 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) 01691 653499 01691 654247 www.coveragecareservices.co.uk Coverage Care Services Ltd Denise Beryl Morris Care Home 40 Category(ies) of Dementia (14), Old age, not falling within any registration, with number other category (26) of places Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home may accommodate a maximum of 40 persons. The home may accommodate a maximum of 26 Elderly Persons and a maximum of 14 Older Persons with Dementia. Mrs Morris must achieve the Registered Manager Award by 2005. Date of last inspection 27th October 2005 Brief Description of the Service: Fairholme is registered to care for a maximum of forty older people; within this number up to fourteen of the service users may have dementia care needs. The care home provides both long term and respite care, there is a designated respite unit. All of the rooms within the home are single and all meet the National Minimum Standards. The Registered manager Mrs Denise Morris has been at the home since June 2003. The registered provider is Coverage Care Services Ltd - a ‘not for profit’ organisation registered with the Register of Industrial and Provident Societies and has a charitable trust status. Coverage Care Services Ltd make their services known to prospective service users in: The Statement of Purpose, Company Brochure and web site which also contain their contact e mail address. The inspection report is mentioned in the statement of purpose and summarised in the service user guide. It is also on display in all homes’ entrance halls with a note stating the document can be made available to copy and take away. Coverage Care Services rates are reviewed annually on 1st April each year and service users are notified one month in advance. The only additional charges to service users are for toiletries, hairdressing, newspapers and escorting to hospital for routine appointments. This is clearly laid out in the terms and conditions. Fees for Fairholme as of 1st April 2006 are: £333.76-394. All service users pay monthly by standing order or by cheque usually on the 15th of the month. This is two weeks in advance and two weeks in arrears. Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: management, quality assurance, home visit information from the provider, staff records kept in the home, medication records, discussion with people who use the service, discussions with the staff team, discussion with the manager, tour of the premises, previous inspection reports, quality assurance process, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. What the service does well: What has improved since the last inspection? What they could do better: Storage space should be provided for equipment. Wheelchairs should not be stored in facilities used by service users as they create a hazard. Medication should not be signed for until it has been administered. Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 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 Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Key standards 1.2.3. The homes statement of purpose and service user guide provides service users and prospective users with details of the services the home provides, enabling an informed decision about admission to the home. Assessment of need is conducted in a respectful and plain speaking way so that service users understand their needs will be met during their stay. EVIDENCE: Two service users spoken with said they had been given the opportunity to spend time in the home. Some have been for regular respite stay or had been attending day care and were therefore familiar with the home. An individual member of staff (keyworker) is allocated to give them information, help them Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 9 to feel comfortable in their surroundings, and enable them to ask any questions about life in the home. Conversations with staff confirmed that the staff team are qualified and experienced to work with the needs of the service users. Documentation and training logs showed that specialist areas of work have been explored and that staff have access to detailed guidance and training materials. The home provides a statement of purpose that clearly sets out the objectives and philosophy of the service supported by a resident guide that summarises the statement and provides good clear information about the home. The guide is precise in what the prospective service user can expect and gives a good detailed account of the quality of the accommodation, qualifications and experience of staff, how to make a complaint, recent CSCI inspection findings and contains comments and experiences of residents living at the home. All residents have a copy in their room. Each resident is provided with a statement of terms and conditions prior to moving to the home an example of which was seen. This sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the resident. This is clear, jargon free, easy to understand and gives the service user a very clear understanding of what they can expect. Admissions are now not made to the home until a full needs assessment has been undertaken. The home is then able to confirm that they can meet the needs of the individual through the service they deliver as detailed in the statement of purpose. For people whom are self funding and without a care management assessment the assessment is always undertaken by a skilled and experienced member of staff. Evidence seen in care files confirms that the assessment is conducted professionally and sensitively and has involved the family or representative of the resident. Where the assessment has been undertaken through care management arrangements the registered person now insists on receiving a summary of the assessment and a copy of the plan. Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Key standards 7.8.9.10. The health and personal care, which a service user receives, is based on their individual needs thus promoting good health. Staff have a good attitude to their work and the principles of respect, dignity and privacy are put into practice. EVIDENCE: All service users have a care plan and four were examined as part of ‘case tracking’. These were up to date and had been regularly reviewed. Care plans demonstrated service users right of access to health and remedial services is upheld. The health care needs of those residents too frail to leave the home are managed by visits from local health care services e.g. the optician was visiting service users on the day of inspection. A recent internal audit by Coverage Care Services Ltd reviewed that the systems to receive, store, administer and dispose of medication in the home were in place and followed according to the home’s policies. All senior care Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 11 staff have undertaken the relevant training. However, it was observed during a medication round on one unit, that drugs were signed for before administering them which does not comply with the policies of the home. Staff were seen and heard to respect service users’ privacy and dignity. They were allowed to go about their usual routines and sit where they liked. The staff were seen to interact well with service users and it was evident that relationships are close but still professional. Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Key standards 12.13.14.15 Staff provide for service users support and leisure needs and use this to assist them to exercise choice and control in their lives. Dietary needs of service users are very well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: Rotas are in place to allow for sufficient staff resources for activities and leisure pursuits. The home operates a key worker system, which enables closer resident/family staff relationships where likes, dislikes and needs are shared. Staff spoken with were aware of their roles. The home has developed a system for displaying information and bringing attention to community events and activities. Service users stated that family and friends are made welcome and know they can visit the home at any time. Staff were seen to make time to talk to service users. The design of the home provides seating areas within the Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 13 communal areas of the home where residents can entertain their visitors, in addition to the privacy of their own room. The home provides information and telephone numbers for contacting independent people who will act as advocates on the service users’ behalf. Service users have the choice to bring a limited amount of small goods with them on admission to the home and were seen to keep personal items which are important to them in their own room. Within the service there is evidence of a good awareness and understanding of equalities and diversity with respect to age (beauty therapy-not just for the young), disability (equality of all sharing the activities/outings) and beliefs (various events depending on individual beliefs). There is ownership of the equality and diversity agenda by staff at all levels, and they are encouraged to contribute to developments as seen with various topics in the staff meeting agenda. Services users felt that food and mealtimes are something to be looked forward to. An experienced cook is responsible for providing quality nutritional meals that meet the dietary needs of the service users. The home holds the platinum award for healthy eating. Tables were set attractively for breakfast with the necessary cutlery and aids to help individuals during their meal. Residents enjoy the flexibility of meal arrangements and said they enjoyed being able to eat in their own room if they wished. Regular drinks are available and staff were always willing make a cup of tea at any time when asked. Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Key standards 16.18. Service users have access to a complaints procedure that enables them or their supporters’ views to be listened to and acted upon. Staff are provided with induction and on-going training regarding adult protection. This provides staff with the relevant knowledge to safeguard service users from many types of abuse. EVIDENCE: The service has a complaints procedure that is up to date, very clearly written, and is easy to understand. Service users, when asked, were unsure of how to formally make a complaint but they said they would quite happily talk to one of the staff in charge. The complaints log showed that unless there are exceptional circumstances the service always responds within the agreed timescale. Complaints are always reviewed as part of the provider’s monthly review of the conduct of the home. Those received since the last inspection had been appropriately dealt with and resolved. The policies and procedures regarding protection of residents are in place and staff spoken with were aware of how to respond if an allegation of abuse were made to them. Training of staff in the area of protection is regularly arranged by the home. Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 15 Service users stated that they are very satisfied with the service provision, feel very safe and well supported by staff that have their protection and safety as a priority. Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Key standards 19.26 Fairholme is comfortable and homely and service users live in a wellmaintained environment. EVIDENCE: The CSCI is regularly informed of premises issues through the reports from the provider. A problem with a leaking roof has been addressed and is awaiting redecoration. Decoration of a bathroom was in progress, the colour of which was reported to have been chosen by staff. The management should give consideration to seeking the views of service users in any future decoration of their facilities. Generally, the home has a well-maintained environment, which provides aids and equipment to meet the care needs of the residents. Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 17 They have the choice to bring small personal items of furniture into the home as was seen in those rooms entered. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in privacy or in their own rooms. There is a choice of bathing facilities, both assisted and unassisted, showers and baths and there are a number of toilets strategically placed around the home. However, the shower room on Poppy unit was being used to store wheelchairs which is a hazard for frail service users. Service users were able to state that the temperature in the home can be changed in their own rooms. The home is well lit, clean and smells fresh. The management implements an infection control policy. They encourage their own staff to work to the homes’ policy to reduce the risk of infection as seen discussed in the minutes of staff meetings. Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Key standards 27.28.29.30 Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of residents. EVIDENCE: Services users commented that they have confidence in the staff that care for them. Staff spoken with said that through the in depth training they receive they feel very confident within their role in the staff team. Management encourage staff members to undertake external qualifications beyond the basic requirements, and recognise the benefits of a skilled, trained workforce. The service clearly defines the roles and responsibilities of staff through accurate job descriptions and specifications as seen in a recruitment file. The service ensures that all staff within its organisation receives relevant training that is focussed on improving outcomes for residents. The service uses external providers to deliver this training if they have not got the appropriate skills within the organisation. An induction file and training portfolio of a member of staff recruited June 2006 was seen and a training portfolio of Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 19 another member of staff spoken to. Both verified the training provided as per conversations. The service has a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the service recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of service users. One staff recruitment file was seen which contained all the relevant information required by the Care Homes Regulations 2001. One recent member of staff recruited confirmed that the service was clear about what was involved at all stages and was robust in the following of its procedure. There is little use of any agency or temporary staff Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Key standards 31.33.35.38 The ethos of the home is based on openness and respect with effective quality assurance systems developed by the provider to achieve good outcomes for service users in all areas of care. EVIDENCE: The manager has the required qualification and experience to run the home. Through discussion she demonstrated that staff at Fairholme strive to provide an increased quality of life for residents. The manager works with a strong staff team who have been trained to a high standard. Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 21 The home has policies and procedures, which the provider effectively reviews and updates, in line with current thinking and practice. Systems are in place to monitor staff adherence to policies and procedures during their practice, e.g. medication spot checks. Management processes ensure that they receive feedback on their work through supervision and appraisals, examples of which were seen. The provider has a good track record of meeting relevant health and safety requirements and legislation and conducts its own audit to ensure compliance with policies. Records are of a good standard and are routinely completed. Fire records were sampled and were in order. The registered manager together with support from the provider has the skills and ability to deliver corporate business planning and provides a quality assurance and monitoring process through service users satisfaction questionnaires and residents meetings. The home has all the necessary insurance cover in place to enable it to fulfil any loss or legal liabilities. If they wish and are able to, service users are helped to take responsibility for managing their own money. They are provided with facilities to keep their valuables and money safe. Where the home is responsible for resident’s money it works to a very rigorous system, it maintains very clear records that are routinely kept up to date and can be used to track individual residents finances. These arrangements are regularly audited by management. Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 22 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Fairholme DS0000020664.V296997.R01.S.doc Version 5.2 Page 25 - 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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