CARE HOMES FOR OLDER PEOPLE
Fairlawn St Marys Road Ferndown Dorset BH22 9HB
Lead Inspector Trevor Julian Unannounced 09 & 11 April 2005 15:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fairlawn Version 1.10 Page 3 SERVICE INFORMATION
Name of service Fairlawn Address St Marys Road, Ferndown, Dorset, BH22 9HB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01202 877277 01202 861349 enquiry@dorsettrust.co.uk The Dorset Trust Mrs Kim Marie Harding CRH 60 Category(ies) of OP - 40 registration, with number DE(E) - 20 of places Fairlawn Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: One named person (as known to CSCI) may be accommodated within the category or DE(dementia). The person refered to above may be accommodated under the age of 65 (this condition will not apply after the persons 65th Birthday). Date of last inspection 24 January 2005 Brief Description of the Service: Fairlawn is a residential care home registered with the Commission for Social Care Inspection to accommodate a maximum of 60 older people including up to 20 with dementia. The premises are operated by The Dorset Trust, a not for profit organisation, it is managed by Mrs K Harding. The home is purpose built and was opened on the 9th June 2003. Service users are accommodated on the ground, first and second floors. The second floor provides specialist care for up to 20 people with dementia. All bedrooms are for single occupancy and have en suite facilities. Communal areas are provided on all the floors and include kitchen areas where snacks and drinks can be made. On the ground floor is a large area including a conservatory which is used for large group activities. There are three staircases and two passenger lifts. Outside the grounds are landscaped and one area provides a safe garden with varieties of sensory plants and other features. Fairlawn is located in the centre of Ferndown with shops and amenities available within a short walk. Fairlawn Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection took place on Saturday 9th April 2005 and was concluded on Monday 11th April. The inspector was on the premises a total of 6.5 hours. This was the first of two statutory visits to be completed during the year and focussed on the weekend staffing arrangements. Information was gathered through discussion with residents, visitors, staff and the deputy manager. Further information was gained through examination of records and a tour of the premises. What the service does well:
The home provides good information to prospective residents and their representatives to aid their choice of home. No one is admitted without an assessment to ensure that an individual’s needs can be met. Individual care plans were in place and of a good standard although one file reviewed did not accurately reflect the equipment provided. The home’s activity organiser arranges a variety of activities, these included table-top games, quizzes and crafts; excursions were being planned for the warmer weather. The home is fundraising for an adapted minibus. Residents confirmed that there was a marked improvement in the quality and variety of food. The premises provide a safe and comfortable environment; the rooms are well presented and all of a good size, the building is also secure. There are assisted baths and showers on each floor with aids also available such as grab and hand rails. To safeguard residents the organisation offers good levels of training for the staff. The staff have developed good relationships with the residents resulting in a supportive and caring environment in which the residents feel secure and comfortable. There were sufficient numbers of staff on duty. The home benefits from having a stable and committed management team. Fairlawn Version 1.10 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fairlawn Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Fairlawn Version 1.10 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 3. Standard 6 intermediate care was not provided at the home. Information was provided to assist people in deciding to live at Fairlawn and visitors are welcome to visit at any time. The home continues to have a comprehensive admission procedure ensuring that assessed needs can be met within the home. EVIDENCE: The home has a copy of the service users’ guide and the latest inspection report in the entrance lobby. The relative of a service user confirmed that she had been given information about the services provided within the home. Two new service users had completed pre admission assessments on file and their representatives said that the assessments had been completed in hospital before transfer to Fairlawn. The representatives had also visited the home before deciding to recommend placement they also confirmed they had been given information about the services provided. Fairlawn Version 1.10 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8, and 10. The home was generally meeting the needs of the residents with some areas identified for improvement. Attention to those areas will further reduce risks to the residents and also assist in raising dignity. All residents had a plan of care although the information was not always accurate. EVIDENCE: The care records were in place for the sample used for case tracking. Care plans showed regular reviews, however one care plan showed particular aids to be used, on further investigation it was found that the aids were never provided but the care plan had not been revised to reflect the change. The care plan had not been updated. Basic care plans were held in the residents’ bedroom. An agency carer said that this was helpful when working with individuals. Daily records were kept; for the ground and first floor the recording was appropriate for the level of care provided. On the specialist, second floor, unit the level of recording was not always adequate, during the visit it was found that on occasions some people did not have their dentures in or were not wearing glasses contrary to the information in the care plan.
Fairlawn Version 1.10 Page 10 The residents said that the staff were kind and helpful. During the visit the staff were seen to treat people with respect and patience. Several people said they had experienced problems with the return of clothing from the laundry. This issue was known to the management team who were hoping to resolve the problem. Fairlawn Version 1.10 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15. The activities offered in the home were based on the preferences of the individual residents. The menu offers good variety of appetising meals. EVIDENCE: The home had recruited an activity organiser who was planning a series of excursions for the spring and summer. The activity programme was displayed on notice boards on each floor, the care plans held details of activities undertaken and there were social histories on the files viewed. A group of residents were playing scrabble in the conservatory, they said that they enjoyed the activities being offered. The home has monthly church services, one resident said they were not always publicized. There are three communal areas on each floor and all bedrooms were for single occupancy allowing privacy when receiving visitors. Visitors said they were able to visit at any time and were always made welcome by the staff. Personal records were available to residents but none had requested to see them. Information about independent advocacy services was contained in the service users’ guide. During the visit the deputy manager was in discussion with a new resident’s carer about bringing in some furniture etc. Fairlawn Version 1.10 Page 12 All residents said that the standard of food had improved since the last visit. During the visit two evening meals were being served. Both meals offered a good choice and on both occasions fresh fruit was provided. Fairlawn Version 1.10 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None Not assessed during this inspection. EVIDENCE: Fairlawn Version 1.10 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 21, 24, 25 and 26. The home provides a safe, warm and comfortable environment. The premises are normally well maintained although an issue was noted on this occasion. Suitable communal assisted bathrooms and toilet facilities were available on each floor and each bedroom had en-suite toilet and washbasin. The bedrooms seen were comfortable and suitable for the care needs identified. There were areas of the home that were not cleaned to a reasonable standard. EVIDENCE: The premises were purpose built in 2003 and provide a good standard of accommodation; each bedroom has en-suite facilities. There are communal bathrooms and toilets on each floor. During the visit residents told the inspector that the lighting in the conservatory was poor, it was found that three lights were not working, these were immediately replaced.
Fairlawn Version 1.10 Page 15 The rooms seen had the recommended fixtures and fittings and all had been personalised by the occupant. Residents said the home had been kept warm throughout the winter; hot water and surface temperatures are regulated to guard against scalding and burns. The laundry is carried out on site; commercial washers and dryer were provided for the purpose. During a tour of the premises some areas of the home were in need of cleaning. These areas were identified to the deputy manager. There were no unpleasant odours. Fairlawn Version 1.10 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 Staffing levels were appropriate for the needs of the residents. Recruitment practices and staff training provide safeguards to protect the residents. EVIDENCE: The staffing rotas showed continued reliance on agency care staff to cover vacancies. At the previous inspection there had been evidence that recruitment had been improving but recently there had been a number of factors causing another dip. Staff were continuing to be recruited. The agency staff said they often worked in the home providing some consistency. During the visit the call alarm response time was monitored and showed that the alarms were promptly responded to. The staff were recruited according to the organisation’s policy, all staff complete an induction and foundation programme leading on to NVQ in care. A recently appointed care team manager said that the training was accessible to staff and its quality was very good. Fairlawn Version 1.10 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38 The home does promote the health, safety and welfare of residents. The home is well managed by a dedicated team, however, the management structure does not always benefit the service user. EVIDENCE: Fire testing and servicing programmes were up to date. Agency staff confirmed that they were trained in fire procedures before they first worked in the home. Accident and incident reports were analysed for trends. The staff receive training in health and safety and safe moving and handling. The organisation does carry out annual quality assurance monitoring exercises. Through discussion with some residents it was found that residents meetings were stopped some time ago due to lack of interest. It was felt by some people that they were no longer able to raise ideas and suggestions. It was hoped that the meetings or some other consultation mechanism could be introduced.
Fairlawn Version 1.10 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x 3 x 3 x 3 2 STAFFING Standard No Score 27 2 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 2 x x x x 3 Fairlawn Version 1.10 Page 19 No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 7 26 32 10 Good Practice Recommendations Care plans should reflect the care needs of the individual and include information about any specialist equipment needed. The standard of housekeeping should be monitored. Residents should have accessible communication channels to allow ideas and concerns to be passed to the homes management. Care should be taken to improve the return of clothing to its rightful owner. Fairlawn Version 1.10 Page 20 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF 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 Version 1.10 Page 21 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
