Inspection on 23/08/06 for Fairholme House

This inspection was carried out on 23rd August 2006.

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 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 House 30/06/08

Fairholme House 21/06/07

Fairholme House 10/11/05

Fairholme House 05/07/05

Fairholme House 09/11/04

Fairholme House 06/05/04

Fairholme House 06/02/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Fairholme House Church Street Bodicote Banbury Oxfordshire OX15 4DW Lead Inspector Annette Miller Unannounced Inspection 23rd August 2006 8.00 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 Fairholme House DS0000013085.V306556.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 House DS0000013085.V306556.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairholme House Address Church Street Bodicote Banbury Oxfordshire OX15 4DW 01295 266852 01295 266954 info@fairholmehouse.com 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) Oxford Care Homes Limited Ms Jacqueline Moss Care Home 22 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (22), of places Physical disability over 65 years of age (2) Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 22. 10th November 2005 Date of last inspection Brief Description of the Service: The home is situated in a village location on the outskirts of Banbury. The village has a post office, church and a public house. Twenty bedrooms are available for single occupation on two floors and there is one double room. All bedrooms have en-suite facilities of toilet and washbasin. There are also three bathrooms. There are two lounges and two conservatories on the ground floor providing comfortable communal accommodation. The home provides entertainments and activities for those wishing to take part. There is a pleasant garden at the back of the home for residents to use. The fees for this home range from £409.00 to £609.00 per week. Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the 1st April 2006 the Commission for Social Care Inspection has developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the home at 8 am and was in the home for 9 hours. The inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the manager and any information that the commission has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection, or who responded to questionnaires that the commission had sent out. Three residents, seven relatives and seven healthcare professionals returned comment cards directly to the commission. All responses were good indicating that people using the services were satisfied with the way in which the home was managed and the standard of care given to residents. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. What the service does well: What has improved since the last inspection? Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 Page 6 The care that is provided is consistently good. 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 House DS0000013085.V306556.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 House DS0000013085.V306556.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The home does not provide the required amount of written information to help prospective residents make an informed decision about moving into the home. Intermediate care is not provided. EVIDENCE: The home has a Statement of Purpose but it does not include all the information that is required by the relevant regulation. For example, the business address of the proprietor and the manager needs to be shown, and also their qualifications. The inspector noted that the document refers to people being admitted from the age of 60, whereas the home is only permitted to admit residents aged 65 and above. If younger residents wish to be admitted the manager must agree this with the Commission for Social Care Inspection (CSCI) prior to the person’s admission. Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 Page 9 The home does not have a Service Users’ Guide and the manager must arrange for this document to be produced in accordance with the relevant regulation. A copy must be supplied to every resident and prospective resident as well as providing a copy to CSCI. The manager assesses all prospective residents who are self-funding to ensure the home is able to meet each person’s needs. The inspector noted minor omissions concerning some aspects of potential care needs, and these were brought to the manager’s attention during the inspection. The manager confirmed that when a prospective resident is admitted through care management, she visits the person in his/her own home, or hospital if that is the current situation, as well as obtaining a copy of the care manager’s assessment. From the evidence seen and comments received, the inspector considers that this home would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Fairholme House DS0000013085.V306556.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents’ health care needs are being met. Also, personal support is offered in such a way that promotes and protects residents’ privacy, dignity and independence. EVIDENCE: All seven relatives who returned comment cards to CSCI are satisfied with the standard of care provided. Health care professionals also expressed satisfaction and made comments, such as: “It appears to me to be a good home, well run with happy residents.” “I have always found the staff at this home to be caring and conscientious. We have a good working relationship. The patients have never made any complaints to me.” Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 Page 11 The inspector examined a sample of care plans and found that residents’ care needs were listed, together with the action carers needed to take to ensure all aspects of the health and personal care of residents are met. Some care plans had not been reviewed monthly and this needs to be done to ensure appropriate care is provided at all times. The manager should remind staff to sign and date any entries made in the care records to enable any queries that arise to be raised with the correct member of staff. The manger should ensure that residents are weighed monthly to enable appropriate action to be taken to deal with weight variations. Weight records were only recorded in some care plans. The home has ‘stand-on’ scales, which may not be suitable for all residents, and consideration should be given to purchasing ‘sit-on’ scales for less able-bodied residents. GPs and district nurses visit the home regularly to give medical and nursing care and a record of these visits is kept. The home has appropriate procedures to manage the storage, recording and distribution of medication. A random selection of residents’ medication was inspected and was found to be satisfactory. Fairholme House DS0000013085.V306556.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home provides a range of activities to ensure residents have opportunities to participate in stimulating and motivating pursuits. Meals and mealtimes are not rushed and provide an enjoyable social occasion for residents. EVIDENCE: The residents spoken to were happy with the range of activities and opportunities provided, which they said helped them to remain mentally alert. A visitor said she thought staff worked hard to promote activities and praised the manager for spending time with her relative doing crossword puzzles. There is a pleasant garden that is well used by residents in good weather, as well as two conservatories providing quiet surroundings. Two visitors said they thought visiting arrangements were very good and confirmed they could visit whenever they wished. A visitor said she occasionally visited at 8 am and appreciated being able to see her relative at this time. Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 Page 13 The inspector arrived at 8 am when breakfast trays were being taken to residents in their rooms. Staff said that some residents preferred breakfast at a different time and this was arranged. Most residents had decided to eat lunch in the home’s dining room on the day of inspection, although meals can be served anywhere in the home to meet residents’ individual wishes. Residents spoken with said the standard of food was good. Fresh vegetables and seasonal products are used whenever possible, and the menus showed a varied and nutritious diet was provided. A member of staff visits residents each day to discuss the planned menu and to discuss alternatives to ensure residents individual likes and dislikes are taken account of. Fairholme House DS0000013085.V306556.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents, relatives and friends can be sure that their complaints will be listened to, taken seriously and acted upon. There are procedures in place to protect residents from abuse. EVIDENCE: The complaints procedure is displayed in reception. Five out of the seven relatives who returned comment cards said they were aware of the complaints procedure. Neither the manager, nor CSCI, has received information about any complaint since the last inspection. The manager has a copy of the Oxfordshire multi-agency codes of practice for the protection of all vulnerable adults from abuse, exploitation and mistreatment. These codes are discussed with new staff during induction. NVQ training includes a core topic on the protection of vulnerable adults and eleven carers have undertaken this training. The manager should ensure that any staff member who has not yet attended POVA training does so, and that regular updates are provided for all staff. Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 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 the following standard(s): 19, 23 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The standard of the environment within this home is good providing residents with an attractive and homely place to live. EVIDENCE: The standard of décor and furnishings is good. A number of bedrooms were seen and all were clean, well decorated and personalised with residents’ own belongings. There were no unpleasant smells in the home, although the manager said this had been a problem recently in one of the bedrooms. This was resolved by fitting a new carpet. Bedrooms have en-suite facilities consisting of a toilet and washbasin. There are also three general bathrooms (one with a shower). One of the bathrooms on the 1st floor being is being refurbishment during 2006, when a walk-in shower is being installed. Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 Page 16 Access to the laundry is from a corridor near to the main lounge and staff should ensure the door is kept locked when the laundry is not in use. The inspector visited the laundry late afternoon to inspect the facilities and found the door unlocked with no member of staff in the room. This exposes residents who are confused to potential risk. Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. Two recruitment files did not contain all of the information and checks required and this potentially placed residents at risk of harm. Staffing levels and the number of staff with a national vocational qualification in care are good, but because of the omissions found in two recruitment files, the overall rating for this section cannot be higher than poor. EVIDENCE: Comment cards from relatives showed that six out of seven respondents thought staffing levels were sufficient. Comment cards from relatives showed that one relative thought there were ‘always’ enough members of staff on duty; two thought this was ‘usually’ the situation. On the morning of inspection there were four carers on duty, as well as sufficient domestic staff to provide catering and cleaning services. The manager was on duty throughout the day. There were three carers for the afternoon and evening, including an evening cook from 4.30 – 7 pm. Two carers were on duty overnight. The inspector considers this level of staffing to be sufficient for the 20 residents who were in the home at the time of inspection. Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 Page 18 10 out of 19 carers have NVQ level 2 in care and one carer has NVQ level 3. The manager said that a range of other training opportunities is provided but training records were not available to verify this. Two staff files were looked at and neither contained all the information and checks needed. Two written references are needed for all staff. In exceptional circumstances when these cannot be obtained, the manager must ensure that the reason for this and the outcome of verbal references is fully documented. It was found that a verbal reference had been obtained for one employee, but there was no record on file of the outcome of this reference, or why written references could not be obtained. This is poor practice. All new employees must have a criminal record bureau (CRB) check to ensure they are ‘fit’ to work with vulnerable people. In exceptional circumstances the manager is permitted to start a new member of staff before receipt of a CRB, but, in this situation, a check against the protection of vulnerable adults list must be obtained (called a POVA First check) before starting a new worker. This was not done for one member of staff who started on the 17th July 2006. The inspector spoke to the organisation that arranges these checks and obtained confirmation that the CRB disclosure was issued on the 21st August. The manager has since confirmed this in writing. Applicants had not provided a full employment history. This is required to enable the manager to check any gaps in employment. All new workers start an induction programme that involves completing an induction workbook. The manager confirmed that the home’s induction training meets the requirements of the Skills for Care national induction programme, and that workbooks are sent to an external examiner for the training to be verified. Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 Page 19 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, 33, 35, 36 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The manager provides clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. However, some maintenance records were not available for inspection and there were also some health and safety issues found that had the potential to put residents at risk. EVIDENCE: The inspector received many good comments from residents, visitors and staff about the way in which the home was managed. The manager has considerable management experience and has worked with older people for a number of years. She has the Registered Manager’s Award (level 4 NVQ in management) and has nearly completed level 4 NVQ in care. Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 Page 20 The manager obtains informal feedback from residents and their visitors during general conversation, but there are no formal quality assurance systems in place. These systems should be implemented to assist in the future development of the quality of the service for service users. Residents are encouraged to handle their money for as long as they can before involving the help of a representative. The manager arranges for day-to-day incidental expenses to be paid out of a ‘float’ provided by the owner and residents are invoiced monthly for payment. The manager does not permit staff to be involved with residents’ finances. The manager has tried to introduce staff supervision but has met some resistance from staff. Supervision is important because it gives the opportunity for all care staff to have a one-to-one meeting with their mentor/manager and to discuss any training needs they may have and their progress in their job. It is recommended that the manager and key senior staff attend supervision training to enable them to establish a system that works, and which carers find helpful. Fire alarm tests and emergency light tests are carried out and records are kept. The manager said that checks on the temperature of hot water to baths, showers and sinks accessible to residents are kept, but they could not be located for the inspector to check. Water temperatures need to be closely monitored to ensure hot water is kept at a safe level. Fire training for staff involves watching a video and completing a questionnaire. The manager must ask Oxfordshire Fire Service whether or not this level of fire training is adequate. Some first floor windows are not fitted with window opening restrictors and this means there is the potential for residents to fall out of windows that are open. It is advisable to restrict the opening to 100 mm. (Reference: Health and Safety in Care Homes published by the Health and Safety Executive.) The manager should ensure that cleaning substances hazardous to health are kept secure when not in use. A cleaning substance used in the laundry had been left out with no staff member present, and the laundry door was unlocked. This was a potential hazard to any resident who might have wandered into the laundry. Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 Page 21 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 1 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 X X 2 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X 2 X 2 Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 Page 22 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. 1 Standard OP1 Regulation 4 and Schedule 1 Requirement The manager must review the home’s Statement of Purpose to ensure it contains all the information that is required, and that this information is correct and up-to-date. A copy must be sent to CSCI The manager must provide a Service Users’ Guide and ensure that residents and prospective residents are given a copy. A copy must also be sent to CSCI. The manager must confirm in writing to the inspector that the recruitment information and checks that were found to be missing at inspection have been obtained. Timescale for action 31/10/06 2 OP1 5 31/10/06 3 OP29 19 30/09/06 Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 Page 23 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 OP3 OP7 Good Practice Recommendations Consideration should be given to using a pre-assessment form with pre-printed headings to ensure all care needs shown against Standard 3.3 are assessed. Care records: ●Review care plans monthly. ●Weigh residents monthly and keep records. ●Records to be signed and dated. Consideration should be given to providing ‘sit-on’ weighing scales. Training on the protection of vulnerable adults should be arranged for members of staff who have not yet attended this training. Regular updates should also be provided. The laundry room should be kept locked when it is not in use to protect residents from possible danger. Training records should be kept for each member of staff. Implement a programme of regular formal staff supervision and maintain records. Residents should be provided with an opportunity to give formal feedback, anonymously if they wish, on the care and services provided. All chemicals (other than low risk domestic cleaning chemicals) should be kept in a locked cupboard when not being used. Window restrictors should be fitted to upper floor windows, unless a risk assessment, based around the individuals that use the service, indicates how windows are otherwise safe. The temperature of hot water to baths, showers and basins accessible to residents should be regularly checked with records kept. 3 4 5 6 7 8 9 10 OP8 OP18 OP26 OP30 OP36 OP33 OP38 OP38 11 OP38 Fairholme House DS0000013085.V306556.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, 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 © 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 House DS0000013085.V306556.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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