Inspection on 01/07/08 for Fairmont Residential Ltd

This inspection was carried out on 1st July 2008.

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

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

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Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

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Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 Fairmont Residential Ltd 144 Chester Road South Kidderminster Worcestershire DY10 1XB Lead Inspector Emily White Key Unannounced Inspection 1st July 2008 11:30 Fairmont Residential Ltd DS0000071342.V367419.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 Residential Ltd DS0000071342.V367419.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 Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairmont Residential Ltd Address 144 Chester Road South Kidderminster Worcestershire DY10 1XB 01562 634324 01562 636641 Saranne.bailey@fairmont-residential.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) Fairmont Residential Ltd Mr Paul Whitefield Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only (code PC) to service users of the following gender Either Whose primary care need on admission to the home are with the following categories: 2. Learning Disability (LD) 4 The maximum number of service users to be accommodated is 4. Date of last inspection New service registered 8th January 2008. Brief Description of the Service: Fairmont Residential Ltd, 144 Chester Road South, Kidderminster, is a care home for four young people aged between 18 and 25 years old with severe learning disability and associated autistic spectrum disorder. The service has been set up with training and support links from Sunfield, a children’s home and school for children with severe and complex learning needs. It is anticipated that this link will continue as the service develops. 144 Chester Road South has been refurbished to an excellent and modern standard and provides spacious accommodation with a large garden to the back. The house is conveniently located with access to local amenities in Kidderminster and the wider area of Wyre Forest. A service user’s guide was not available on the day of the inspection. Information about fees can be obtained from the service. Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The manager, Mr Whitefield sent information about the house to us before we visited. One person who lives at the house sent us a survey. We visited on a week day, and the manager was on duty and helped us. We met one person who showed us around his home and we talked in private to him about his views. We also met his key worker. We looked at some records such as care plans and medication and looked at how the house is run. What the service does well: What has improved since the last inspection? This is a new service. Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Fairmont Residential Ltd DS0000071342.V367419.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 Residential Ltd DS0000071342.V367419.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People can be confident the service can support them because they have had a full assessment of their needs before moving there. The service needs to develop accessible and person centred information to help people to decide whether the service can meet their needs. EVIDENCE: The service assesses people’s needs in a detailed way even when they are being considered on an emergency basis. One person’s file shows that the assessment questions are detailed, that they are visited at home, and relevant assessments are used from social workers and schools. The manager is very clear about the assessment of people’s needs to ensure it is the right service for them. Staff are very clear about people’s needs and staff files show that they are well trained to meet people’s needs. However there is a lack of person centred information available to people to help them make decisions about moving to the service. Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 9 The service has a detailed statement of purpose which we saw, and a service user guide which was not available to view during our visit. These are not currently available in accessible formats for people who use the service. There is a “Fairmont story” using photographs and clear language which people are shown when they move to Fairmont, but this is not available on an individual basis. One person who uses the service has a contract with social services but not a personalised one with Fairmont. At the time of our visit we were only able to look at the experience of one person who had come to Fairmont on an emergency basis, which gave us limited information. As the service is new it has not been able to develop its admission procedure fully, but would expect to do this as new people move to the service. Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are involved in as many aspects of daily life as possible and they are given opportunity to express their opinions. People’s needs and goals are met and they are supported to take risks to help them stay independent. The service needs to develop methods of assisting people in making decisions about their lives and being more involved in their care planning. EVIDENCE: We observed someone being assisted by their keyworker to make decisions for the day ahead using a picture board with movable pictures. This person told us that he “makes decisions about the day” and “can do what he wants to do”. We spoke to this person’s keyworker who is very clear about the importance of helping people to take risks and being supportive of this, as well as maintaining their confidentiality. The daily notes by staff support this view. Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 11 This person’s care plan contains full risk assessments about key areas of their life which are completed and reviewed monthly by the keyworker. We looked at the care plan which shows that the information is based on the assessment information. It is a very detailed care plan focused on health and social care needs, which uses positive language like “I can”, “you can help me by” and “be aware of”. The information in the care plan is very clear for staff and they are able to talk about the person’s care needs knowledgeably. The care plans are reviewed at least monthly and the people’s changing needs are recorded in detail. The care plan is not available in alternative formats for people. It is not clear from the plan whether people who use the service are involved in setting it up. When we asked someone, he was not able to show us through his care plan. Fairmont’s statement of purpose says that an Individual Support Plan will be set up with people who use the service in addition to their care plan. The person we spoke to has moved in temporarily and did not have an Individual Support Plan, so we were not able to see an example of one. As people move to the service it will be important for them to be fully involved with their support planning. Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have opportunities to develop their life skills, take part in appropriate activities, develop relationships and be part of their local community. They are treated as individuals and are as independent as they are able to be. Food is healthy and people’s choice is sought about this and other lifestyle activities EVIDENCE: We spoke to someone who uses the service about his lifestyle at Fairmont. He told us about a variety of things that he had been doing for example the cinema, theatre, seeing his old friends, his mum and cousins, shopping, and going to a club on Monday nights. His weekly timetable and the daily log shows he has a lot of opportunity to access local shops, library, DVD rental, and the cinema, and good contact is maintained with family. Records show that Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 13 Fairmont enrols people into college if they are keen and links are maintained with their old school. We were shown around the house by someone who uses the service, who clearly felt comfortable and had free reign of the house. We observed good examples of this person participating in daily life at Fairmont, such as domestic tasks and making lunch. Daily routines are part of the personal timetable which people can choose from. Favourite foods were discussed with someone who uses the service, and it is clear that there is a lot of choice and opportunity to be involved in preparing favourite foods. Menus and recipes were seen which are written in an accessible format. The cupboards and fridge contain good supplies of healthy food and there is opportunity for regular treats such as takeaways to provide a balance. Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18 ,19, 20, 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s medication is managed safely. People’s healthcare and personal needs are met by staff who understand their needs and who have been appropriately trained. EVIDENCE: A person using the service told us he gets all the help he needs and is happy with the help from his carers. The care plan, daily notes and discussions with staff all support each other and show that people get the personal care they need. The keyworker system ensures staff know the needs of the person they are working with. Regular review of the care plan shows increased independence in personal support within three weeks of moving to Fairmont. Accident and injury logs and health contacts forms in the care plan show these are all documented appropriately and action is taken quickly. Staff show awareness of particular health concerns and records show that advice is sought from the GP at appropriate times. Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 15 We spoke to a key worker who was aware of the full details of people’s medication. Staff files show that they have received medications training, and medications were seen to be stored, obtained and documented appropriately. There is a medications policy which the manager says will be regularly reviewed. It is also the manager’s intention to support people to manage their own medication if possible although there has not been opportunity for this yet. Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service safeguards people from abuse and neglect through thorough recruitment, training, policies and procedures. People know how to complain and the service has a system in place that ensures complaints are acted upon quickly. The service needs to make the complaints procedure more accessible to people who use the service so they know how to complain. EVIDENCE: The complaints policy and adult protection and prevention of abuse policies are clear to staff and with correct information for local contacts and CSCI. We spoke to staff who are aware of the complaints process as well as the meaning of safeguarding adults. Complaints are recorded, and it is clear from the daily record keeping, and the accident and injury logs that there is an open culture and clear recording process for all activities at the service. From these records it is clear that accidents and concerns about behaviour are dealt with appropriately by staff. Practices for safekeeping people’s money are appropriate. The manager is keen to access further external safeguarding adults training although all staff have had some training as part of their induction. From observations of staff interactions and daily records it is clear that staff and manager listen to and act on wishes of the people who use the service. Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 17 The complaints procedure has not been translated into an easily accessible format for people who use the service. The manager explained that people had been informed verbally about how to complain, but the complaints procedure should be accessible for people with different needs as they move to the service. We spoke to someone who uses the service who told us that he knows how to complain if he is not happy. During the course of the day this person was observed talking to the manager and his key worker about an issue that was bothering him and this was dealt with appropriately. Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The house has been refurbished to meet the needs of people with autism. It is also a welcoming environment for young people to live and feel at home. The house is clean, comfortable and well maintained. EVIDENCE: We were shown around the premises by someone who uses the service. All areas are accessible and bedrooms are personalised with pleasant ensuite bathrooms. There is a large garden for recreation which is used for football, other sports and gardening. The kitchen and lounge are attractive and homely and have been refurbished in a modern style. The environment at Fairmont is still “new” and appears quite clinical because of this. This will be improved by further personalisation of communal areas Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 19 when new people move in and adapt it to suit their needs and personal preferences. The house is very clean in all areas. During the course of the day staff were observed following hygienic practices. Staff interviews confirm that they are aware of infection control and hygiene and have received training which is noted in their files. There is a clear infection control policy. Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a well trained staff group in sufficient numbers to meet the needs of the people who use the service. The staff are competent and qualified in relevant specialist areas, and they receive excellent support from their manager, which helps them to support people who use the service. EVIDENCE: Staff interviews confirm they are aware of their roles and are aware of the key policies and procedures of the service. Staff know people’s needs well and observations show that they are able to develop a relationship with people who use the service, and have the right attitudes and characteristics to work with them. Observations of someone using the service with their key worker show that staff have a rapport with people and they enjoy the time they spend together. Staff files show that they have been well trained and have the necessary skills and experience to do their jobs. Most care staff hold NVQ 3 or are working Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 21 towards it, and new staff follow one week initial training followed by followed by a comprehensive induction pack to work through. A training database is held and a log kept of staff training, and certificates held in their file. Staff report feeling well supported by the manager through regular supervision and regular staff meetings which take place weekly. People are safeguarded by a robust recruitment process. We looked at two staff files which contain an interview checklist, interview notes, CRB certificates and two written references. Staff told us about the rigorous interview process and probationary period when they started work. The manager told us that he plans for people who use the service to be involved in staff recruitment in future. Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42, 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have confidence that the service is managed appropriately and according to their wishes. The environment is safe, and health and safety practices are carried out. The service needs to develop ways of helping people to be involved in the management of their service so that their opinions are listened to. EVIDENCE: The manager is well qualified to manage the service and discussions with him show an open, positive and inclusive approach to management. The service is well set up with the correct policies and procedures and staff training for when new people move in. All policies have review dates set up and will be Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 23 developed as necessary as people move in. Staff told us that they have been involved with policy making from the set up and are very happy with the running of the service so far. The manager told us that the quality review process will involve getting feedback from service users, advocates and staff and collecting the information to form an action plan or development plan. There is little evidence of this due to the recent opening of the service however there are plans for setting up residents meetings and other methods for people to become involved in the management of their service. This will need to be developed according to people’s needs and wishes when they move in. Staff files confirm that they have received training in moving and handling, fire safety, first aid, food hygiene and infection control. The manager has a background in health and safety and has ensured that the service complies with legislation and ensures the health and safety of service users and staff, for example medications and substances hazardous to health were observed to be stored correctly. Accidents and injuries are recorded and reported if significant. We observed excellent record keeping in the form of daily records, a contact book, a going out book, and a “sanctions” book. Records are kept securely in the office. Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 24 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 2 2 3 3 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 2 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 2 3 3 3 3 Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No – new service 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 statutory requirements have been made. 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 Refer to Standard YA1 Good Practice Recommendations The service user’s guide should be developed into accessible formats to help people make decisions before the move to the service. A contract and statement of terms and conditions should be developed and agreed with each prospective person moving to the service. An individual support plan should be developed with each person as described in the statement of purpose. This should be in a format that people have chosen and can easily access. Staff should provide people with the information they need to make decisions about their own lives, and be able to demonstrate how individual choices have been made, particularly in relation to their care plan. 2 YA5 3 YA6 4 YA7 Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 26 5 YA8 Accessible information and opportunity to participate in the running of the service should be provided to people who use the service. A copy of the complaints procedure should be given to all people. This should be in a format that is appropriate to their communication needs. An annual development plan and a system of self monitoring should be adopted. This should be based on people’s views. 6 YA22 7 YA39 Fairmont Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Residential Ltd DS0000071342.V367419.R01.S.doc Version 5.2 Page 28 - 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. 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