Inspection on 12/11/07 for Fairkytes

This inspection was carried out on 12th November 2007.

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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 Fairkytes 42 Fairkytes Avenue Hornchurch Essex RM11 1XS Lead Inspector Margaret Flaws Unannounced Inspection 12th November 2007 12:30p Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 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 Fairkytes DS0000070559.V354281.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 Adults 18-65. 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. Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairkytes Address 42 Fairkytes Avenue Hornchurch Essex RM11 1XS TBC TBC 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) Clearwater Care (Hackney) Ltd Mrs Brenda Elizabeth Netto Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 5 Date of last inspection Brief Description of the Service: The home is a small family type residential house in central Hornchurch, next door to 40 Fairkytes Ave, another learning disability service run by the same provider. Brenda Netto manages both services. Clearwater Care runs five services, including this one, in East London. The five bedroom house is refurbished to a high standard with good quality fixtures, fittings and furniture. There are five bedrooms – three with ensuite shower room and two with ensuite toilet and shared bathroom facilities. It is a spacious property with a good sized garden. It is within walking distance of shops, amenities and public transport. Fees for the home are £1500 per month. Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This first inspection took place over one day and the Registered Manager assisted me throughout. I spoke to both people currently living in the home and to one staff member on duty and observed interactions between them. The inspection consisted of a tour of the premises, reading the home’s policies and procedures; all care record and a sample of staff records, health and safety files, other home records and pre-registration correspondence. The home also provided CSCI with an Annual Quality Assurance Assessment, which added good quality information to the inspection. What the service does well: What has improved since the last inspection? What they could do better: Three requirements were made at this inspection. All portable electrical items must be tested. The evacuation plan must be reviewed in relation to the back door lock. Once fire training has been completed, details must be sent to CSCI Fairkytes DS0000070559.V354281.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. Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The assessment procedure is good and comprehensive, as a basis to meeting the needs of prospective residents. EVIDENCE: The home was registered in September 2007 and currently has two residents. It has a good Statement of Purpose and Service User Guide. The Registered Manager said the home is currently looking to purchase communication software to write the Service User Guide in an easy read format. Some current information, for example, the house rules, is in picture format. The assessment procedure is outlined in the Statement of Purpose and the Service User Guide. Information about this procedure was also outlined in the Annual Quality Assurance Assessment provided to CSCI. I checked the files of the two residents. Both are young people with learning difficulties. The files contained assessments from the placing authority and initial assessments completed by the service. These provided a good basis to develop care plans. One person visited the home on a trial visit prior to coming to live there and was able to take photographs during the home’s refurbishment. The Registered Manager travelled to another part of the country to complete a full assessment for this person. The other resident came Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 9 into the home after an emergency intervention by Havering Social Services and assessment took place at respite unit. Assessment is ongoing, as there was limited information available initially on the person’s history. Contracts were being finalised at the time of the inspection. While some further new assessments have been completed, referrals and admissions have been put on hold until the home has finished recruiting and training a full staff complement. The Registered Manager said that the organisation is streamlining assessment procedures and a newly recruited Assessment and Referrals Manager will accompany her on future assessments. Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home have their needs assessed and recorded in an individual plan. They are supported to make decisions about their lives in line with their wishes. Risks are assessed, discussed and documented. EVIDENCE: Comprehensive individual plans were in development at the time of the inspection but there was good information on current care plans and guidelines on file to help staff know the residents’ needs and wishes and work to meet them. I observed interactions between the residents, the Registered Manager and the staff member on duty. This interaction was healthy, positive and clearly demonstrated the warm and understanding between the staff and the residents. The staff demonstrably supported the residents to make decisions, based on the residents expressed wishes. For example, one person had been Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 11 invited to return to his previous home in another part of the country for an awards ceremony. On prompting from the staff, he rang and arranged this with the home and negotiated with staff to accompany him there overnight. The AQAA outlines how day to day consultation takes place in the home. I spoke to each resident and they were very positive about living at Fairkytes and said they felt fully involved in the running the home and able to enjoy their lives there. This is the first time that the residents have lived in an adult service and the staff were clear about their role in supporting them in developing independent living skills as adults. Daily notes were of good quality and were clearly written in a non-formulaic way. There are clear risks to one resident, related to previous history. The home has a good risk assessment and procedure to cover this. Another risk identified for a resident was behaviour when in the car. This risk had been documented and managed. Other risk assessments were in development, to be produced on an individual basis. A procedure is in place for regularly reviewing care plans and risk assessments, with the involvement of the people living in the home. The AQAA states that this will actioned over the next few months in full consultation with the residents. This is in line with the service philosophy. Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living in the home can be confident that they will be supported in their personal growth and lifestyle choices through activities, relationships and community involvement. They can be confident that their rights and responsibilities will be recognised. They benefit from a healthy diet, good quality food of their choosing. EVIDENCE: The two young adults living in the home attend a local college four days a week. They both have different days off at home during the week, which enables them to pursue individual leisure interests. At the time of the inspection, because they had only been living at the home for four weeks, they were trying different things out. For example, one person is exploring beauty therapy options. They have been to local pictures, shops, YMCA, bingo, the circus and other leisure facilities. The home is working closely with the college to reinforce and support their learning of “social, emotional, communication Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 13 and independent living skills” (AQAA). They are also able to socialise with residents living next door at 40 Fairkytes Avenue. Because of the personal circumstances of the residents, neither has significant family involvement at present. Both residents come from the local area and had attended the same school when they were younger. They have been invited by the headmistress to have afternoon tea at school and said that they were pleased about doing this. They are involved in the physical running of the house, for example, tidying their rooms and doing their washing. However, the Registered Manager said that she intends to develop a more structured programme for housekeeping tasks. I was at the home during the preparations for the evening meal and I checked the menus and food available. The fridges and cupboards were well stocked, with a varied and plentiful supply of fresh food. The residents said what they wanted to eat. Fridge and freezer temperatures had been monitored and recorded. Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The physical and emotional needs of people living in the home are assessed and health checks are planned for. Personal support tends to be of a prompting nature. Residents are protected by the home’s medication policies and procedures. EVIDENCE: Personal support is generally prompting. Each person has recorded health notes and plans for proactive health checks to be scheduled. The service is currently liaising closely with the local social services office to ensure that the residents’ physical and emotional needs are fully assessed and met. The Registered Manager said she was pleased with the degree of support provided by the residents’ social workers. One person does not take medication and the other takes a medication for epilepsy. A risk assessment is in place. I checked the medication storage arrangements, which were sound. The medicines are kept in a locked cabinet in the office. The Medication Administration Record (MAR chart) was accurate. Currently, staff collect the medication from the local pharmacy but the home Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 15 has a contract with Boots which is due to start. Staff currently working in the home had been trained in medication administration and newly recruited staff were due to be trained. The medication policy and procedure is clear. Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living in the home are generally protected by good complaint and adult protection policies and procedures and by staff trained to use them. EVIDENCE: The service has clear complaints and adult protection policies and procedures in place. The Registered Manager said that this will be translated into a pictorial format as soon as possible. No complaints had been received at the time of the inspection. Current staff have been trained in adult protection and plans are in place to train newly recruited staff within the next month, before they start on duty. The home has a copy of the London Borough of Havering’s Adult Protection Policy and Procedure. Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is refurbished to a high standard to provide a good environment for the residents to live in. The home is kept clean and hygienic. EVIDENCE: I toured the building with the Registered Manager and one resident showed me his room. He said he was very happy with the room and was able to personalise it as he chose. The open plan lounge/kitchen are is large and comfortable, with a Sky TV. There are french doors leading out onto a large garden, with a purpose build shed which the Registered Manager said will be used in the future for activities. Some of the mirrors in the home have a distorting effect and these are being replaced. Taps have symbols on them to indicate hot and cold. Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 18 The laundry facilities are good. There is a new washing machine with wash temperatures up ton 90 degrees and a dryer. The home was clean and hygienic on the day of the inspection. Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living in the home are protected by appropriate recruitment procedures and supported by well trained staff. At the time of the inspection, sufficient staff were on duty to meet the needs of the people living in the home but staffing need to be increased as the occupancy moves to capacity. EVIDENCE: Clearwater Care has a sound recruitment procedure, which the home has followed. There is now a new HR Manager in place, whom I briefly met. I checked five staff files and all had pre-employment checks completed. The Registered Manager said that recruitment was held up while waiting for Criminal Records Bureau checks to be completed, which is why new admissions have been held off. Some new staff have undertaken shadowing and induction at 40 Fairkytes Ave but the Registered Manager was clear that overlapping with the next door property was a temporary and limited process. All foundation training for new staff due to start had been completed and the Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 20 training records for this were clear. Further training for other new staff was scheduled. Staff currently working in the home had NVQ qualifications. The current rota in place has one staff member on each shift, plus the Registered Manager during the weekdays. However, new staff have been recruited and, after training, the number of staff on duty will increase to enable the home to operate at full capacity. Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living in the home benefit from committed and competent management. They can be confident that they will be consulted on the running of the home and that, despite adjustments to be made at this stage, their health and safety will be protected. EVIDENCE: The Registered Manager has many years experience in running care homes and holds an NVQ4 Registered Managers’ Award. For the foreseeable future, she will manage this home and 40 Fairkytes Ave next door. This was agreed on registration. I discussed this with the Registered Manager. She was clear that both she and the organisation will monitor and review the workload involved, especially once this service was operating at capacity, to ensure that this continued to be an effective arrangement for both service and remained within her capacity. Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 22 There is a quality assurance policy and procedure and the Registered Manager said that over the next few months, this will be systematically put in place. This will include regular residents’ meetings, formal consultation with residents, their families, professionals and advocates. The home has a sound equal opportunities policy and procedure. The home is still developing its procedure to support and protect the residents’ finance and access to their own money. Some issues with access to their own money were identified at this inspection. There is a good incident and accident reporting system. Since opening, there has been one incident, which was very clearly written, with actions taken as a result. I checked the health and safety certificates for electrical installation, emergency lights, gas safety, and fire equipment. These were all up to date, with no problems identified. Water temperatures are controlled and the water has been tested for legionella. The home has public liability insurance. Some items in the home, such as the television, require Portable Appliance Testing. A requirement is given. The home has a fire risk assessment and the building has a fire safety certificate. A fire officer recently visited the home and they are waiting for his report. Some staff have attended fire safety and the rest of the staff are due to complete this training within the month. A requirement is given that evidence of fire training for all staff be supplied to CSCI. The back door in the kitchen is only lockable with a key. It is required that the home seeks professional advice on improving the evacuation access through this exit. Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 3 2 X Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 24 First inspection 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 YA42 Regulation 13(4) Requirement The Registered Persons must ensure that the evacuation plan is reviewed in relation to the back door lock. The Registered Persons must ensure that details of completed fire training for staff are sent to CSCI The Registered Persons must ensure that all portable electrical items are tested. Timescale for action 30/01/08 2 YA42 13(4) 31/12/07 3 YA42 13(4) 31/12/07 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 Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Fairkytes DS0000070559.V354281.R01.S.doc Version 5.2 Page 26 - 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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