Inspection on 31/01/08 for Fairlawns Residential Care Home

This inspection was carried out on 31st January 2008.

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

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Fairlawns Residential Care Home 41 Wash Lane Clacton On Sea Essex CO15 1UP Lead Inspector Francesca Halliday Unannounced Inspection 31st January 2008 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 Fairlawns Residential Care Home DS0000070301.V358131.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. Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairlawns Residential Care Home Address 41 Wash Lane Clacton On Sea Essex CO15 1UP 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) 01255 425296 kausarsadiq@gmail.com Mr Mahendra Pratap Rambojun Mr Navinlall Ramrutton Mrs Kauser Jehan Sadiq Care Home 19 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (19) of places Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 19 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 6 persons) The total number of service users accommodated in the home must not exceed 19 persons. This is the first inspection since change of ownership of the home. Date of last inspection Brief Description of the Service: Fairlawns Residential Care Home is a converted private residence situated in a residential part of Clacton on Sea. It is approximately five minutes from the sea front and ten minutes walk from the town centre. The home can accommodate up to 19 residents and it mainly caters for older people and people with dementia. The home has three shared rooms and thirteen single rooms and all bedrooms have an en-suite toilet and hand basin. There are stairs and a passenger lift to the first floor. The home has a range of communal areas. There is a garden at the rear of the home and limited off road parking at the front of the home. The fees at the time of inspection in January 2008 were from £374 to £440. Private chiropody, hairdressing and toiletries were extra to the above fees. For up to date information on fees contact the home directly. Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. This unannounced inspection visit took place on 31st January 2008. The term resident is used throughout the report to refer to people who live in the home. Throughout the report the term “we” refers to the Commission for Social Care Inspection. The registered manager was present throughout the inspection. A number of residents were spoken with during the inspection, although advanced dementia made communication difficult with some residents. A number of staff and relatives were also spoken with during the inspection. The home was predominately for older people and people with dementia. Two residents with a mental health diagnosis had been admitted and a variation to the home’s registration had been requested. Appropriate staff training in mental health was being provided. What the service does well: What has improved since the last inspection? What they could do better: Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 6 Improvements had been made to the environment since the new owners took over but some further work was still necessary. The access to the rear garden was not level and was a potential hazard to both residents who were mobile and those in wheelchairs. The home only had one bath, which was suitable for current residents’ needs and an additional assisted bath or shower was needed. The screening in shared rooms did not provide full privacy for residents receiving personal care. A washing machine with a sluice cycle was needed to improve infection control practices in the home. 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. Fairlawns Residential Care Home DS0000070301.V358131.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 Fairlawns Residential Care Home DS0000070301.V358131.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): Standards 1 and 3 (standard 6 not applicable). Quality in this outcome area is good. Residents can be confident that they will have an assessment and only be admitted if the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a range of information for prospective residents and their representatives. This included a statement of purpose and a guide to the home. The statement of purpose required a few amendments. The manager said she would ensure that it was updated and a copy sent to the commission. The manager carried out pre-admission assessments, prior to accepting a new resident, in order to ensure that the home could meet their needs. Prospective residents and their relatives were encouraged to visit and spend some time in the home before making up their mind about its suitability. The documentation met the standards and included a mental health assessment for use when appropriate. The standard of assessments seen was good. The manager confirmed that another assessment was carried out on admission. Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 9 She also said that a more comprehensive assessment was carried out a month after admission, when the resident had settled in and staff had a greater understanding of their needs and their wishes regarding their care. Fairlawns Residential Care Home DS0000070301.V358131.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): Standards 7, 8, 9, 10 Quality in this outcome area is good. Residents receive person centred care and their health needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents and relatives we spoke with said that they were very happy with the standard of care and the support they received from staff. Relatives said that communication with them was extremely good. They said that staff kept them informed of any health concerns and involved them in decisions about care when appropriate. One relative said, “All staff are caring and pleasant”. Another stated in a letter “We could not have wished for a better environment than that at Fairlawns”. The home practiced person centred care. Staff we spoke with had a detailed understanding of residents’ health and care needs and their individual preferences. The home had a range of care documentation, which included a range of risk assessments. The manager was aware that the documentation Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 11 needed to be reviewed and developed to provide clearer documentary evidence of the care planned and the care being provided. An example of a detailed care plan and assessment was sent to us following the inspection, which demonstrated a very good understanding of the resident’s needs. The manager had received a letter from social services praising her advocacy and her excellent liaison with various agencies on behalf of individual residents. There was evidence that staff had improved the health and welfare of a number of residents following admission. Appropriate action had been taken when one resident had falls. The manager said that they had very good support from three local GP practices. They also had very good support from district nurses and mental health nurses. She said that the home had good relations with the community matron and the consultant for older people. A chiropodist visited the home on a six weekly basis. The manager confirmed that residents were assessed for a sensory impairment and referred as appropriate. Optical checks were arranged and hearing tests when necessary. The manager said that the home had some dental support but that she was trying to organise a more comprehensive service. The manager was liaising regularly with social services and taking steps to resolve problems with funding for three residents, as she had concerns that lack of funding (full funding for one resident and partial funding for two residents) could potentially impact on the home’s ability to purchase appropriate moving and handling equipment for residents. The medicine administration records (MAR) were generally well completed but on occasions staff needed to clarify the codes used when residents did not receive their medicines. The manager confirmed that staff were now monitoring the temperature of all storage areas and would take action if temperatures exceeded 24c. She said that the receipt and return of controlled drugs (CDs) was now being recorded in the CD register and the systems for recording “as required” medicines were being improved. The manager said that she would be reviewing the homely remedies in consultation with GPs who attended the home. The manager was advised to speak to the pharmacist and request that medicines were labelled on the container as well as or instead of the outer carton to reduce the risk of cross infection. The manager is to be commended for her success in reducing the amount of antipsychotic medicines and sedatives used once residents had been admitted to the home. She was in the process of asking GPs to change a number of medicines to “as required” rather than at regular times each day. She confirmed that the GPs carried out regular reviews of residents’ medication. All care staff had received training on medication and three senior staff were due to attend training in advanced medication in relation to mental health and medicines and the law. Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 12 The manager placed a great emphasis on respect for the individual residents and on staff preserving their dignity at all times. The staff we observed were courteous and caring when interacting with residents. The manager acted as an excellent role model for her staff. Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 13 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): Standards 12, 13, 14, 15 Quality in this outcome area is good. Residents are encouraged to develop or maintain their social and life skills and maintain their independence for as long as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a range of activities and social stimulation. Some trips had been arranged and there were social events at the home to which relatives were invited. The manager was encouraging regular one to one sessions with all residents. Care staff were due to attend training in activities and the manager said that they would then pay a more active role in social activities. The manager was keen to ensure that residents with all conditions and at all stages of dementia had access to social stimulation to improve their quality of life. The manager was planning to establish a room that could be used for activities. The manager was aware of the importance of community links and was in the process of developing them. Arrangements were made for residents who wished to attend church. Religious services had previously been held at the Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 14 home but the manager said that there had been a recent lack of interest and that they would try to reinstate the services if any residents requested it. The local library visited the home on a regular basis and staff assisted residents to obtain the books that reflected their interests and tastes. Relatives confirmed that they could visit at any time and said that they were always made to feel very welcome in the home. Residents were treated as individuals and there was evidence that staff encouraged residents to make choices and retain their independence. Residents spoken with said that they were very happy with the meals in the home. The home operated a four week rolling menu. The home served a cooked breakfast on two days a week, had choices at lunchtime and sandwiches and soup in the evening. The environmental health officer visited the home in the summer and there were no requirements. Staff monitored residents’ nutritional needs very closely and liaised with the GP to obtain supplements when necessary. One resident who was constantly active and was reluctant to sit for a meal was given additional sandwiches and “finger food”. The manager confirmed that there was cereal, fruit and the ingredients for sandwiches available at all times. A relative said that staff tried to meet the needs of the resident they visited and helped them to choose the food that they preferred. Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 15 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): Standards 16 and 18 Quality in this outcome area is good. Residents feel safe and are confident that any concerns are promptly addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a complaints procedure. Residents and relatives said that the manager dealt with any concerns very promptly. Residents said that they felt safe in the home and that they had not had any complaints. All staff had received training in safeguarding vulnerable adults. The manager reinforced this training regularly at staff meetings and during staff supervision. Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 16 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): Standards 19, 21, 24, 26 Quality in this outcome area is adequate. Residents live in clean and fresh surroundings but some improvements to the environment are needed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager said that a number of areas of the home had been redecorated since the home changed ownership. She said that the proprietors were planning further improvements to the home. This included improved signage and pictograms, improving the access to the garden for wheelchairs, changing bedroom door locks to those more suitable for older people, new furniture and further redecoration. The home had four communal areas to meet residents’ different needs. The manager said that she was hoping to turn the conservatory into an activity area. Relatives confirmed that the environment had improved since the new owners took over. Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 17 The home had one bathroom with a bath hoist and one domestic style bath, which was not suitable for current residents’ needs. The manager said that only the assisted bath was used and there was a plan to turn the second bathroom into an assisted bath or shower. Residents’ rooms were generally well personalised. The manager said that assessments were being carried out with each resident to assess the appropriateness of their having a lock on their door and if so the type that would be most suitable. The emergency call bells in residents’ en-suite toilet were not easily identifiable as they looked like light switches. The screening in shared rooms was not adequate to provide complete privacy when personal care was carried out. The home did not possess a washing machine with a sluice cycle or use dissolvable red bags for handling soiled laundry. We advised the manager that hand sluicing soiled laundry was poor infection control practice. The home was clean and free from unpleasant odours on the day of inspection. Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 18 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): Standards 27, 28, 29, 30 Quality in this outcome area is good. Residents have confidence in the staff that care for them. Training is provided to enable staff to meet individual residents’ needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staffing levels at the time of inspection (for fifteen residents) were three carers during the day and two at night. The manager was supernumerary to these numbers. In addition to this the home had a cook from 09.30 – 1.30 each day and an activity coordinator for two days a week and a volunteer who also did one to one sessions and activities with residents. We sampled three staff files. All the required information had been obtained prior to staff taking up a position in the home. This included references, a Criminal Records Bureau (CRB) check and a check with the Protection of Vulnerable Adults (POVA) list. Staff training was being given a high priority. A number of staff had completed National Vocational Qualification (NVQ) at level 2 and the remaining care staff were in the process of doing the training. A number of staff were also due to commence NVQ level 3. Staff had received a range of training to enable them to meet residents’ needs. This included training on dementia, challenging Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 19 behaviour and sensory impairment. The manager said that staff from abroad were given training on cultural issues in this country at their induction. The manager confirmed that she would be bringing in an induction in line with the Skills for Care common induction standards in addition to the home’s induction. The following training had been arranged: safeguarding residents with dementia and mental health conditions, medicines in mental health, the law in relation to mental health medicines, diabetes, care planning, activities for people with dementia and food hygiene. Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 20 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): Standards 31, 32, 33, 35, 38 Quality in this outcome area is good. Residents can be confident that the home is well managed and run in their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager had a degree and had considerable experience of working with older people and older people with dementia. She had completed the registered manager’s award and was awaiting her certificate. She was due to attend a five day course on mental health. The manager was on call at all times and the home would benefit from the appointment of a deputy manager to share the management responsibilities and the on call duties. The manager provided an excellent role model for staff. She promoted an open, supportive and inclusive environment with an emphasis on providing person centred care. Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 21 The annual quality assurance assessment (AQAA) demonstrated that the manager had a good understanding of quality assurance and was taking positive steps to improve the quality of care and services in the home. She had informal systems of monitoring standards in the home but the home would benefit from developing formal audit systems. This would enable staff, other than the manager, to become directly involved in monitoring and improving standards. A survey of residents and relatives was carried out in December 2007 and the feedback was very positive. There were good systems in place for managing residents’ personal money safely. Receipts for services such as hairdressing and chiropody were kept in each resident’s folder. We checked some of the balances and all were correct. The home had systems in place for servicing and maintenance of equipment. The manager confirmed that the recommendations from the last fire inspection and fire risk assessment were being actioned. Staff had completed training in safe working practices such as moving and handling, first aid, infection control and fire safety. Health and safety training was due shortly after this inspection. We did not notice any obvious hazards during the inspection. The manager said that a member of staff was now responsible for health and safety in the home. Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 22 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X 2 X 2 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 4 3 X 3 X X 3 Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Not applicable 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 1. OP19 Regulation 13(4) Requirement The access to the garden must be made level in order to reduce the risk of accidents for residents and improve the access for wheelchair users. The home must provide sufficient bathing facilities to meet the needs of current residents. The screens in shared rooms must be improved in order to ensure privacy when personal care is carried out. The emergency bell in residents’ en-suite toilet must be clearly identifiable in an emergency so that staff can respond promptly to residents’ needs. A washing machine with a sluice cycle must be used in conjunction with dissolvable red bags to reduce the risk of cross infection to staff and residents in the home. Timescale for action 01/05/08 2. OP21 23(2)(j) 01/08/08 3. OP24 12(4)(a) 13(4)(c) 01/04/08 4. OP26 13(3) 01/05/08 Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 24 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 Fairlawns Residential Care Home DS0000070301.V358131.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Fairfax House Causton Road Colchester Essex CO1 1RJ 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. 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