Random inspection report
Care homes for older people
Name: Address: Fairlight Manor 48 Fairlight Avenue Telscombe Cliffs East Sussex BN10 7BS one star adequate service 18/12/2008 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Judy Gossedge Date: 1 3 0 5 2 0 0 9 Information about the care home
Name of care home: Address: Fairlight Manor 48 Fairlight Avenue Telscombe Cliffs East Sussex BN10 7BS 01273582786 01273582786 ashnazpatel@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Fairlight Manor Ltd care home 19 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: 19 The maximum number of service users to be accommodated is 19 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender; Either whose primary care needs on admission to the home are within the following category : Dementia (DE) Date of last inspection Brief description of the care home Fairlight Manor is located in a quiet residential area of Telscombe Cliffs, near to the seafront and local shops and amenities. The property comprises of two large semidetached houses, which have been made into a single building and extended. Residents accommodation is presented over three floors; a passenger lift is available to all floors. The home has a large sitting room with television and stereo, with a smaller dining room situated just off, between the sitting room and the kitchen. Residents have access to the garden at the rear of the premises that is equipped with garden furniture and umbrellas in the summer for them to use during the fine
Care Homes for Older People Page 2 of 11 1 8 1 2 2 0 0 8 Brief description of the care home weather. The home provides personal care and support to residents who are both privately funded and those who are funded by Social Services. The homes fees at the time of the Inspection range from £423.86 to £525.00 per person per week. Additional costs are charged for hairdressing; chiropody, newspapers, toiletries and contributions are requested for outside activities. The homes literature states that `the home is committed to working with these individuals, and believe that however impaired they are, they still deserve to be treated with respect and dignity. A Statement of Purpose and Service Users Guide is available to reference. Care Homes for Older People Page 3 of 11 What we found:
The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Fairlight Manor care home will be referred to as residents. The inspection was undertaken over three hours on 13 May 2009 by two Regulation Inspectors. The inspection was undertaken to follow up on Requirements made at the last key inspection on 18 December 2008 and to review the progress made of further developments in progress at the last inspection. The Manager was asked to completed an Annual Quality Assurance Assessment (AQAA) information from which informed this inspection. The inspection involved a tour of the premises as the condition of some areas of the home has been an issue in previous inspections, looking at a sample of the homes records, discussions with residents, visiting relatives and staff, and observations on the day. There were eighteen people resident in the home. Mr Patel the Registered Manager and Provider was not present, but was spoken with over the telephone during the inspection. Mr Patel has a new acting appointed manager since the last inspection, who is responsible for the day-to-day running of the home, with Mr Patel overseeing management matters through her. The CQC had not been made aware of the changes in management arrangements for the home and should have been notified. The appointed manager was on duty and facilitated the inspection. Mr Patel stated that this was an interim arrangement with a new appointed manager due to start working in the home on 1 June 2009, and that an application will then be made for the appointed manager to become the Registered Manager for the home. Feedback on the outcome of the inspection was given to the appointed manager. The outcome of this visit is as follows: Choice of Home - Needs Assessment. The documentation for two new residents was viewed. Both had a pre-admission assessment completed, but neither had been sent a letter from the home to confirm in writing, that having regard to the assessment made the home can meet the residents care needs to protect the residents. The appointed manager stated she was aware that a letter should be sent and that this would be addressed. So a Requirement has not been made on this occasion. Health and Personal Care - Service User Plan. Four residents individual care plans were viewed. Two were for new residents, both did not have a photograph of the resident in place. One did not have a care plan in place or supporting risk assessments including a falls risk assessment and the person had been resident in the home for six days. The other care plan was only partially completed, did not have a falls risk assessment in place although the pre-admission documentation completed detailed this resident had a high risk of falling. Two care plans were viewed for existing residents and for one it was in need of review as did not detail the residents current care needs. This was discussed with the appointed manager who stated that for both the new residents it would be ensured that all the required documentation will be in place within the following two days
Care Homes for Older People Page 4 of 11 and that the third care plan would be updated. So a Requirement has not been made on this occasion. One care plan viewed had supporting guidance for staff to follow in relation to any challenging behavior exhibited. But there was no evidence of the detailed risk assessments which were due to be implemented. Health and Personal Care - Health Care It was evidenced that a format is now in place to detail individual risk assessments are recorded in relation to the risk of pressure sore development to protect residents. The appointed manager stated that currently there are no residents in the home who have any moving and handling issues identified. Health and Personal Care - Medication. A sample of the medication administration records were viewed and were adequate. It was not evidenced that further guidelines for medicine prescribed on a as and when required basis are provided for staff to reference. Daily Life and Social Activities - Meal Times. The cook was spoken with who stated she has completed basic food hygiene training and is due to complete further training specific to her role later in the year. She evidenced that there are records of individual residents food consumption, that these have been further developed to record all meals taken in the home and that the records are signed. Since the last inspection residents are now being asked prior to their meal which option they wish to choose from the menu, and desserts are now plated and taken around to the residents so they can look and choose from the selection. The cook stated that the menus are in the process of being seasonally changed and that residents likes and dislikes are being taken in to account. Regular deliveries of fresh fruit continue and enable residents to choose this option if they wish. Environment - Premises. The bathroom next to the laundry room was not fully accessible due to it being used to store cleaning mops and buckets. This was discussed with the appointed manager who stated this was not usually used for storage and that this would be addressed with immediate effect. Two bedrooms did not have a net curtain up at the window and for another the net curtain was falling down. The appointed manager stated this would be addressed and that one was being repaired as it had been damaged. In one bedroom there was a strong odour, in two other two bedrooms the carpet was dirty and in a further bedroom the sink area was dirty. Staffing of the home is detailed under staffing complement. Further work previously identified in the garden area has not yet been completed, and the appointed manager stated that this is still due to be completed. Environment - Hygiene and Control of Infection. Care workers were observed wearing disposable gloves for tasks where these were not required to be worn and gloves were being disposed of in the waste bins in residents bedrooms. This was discussed with the appointed manager who stated that would be discussed with the care workers to ensure appropriate use and disposal of gloves to ensure infection control procedures are maintained in the home. Staffing - Staff Complement. The staffing rota for the week and previous week was viewed. Only a small sample was available to view as the appointed manager stated further copies were with the Registered Manager. It should be ensured that all the required information is available to view in the home. The rota detailed that on the day of the inspection the Registered Manager was on duty when he was not. This was discussed with the appointed manager as it must be ensured that the rota is up-to-date and accurately reflects the staff on duty and she stated that this would be addressed. On the day of the inspection there were three care workers on duty for eighteen residents, some
Care Homes for Older People Page 5 of 11 of the residents were seated in the lounge during the inspection and others were in their bedrooms situated on all floors in the home. The appointed manager was on duty and the cook. There was no domestic support and domestic and laundry tasks were being undertaken by the care staff. The domestic assistant was not due to be working in the home for the next four weeks and it was not evidenced that any cover had been arranged during this period. Two waking night members of staff were due to be on duty that night. Staffing levels were discussed with the appointed manager on the day and she agreed to feedback to the Registered Manager the outcome of the discussion. Staffing - Recruitment The staff files for two new members of staff were viewed and both detailed evidence of two written references having been received and a satisfactory Criminal Records Bureau/Protection Of Vulnerable Adults First check. Staffing - Staff Training. There was detailed individual records being developed and available to view during the inspection to evidence training staff has completed or is due to complete. On discussion with the appointed manager not all the staff had completed training as listed on the records and it should be ensured that the records accurately reflect staff attendance or non attendance. Two care workers spoken with confirmed they had completed a range of training and had received safeguarding adults training. Management and Administration - Day-to-Day Operations The CQC have not received written confirmation of the current management arrangements to ensure the home is run in an effective manner and ensures the aims and objectives of the home are met. Management and Administration - Quality Assurance. It was not possible to fully evidence the quality assurance process in place, as the appointed manager stated that this is undertaken by the Registered Manager. A sample of records of visits by Mr Patel to meet the requirements of Regulation 26 were viewed. Management and Administration - Staff Working Practices It was not possible to evidence that the maintenance of equipment and services in the home. This information was also not detailed in the AQAA. What the care home does well: What they could do better:
There have been some areas of improvement in areas highlighted following the last inspection. Four of the five Requirements made following the last inspection were reviewed and evidenced they had been met. Further Requirements have been in relation to notifying the CQC of any changes in the management arrangements for the home, that guidance is in place for when residents are taking medication as and when, staffing levels are kept under review and are sufficient to meet the care needs of the people resident, and that evidence is provided for the maintenance of services and equipment in the home. Other areas identified for improvement, but Requirements were not made as the appointed manager stated these
Care Homes for Older People Page 6 of 11 would be addressed were, that residents or their representatives receive written confirmation that the residents care needs can be met in the home, residents documentation, including a photograph, a care plan and supporting risk assessments are in place for new residents, residents care plans accurately detail the care to be provided, staff rotas are available to view and accurately reflect who is on duty and staff training records should accurately detail when staff have or have not attended the proposed training. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 25 24 That hot water is provided close to recommended safe temperature of 43C at outlets accessed by residents. To protect residents. 31/01/2009 Care Homes for Older People Page 8 of 11 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 9 13 That guidance is in place where residents are taking medication as and when required medication. To protect residents and staff. 30/06/2009 2 27 18 That staffing levels are kept under review to ensure adequate staffing is in place to meet residents care needs. To protect residents and staff. 30/06/2009 3 38 39 That the CQC is notified when there are any changes to the management arrangements in the home. To protect residents and staff. 30/06/2009 4 38 13 That up-to-date records are 30/06/2009 available to view of the maintenance of services and equipment in the home. To protect residents and Care Homes for Older People Page 9 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action staff. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 11 of 11 - 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!
