CARE HOME ADULTS 18-65
Fairmont 30 Watling St Road Fulwood Preston Lancashire PR2 8DY Lead Inspector
Ms Susan Dale Unannounced Inspection 17th January 2006 10:00 Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 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 Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 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 Adults 18-65. 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. Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Fairmont Address 30 Watling St Road Fulwood Preston Lancashire PR2 8DY 01772 715228 01772 713768 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) J.T. Care Homes Limited Mr John Walmsley Care Home 28 Category(ies) of Physical disability (28) registration, with number of places Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 7th June 2005 Brief Description of the Service: Fairmont is a residential care home for twenty-eight adults both male and female with a physical disability. The home is situated in Fulwood, Preston close to local shops and several other amenities. The home is a purpose built three-storey building with a passenger lift that facilitates access to all parts of the building. A large lounge is situated on the ground floor and a smokers lounge on the lower ground floor. The front door of the home is automatic providing easy access for all wheelchair users. Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and focused mainly on the standards not assessed at the last inspection. The inspector was able to speak to service users, staff, a director of the company and examine various records. The registered manager was not on duty at the time. A tour of the premises took place. What the service does well: What has improved since the last inspection? What they could do better:
The future for the management of the home is currently uncertain and interim arrangements for the short term are in place but long-term plans must be established that will promote confidence in service users and staff on how the home is run. Although suitable activities are in place these need to be extended as service users spoken with said they would like to go out more but needed escorting. The residents meetings need to be more focused on service users’ needs and service users should be encouraged to lead the meetings to express their
Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 6 views. This should also provide an opportunity for service users to participate in the devising of policies and procedures. As at previous inspections, recommendations have been made that staff would benefit from specialised training in the area of physical disability and the impact this can have on the mental health of certain individuals. Some of the service users have challenging behaviour and staff require training in this area in order to deal with the inappropriate behaviour of certain service users. A formal system of quality assurance specifically devised for the service users, their friends and relatives in the home should be obtained to obtain their views. 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. Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed at the announced inspection in June 2005. EVIDENCE: Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 & 10 Opportunities are provided for service users to put forward their views on how the home is being operated. Confidentiality is maintained at all times. EVIDENCE: Service users spoken with confirmed that meetings are held on a regular basis where they are provided with an opportunity to discuss any issues that arise in the day-to-day running of the home. There was written evidence of a residents meeting held in September 2005 and it appears that the meetings are ‘chaired’ by a member of staff and not one of the service users. Some of the issues raised were on behalf of the management of the home and very little on the agenda from the point of view of the service users. It would be beneficial if the service users nominate a representative of their own to act as chairperson at meetings in future. Staff are taught the importance of maintaining confidentiality at the initial induction and policies and procedures are in place on this subject. Written information held on behalf of service users is kept secure. Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 Activities are provided that meet the capabilities of the service users within the home. EVIDENCE: There is staff member dedicated to providing activities each Wednesday afternoon employed by the company. The service users spoken with really enjoyed participating in the activities and all stated that they would like to have the activities extended. According to the registered owner who was visiting the home at the time of the inspection, the activities person will be more available in the future. Over the Christmas period, entertainment was provided throughout with several parties and visiting singers, other activities included dominoes, carpet bowls, bingo and beetle drives. According to the service users the film evenings are now no longer available as the person providing them has stopped doing so; the mobile shop is also no longer available. Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 11 Some of the service users spoken with felt that there was not enough going on and that they would like to get out more but there were not enough available staff to accompany them to for example the local pub or the shops. One of the service users wishes to use his own computer and it was generally felt that access to the internet would be a useful facility and could be an item raised for discussion at residents meetings. Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21 Appropriate policies and procedures are in place with regard to the illness and death of a service user. EVIDENCE: Staff spoken with knew the procedures to follow in the event of the serious illness or death of a service user; some of the staff have had nursing experience and therefore had to deal with these issues in the past. At the initial assessment a recording is made of any wishes the individual concerned has with regard to their illness and death and family members are contacted as necessary. Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed at the announced inspection in June 2005. EVIDENCE: Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 28 & 29 The home is comfortable and safe and the bedrooms meet individual needs. There are no shared bedrooms. Specialist equipment is available according to need. EVIDENCE: Since the last inspection the lounge carpet, which was a little worn, has been replaced and the furniture has been re-arranged with a new lamp, curtains and an attractive flower arrangement. In addition to the radiators, all the pipe work throughout the home has now been covered to provide safe surface temperatures. A tour of the premises was undertaken and the bedrooms seen were decorated and furbished according to the needs of individual service users. Service users are able to bring their own personal possessions according to the space available. At the last inspection one of the en-suite toilet seats was unstable and has been replaced. Environmental adaptations have been fitted according to the needs of individual service users. Grab rails are in place throughout the communal areas. A suitably qualified specialist first assesses any aids or equipment
Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 15 provided. Storage facilities are provided for wheelchairs/mobility equipment and the front door opens automatically for ease of access. An alarm system is situated within each room. The domestic employed by the home had not turned up for duty however all parts of the home were clean and tidy. Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 & 36 Staff work as a team for the benefit of service users and are appropriately supervised. Staff would benefit from some additional specialised training. EVIDENCE: Staffing levels are sufficient for the requirements of the home however currently there is uncertainty about the future management of the home and this needs to be resolved as soon as possible. Staff receive one to one supervision every three months and staff spoken with felt well supported and that they could approach the registered manager at any time with concerns. The registered manager was not on duty during the inspection and therefore it was not possible to determine how many staff now have an NVQ qualification. Staff confirmed they had received general training such as moving and handling, health and safety and food hygiene. Several service users have challenging behaviour and this has been so detrimental to both service users and staff. Some training on Violence has been provided via videotape. As at previous inspections, it is recommended that staff would benefit from some indepth training on Challenging Behaviour. Also training on physical disabilities and the emotional consequences of disability would provide insight and assist staff to deal with the psychological impact of a physical disability.
Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 17 Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38, 39 & 40 The future management of the home needs to be resolved. Policies and procedures are in place for the protection of service users but there is still a need to provide a system for the views of the service users to be known. EVIDENCE: Currently the registered manager is not available full time. The inspector is satisfied that measures have been taken to ensure that a senior staff member is available at all times and oversight is being provided by Head Office; however the future management of the home needs to be resolved as soon as possible to allay any concerns from staff and service users. Although the views of service users in the running of the home are considered at meetings and verbal consultation takes place on a daily basis, there is no written evidence that the views of service users or their friends and relatives are sought. As the registered manager was not available during the inspection it was not possible for the inspector to ascertain whether there are any plans to provide a formal system in the future. Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 19 The home has extensive policies and procedures but as recommended at previous inspections there is a need to devise a system whereby staff and service users are able to participate in the process of producing and reviewing policies and procedures. All policies and procedures are accessible to staff and service users. Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 X 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 N/A 29 3 30 x STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 X 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X 3 X 2 2 2 X X x Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 21 Yes 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 YA38 Regulation 8 Requirement The future management arrangements of the home needs to be resolved. Timescale for action 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA32 YA32 YA39 Good Practice Recommendations Care staff should continue to obtain a qualification at NVQ level 2 in Care. Staff should be provided with training in Challenging Behaviour and Physical Disability. A formal system should be adopted to obtain the views of service users, friends and family on the running of the home. Fairmont DS0000009842.V252469.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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