Inspection on 16/01/07 for Fairview

This inspection was carried out on 16th January 2007.

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

Fairview 29/05/08

Fairview 04/07/07

Fairview 09/02/06

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Fairview Pinks Lane Baughurst Tadley Hampshire RG26 5NG Lead Inspector Craig Willis Unannounced Inspection 16th January 2007 10:30 Fairview DS0000065821.V321993.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 DS0000065821.V321993.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 DS0000065821.V321993.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairview Address Pinks Lane Baughurst Tadley Hampshire RG26 5NG 0118 981 4280 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) Community Homes of Intensive Care and Education LTD Miss Hannah Sheather Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Fairview DS0000065821.V321993.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Fairview is registered to provide care and accommodation for 6 people aged 18-65 who have a learning disability. The home is situated in the village of Baughurst, within walking distance or short drive to the amenities within the village of Tadley, and within 30/40-minute car journey to the towns of Basingstoke, Newbury and Reading. Fairview is a two storey four-bedroom detached property with an annex that contains two single rooms with en suite, lounge and kitchen. On the first floor of the main house there are four single rooms and a bathroom; two of the rooms have an en-suite facility. The ground floor has a separate toilet with washbasin, large lounge / dining room, kitchen, laundry, sleep-in room and a conservatory. A fence separates the two units and their gardens, however staff move freely between them both. The back gardens are laid mainly to lawn with a vegetable plot in the annex garden, and the front garden is laid with gravel with room to park several cars. The deputy manager reported that the range of fees at the home was £1035 to £2658.72 per week, depending on the needs of the service user. Fairview DS0000065821.V321993.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to write this report was gained from a review of the information the provider sent to the Commission for Social Care Inspection (CSCI), including a pre-inspection questionnaire, and a site visit to the home on 16th January 2007. Comment cards were received from all six service users and four relatives. During the site visit the inspector spoke with three of the service users, observed the interactions between service users and staff and spoke with the staff on duty, including the deputy manager. A phone conversation was held with the manager on 18th January 2007, as she was not present during the visit. A tour of the building was made and documents relating to the running of the home were inspected during the visit. What the service does well: There are good systems to assess the needs of potential service users before they move into the home. The needs of service users are set out in care plans and risk assessments, which they are involved in writing and reviewing. This helps staff to know how to meet their needs. The home provides good support for service users to take part in a wide range of activities they enjoy. Service users are supported to see their family and friends regularly and the menus provide a balanced diet of food they enjoy. Service users like the way staff help them, which maintains their privacy and dignity. Support is provided for service users to see their doctor and attend other health services when they need to. Service users are confident that any complaints they make will be taken seriously and acted upon. The home is well maintained and provides a safe, homely environment for service users. Staff are well trained and do not start working at the home until the manager has checked whether they have any convictions and has obtained references from places they have previously worked. An experienced manager runs the home and there are good systems to use the views of service users to plan improvements. Fairview DS0000065821.V321993.R01.S.doc Version 5.2 Page 6 What has improved since the last 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. The summary of this inspection report can be made available in other formats on request. Fairview DS0000065821.V321993.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 DS0000065821.V321993.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): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems to assess the needs of service users before they move into the home. EVIDENCE: The files of three service users were inspected during the visit. Each contained an assessment of their needs that was completed before they moved into the home. This assessment covers the individual needs of service users, including communication, personal care, religious and cultural needs. No service users have moved into the home since the last inspection. Fairview DS0000065821.V321993.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): Standards 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good care planning and risk assessment systems, which support service users to make day-to-day decisions about their lives and take managed risks. EVIDENCE: The personal files of three service users were inspected during the visit. Each service user had a care plan that was developed from their initial needs assessment. These plans are reviewed regularly with the service user and have been changed where their needs have changed. The deputy manager reported that the home has a good relationship with the local learning disability team. Psychology services have been involved in developing a “method of approach” for service users with challenging behaviour, which gives staff detailed guidance on how to work with service users. These documents are included in the care plans. All six service users who completed a CSCI comment card said they made decisions about what they do each day. Staff were observed throughout the Fairview DS0000065821.V321993.R01.S.doc Version 5.2 Page 10 visit discussing issues with service users, presenting various options and the consequences of making that decision. Risk assessments are in place for all three service users whose files were inspected. These documents set out the assessed hazards to service users and action to minimise the risk of harm. The risk assessments are regularly reviewed. Since the last inspection a risk assessment has been completed covering the restricted access to food in the annex, complying with the requirement that was made. Whilst this assessment covers the actions that staff should take, it was recommended that it should include more information about the reasons for the restriction and details of the health professionals who have been involved in the assessment. The deputy manager agreed and said she would review the assessment. Fairview DS0000065821.V321993.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): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support for service users to take part in suitable activities, to maintain relationships with family and friends and to have a balanced diet of food they enjoy. Staff work in a manner that respects the rights and responsibilities of service users. EVIDENCE: Service users are supported to take part in a range of educational and leisure activities, including local college courses, horticultural day services, cinema trips, football matches and visits to a local social club and pub. One service user is currently attending a training course with the aim of finding employment. One service use spoken with said they had enjoyed watching a darts competition over the weekend and liked to grow vegetables in the garden. Support is provided for one service user to attend a local church. Service users spoken with said they enjoyed their activities and there were enough staff to support them. All six service users who completed a CSCI Fairview DS0000065821.V321993.R01.S.doc Version 5.2 Page 12 comment card said they could do what they wanted to during the day, in the evenings and at weekends. Service users are supported to keep in touch with family and friends if they want to, and those spoken with said they were able to see their visitors in private. Staff were observed providing support in a friendly and respectful way, which maintained the privacy and dignity of service users. The home has a planned menu that takes into account the likes and dislikes of service users and provides a varied and balanced diet. Those spoken with said the food was good, and they could always have an alternative meal if they did not like the one being prepared. Mealtimes are flexible to fit in with service users’ activities. The kitchen was stocked with a variety of good quality food. Fairview DS0000065821.V321993.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): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support to meet the personal care and health needs of service users. Medication is safely stored and changes made during the visit to the way administration records are made will help to keep service users safe. EVIDENCE: Service users spoken with said that staff treat them well and listen to them. Staff spoken with demonstrated a good understanding of the needs of service users. Records are maintained of service users’ visits to health services, including GP, dentist, chiropodist, psychiatrist and community nurse. The records kept include details of any advice given by the practitioner. One service user spoken with said they were able to see their doctor when they needed to. Since the last inspection a new medication cabinet has been fitted in the office. Records are maintained of medication brought into the home, administered and returned to the pharmacist. Medication is regularly checked to ensure that the balance recorded matches the stocks held and that all administration records have been fully completed. It was noted during the inspection that Fairview DS0000065821.V321993.R01.S.doc Version 5.2 Page 14 medication prescribed to be administered at 8am and midday had not been signed for by the staff member responsible. The deputy manager reported that staff signed for the medication they had administered before they went off shift, and not at the time they administered it. The inspector expressed concern that this was not a safe system of administering medication and was not in line with the organisation’s medication policy. The deputy manager took immediate action to inform all staff that they must sign for medication administered to service users at the time of administration. Feedback was also given to the home’s operations manager at the end of the visit. The operations manager expressed concern in the method of administration and provided assurances that he would ensure the changes the deputy manager made were adhered to. As a result of the swift action to resolve the issue and assurances given during the visit, a requirement is not made in this report, however, compliance with the organisation’s medication policy will be assessed at future visits. All staff administering medication have undertaken training and none of the service users currently administer their own medication. Staff that have not completed the medication training confirmed that they do not administer any medication. Fairview DS0000065821.V321993.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): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident their complaints will be taken seriously and acted upon and the home has good adult protection systems, which helps to keep service users safe. EVIDENCE: The home has a complaints procedure available, which sets out who will deal with a complaint and how long the provider will take to respond. The procedure has been supplied to all service users in an accessible symbol format using “widget” symbols, which is a communication system used by some of the service users, however, this version has not been updated to reflect the new provider since the home was taken over. The manager reported that she had obtained the appropriate computer software and would make the necessary changes to the “widget” version of the procedure. One service user spoken with said they know what to do if they want to make a complaint. All six service users who completed a CSCI comment card said they know who to speak to if they are not happy and know how to make a complaint. Two of the four relatives who completed a CSCI comment card said they did not know about the home’s complaints procedure. The manager agreed to send copies of the procedure to all relatives. No complaints have been received since the last inspection. The home has an adult protection policy and a copy of the local authority adult protection procedures. Staff have received adult protection training and those spoken with demonstrated a good understanding of abuse and action to take if abuse was reported or suspected. Fairview DS0000065821.V321993.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a safe, homely environment for service users. EVIDENCE: A tour of the communal areas of the home was made during the visit. The home is well maintained and decorated. Work was being completed on redecorations in the lounge following re-plastering and painting. Furnishings are domestic and of good quality, with new sofas in the lounge. New carpets have also been fitted in the communal areas of the home. The home has an enclosed rear garden, including a vegetable patch, that service users are able to access. Staff reported that an in-house maintenance team completes maintenance work quickly. This was supported by the maintenance records that indicated most maintenance was completed within two to three days and there are currently no outstanding maintenance issues. The home has a separate laundry room, which means laundry is not taken through food Fairview DS0000065821.V321993.R01.S.doc Version 5.2 Page 17 preparation or storage areas. There are hand-washing facilities in the kitchen, laundry room, bathrooms and toilets. Fairview DS0000065821.V321993.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems to protect service users and meet their needs through the staff training programme and recruitment procedures. EVIDENCE: The deputy manager reported that four of the ten staff employed have achieved the National Vocational Qualification (NVQ) at level two or above and three have just submitted their completed portfolio for assessment. One member of staff has just started the award. During the visit, staff were observed interacting with service users in a friendly and respectful manner. The deputy manager reported that four new staff have been employed since the last inspection in February 2006, although could not find details recruitment checks that had been undertaken. The manager confirmed by phone that Criminal Records Bureau disclosures and references were obtained before they started work. The manager also said that the documents were available in the home, although had been placed in a separate file as she was working on them, which was why they could not be found during the inspection. Staff spoken with said that they received good training, which helped them to meet the needs of service users. A record is kept of all training that staff have Fairview DS0000065821.V321993.R01.S.doc Version 5.2 Page 19 undertaken and a new training matrix has been developed to give an overview of gaps in staff training. Courses staff have completed include first aid, medication administration, crisis intervention and prevention, moving and handling, food hygiene, fire safety, health and safety, adult protection, autism, epilepsy and Makaton sign language. Fairview DS0000065821.V321993.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a competent manager and there are good systems to use the views of service users to plan improvements. EVIDENCE: The manager is currently in the final stages of completing the Registered Manager’s Award. The manager said she receives good support from the senior management staff and is able to speak with them whenever she needs to. Staff spoken with said they receive very good support from the manager. The home has sent out questionnaires to service users, relatives and care managers to gain their views of the quality of the service that is being provided. Service users spoken with confirmed they have meetings, when they can say what they think about the way the home is managed. The information from service users and their relatives is used to feed into a service Fairview DS0000065821.V321993.R01.S.doc Version 5.2 Page 21 plan, which includes goals for the service to achieve over the year. Senior managers from the organisation visit the home each month to review the service quality. Reports of these visits contain actions that are required to improve the service, however, the concerns highlighted in this report about medication practices had not been identified. The home has a fire risk assessment and regular checks are made of the fire warning system and the equipment. There are risk assessments for the building, which are regularly reviewed and contain actions that should be followed to minimise the identified risks. The gas boiler is serviced annually and annual tests of portable electrical appliances are completed. Assessments are completed for chemicals used in the home, which are stored in a locked cupboard. The temperatures of the fridge and freezer are taken daily and recorded. Accidents and incidents to service users and staff are recorded and reported where necessary. Fairview DS0000065821.V321993.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 2 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 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 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 2 X 3 X 3 X X 3 X Fairview DS0000065821.V321993.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard Good Practice Recommendations Fairview DS0000065821.V321993.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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