Inspection on 20/06/06 for Fairmont

This inspection was carried out on 20th June 2006.

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

Fairmont 04/09/07

Fairmont 17/01/06

Fairmont 07/06/05

Fairmont 25/01/05

Fairmont 12/08/04

Fairmont 01/03/04

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Ruskin Lodge

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Cornmill Nursing Home

Vitalise Sandpipers Centre

Sue Ryder Care Birchley Hall

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

CARE HOME ADULTS 18-65 Fairmont 30 Watling St Road Fulwood Preston Lancashire PR2 8DY Lead Inspector Ms Susan Dale Unannounced Inspection 20th June 2006 10:00 Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 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.V295772.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 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.V295772.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairmont Address 30 Watling St Road Fulwood Preston Lancashire PR2 8DY 01772 715228 01772 713768 jtcarehomes@hotmail.com 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.V295772.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2006 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.V295772.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and the focused mainly on key standards. The inspector was able to speak to service users and staff and examine various records. Comment cards were provided to service users, relatives/friends and health professionals prior to the inspection. 11 comment cards were returned from service users, 1 from a relative/visitor and 2 from general practitioners and the results were taken into account as part of the inspection. A tour of the premises took place. What the service does well: What has improved since the last inspection? Several rooms have been decorated with new carpets and curtains. There has been a new bathroom and shower. The care plans have been improved since the last inspection and in general cover physical requirements but also take into account hobbies and interests. Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 6 A dedicated Activities Co-ordinator is employed and attends the home one-day a week. A record is now being kept of the activities undertaken and who has participated. A new assistant manager has been employed and following a probationary period hopes to be registered with the Commission for Social Care 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. Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 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.V295772.R01.S.doc Version 5.2 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): 2 Quality in this outcome group was good. A comprehensive assessment takes place to ensure that the home meets the needs of any prospective service user. EVIDENCE: Service user records were examined and a full assessment takes place that covers all required. Service users confirmed that the assessment takes into account their views and wishes with regard to their care. Information about the advocacy service is available for service users requiring an independent advocate. A flexible approach is offered with regard to an introductory visit to the home. Information about the Admissions Policy including emergency admissions is included within the Statement of Purpose and Service Users’ Guide. Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 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): 6, 7, 8 & 9 Quality in this outcome group was adequate. A care plan is devised that meets the individual needs of service users and ensures that any element of risk is recognised and recorded. Service users meetings could be used more constructively and encourage more user participation. EVIDENCE: The assessment process leads to the development of a care plan that covers all areas of physical need. The care plans have been improved since the last inspection and in general cover physical requirements but also take into account hobbies and interests. Service users confirmed that they receive encouragement from staff and lead independent lives as much as possible, socialising visiting the shops and pubs, reading and watching TV. Strategies are in place via the care plans to ensure service users co-operate where there is an element of risk to other service users and staff through their behaviour e.g. excessive drinking. Any element of risk is examined as part of the initial assessment and the details are recorded on the care plan. Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 10 Service users confirmed that they are not allowed to bring any alcohol into the home without first asking permission, as there have been problems in the past with some drunken behaviour. There were 11 comment cards returned from service users and all of them were positive with staff generally listening and acting on what was said to them and they were allowed freedom at all times. Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 11 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, 13, 15, 16 & 17 Quality in this outcome group was good. Service users are encouraged to participate in activities, integrate with the local community and maintain relationships with family and friends. EVIDENCE: Service users and staff confirm that opportunities are provided to maintain and develop social, emotional, communication and independent living skills. Service users are provided with information about local churches and encouraged to access social activities in the community. The home is situated close to local shops and public houses and is situated on a bus route, which provides access to the town centre. Service users confirmed that they are encouraged and supported to participate in the local community. One service user goes in the town centre almost every day on her own by taxi and other service users are accompanied as necessary by a staff member. Service users spoken to confirmed that a range of activities is provided. A dedicated Activities Co-ordinator is employed by J.T. Care Homes Ltd. to Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 12 attend the home one-day a week. Activities include shopping trips either in a group or individually; quizzes, chess, scrabble, carpet bowls and film shows. Service users are also assisted to go on holiday individually and are encouraged to be as independent as possible and pursue their chosen hobbies and activities. A record is now being kept of the activities undertaken and who has participated. Service users confirmed that they are supported in maintaining links with family and friends. Service users are able to maintain friendships outside the home and lead as independent a life as possible. One of the service users spoken to is visited by her young daughter and encouraged to be with her as much as possible. Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 13 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): 18, 19 & 20 Quality in this outcome group was good. The physical and emotional health needs of the service users are met with appropriate policies and procedures. EVIDENCE: Service users are facilitated to take control and manage their own healthcare. Each service user is able to see a General Practitioner of their choice and there was evidence in the documentation of visits by General Practitioners’ as well as hospital visits and other healthcare facilities such as Dentists and Opticians. A comment card was received from a General Practitioner who confirmed that staff had an understanding of the health needs of the service users and worked in partnership with them, they were able to see the service user in the privacy of their own room. Service users spoken to confirmed, that they have a choice with regard to meals, bed and bath times and are able to choose their own clothes, make up etc. Technical aids and equipment were in evidence to assist services user with their day-to-day requirements. Consent to medication was obtained from service users and recorded in their individual plans. Procedures, documentation and suitable storage were in place for anyone wishing to self-medicate but because of the nature of the home and its service users all were deemed unsuitable to self-medicate. Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 14 Medication was administered by internally assessed members of staff and supervised by the manager. Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 15 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): 22 & 23 Quality in this outcome group was good. There are suitable procedures in place for the service users to express their views and to protect them from abuse. EVIDENCE: The home has a suitable complaints procedure that is publicised within the statement of purpose and service users guide. The complaints record was examined and there was only one recording made since the last inspection. There have been no complaints received by the Commission for Social Care Inspection since the last inspection. Service users confirmed that they are aware of the complaints procedure. The home has a policy on Adult Abuse and Whistle Blowing. Suitable policies and procedures are in place with regard to service users’ financial affairs. A safe is available for the storage of any valuables. Staff policies ensure that staff do not benefit from service users’ wills. New staff are cleared with the Criminal Records Bureau and checked against the Protection of Vulnerable Adults Register (POVA). Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 16 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 & 30 Quality in this outcome group was good. The home is well maintained and provides a comfortable homely environment that promotes the independence of the service users. EVIDENCE: A maintenance programme is in operation and since the last inspection bedrooms have been refurbished. There have also been improvements in the lounge and dining room with a new carpet and curtains in the lounge and there is also a large fish tank. There is ample space in the lounge for relaxing or watching one of the two TV’s. There is also a TV in the lounge used by smokers. Several bedrooms have been enlarged and provided with en-suite toilets to extend the living space within the bedrooms for the benefit of wheelchair users. A shower room more suitable for wheelchair users has been installed on the first floor. Environmental adaptations have been fitted within the home and particularly within the bedrooms, according to the disability requirements of the individual concerned. Storage facilities are provided for wheelchairs/mobility equipment. Service users are able to bring their own possessions into their private accommodation and the rooms seen reflect the occupants hobbies and interests and taste with regard to the décor. Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 17 Observation of the home showed the facility to be clean and hygienic. Appropriate policies and procedures are in place for the control of infection. Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 18 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): 32, 33 & 35 Quality in this outcome group was good. The service users needs are being met by suitably trained staff. EVIDENCE: A key worker system is in operation and service users and staff spoken to confirm that there are adequate numbers of staff on duty to meet the requirements of the service users. All staff are provided with induction training and basic foundation training. Several service users have challenging behaviour and this has been detrimental to both service users and staff. At previous inspections a recommendation was made that additional training on physical disabilities and the emotional consequences of disability as well as challenging behaviour would provide insight and assist staff to deal with the psychological impact that a physical disability has on individuals. There was no evidence at the current inspection that this training has been provided although the owners of Fairmont have indicated previously that they are looking for an appropriate training provider. The inspector was unable to check the recent recruitment of staff because the staff records were not available; according to a member of the management team all staff have received clearance from the Criminal Records Bureau. Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 19 There are 11 care staff and 7 staff have obtained an NVQ qualification and the home has thereby met the requirement for 50 of staff to have an appropriate qualification. 6 staff have been trained to provide medication. Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 20 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): 37, 39 & 42 Quality in this outcome group was adequate. The home is well run however service users would benefit if they were encouraged to be more involved in the development of the home. Policies and procedures are in place to protect the health and safety of the service users and staff. EVIDENCE: Currently the registered manager is in the process of obtaining the Residential Managers Award and is working fewer hours. An additional assistant manager has been employed to cover the gap in hours and will be applying for registration with the Commission for Social Care Inspection following her probationary period. Evidence was provided to show that the views of both service users and relatives are sought via questionnaires and their opinions are taken into consideration at management meetings. Staff meetings are held 2 or 3 times a year. Policies and procedures are in place with regard to all health and safety procedures. Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 21 The home has an accident reporting system and several examples were seen at the time of the inspection. Staff confirmed that they had received training in Moving and Handling and that they received training in fire procedures and weekly fire drills. Fairmont DS0000009842.V295772.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 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 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 4 Refer to Standard YA8 YA32 YA37 YA37 Good Practice Recommendations Service users should be encouraged to voice their opinions into how the home is run. Staff should be provided with training in Challenging Behaviour and Physical Disability. Evidence that the registered manager has obtained a suitable qualification should be provided to the Commission for Social Care when possible. The newly appointed Assistant Manager should apply to be registered with the Commission for Social Care Inspection as soon as possible. Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 24 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 © 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 Fairmont DS0000009842.V295772.R01.S.doc Version 5.2 Page 25 - 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!