Inspection on 22/10/07 for Fairlawn

This inspection was carried out on 22nd October 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 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 14/03/07

Fairlawn 20/12/05

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 Ruth Burnham Key Unannounced Inspection 22 October 2007 09:00 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 Fairlawn DS0000023939.V345856.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. Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 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 01622 692161 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.V345856.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th March 2007 Brief Description of the Service: Fairlawn provides care and for older people, requiring some level of support 24 hours a day. The home is a detached property with accommodation on two floors . There are 25 single rooms and one double room, the majority of which have en-suite facilities, the remainder have hand basins and each room has a call bell system, with 2 call points. 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 town centre, 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 and also on street parking available. The current fees range from £335.00 to £510.00 per week, depending on the room occupied, this information was given to the inspector verbally by the manager at the end of the site visit. Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit was carried out on 22 October 2007 between 09.00 am and 3.00 pm as part of the Key Inspection conducted by regulatory inspector Ruth Burnham. During that time the inspector spoke with residents individually and as a group, and also with staff. The registered manager was on the premises throughout the inspection and feedback was given to the manager, deputy manager and assistant manager during and at the end of the inspection. All of the key standards and some additional standards were inspected on this occasion. Comment cards were received in respect of the service from residents, relatives and healthcare professionals. The comment cards from healthcare professionals indicated they were very satisfied with the home. These are some examples: Some specific comments made were; “Staff are always kind and helpful.” “I know my (relative) is safe and well cared for.” “I have no complaints at all, excellent in all respects.” “Activities are very well organised.” What the service does well: Fairlawn continues to be an attractive, pleasantly furnished and comfortable home. Residents spoke highly of the food, with most enjoying their meals in the pleasant dining area. The garden is well kept with an attractive summerhouse which resident enjoy using year round. People who live in the home enjoy being cared for by the caring, friendly and well trained staff. Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Fairlawn DS0000023939.V345856.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 Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1–6 Quality in this outcome area is good. People are provided with good information about the home to help them to make a decision about moving in. There are good assessment procedures to ensure that people’s needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who are thinking about moving into the home are provided with written information about what life is like at Fairlawn. This information is contained in the Statement of Purpose and Service User Guide. People are also encouraged to visit the home wherever possible before moving in to help them decide if the home will be suitable for them. They are able to have a meal and spend time with staff and the people who live there, a member of the management team is always there to answer any questions. Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 9 A member of the management team always visits the person, either in their home or in hospital, to carry out a detailed assessment to ensure the home will be able to meet their needs before a place is offered. Each person is given a statement of terms and conditions with their contract which informs them about their rights and responsibilities, they are also given a copy of the residents’ charter. Intermediate care is not provided. Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 – 10 Quality in this outcome area is adequate. People are supported to manage their healthcare needs however nutritional screening needs to be more robust to ensure good health is maintained. Some improvement is needed to care planning and risk management to ensure a more person centred approach. People are protected from harm through the safe handling of medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Everyone who lives in the home has a care plan. New care plans are being developed following advice given at the last inspection. Discussion took place about how to develop a more person centred approach to care planning and risk management to enable staff to provide more sensitive and consistent support. Five people’s individual files were seen, the assessment elements of the care plans and risk assessments were very good however guidance about the actions staff need to take to meet individual needs and minimise risk of harm was not clear enough to ensure that people will be supported in line with Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 11 their individual wishes and preferences. Regular reviews of the care plans are carried out and in addition a review meeting takes place periodically with the resident’s involvement. People sign to agree their individual care plans. People are supported with their healthcare needs and have access to their GP, whenever they ask or need to. Health care records are well maintained. Visits by healthcare professionals are marked with a coloured dot in the daily record then transcribed periodically onto a health record sheet, this enables easy tracking of visits. Nutritional assessments were being recorded however people who are at risk in this area are not being weighed regularly. One person who had moved into the home this year at a very low weight had not been weighed at all, in spite of this her nutritional supplements had been stopped because she was eating better. The manager was reminded that treatments, including nutritional supplements should not be stopped without consultation with the prescribing GP. Professional advice about continence is accessed through the district nursing service. Medication is stored securely. The home has a medication policy. Lockable storage is provided for residents who manage their own medication. Risk assessments are in place for residents who are self medicating. Competency based medication training is being sourced for all staff administering medication. People who were spoken to said staff were very kind and helpful and that they help them with their personal care needs in a way which respects their privacy and dignity. Residents are addressed by the name they prefer and receive their mail unopened. Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People who live in the home are supported to live life as they choose and have opportunity to take part in a variety of activities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who were spoken to said that they were satisfied with the number and variety of activities, each person is given a monthly events sheet which includes all the in house activities and entertainment. People had particularly enjoyed the violinist who performed in the home recently. Other activities include quizzes, games, discussion groups and film shows. Many of the residents are very able bodied and or have relatives living nearby and are able to access the community. People are able to live life as they choose; routines in the home are flexible. There is a residents meeting held once a month and chaired by one of the residents. The chairperson said the management always welcome suggestions and act on them wherever possible. Arrangements are made for people who choose to do so to take part in religious services. A communion service was being held in the home during the visit. Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 13 There are no restrictions on visiting and residents choose whom they see and when. Visitors are now able to make refreshments in the new snack kitchen close to the lounge. People are encouraged to personalise their rooms by bringing in personal possessions and items of furniture if they wish. They are encouraged to manage their own finances for as long as they are able. All the residents spoken with said the food was very good, well cooked and presented. Many of the residents eat in the dining room and enjoy a chat over lunch. Fresh fruit is available and there is a water cooler in the dining room for residents and visitors use. Hot meals are served from a heated trolley to ensure they remain at a suitable temperature for residents. Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. People who live in the home are listened to and are free to offer comment or complaint. They are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home are listened to and are free to offer comment or complaint. One person who had had cause to complain to the management said that the situation had been resolved and there had been no problems since. There is a clear complaints policy which has been amended and updated since the last inspection. The manager signs off complaints to indicate she is aware of them and plans to further improve complaints recording procedures in the next few months People in the home are protected from abuse through appropriate policies and procedures. All staff have undergone training in the protection of vulnerable adults since the last inspection. Recruitment procedures include checks on all staff through the criminal records bureau. Fairlawn DS0000023939.V345856.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 – 26 Quality in this outcome area is good. The attractively furnished, tastefully decorated, clean, safe and homely environment enhances the quality of life for people who live in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The attractively furnished, tastefully decorated and homely environment enhances the quality of life for people who live in the home. Lounge and dining areas are very attractive, comfortable and homely. Tables are laid with cloths, matching napkins and flowers. At the time of the visit the home was clean throughout and free from unpleasant odours. Gardens are well maintained and accessible to residents with a large, well furnished summerhouse. Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 16 People are encouraged to personalise their rooms, those seen were homely, very comfortable and had plenty of personal effects. On person who moved into the home recently said that the window in his room had been replaced at his request with a double glazed unit which he could open easily. All bedroom fire doors have door guards fitted which allows service users to keep their doors open for ease of access or to suit their individual wishes whilst maintaining fire safety. People benefit from the good facilities the home offers. Bathrooms and toilets are conveniently located and the majority of bedrooms have ensuite facilities. Liquid soap and disposable hand towels are provided in all communal bathrooms to minimise risk of cross infection. The laundry has been relocated outside the main house, this has freed up space next to the lounge where a small snack kitchen has been fitted for the use of residents and relatives. The main kitchen is well equipped. Fairlawn DS0000023939.V345856.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People who live in the home benefit from the care provided by the well trained staff team. The retention of staff needs to improve to ensure continuity of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the care provided by the well trained staff team. The home generally has 3 staff on duty in the morning, 2 in the afternoon and 2 at night, providing hands on care to residents. On the morning of the site visit there were 3 care staff on duty in addition to the assistant manager and the deputy manager. People who were spoken to during the visit made comments such as ‘the staff are lovely.’ ‘they are very kind.’ They said they did not have to wait long for assistance. Almost 50 of staff either have or are working towards a National Vocational Qualification. It is planned that more staff will be inducted into NVQ level 2 in the next few months. Robust recruitment policies and procedures protect the people who live in the home. Three staff files were examined, these included detailed application forms with full employment histories, 2 written references and evidence of appropriate criminal records bureau checks. People who live in the home have had to get used to a number of new staff this year with 9 staff leaving over the last year. The manager said that a number of changes have been introduced to improve the service recently which staff have not always found easy, she is committed to improving retention levels in the next year. Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 18 Staff files and other records also show a commitment to ongoing training to ensure staff are competent to carry out their roles. All new staff undergo induction training. Staff files and other records show evidence of training undertaken by staff. Fairlawn DS0000023939.V345856.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 – 38 Quality in this outcome area is good. The home is run in the best interests of the people who live there. Their health and safety is promoted through safe working practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is run in the best interests of the people who live there. The manager has achieved the Registered Managers Award and has experience of working with an older client group. The manager has run the home for many years. A deputy manager has been appointed who is currently undertaking a level 4 NVQ in care along with the assistant manager. The manager has worked hard to comply with requirements and recommendations made at the last inspection and the majority of work required has been completed. Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 20 People are encouraged to express their views and make suggestions to improve the service. There are monthly residents meetings chaired by one of the residents. Examples were given where the management has made changes in response to suggestions from residents. People who were spoken to during the visit were very happy with the home and residents found the lifestyle they experienced matched their expectations. The Commission’s Annual Quality Assurance Assessment was completed and returned by the manager before the inspection. Information provided has been included in this report. This document shows plans for developing the service in the coming year to continue to improve peoples’ quality of life. Some people are helped to manage their finances. The home holds money on behalf of many residents. This money is held separately for each person and individual account sheets are maintained. People are protected through policies with regard to health and safety and an environmental risk assessment. All staff receive training in basic food hygiene, fire safety, first aid, moving and handling, health and safety and infection control. There were some areas of concern noted where staff were not following correct procedures to minimise risk of infection however these were immediately addressed by the manager who will be taking further action to reinforce training through individual supervision. Fire drills are carried out regularly and a fire logbook is maintained. Records are kept which show that equipment and installations are regularly checked. A qualified person has carried out a fire risk assessment in the last year. Work is progressing well to complete the provision of radiator guards in all areas of the home; the majority of this work has been completed. Fairlawn DS0000023939.V345856.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 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 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 3 17 3 18 3 4 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 15 (1) 13(4) Requirement The registered manager shall after consultation with the service user prepare a written plan as to how the service users needs are to be met. In that; There must be clear guidance for staff which is person centred to enable care staff to provide care for the resident in line with their individual needs, wishes and preferences. Care plans should include detailed risk assessments with clear guidance for staff on how to minimise risk in all areas of peoples’ individual daily lives. Timescale for action 31/12/07 2 OP8 12(3) The registered person shall, for 30/11/07 the purpose of providing care to service users, and making proper provision for their health and welfare, so far as practicable ascertain and take into account their wishes and feelings. In that nutritional screening including weight gain or loss must take place and prescribed nutritional supplements shall not be stopped without consultation Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 23 with the GP. 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 Fairlawn DS0000023939.V345856.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Fairlawn DS0000023939.V345856.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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