Inspection on 30/08/05 for Fairlea

This inspection was carried out on 30th August 2005.

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

Fairlea 27/07/07

Fairlea 11/08/06

Fairlea 08/12/05

Fairlea 19/08/04

Fairlea 16/04/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Fairlea Fairlea Chope Road Northam EX39 3QE Lead Inspector Andrew Towse Unannounced 30 August 2005 10:30hrs 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. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Fairlea Address Chope Road Northam Bideford EX39 3QE 01237 474554 01237 424354 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) Devon County Council Mrs Patricia Anne Lock Care Home 33 Category(ies) of OP Old age (33) registration, with number PD Physical disability (33) of places PD(E) Physical dis - over 65 (33) Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 To admit one named service user under the age of 65 years for respite care Date of last inspection 19 August 2004 Brief Description of the Service: Fairlea is a detached former Gentlemans Residence. It stands within its own grounds. It accommodated up to 33 elderly persons who may also have a physical disability. The accommodation is all in single occupancy bedrooms, although shared room would be made available on request. The accommodation also comprises a large dining area, a conservatory and sweveral smaller lounge areas, most of which are situated on the ground floor. All areas of the home can be accessed by either stairs or a passenger lift. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced. The information contained in this report was obtained through data forwarded to the CSCI by the home prior to the inspection. During the inspection records, including care plans, were inspected and further information obtained through observation, and through discussion with staff, the manager, residents and their relatives. What the service does well: 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. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 6 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 Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 7 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) 3,6, The home’s ability to meet prospective residents’ needs is assured by its admissions process which includes visits to the potential resident, assessments and in many cases previous respite care. EVIDENCE: The files of three recently admitted residents were examined. Two of these had initially been in receipt of respite care so their needs were well known by the staff at the home prior to their admission, and alternatively, those prospective residents had knowledge of the home and the services it offered which enabled them to make an informed choice about whether they wanted to reside there. Another resident had been admitted from hospital. Prior to admission to Fairlea, the registered manager had visited this prospective resident at the hospital to discuss this person’s needs and the services available at Fairlea. A record had not been kept of this introductory assessment meeting. This person’s file contained nursing referral forms which comprised assessments compiled by a staff nurse relating to this person’s capabilities and needs. Residents’ files were seen to contain contracts. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 8 This home offers interim care for those leaving hospital but does not offer intermediate care. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 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, 9, 10, 11 Residents’ health, personal and social care needs are met as was shown by entries on care plans and through general discussion with both residents and their relatives. EVIDENCE: Four files which were examined were seen to contain Individual Care Plans. All were seen to be reviewed regularly. Residents’ signatures were seen on the review notes which demonstrated both their involvement in the development of the plans and their agreement with their contents. Care Plans are kept in resident’s bedrooms together with daily records which residents can look at when they want. Visiting relatives were also aware of the care plans and of the key worker system. Written information on a resident’s care plan showed that the staff worked alongside district nurses in meeting this person’s needs. Care plans referred to personal care and there was evidence in one resident’s bedroom of the maintenance of the resident’s oral hygiene and comfort. Fairlea operates its medication administration in accordance with the Devon County Council Policy. It also has a separate Homely Medicines Policy. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 10 Controlled medication was seen to be stored appropriately and its administration recorded by double signatures and constant stock recording. All residents have been given a copy of Fairlea’s Resident’s Handbook. This refers to staff respecting confidentiality and providing care with ‘compassion, kindness and understanding’ and creating a ‘homely informal atmosphere.’ The Quality Standards of the home state that ‘services will promote independence and maintain dignity and respect at all times.’ The above was confirmed by residents, who when spoken to confirmed that they were treated with respect. The home does not currently have shared rooms, however these could be available at the specific request of residents. Care Plans showed that the home was respectful of resident’s wishes regarding how they wished to be addressed. The resident who was in receipt of palliative care was seen to receive care from staff which maintained her dignity and comfort. There was appropriate communication between the home and the family. Records showed continuing input from general practitioners and district nurses to ensure that the resident received appropriate attention to her comfort. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 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, 13, 14, 15 From discussion it was seen that the lifestyle experienced by residents at Fairlea matched their needs and reflected, wherever possible, their preferences. EVIDENCE: Information is displayed regarding activities available to residents. Up until the start of 2005, a newsletter also added to the quality and amount of information circulated to residents. The home has access to a minibus. This allows residents to have rides into the community. Although previously, longer trips out were arranged, smaller trips, more suited to the current residents’ needs are now arranged and one was taking place on the day of the inspection. Residents spoke of being able to choose at what time they got up or went to bed. The majority of residents said that they could have a bath when they chose, however a response to the ‘Client Satisfaction Survey’ did not correspond with this and the manager being aware of it had addressed the issue. Residents are encouraged to maintain contact with family and friends. Visiting relatives confirmed that they could visit at any time and were made welcome. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 12 The Resident’s Handbook states that ‘visitors are welcome at any time within reason.’ The manager reserves the right to refuse admission to relatives or friends if this corresponds with the wishes of the resident concerned. On entering the home, residents can bring with them items of furniture or objects of sentimental value. Residents were seen to have brought in some personal items and one staff member has taken the time and effort to restore and enlarge personal photographs using a computer, to assist residents in both personalising their rooms and positively bring back important past memories. The home has a rotating menu. Residents spoken to were positive about the food available. The menus were seen to incorporate choice. Mealtimes were seen to be relaxed. Staff were seen to assist residents, enabling them to eat in a dignified manner and at a speed dictated by their needs. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 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) 16, 18 The home operates an appropriate complaints procedure which is known to residents and their safety is further protected by the home arranging training for staff relating to the Protection of Vulnerable Adults. EVIDENCE: The home uses the complaints procedure compiled by Devon County Council. This had appended a sticker which referred to the Commission for Social Care Inspection and gave its contact details. In the Resident’s Handbook there is further reference to the CSCI in relation to the addressing of complaints. A questionnaire circulated to residents showed that they were aware of the complaints procedure. There are no recently recorded complaints. The home has a large folder containing information regarding the Protection of Adults at Risk. This includes a practical guide, investigating procedures, strategy meeting guidance, multi-agency procedures and an alerter’s guide and flow chart. The home has put forward the majority of staff for Protection of Vulnerable Adults (POVA) training however due to the trainers being unable to accommodate these numbers their names have been resubmitted for future POVA training. The registered manager is aware of the need to report staff unsuitable to work with vulnerable adults for possible inclusion on the POVA register. She has not had to refer any staff. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 14 Residents are protected from financial abuse by the home’s policies which preclude staff from involvement in the making of, or benefiting from residents’ wills. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 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 standard(s) 19, 20, 21, 22, 23, 24 Fairlea has recently been refurbished in many areas which has upgraded this safe, well-maintained, pleasant environment which is suitable to the needs of those who reside there. EVIDENCE: Although residents who want to share rooms would be accommodated at Fairlea, all those currently resident there are, of their choice, in single occupancy bedrooms. Bedrooms were seen to be lockable and to have been personalised by the addition of furniture and items of sentimental value. One staff member has been pro active in reproducing and restoring residents’ old photographs which were apparent in one bedroom. The home’s guide refers to the right of residents to bring in items of furniture. Records, confirmed by discussions with residents, showed that wherever possible they are offered a choice of bedroom. The home has several separate lounges and a large dining area which is large enough for all residents to use for communal activities. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 16 In addition to this diversity of communal areas the home now has a newly built conservatory complete with a ramp which facilitates access to the garden area for wheelchair dependent residents or those who find steps difficult. There are toilet facilities within close proximity of the lounge and dining areas. Since the last inspection the male toilets have been upgraded. They are now pleasantly tiled and are suitable for use by people with disabilities who may need assistance. The home has a variety of baths suitable to meet the needs of service users. As several residents are wheelchair users, storage had been identified as an issue and possible safety hazard. To rectify this a former residential bedroom has now been converted into a storage room All levels of the home are accessible either by use of stairs or passenger lift. The home has an appropriate level of hygiene and cleanliness. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 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 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, 28, 29, 30 Although the home appears to have a recruitment procedure which ensures the protection of service users, records maintained within the home need to be completed in order to reflect this. EVIDENCE: From observation, discussion and examination of the rotas the staffing levels at Fairlea currently meet the needs of those who reside there. There are no staff under 21 years of age. The cleanliness of the home showed that there are appropriate numbers of domestics employed to work there. Records showed that the home now has over 50 of its care staff with NVQ 2 or above and others are scheduled to start the course. A member of staff is also taking part on the NVQ assessors course which will assist the home in ensuring the availability of NVQ training within the home. The home has a policy of all new staff being interviewed and only being able to work unsupervised when the home has received two satisfactory references and CRB clearance. Staff records are however kept at central offices and could not be seen during the inspection. Instead the home has started to keep records of each staff member detailing what documents are available relating to them and which, when completed would demonstrate the home’s compliance with the Regulations. At the time of the inspection these records had yet to be completed. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 18 Inspection of the records of recently employed staff showed that the home runs an appropriate induction course and that they had all either completed it or were still working through it. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 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 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) 31, 33, The views and opinions of residents are sought through the home’s annual ‘Client Satisfaction Survey’ and are incorporated into developing the service available at the home. EVIDENCE: The registered manager has been manager of Fairlea for many years and has attained her NVQ 4 qualifications, therefore in terms of experience and qualifications she meets the requirements of the National Minimum standards. The home has quality assurance and monitoring systems. This includes a ‘Client Satisfaction Survey’ which was carried out earlier in 2005. Residents either complete this survey themselves or are assisted in doing so by someone independent from the home in order that the responses truly reflect the thoughts of the resident concerned. It was seen that responses from residents were acted upon. The home also has a written Development Plan for 2005. Many issues raised in this plan had been addressed at the time of the inspection and included much refurbishment of the premises. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 20 The manager is putting into place a system of supervision. This has yet to achieve the frequency required by the National Minimum Standards. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 3 3 3 3 3 3 x x STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x x x x Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 22 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. 1. Standard 29 Regulation 19 Requirement The registyered person shall not employ a person to work at the care home unless he has obtained in respect of that person information specified in Schedule 2.(in this instance, records relating to this schedule demonstrating that such information is held at the central office, have yet to be completed) Timescale for action 31.10.05 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. Refer to Standard 36 Good Practice Recommendations Care staff receive formal supervision at least 6 times a year. Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Fairlea D54 D06_s39193_fairlea_v235923_300805 stage 4.doc Version 1.40 Page 24 - 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. 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