Inspection on 15/11/07 for Fairview

This inspection was carried out on 15th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fairview 27/11/06

Fairview 30/01/06

Fairview 14/09/05

Fairview 09/03/05

Fairview 25/10/04

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Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

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Paradise Lodge

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Upaya Ananda

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

CARE HOME ADULTS 18-65 Fairview 68 Freeland Road Clacton On Sea Essex CO15 1LX Lead Inspector Jenny Elliott Unannounced Inspection 15th November 2007 09:00 Fairview DS0000017814.V354915.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 Fairview DS0000017814.V354915.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. Fairview DS0000017814.V354915.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairview Address 68 Freeland Road Clacton On Sea Essex CO15 1LX 01255 427150 01255 430908 cathycovey@btinternet..com Wilkinson03@aol.com Mr Paul Wilkinson 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) Mrs Catherine Covey Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (2), Physical disability (1) of places Fairview DS0000017814.V354915.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 5 persons) One person, under the age of 65 years, who requires care by reason of a learning disability who also has a physical disability and whose name was supplied to the Commission in April 2003 Two named service users, over the age of 65 years, who require care by reason of a learning disability, whose names have been made known to the Commission The total number of service users accommodated must not exceed 5 persons 30th January 2006 4. Date of last inspection Brief Description of the Service: Fairview is a residential care home offering care to five service users with a learning disability. One service user also has a physical disability and three of the current service user group are over 65 years of age. The home is located in a semi-detached property in a residential area in Clacton on Sea. The local shops, cinema, theatre, sea front and hospital are within a half-mile radius. Each service user has their own room; two of the rooms have en-suite facilities. A further bathroom/shower room and separate toilet are found on the first floor, with a ground floor separate toilet. Alongside this there are communal facilities of a lounge, dining room, conservatory and rear enclosed garden. Service user accommodation is found on the three floors of the home. The office/training room for the home is found in a detached building in the garden, with further office accommodation on the second floor of the home. At the front of the property there is a paved area and off-street parking in the driveway. Fairview DS0000017814.V354915.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information for this report was gathered from a number of sources. Six and a half hours were spent at the home. During this time discussions were held with people who live and work there, the manager and provider. In addition records belonging to service users and relating to staff were inspected. A tour of the building was also undertaken. As well as visiting the service, we took note of information that had been sent to us since the last inspection. This includes notifications of incidents as well as the completed Annual Quality Assurance Assessment and improvement plan which the service is required to send to the Commission upon request. What the service does well: What has improved since the last inspection? Improvements were noted in a number of key areas during this inspection. Arrangements for the recruitment and training of staff were more structured. This helps to ensure that people are cared for by appropriate staff who have the necessary skills to carry out their role. The home had introduced risk assessments which means that people living at the home are not unnecessarily restricted in their choices. The service had also reviewed some important policies and procedures. In particular the policy which helps staff to protect vulnerable people and the policy that describes how complaints will be dealt with. The home has developed a range of surveys to help them improve the care in the way that the people who live there want them to. Fairview DS0000017814.V354915.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. Fairview DS0000017814.V354915.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 Fairview DS0000017814.V354915.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People coming to live at the home can expect to have their needs assessed. EVIDENCE: The home had not admitted any new service users since the last inspection. Records belonging to three of the people who live at the home were looked at in detail. The assessment for one person included some good information that was specific to that individual. It was simply laid out, but clearly addressed key areas. For example it said ‘[service user] has a good memory for the time of [their] medication’ and ‘[service user] loves going out. But does not like going out with other service users.’ The assessment records for the two other people were not fully completed. The manager advised that she was in the process of introducing new assessment and care planning documentation to the home. The new assessment documentation should help the service obtain good information upon which the home can make a decision about a person’s suitability. Fairview DS0000017814.V354915.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home can expect to be supported with dignity and respect. EVIDENCE: New care planning documentation was being introduced by the home. Some of the information contained in care plans provided clear guidance, for example ‘[service user] can be verbally aggressive at times, staff to speak to [them] in a calm manner giving [them] lots of reassurance. [service user] is articulate and is capable of explaining to staff much of what [they] require’. For another person the information and guidance was much less informative. For example, under the identified need of personal hygiene one care plan stated ‘needs assistance with washing [their] hair.’ Under the associated activities/tasks column for this need was a list of people ‘GP, keyworker, staff, manager, CPN’. Fairview DS0000017814.V354915.R01.S.doc Version 5.2 Page 10 This does not provide sufficient information to describe how this person’s assessed needs should be met or suggest that the person was involved in drawing up the plan of care. Some good information from the old care plans had not yet been transferred over to the new paperwork. It was clear from observation throughout the day of the inspection that people made choices about their daily routines. People had their breakfast at different times and preferences about where they sat in the dining area were respected. Risk assessments had been revised and improved since the last inspection. The risk assessments seen clearly identified risks and action to be taken to reduce or manage the risk. There was no risk assessment in place for the use of bedsides and discussions with staff, manager and provider did not provide a clear reasoning for the use of this equipment. The service has a history of addressing issues raised through the inspection process, and the Commission is confident that, following discussion this will be addressed promptly. The interaction between staff and service users was of a good standard and demonstrated knowledge of people’s interests and preferences. Fairview DS0000017814.V354915.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home can expect their interests and preferences to be supported by staff. People living at the home will not necessarily have opportunities to develop new interests. EVIDENCE: The daily records belonging to three people were inspected for a two-week period ending 14th November 2007. The entries for each person were similar for the whole period, suggesting a mundane and fairly uneventful lifestyle. Discussions with service users and observations of their daily routines provided evidence of a slightly more interesting lifestyle. People living at the home seemed very settled, one person told me they ‘liked living here’ and ‘wanted to live here forever’. One person told me about a variety of friends and relatives they had from the local community. Another Fairview DS0000017814.V354915.R01.S.doc Version 5.2 Page 12 person told me about a TV presenter they liked and showed me a signed photograph from the person, which had been requested by staff. One person living at the home had very good number and manual dexterity skills. They were occupied on a daily basis with the same kind of activity. They clearly enjoyed this and were keen to demonstrate their abilities in this area. There was nothing in their care plan about what other activities could be introduced to the person to enhance the quality of their life. One person had frequent contact with their parents and it was clear that this was very important to them. One person told me about a visit to the shops in a nearby town with other people living at the home and staff. They had enjoyed this and said they would like to do this more often. Other than watching a firework display, the daily notes inspected referred to watching TV or DVD’s. Two people were observed having their breakfast, at times they chose. One person was observed being supported in a way that promoted their dignity and choice. The member of staff helping them explained what was in front of the person and always said what they were going to do (for example wipe the table) before they carried out the task. This was very important for the person concerned and demonstrated a good understanding of their needs. Fairview DS0000017814.V354915.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live at the home can expect to have their health care promoted by the home. Specialist services or equipment will not necessarily be an integral part of care plans. EVIDENCE: As has already been described, people living at the home were able to make choices about their daily routines and staff supported them in this. The people living at the home looked as though they, their clothes and belongings were well cared for. An external professional had secured specialist help for one person. The home was not clear about the purpose of this or whether it may impact on how care is provided. Daily records showed that people accessed community based health services such as the doctor and dentist. On the day of the inspection one person had a Fairview DS0000017814.V354915.R01.S.doc Version 5.2 Page 14 sticky eye, the manager advised they would make a doctors appointment for this person. The weight of people living at the home was regularly monitored, this can be an important indicator of well being. One of the people living at the home had bedrails on their bed. The rails were not covered, but staff and the manager explained that as part of this person’s bedtime routine a range of soft toys were set against the rails. It was not clear from this discussion what the current needs of the service user were in relation to the provision of the rails. There was no associated needs or risk assessment on the person’s care plan. The manager was aware of the risks associated with this equipment and said they would seek specialist advice to determine whether this was the most appropriate equipment to use. The home has a history of responding positively to issues arising from the inspection process and the Commission is confident that this would be addressed promptly and a more pro-active approach would be taken to assessing the risk of all equipment in the home. There had been a noticeable improvement in the quality of other risk assessments seen at the inspection. There were no omissions noted in the records of the administration of medication. There had been no change to the system in place at the last inspection, where it was found to meet national minimum standards. Fairview DS0000017814.V354915.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at the home can expect the home to take action to protect them. EVIDENCE: The home had reviewed key policies since the last inspection. This includes it’s Safeguarding policy (for the protection of vulnerable adults) and complaints procedure. Both policies had been improved, but would benefit from further review. The safeguarding policy states an incident would be investigated by the home without a referral in the first instance to the safeguarding team, this does not meet the requirements of the local authority procedure. The manager advised she had drafted a supplementary sheet with contact details in the event of an incident and a copy of Essex County Council’s alert form. This would be good information for staff. The home had made an appropriate referral to the safeguarding team following an incident earlier in the year, and followed this up with appropriate action. The training records for two members of staff were inspected, both contained certificates for training in Adult Protection. Fairview DS0000017814.V354915.R01.S.doc Version 5.2 Page 16 A copy of the new complaints procedure was on the notice board. A further review of this procedure is required to ensure it fully meets the needs of people living at the home and regulatory requirements. No complaints had been received about the home by the service or the Commission. Fairview DS0000017814.V354915.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in this home benefit from a good standard of accommodation. EVIDENCE: During the inspection all of the communal areas and the bedrooms belonging to the people whose records were inspected in detail were inspection. One person kindly showed me their room and told me they ‘didn’t mind [named member of staff] helping with cleaning up because she looked after all of [their] things.’ In discussion the member of staff demonstrated sensitivity in explaining how this person was supported to care for their environment. Generally the decorative state of the home was very good. The communal areas were bright, clean and pleasant places to spend time. Furniture was comfortable, domestic in style and suited the needs of people living in the home. Bedrooms contained personal belongings of the people who used them. Fairview DS0000017814.V354915.R01.S.doc Version 5.2 Page 18 The carpet in the hallway and on the stairs was in need of replacement. The manager advised that this was being done the following week. Fairview DS0000017814.V354915.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at the home are supported by staff who have the appropriate qualities and training. EVIDENCE: Throughout the day of the inspection staff demonstrated through their actions and verbally, respect for people living at the home. There was evidence from the records held by the home that steps had been taken to improve performance under this group of standards. The records relating to recruitment showed that checks such as criminal record enquiries and references had been carried out before a person started work. The home had a planned approach to the induction and on-going training of new staff. Much of the training was carried out in-house by the manager, provider or with the use of DVD’s and videos, but it was linked to competency Fairview DS0000017814.V354915.R01.S.doc Version 5.2 Page 20 assessments through the National Vocational Qualification (NVQ) in Care. New staff cover the homes induction in their first two weeks of employment, then work through the Skills for Care induction programme over the next 13 weeks. Completed induction records were seen during the inspection. The provider advised that staff were not offered a permanent contract until they have successfully completed both induction programmes, and that once this was done staff would meet the NVQ assessor to discuss completing this qualification. The home reported that 90 of care staff had achieved, or were working towards completion of NVQ level 2 or above in Care. Fairview DS0000017814.V354915.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at the home benefit from the procedures and practices carried out or overseen by the manager. EVIDENCE: Mrs Covey is the registered manager of this and another home in the same area, she divides her time between homes as needed. Mrs Covey has the qualifications and experience considered necessary to run a care home. After the last inspection the service was required to provide an improvement plan to the Commission explaining how they would address the shortfalls identified. A reminder had to be sent to the service before an incomplete plan Fairview DS0000017814.V354915.R01.S.doc Version 5.2 Page 22 was returned. The service also had to be reminded to complete and return the Annual Quality Assurance Assessment. This is a document that all care services are required to complete on an annual basis. It is also noted that the service has made significant progress in a number of key areas since the last inspection. These include the recruitment and training of staff and the review of policies and procedures. The service has developed a range of satisfaction surveys using a mixture of smiley faces and written word, each survey also has space for people to add additional comments. The surveys will be sent to people who live at the home, their relatives and staff working at the home. Responses will be collated to identify areas of most and least satisfaction. The provider is confident that this will provide sufficient information to inform the development of the service. A copy of the final report will be sent to the Commission. A range of health and safety certification was inspected. They showed that services and equipment had been maintained and/or checked in line with legislation and to protect people living at the home. The records accounting for service users personal expenditure were inspected. There was a clear recording system in place. One cash balance was checked against the recorded balance and was found to be correct. Receipts were not always available for hairdressing, chiropody or expenditure undertaken by staff on behalf of service users. These are important because they would provide a complete audit trail. Fairview DS0000017814.V354915.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 2 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 2 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 2 2 x LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 X 3 X 2 X X 2 X Fairview DS0000017814.V354915.R01.S.doc Version 5.2 Page 24 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 YA18 YA6 Regulation 15 Requirement The home must make sure that, after consulting with service users, care plans describe how their needs are to be met. The home must make sure that any identified risks are properly managed. This is with regard to the use of bedrails. The home must ensure that its policies and procedures meet regulatory requirements. This is with regard to safeguarding and complaints policies. Timescale for action 29/02/08 2. YA19 13(4)(c) 31/12/07 3. YA23 YA22 13(6),22 31/01/08 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 YA14 Good Practice Recommendations The home should consider how it can expand the range of opportunities open to service users. Fairview DS0000017814.V354915.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Fairview DS0000017814.V354915.R01.S.doc Version 5.2 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. 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