Inspection on 20/12/05 for Fairlawn

This inspection was carried out on 20th December 2005.

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

Fairlawn 12/10/09

Fairlawn 21/10/08

Fairlawn 22/10/07

Fairlawn 14/03/07

Fairlawn 01/07/05

Fairlawn 08/12/04

Fairlawn 19/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Fairlawn 327 Queens Road Maidstone Kent ME16 0ET Lead Inspector Marion Weller Announced Inspection 20th December 2005 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 Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 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. Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fairlawn Address 327 Queens Road Maidstone Kent ME16 0ET 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) 01622 751620 Mrs Mary Alexandra Lawrence Mr Michael Andrew Lawrence Mrs Mary Alexandra Lawrence Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st July 2005 Brief Description of the Service: Fairlawns is a detached property with accommodation on two floors and provides care for older persons. There are 25 single rooms and one double room, all having en-suite facilities with a call bell system. There is a television point in each of the bedrooms. Each room has the potential for individual telephone lines to be installed at the request of the service user and personal phone bills from a service supply company sent direct. The home is in a quiet residential area located close to Maidstone, with both rail and bus links. There is a well-maintained garden area surrounding the property, with summerhouse for service users use, which includes a call bell. There is a large driveway to the front of the property allowing visitors to park. A varied range of social activities is planned and involvement with the local community is promoted and maintained. The home has undergone major refurbishment of the kitchen and ground floor facilities, building a further two bedrooms with en-suite facilities. Some work continues to further improve the gardens to the rear of the property Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted by Marion Weller, Regulatory Inspector, who was in Fairlawn from 9.30 am until 3.10pm. During that time the inspector spoke with the responsible individual and the manager, service users, a community nurse, team leaders and some staff. Parts of the home were seen, some records and documents were inspected and the last inspection report was discussed. Comments made by service users during the inspection included: • • • “Nobody could be more cared for, or looked after better than I am here.” “Staff delightful, plenty of talk and laughter” “It is not just any home, it is my home!” What the service does well: What has improved since the last inspection? The homes Statement of Purpose has been revised and all elements meet the requirements of regulation. The owner now arranges formal monthly visits and sends copies of the written report concerning the conduct and standard of care provided in the home to the CSCI and the manager. Closer monitoring of the application and receipt of Criminal Records Bureau Checks now protects residents from risks of abuse. Quick release fire door guards have been fitted to service users bedroom doors, which promote individuals freedom of access and safety. Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 Page 6 Most areas of the home to which service users have access have radiator guards fitted. Some toilet frames have been fixed to the floor, which further protects service users health and safety The manager and some staff have undertaken NVQ qualifications to evidence competence in their roles. The home now notifies the CSCI formally of any situation that might adversely affect a service users health or well being in a timely manner. 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. Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 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 Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 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): 123456 Sound systems are in place for prospective service users to decide whether Fairlawn is the right home for them. EVIDENCE: The home has a service user guide and a statement of purpose, which meets the demands of regulation. Comprehensive assessments are carried out prior to a service user moving in to ensure that the home can meet their needs. Information gained during the assessment is used as the basis for the care planning system. Service users were able to visit the home before moving in and said staff had been very helpful in assisting them to settle. Service users are given a written contract. The home has recently revised the document in line with the Office of Fair Trading guidelines. The document clearly states the responsibilities of the organisation and the rights of the service user. A comment from a visiting professional received prior to the visit said, “Residents settle in well and rarely move away, very pleasant staff who are caring and cooperative. Intermediate care is not offered at Fairlawn. Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 Page 9 Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 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 10 11 Service users health and welfare needs are fully met by care plans, which offer clear guidance for staff and are comprehensively maintained. Service users benefit from good liaison with relevant health care professionals. EVIDENCE: Care plans provide clear and informative guidance for staff on how they should meet service users needs. They were seen to be comprehensive, detailed and had been regularly reviewed. Any changes in service users circumstances were clearly recorded and appropriate action taken to ensure identified needs continue to be fully met. Service users signed care plans. Service users access to health care professionals was being maintained and recorded. The home benefits from a very positive relationship with community nurses and local surgeries. A visiting health professional commented, “…There is no problem working with the staff here, I am very happy with the home on my visits.” Service users spoke of their medical appointments, staff were very Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 Page 11 aware of advice received from health professionals in regard to individuals specific needs and were seen to act upon them. Medication was not inspected thoroughly on this occasion although the medication room used was well maintained and medications were seen to be stored in accordance with their instructions. The home has good systems in place for medication administration, which the manager states have been further improved upon in line with good practice guidance. Service users privacy and dignity was seen to be promoted. Service users could meet with visitors and make phone calls in private. Bathrooms and toilets were lockable. Continence aids were left on top of the toilet cistern in one toilet. Service users would benefit from the items being correctly stored to further protect their privacy and dignity. Discussion took place with the manager about the homes policy on dealing with increasing dependency and death of service users in the home. It was clear that the situation is handled in a sensitive and respectful manner in line with individual service users wishes. The home has written guidance, which informed and supported their practice on this issue. Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 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 15 Service users have a good standard of living with plenty of home cooked food. Routines of daily living were flexible and individuals had opportunities for interesting activities in line with their wishes and capacity. EVIDENCE: There is a programme of activities available for service users both inside the home and in the wider community that is designed around individuals recorded preference and capacities. Service users spoke of the staff group’s efforts to make the Christmas celebrations very special for them. A Christmas party had taken place earlier in the month to which service users friends and family had been invited. A Pantomime team were presenting ‘Thumbelina’ and another musical entertainer was also booked. The home was attractively decorated for the Christmas festivities. Service users said friends and relatives are always made welcome, regardless of the season, and visit them frequently. The homes menu plans were seen. The items included were varied and alternatives were offered. Service users spoke about the high quality of the food provided and that there was plenty of it. Minutes of a recent service users meeting were seen. Food was on the agenda. It was said that a lively discussion had taken place. One service user had requested a salad to be Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 Page 13 offered as an alternative every day. This had been agreed in theory, but the manager had said, “perhaps not every day”. A request for scones was made. The cook had agreed to a selection of fruit, plain and cheese being provided. Some comments from service users received prior to the inspection had requested a cooked breakfast occasionally. Another had said, “ The food can sometimes be too mushy, food should be provided for people with and without teeth! On the day of the visit lunch was taken in a relaxed atmosphere and staff offered assistance in a discreet and sensitive manner. The food was appetising, hot, well presented with portions provided to individual taste and capacities. Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 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): 16,18 Service users and their relatives can be confident that complaints or concerns will be taken seriously and responded to quickly. EVIDENCE: The home has a policy for dealing with complaints. A record of complaints is kept. The home has procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of service users. During the visit the manager demonstrated a firm understanding of adult protection procedures and to whom to refer allegations of abuse to. The CSCI was made aware both by the home and Social Services of a recent adult protection alert. The matter was thoroughly investigated with the assistance of the manager, Social Services and the Police. There was no role for the CSCI. The matter is now resolved and closed. To ensure that this situation does not have the potential to reoccur, revised procedures have been adopted by the home. The effective nature of these was discussed with the manager and fully inspected during this visit. Compliance with good practice and regulation were evidenced. Advice about improvements in the recording of complaints and concerns received by the home was further discussed with the manager. The manager stated the intention of rectifying current recording methods. The home notifies the CSCI of any situation that adversely affects the well being of service users in a timely manner. Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 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 20 21 22 23 24 25 26 Service users enjoy a clean, comfortable and well-maintained environment where they can have familiar belongings to help them feel at home. EVIDENCE: The home was found to be in very good decorative order and was well maintained, beautifully clean and free from unpleasant odours. The front garden was immaculate. There is a large attractive garden to the rear of the property with a summerhouse for service users use, which includes a call bell. The homes handyman continues work to build raised flowerbeds in the rear garden. Service users rooms were homely, very comfortable and had plenty of personal effects. Some bedroom fire doors had recently had door guards fitted. The manager explained that the guard allows service users to keep their doors open for ease of access or to their individual wishes, but doors close automatically if the fire alarm sounds to ensure safety. Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 Page 16 Lounge and dining areas were very attractive, with little extras such as fresh cut flowers. Radiator covers have been fitted to most areas of the home to which service users have access. The work continues to a set programme. All the communal areas of the home had sufficient space for normal daily living and activities. There were sufficient toilets and bathrooms available to clients with equipment to maximise independence. All were clean and personal toiletries were being kept hygienically. Not all toilet frames are fixed to the floor. The manager has the work prioritised to a set programme. The home has exceptionally high standards and practices in place for infection control, including laundry sorted for temperature washes and specialist equipment available, such as a high quality industrial washing machine and hand disinfection dispensers around the home. Staff evidenced a very good understanding of infection control and the measures taken to minimise risk. Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 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 Service users can expect the best from staff who have designated roles and responsibilities. Service users needs could not be consistently or reliably met by the current staff rota arrangements. EVIDENCE: The home generally has a very good level of staff to support service users, including additional staff available at breakfast and teatime. Ancillary staff are employed for catering; gardening; maintenance and cleaning. The staff rota allocation is not consistent however. The rota seen did not show the skill mix of staff or the numbers allocated during weekdays to be available at specific periods during the weekends. For instance, rota week 2 shows no senior staff on duty before 2pm Saturday or after 2pm on Sundays. Rota week 1 shows no senior staff on duty after 2pm Sunday. Care staff are responsible for the home in the absence of senior staff. It was suggested to the manager that the weekend staff rota requires review and revision to ensure that staff are rostered in sufficient numbers and with a sufficient skill mix to meet the assessed needs of service users at all times. The manager spoke of their intention to undertake the work. All service users spoken with were very complimentary about the staff and had nothing but praise for them and the service they received. Comments received prior to the inspection raised some concerns about lack of staff on duty at specific times. Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 Page 18 Recruitment processes were discussed and inspected thoroughly. They were found to be robust and offered protection to people living at the home. Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 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 32 33 35 36 37 38 The manager has a good understanding of the areas in which the home needs to improve. Planning was in place and set out how this improvement was going to be resourced and managed. EVIDENCE: The manager has recently achieved the Registered Managers Award and has experience of working with an older client group. The manager described an open and inclusive approach to the management of the home and has high expectations of the service to be delivered. Staff and service users said they considered the manager to be approachable, understanding and supportive. The home has recently reviewed their terms and conditions and service user contract documentation in light of the Office of Fair Trading Guidance on Unfair Terms in Care Homes. Improved guidance regarding the security of personal Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 Page 20 property and the provision of secure facilities are available to service users in light of the recent adult protection alert. The manager stated that all aspects of service users financial security, for which the home has direct responsibity, have been revised and safeguarded. This evidences the homes good practice in the review of policies and procedures and has resulted in improved safety and security for service users. The office has a punch key locking system fitted so that service user records and documentation are kept secure. Staff records complied with Regulation. Formal staff supervision records were in evidence, however, the process needs to be planned regularly and take place at least six times a year. The owner now arranges formal monthly visits and sends copies of the written report to the CSCI and to the manager. The information provided in the first report received was comprehensive and detailed. The home has a good understanding of issues relating to health and safety. Work to complete the provision of radiator guards to all service user access areas continues to a fixed programme. Not all toilet frames are yet fixed to the floor. Work to a toilet frame that had recently been fixed, was competently undertaken to a good standard. The manager stated that the remaining work is planned as a priority. Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 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 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 3 3 3 3 4 3 2 4 STAFFING Standard No Score 27 2 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 2 3 2 Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 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 OP27 Regulation 18 (1) (a) Requirement The Registered person shall, having regard to the size of the care home, the statement of purpose and the needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. In that: The staff roster should be revised as a matter of priority to deploy both sufficient care hours and a senior staff member who is suitably qualified, competent and experienced to meet the assessed needs of service users during weekend day duty periods. Action plan to be received by CSCI within the timescale given. Timescale for action 13/02/06 Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 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 OP10 OP16 Good Practice Recommendations It is recommended that appropriate storage is provided for continence aids in service user toilets It is recommended that a concise record is kept of all concerns and complaints and includes details of investigations and actions taken by the home to resolve the issues raised. It is strongly recommended that the manager fulfil the stated intention of ensuring all radiators in service user access areas are guarded. It is strongly recommended that staff supervision takes place regularly six times a year and sessions are recorded. It is recommended that the manager fulfil the stated intention of fixing all freestanding support frames that go over the toilet seat to the floor. 3 4 5 OP25 OP36 OP38 Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Fairlawn DS0000023939.V263853.R01.S.doc Version 5.0 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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