Inspection on 21/06/05 for Fairholme

This inspection was carried out on 21st June 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 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 14/11/06

Fairholme 27/10/05

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 Patricia Scott Unannounced 21 June 2005 09:15 st 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. Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Fairholme Address Morda Road Oswestry Shrosphire SY11 2AP 01691 653499 01691 654247 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) Coverage Care Shropshire Limited Denise Beryl Morris Care Home Only (PC) 40 Category(ies) of 26 x Old age, not falling within any other registration, with number category (OP) of places 14 x Dementia (DE) Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate a maximum of 40 persons. 2. 3. 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 22nd November 2004 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 (Shropshire) Ltd – a ‘not for profit’ organisation registered with the Register of Industrial and Provident Societies and has a charitable trust status. Fairholme has pleasant gardens and grounds, which are well maintained and provide a safe outside environment for the service users and their visitors. Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 21st June 2005 between the hours of 09.30 and 12.30 and was unannounced. The National Minimum Standards for Care Homes for Older People focus on achievable outcomes for service users – that is the impact on the individual of the facilities and services of the home. Evidence was looked for that the standards were being met and a good quality of life enjoyed by service users through: • Discussions with service users, families and friends, staff and managers. • Observation of daily life in the home • Scrutiny of written records (including care plans for 4 service users). The statement of purpose was used to assess how far the home’s objectives to be able to meet service user requirements and expectations were being met. Reports regarding an overview of the conduct of the home are sent to CSCI on a monthly basis by the Head of Operations for Coverage Care. These, as well as the risk assessment from the last inspection were taken into account to determine the core standards focused on and depth of inspection. The Commission does not currently have any concerns regarding this home. What the service does well: The home provides for the needs of elderly people including those with dementia through small group living and a wide variety of activities. Service users were seen to be treated in a respectful and dignified way and some of those spoken with stated that they were well cared for at Fairholme. Two service users spoken with who were in for respite care stated that Fairholme is “the best home in Oswestry”. After appropriate risk assessment, service users are not discouraged or unduly restrained from undertaking activities solely for fear that for example, they may hurt themselves. Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 Page 6 Coverage Care provides training to a level that creates a trained and experienced staff team that is well managed as examination of files and in discussion with staff and the manager showed. The manager spoke of wanting to improve the interior design of the environment to create a more homely, personalised feel to the place. What has improved since the last inspection? 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. Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 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 Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 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 The homes statement of purpose and service user guide is good providing service users and prospective users with details of the services the home provides, enabling an informed decision about admission to the home. Pre-admission needs assessments are thorough ensuring that service users who move into the home are assured that their needs will be met. EVIDENCE: The statement of purpose and service users guide have been updated for March 2005 and are on display in the foyer. The information provides details of needs assessments to be conducted prior to admission and examination of care plans on the units confirmed that this process had been carried out. The manager stated that informal visits are encouraged and potential service users can spend time from half a day to a full day and a week end. The home provides respite care and a service user who was receiving such a break in the home stated that the transitions between the home and their own home were always fine and they usually enjoyed their stay. Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 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 standard(s) 7,8,10,11 There is a clear, consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. Personal support in this home is offered in such a way as to promote and protect service users’ dignity and privacy in their daily life as well as at the end of life. EVIDENCE: Care plans looked at for 4 service users were consistently completed and had all the useful information in them that is necessary to enable a care worker to provide the right care for that individual in a way that meets their wishes and preferences. Ascertaining such information can be difficult when an individual has dementia or mental health problems and records provide evidence of consultation with families and other supporters. The information that was read showed that individuals receive the level of care which their own situation requires. All care plans seen had been signed by the service user or their relative. Visits by other health care professionals are documented e.g. GP, CPN (Community Psychiatric Nurse). Wherever possible continuity of care for the Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 Page 10 service users’ declining state of health is assured. District nurses are called upon to assist with clinical help and advice where necessary. Regular monitoring and review of a service user’s condition takes place to ensure that the correct treatment and care is being given. The care plan of a service user who was particularly unwell was examined. The detail in this was written in a respectful manner e.g. ‘discreet observation of skin’ when carrying out pressure area care. A nutritional risk assessment for this person had identified a poor appetite and a food supplement had been provided to help this problem. The care notes also documented specific contact with the GP. This person was asleep during the visit and looked comfortable and pain free. The equipment used as recorded in the care plan was seen to be in place, such as air mattress for pressure relief. The relative of a service user was spoken with who stated that she was very satisfied with the care. This person did not normally visit during the morning but had called to take her husband out for the day. Lack of communication between staff had resulted in this person not being ready early enough and the home must be sensitive to this issue. Otherwise, she said that they had dealt with him very well and was pleased with the personal care he had received. This service user commented that the “staff are very good”. Behaviour management plans are in place for people with dementia. Staff take time to understand individual’s problems and knowledge acquired through training is put to use; e.g. one service user who had anxiety about patterns in his room had been provided with plain décor and bedding which had a positive impact on his well being. The home has scored a 4 for standard 10, the evidence for which is reflected throughout other standards in this report. Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 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 standard(s) These standards were not assessed on this occasion. EVIDENCE: Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 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 standard(s) These standard were not assessed on this occasion. EVIDENCE: Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 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 standard(s) 19 The standard of the environment within this home is very good providing service users with an attractive and homely place to live. EVIDENCE: A tour of the premises showed that regular decoration takes place which is also documented. The manager stated that the bathrooms are due for a re paint in this years budget. Two new baths have been fitted and corridors have new carpets. The floor around the toilet in a communal shower room (room 41) is stained from accidental soiling. It is the intention of the manager to work to improve the interior design of the environment. The gardens are well kept and the service users on the dementia unit can walk around their secure garden without restriction. Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 Page 14 Of particular note were the comments of one service user whose care was case tracked who said: “this is my home. I live here. Its great.” Her room was full of personal possessions and memorabilia which she referred to during our conversation. New kitchen units have been installed on two units. Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 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 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) 27,29.30 The arrangements for the induction and training of staff are good with the staff demonstrating a clear understanding of their roles. There is a good match of well-qualified staff offering consistency of care within the home. EVIDENCE: Three staff files were seen which contained all the required information. They showed that their recruitment procedures had been followed and that legislation had been complied with. The home has achieved 59 for staff trained to NVQ 2 in care. This exceeds the minimum standard of 50 . The levels of staff on duty today were such as to ensure that service users needs could be met. Relevant training has been provided and staff spoken with confirmed this. Staff are offered financial support, subject to approval, for individual professional development. Staff observed carrying out their duties were seen to be responsive and understanding of individuals wishes and needs. Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 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 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) 31,32,33,38 The manager has a vision for the home that will enhance the facilities even further for the benefit of service users. EVIDENCE: Staff were complimentary about the support from senior management. Service users said that they would feel happy to approach Mrs Morris should they have any “quibbles about their care”. The home has its own quality assurance system that consists of satisfaction questionnaires. The results of which are sent to the Commission. Monthly visits to the home are conducted by the Head of Operations for Coverage Care. Reports for these visits are received that give an overview of the conduct of the home and are taken into account before an inspection takes place. The report for 26th May 2005 detailed that health and safety checks had Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 Page 17 been carried out regarding water temperatures, showerheads and fire. All were up to date and no defects noted. Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 N/A 3 N/A N/A N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 N/A 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 N/A 13 N/A 14 N/A 15 N/A COMPLAINTS AND PROTECTION 3 N/A N/A N/A N/A N/A N/A N/A STAFFING Standard No Score 27 3 28 N/A 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score N/A N/A N/A 3 3 3 N/A N/A N/A N/A 3 Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 Page 19 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 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. 1. Refer to Standard Good Practice Recommendations Fairholme E56 S20664 Fairholme V234649 UI 210605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 1st Floor, Chapter House South Abbey Lawn SHREWSBURY SY2 5DE 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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