Inspection on 07/06/05 for Fairmont

This inspection was carried out on 7th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fairmont 04/09/07

Fairmont 20/06/06

Fairmont 17/01/06

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 PR2 8DY Lead Inspector Susan Dale Announced 07 June 2005 10:00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Fairmont Address 30 Watling St Road, Fulwood, Preston. Lancashire, PR2 8DY 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) 01772 715228 J.T Care Home Limited Mr John Walmsley Care Home 28 Category(ies) of Physical Disabilty (PD 28) registration, with number of places Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25/01/05 Brief Description of the Service: Fairmont is a residential care home for twenty-eight adults both male and female with a physically 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 smoker’s lounge on the lower ground floor. The front door of the home is automatic providing easy access for all wheelchair users. Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place over 4 hours. The inspector was able to speak to service users, staff and the registered manager. There were no relatives/friends visiting the home at the time of the inspection. A tour of the premises took place. Prior to the inspection a number of comment cards were delivered to service users, relatives/friends and health professionals. A number of comment cards were returned; 8 from service users; 1 from a relative/friend and a General Practitioner. The inspection and comments were very positive with just a few recommendations. What the service does well: What has improved since the last inspection? The details of any wishes with regard to the death of a service user are now recorded on the assessment record. Additional activities include a film show, hot pot supper, bingo and a disco all with a hot pot supper and alcoholic drinks each month. Several rooms have been decorated with new carpets and new curtains and matching duvet covers. A new boiler has been fitted to improve the hot water and central heating system. One of the communal toilets has a new frame to replace the previous frame, which did not provide enough support. Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 6 Staff have been provided with literature that details key policies and procedures and principles of care that they must carry at all times. Additional staff are commencing NVQ training. 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 F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3 & 4 Trial visits and written information about the home is available so that service users can make an informed choice before they take up permanent residency. A comprehensive assessment takes place to ensure that the home meets the needs of any prospective service user. EVIDENCE: Adequate information about the home is contained within the Statement of Purpose and Service User Guide. The complaints procedure within the documentation needs to be updated from the National Care Standards Commission to the Commission for Social Care Inspection. 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. Staff spoken to confirmed that they have received adequate training in order to care for the requirements of the service users. The training provided is general and does not include any specialised training for Adults with a Physical Disability. As at previous inspections, staff spoken to confirmed that they would be interested in receiving specialised training specific to service users with physical and mental disabilities catered for by the home. Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 9 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 F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 6, 7, & 9 A care plan is devised that meets the individual needs of service users and ensures that any element of risk is recognised and recorded. EVIDENCE: The assessment process leads to the development of a care plan that covers all areas of physical need. The care plan does not record any hobbies and interests and as at the last 2 inspections it was recommended that this area should be recorded together with achievable goals. The inspector is satisfied that service users are encouraged to continue with any interests and hobbies and 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. The Care Plans seen showed evidence that the service user has been involved in the process. 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. The details of service users wishes if they should die whilst residing at the home are now recorded. Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 11 Staff respect the right for service users to make decisions and individual choices and the details are recorded on the case files. Service users are supported to manage their own finances. Any element of risk is examined as part of the initial assessment and the details are recorded on the care plan. The format for recording any risk could be improved upon, as it is too prescriptive however the manager has recorded any potential risks separately. Some of the risks recorded are connected with service users’ inappropriate behaviour and aggressiveness towards others. Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 11, 13, 14 & 15 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. Activities include shopping trips either in a group or individually; quizzes; Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 13 chess; scrabble and carpet bowls. A Film Show is provided with a Hotpot Supper and alcoholic drinks the 1st Monday in every month; service users are able to choose the film provided. Bingo is provided on the 2nd and 4th Monday in the month and a Disco on the 3rd Monday. Hotpot Supper is provided on each occasion. 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. 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, she has also just become engaged to one of the other service users. Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 18, 19, & 20 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. Liaison had taken place with District Nurses over the health needs of one of the service users and the need to agree on a way forward because of behavioural difficulties; the problem has now been successfully resolved. 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. Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 15 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. Medication was administered by internally assessed members of staff and supervised by the manager. Formal advice from a pharmacist had been sought regularly. Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 16 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 standard(s) 22 & 23 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. As previously mentioned the complaints procedure needs to be up dated with the name of the Commission for Social Care Inspection. The complaints record was examined and the details recorded could also be described as incidents; according to the manager the details are cross-referenced onto individual files. Service users and staff confirmed that they are aware of the complaints procedure. The home has a policy on Adult Abuse and Whistle Blowing and staff confirmed that they were aware of the procedure. 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 F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 17 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 standard(s) 24, 26, 27 & 30 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 several of the bedrooms have been decorated and new carpets; 2 new beds have been purchased. One of the communal toilets has been fitted with a new frame to assist the service users. 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. A new boiler has been installed to improve the central heating system; the boiler includes controls that ensure the hot water and radiators meet safe temperatures. 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. According to the manager new Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 18 duvets and curtains are to be chosen by the service users and fitted in certain bedrooms. An alarm system is situated within each room. There are sufficient bathrooms and toilets for the amount of service users. Each bedroom has an en-suite toilet. One of the toilets in room 11 is in need of attention as the base is not stable. Observation of the home showed the facility to be clean and hygienic. Appropriate policies and procedures are in place for the control of infection. The washing machine has the facility to wash laundry at a high temperature of 65 degrees centigrade to control the risk of infection. Laundry floors and walls are easily washable and the home has a sluice facility. Infection control training has been provided to all staff via a 12-month training course. Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 34 & 35 Appropriate staff are recruited and service users benefit from staff that are responsive to their needs. Staff receive adequate training but would benefit from specialised training in the area of Physical Disability and Challenging Behaviour. EVIDENCE: Staff files were examined and correct recruitment procedures had been followed including 2 references and clearance with the Criminal Records Bureau and the Protection of Vulnerable Adults Register (POVA). There was evidence of staff training in the records including Induction, Moving and Handling and First Aid. In-house training is provided by District Nurses as necessary including the avoidance of pressure sores. A senior member of staff spoken to had received training in medication. Staff are now provided with a leaflet that they have to carry at all times with guidelines on: Moving and Handling; Fire safety; Missing Residents; Principles of Care; Adult Protection; Whistle Blowing and Health & Safety. All staff have to abide by an acceptable code of conduct that is compatible with the one publicised by the General Social Care Council (GSCC). Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 20 Out of a total of 13 care staff, 4 staff have a qualification at NVQ level 2 and a further 7 staff are due to commence NVQ Training in June 2005. Several of the service users have had Challenging Behaviour and this has been so detrimental to both service users and staff that they have had to be given notice to leave the home. Staff have been placed in difficult situations and it appears that some training on Violence has been provided via videotape. It was recommended that staff would benefit from some more in-depth training on Challenging Behaviour that could be provided in-house. Additional training on physical disabilities and the emotional consequences of disability would provide insight and assist staff to deal with the psychological impact that a physical disability has on individuals. Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 21 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 41 & 42 Effective leadership is carried out by the manager who ensures the implementation of policies and procedures that safeguard the service users’ rights and promotes their Health and Safety. EVIDENCE: The registered manager of the home has several years experience within a care setting and obtained a nursing qualification – S.E.N. in General and Psychiatric Nursing and has also attended several relevant courses through Lancaster and Morecambe College. The manager along with other managers based within care homes owned by J.T. Care Homes Ltd are due to commence training in order to achieve a qualification at NVQ level 4 in Care and Management in the near future. The registered manager has regular meetings with other managers employed by J.T. Care Homes Ltd and they have recently been provided with a new management file that records key procedures that are linked to the National Minimum Standards publicised in the Care Homes Regulations. Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 22 Staff spoken to confirmed that they understand their own and others roles and responsibilities and that they are also aware of their own limitations. Staff meetings are held 2 or 3 times a year and the minutes were seen for a staff meeting held on the 28th February 2005. Residents meetings are held on a regular basis and the last meeting was held on the 6th April 2005. All records and care plans seen were up to date with three entries being made per day. Service users have access to their own records, which are kept in a secure place. Policies and procedures have been devised with regard to all health and safety procedures. Staff that were seen were aware of key policies and procedures and there was evidence on the files showing that staff have been provided with the information. 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 F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 23 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 x x 3 Standard No 11 12 13 14 15 16 17 3 x 3 3 3 x x Standard No 31 32 33 34 35 36 Score 3 2 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fairmont Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 3 x x 3 3 x F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 24 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 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 22 32 32 42 Good Practice Recommendations The complaints procedure needs to be up-dated to include the name of the Commission for Social Care Inspection. 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. The toilet in room 11 needs some maintenance to make it safe. Fairmont F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Unit 1, Tustin Court Portway 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 F57 F09 S9842 Fairmont V202077 070605 Stage 4.doc Version 1.30 Page 26 - 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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