Inspection on 14/10/08 for Fairlight Manor

This inspection was carried out on 14th October 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fairlight Manor 13/05/09

Fairlight Manor 18/12/08

Fairlight Manor 30/06/08

Fairlight Manor 10/09/07

Fairlight Manor 04/12/06

Fairlight Manor 18/11/05

Fairlight Manor 22/04/05

Fairlight Manor 25/11/04

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Random inspection report Care homes for older people Name: Address: Fairlight Manor 48 Fairlight Avenue Telscombe Cliffs East Sussex BN10 7BS The quality rating for this care home is: The rating was made on: one star adequate service 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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 4 1 0 2 0 0 8 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: Fairlight Manor Ltd care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia 19 Over 65 0 Conditions of registration: 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 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 Care Homes for Older People Page 2 of 14 committed to working with these individuals, and believe that however impaired they are, they still deserve to be treated with respect and dignity. Care Homes for Older People Page 3 of 14 What we found: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation 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 14 October 2008 by a Regulation Manager and a Regulation Inspector. The inspection was undertaken to follow up on Requirements made at the last key inspection on 30 June 2008 and due to the seriousness of the failings to meet regulations and poor outcome. The inspection involved a tour of the premises, looking at the homes records, discussions with residents and staff, and observations on the day. Mr Patel the Registered Manager/Provider was not present until the end of the inspection. Mr Patel has made a new appointed manager responsible for the day-to-day running of the home, with Mr Patel overseeing management matters through her. The appointed manager was on duty and facilitated the inspection. Feedback on the outcome of the inspection was given to the appointed manager. The outcome of this visit is as follows: Choice of Home - Information. The Statement of Purpose and Service Users Guide were read and detailed that they had been updated to ensure prospective residents/representatives have accurate information to refer to. References to staffing levels in the Statement of Purpose needs further updating and should be kept under review to accurately reflect the staffing arrangements in the home. Standard met. Choice of Home - Needs Assessment. The appointed manager provided evidence that there is letter, which is sent from the home to confirm in writing, that having regard to the assessment made the home can meet those care needs to protect residents. Standard met. Health and Personal Care - Service User Plan. The appointed manager evidenced that further work has been undertaken to ensure that care plans detail individual residents care needs, provides specific guidance for staff to follow, is devised for each resident in consultation with the resident or their representative and that an up-to-date photograph of each resident is kept on file. The updating had not been completed on all the files and the appointed manager stated that all the updating would be completed by 19 October 2008. Standard met. Health and Personal Care - Health Care The appointed manager was not able to demonstrate that individual risk assessments that cover all residents risks are recorded and responded to in relation to the risk of moving residents and pressure sore development to protect residents and staff. Care Homes for Older People Page 4 of 14 Standard not met. The appointed manager was not able to demonstrate that the moving and handling risk assessments are undertaken by staff that has completed the required training to undertake this task. Standard not met. Health and Personal Care - Medication. The appointed manager evidenced that further guidelines for medicine prescribed on a as and when required basis are provided for staff to reference, a record is now kept of staff signatures that administer medication, and that secure storage arrangements have been provided for the storage of medication awaiting collection from the pharmacist . Standard met. Health and Personal Care - Privacy and Dignity. It was observed during the inspection that net curtains have been provided to all windows to ensure that the privacy and dignity of residents is promoted at all times. Standard met. Daily Life and Social Activities - Activities. The appointed manager stated and evidenced that an activities programme has been put in place in the home and that links in the community have been developed with residents going out to access local facilities. Activities were not facilitated during the morning of the inspection, but a game of skittles was being played during the afternoon. Feedback received on the day was that activities could not always be provided due to current staffing levels in the home. Standard not met. Daily Life and Social Activities - Meal Times. The appointed manager evidenced that records of individual residents food consumption have been further developed to record all meals taken in the home. It should be ensured that these records are dated to ensure the records clearly detail the days that the records apply to. Standard met. The lunchtime routines were observed. Although there was a choice of soup or apple juice residents who did not want soup were not offered apple juice. Some residents did not eat very much and staff did not pick this up. As one resident needs assistance with their meals, which is given to them in their bedroom this leaves one carer to support residents in the dining area. At least two residents needed a verbal prompt to start to eat and needed some reminders. This was not done regularly on the day of this visit and so two residents had cold or at best lukewarm food. Due to the specific needs of residents an additional carer is required at this time. A vegetarian option was provided to those who prefer this diet. Fruit was evident in the lounge and a further delivery of fresh fruit was made during the inspection. Environment - Premises. The bedroom with water damage to the ceiling has not been repaired/redecorated to improve the residents environment. Standard not met. Care Homes for Older People Page 5 of 14 The appointed manager stated that work had been undertaken in relation to the unguarded pipe work, following work undertaken to fit thermostatic valves at hot water outlets accessed by residents to protect residents. This was seen by one of the Inspectors Standard met. Some areas of the home were seen during a brief tour of the premises. Two matters were raised with the appointed manager, who agreed to rectify them immediately. A wet patch was seen in one bedroom by the bed. Faeces were seen on a bedroom floor. Environment - Hygiene and Control of Infection. The appointed manager stated that infection control procedures had been reviewed in the home and evidenced that the supply and accessibility of liquid soap and disposable paper towels for staff has been improved. Standard met. Staffing - Staff Complement. The appointed manager confirmed that the number of care workers on duty during the day has been decreased since Monday 6 October 2008 from three to two care workers. Observations on the day did not evidence that adequate staff were on duty to meet all the care needs of the people resident in the home as indicated above for the lunchtime routines observed. Standard not met. Staffing rotas viewed on the day did not detail when the Registered Manager is on duty in the home and who is in charge on each shift. Staffing - Recruitment The staff files for two new members of staff were viewed One commenced work on 1 October 2008 did not have evidence of two written references in having been received and the other commenced work on 27 June 2008 had one written reference received dated 18 September 2008. Both staff had commenced work prior to a satisfactory CRB/POVA First check having been received. Evidence should also be provided of an individual staff members right to work in this country where applicable If staff commence work following receipt of a POVA First check appropriate supervision must be provided and evidenced until the full CRB check is received The staff file for one existing member of staff was also viewed and did not have evidence of the recruitment checks undertaken. Standard not met. Staffing - Staff Training. There were no records available to view during the inspection to evidence staff has completed all the relevant training, and who had provided the training. Standard not met. Staffing - Staff Training. The appointed manager stated that staff receives in-house induction training, but was not aware that the induction provided needs to meet the requirements of Skills for Care and within the agreed timescale. Standard not met. Care Homes for Older People Page 6 of 14 Management and Administration - Day-to-Day Operations The CSCI have not received written confirmation of the management arrangements to ensure the home is run in an effective manner and ensures the aims and objectives of the home are met. Standard not met. Management and Administration - Quality Assurance. The appointed manager stated and evidenced that information is in the process of being gathered from service users and their representatives other stakeholders such as visiting health and social care professionals for quality monitoring. The outcome should be reported on and made available to interested parties with recorded evidence of action taken in response to demonstrate ongoing review and improvement to the quality of care and services in the home. Standard not met. A sample of records of visits by Mr Patel to meet the requirements of Regulation 26 was viewed. Standard met. Management and Administration - Staff Working Practices The appointed manager did not evidence during the inspection that further guidance has sought from Environmental Health and the Health and Safety Executive and acted upon to ensure a robust health and safety practice is adopted. To include clear polices and procedures and thorough environmental risk assessment that has been actioned as necessary or that all the equipment in the home have been serviced or tested as recommended. Standard not met. New Requirments have been made that evidence that these issues have been addressed are in place in the home. Concerns were raised at the last inspection about the safety of residents in the homes garden. The then appointed manager confirmed that a risk assessment had been completed until further work in the garden had been completed. This was not available to view. Fire checks were viewed and records detailed that the emergency lighting had been checked on 29 September 2008, and that the fire system had not beeen checked since 9 September 2008. What the care home does well: What they could do better: There have been some areas of improvement. Further Requirements have been made relating to the the recording of staff working in the home, the safety of the garden and the maintenance of regular fire checks in the home. However in light of the continuous non-compliance with the Regulations enforcement action is to be taken. This will be through a Statutory Requirement Notice. Of particular concern is the lack of Care Homes for Older People Page 7 of 14 recruitment procedures. 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 8 of 14 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 8 13 That individual risk 31/08/2008 assessments that cover all residents risks are recorded and responded to. These should include risk of moving residents and pressure sore development to protect residents and staff. (This issue is outstanding from last Inspection with date of 1/11/07 not met) That the moving and handling risk assessments are undertaken by staff that have completed the required training to undertake this task. A system is put in place to ensure these are regularly reviewed to protect residents and staff. 2 12 16 That residents are able to access a range of social activities to ensure their individual social care needs are met. 31/08/2008 3 19 23 (2) (d) That the bedroom with water 31/08/2008 damage to the ceiling is repaired/redecorated to improve the resident?s environment. Care Homes for Older People Page 9 of 14 4 27 18 That a system is in place to enable the staffing numbers and skills to be reviewed to ensure staffing numbers are appropriate to meet the assessed needs of residents in the home. 31/08/2008 5 29 17(3)b19 (1) (b) Staff files show all relevant qualifications and training. (This issue is outstanding from last Inspection with date of 15/01/07 and 01/10/07 not met) That appropriate references are sourced for all employees before employment. (This issue is outstanding from last Inspection with date of 1/10/07 not met) That staff do not commence work in the home before a satisfactory Criminal Records Bureau (CRB)/POVA First check has been received. If staff commence work following receipt of a POVA First check, appropriate supervision is provided until the full CRB check is received. To protect residents. 31/08/2008 6 30 18 (a) That staff receive induction 31/08/2008 training to meet the requirements of Skills for Care and within the required timescale. To protect residents. That the management arrangements ensure the 31/08/2008 7 31 10 Care Homes for Older People Page 10 of 14 home is run in an effective manner and ensures the aims and objectives of the home are met. (This issue is outstanding from last Inspection with date of 1/10/07 not met) Care Homes for Older People Page 11 of 14 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, Care Homes 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 27 17 That the staff rota details the 30/11/2008 hours the Registered Manager is on duty in the home and who is in charge of each shift. To protect residents 2 38 13 That evidence is available to 30/11/2008 view in the home that all the equipment in the home have been services or tested as recommended. To protect residents. 3 38 12 That evidence is available to 30/11/2008 view in the home that further guidance has been sought from the Environmental Health and the Health and Safety Executive and acted upon to ensure a robust health and safety practice is in place in the home. To protect residents. 4 38 13 That a risk assessment is in 30/11/2008 place for the garden, which is regularly reviewed and available to view in the home. Care Homes for Older People Page 12 of 14 To protect residents. 5 38 23 That the regular checks of 30/11/2008 the fire system in the home are maintained and fully detail the checks completed. To protect residents. 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 13 of 14 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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. 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