Inspection on 19/09/05 for Fairview

This inspection was carried out on 19th September 2005.

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 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 25/07/08

Fairview 27/07/07

Fairview 23/08/06

Fairview 17/02/06

Fairview 11/01/05

Fairview 10/08/04

Fairview 10/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Fairview 42 Hill Street Kingswood South Glos BS15 4ES Lead Inspector Sam Fox Unannounced Inspection 20th September 2005 09:30 X10015.doc Version 1.40 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 DS0000034844.V249767.R01.S.doc Version 5.0 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 Older People. 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 DS0000034844.V249767.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fairview Address 42 Hill Street Kingswood South Glos BS15 4ES 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) 0117 9352220 0117 9476234 Mrs June Phillips Mr Gordon Norman Brooking, Mr Derek Marsh Mrs Jacqueline Yvonne Reed Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May accommodate up to 24 persons aged 65 years and over requiring personal care May accommodate one named individual aged under 65 years with a physical disability, this condition will be removed when this resident leaves the Home or reaches the age of 65, whichever is the sooner 11th January 2005 Date of last inspection Brief Description of the Service: Fairview is situated in a quiet cul-de-sac in Kingswood and is close to local shops and amenities. Private parking is available in the front of the house. The home is registered to provide personal care and accommodation for up to 24 persons who are over 65 years of age. The home is an older property arranged over three floors. There is a large communal space separated into a lounge and dining area. Bedrooms have been refurbished. There is a shaft lift servicing all floors except for bedrooms 20 and 21. These two rooms are accessed by a small flight of stairs and can only be used by ambulant residents. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection – the purpose of which was to check on residents’ welfare and to make sure they were satisfied with the service they receive. In addition to this key documents were inspected, including two care plans, staff training records and health and safety policies. Evidence was obtained through discussion with the manager and staff team. Eight residents were consulted with and opportunity was taken to join members of the household with their lunchtime meal. What the service does well: What has improved since the last inspection? Positive action has been taken to meet all eleven requirements made at the last inspection. The home has updated its Statement of Purpose and complaints policy and copies of these have been re-issued to all residents. All radiators have been covered and risk assessments have been developed for residents who are at risk of falling. This has made the environment safer. In addition to this the bathroom on the first floor is now fully operational and provides an additional resource for residents. Improvements have been made to the training programme. Staff now receive a more comprehensive induction and can expect to receive their mandatory training at regular intervals. Residents can now be more reassured that they will receive assistance from a knowledgeable and skilled staff team. A formal system for the supervision of staff has been established. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 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. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 There is an effective admissions procedure in place so new residents can be confident that the home will have the resources and skills to meet their needs. EVIDENCE: The manager has updated the Statement of Purpose, which also serves as a brochure. She explained that all new residents are given a copy of this when they express an interest in moving to the home. It was also noted that all residents have been re-issued with this along with an updated complaints procedure. This meets with requirements of the legislation. The manager or deputy completes an initial assessment prior to new residents moving to the home. An example of this was seen during the visit. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 9 During the inspection it was noted that there were two residents who had diagnosed mental health needs. It was apparent that the home have consulted with the relevant health specialists to ensure that they can meet their needs. In order to meet with the requirements of the legislation, however, they must apply to vary their registration to reflect this. A copy of the application form has been sent to the manager. Three residents said they were given the opportunity to look around the house and have a trial visit before making a decision to move there. Some residents said they got their family to look around the home for them, as they were too ill to look themselves. There were signed resident’s agreements on personal files which included a breakdown of the fees and insurance arrangements. This meets with requirements of the legislation. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,11 Residents can be confident that their health care needs will be met by an alert and sensitive staff team. Care and end of life plans should continue to be developed to further ensure that residents receive a personalised and consistent service. EVIDENCE: Opportunity was taken to view two personal files. These contained information about residents’ needs including an initial assessment, preferred daily routines, past history and care plans. Whilst these covered many areas of need and were up to date, the current system is slightly confusing and care plans were limited. An example of this was for one resident who is prone to urine infections – there should be a care plan about this highlighting what the home do to reduce the risk of this happening again. This was the subject of discussion with the manager who is going to consider how this can be resolved. This will continue to be a focus of the next visit, alongside residents’ involvement in them. They should be encouraged to read care plans and sign their agreement to them. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 11 Records provided evidence that residents are supported to see the relevant health professionals and to have regular check ups with the opticians and dentists. All residents spoken with said they could see a GP on request. There were nutritional assessments, that are reviewed regularly and manual handling assessments. The home operates a monitored dosage system for the administration of medication that is supplied at regular intervals by the local pharmacist. It was understood that staff have had training about this since the last inspection (although this was not confirmed through records). The requirements about recording, made at the last visit, have been met. It was noted, however, that the home is not carrying out regular spot checks of medication given on an ‘as and when’ basis. The manager needs to implement a system to achieve this. The manager was advised that residents should be consulted with about their wishes in the event of their death. Information on files about this was inconsistent. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 Residents’ benefit from a relaxed environment so they can dictate their own daily routines which suit their preferred lifestyles. EVIDENCE: Residents said that they could get up and go to bed when they liked. This was observed at the time of the inspection. There was a relaxed atmosphere and it was apparent that residents were dictating their own routines. Some prefer to stay in their rooms whilst others spend time in the communal areas. In addition to this some residents have their meals in their bedrooms. The manager said that they organise some formal activities and at the time of the inspection a harpist was playing. A number of residents said they enjoyed this. They said there was always plenty to do if they wanted to but many prefer a quieter lifestyle. Staff said that friends and family are welcome at any time and this was observed at the time of the visit. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 13 Residents spoke positively about the quality and quantity of food that they received. They said that they were always given the choice of two main meals and this was confirmed through examination of the menus. Opportunity was taken to join with residents during their lunchtime meal. This was served in a sensitive and unhurried manner. The food was well presented and tasty. Residents were observed being given quantities that they preferred and being offered choices if they did not like the main alternatives. It was apparent through discussion with the cook that she knew the residents well and was aware of what they liked. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Residents can be confident that the staff team will listen to their concerns. Action taken about formal complaints, however, needs to be improved so they can be re-assured that these will be fully investigated and acted upon. EVIDENCE: All residents spoken with praised the staff and said they would have the confidence to speak with them if they had any concerns. The complaints procedure is displayed in the hallway of the home and has been updated. This meets with requirements of the legislation. A serious complaint has been made concerning work practice since the last inspection. There was unsatisfactory information to indicate that this had been dealt with according to the home’s complaint procedure or to evidence that the appropriate follow up action had been taken. The home should record all actions taken, with outcomes in the complaints log (if this is confidential in nature, it can be kept separately). The home should also write what actions have been taken as a consequence. The home is now required to send a summary of actions taken to the CSCI. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 15 The manager and a number of staff have received their protection of vulnerable adults training and there is a policy in place about this in the home. She is aware that all staff should receive this as part of their statutory training. The manager has recently convened a residents meeting which she said was useful - it is hoped that she will be able to organise these more regularly from now on as they can provide a useful, more formal forum through which residents can raise issues of concern. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24,26 The home is clean, comfortably furnished and homely in appearance. Minor action needs to be taken to improve access. EVIDENCE: Fairview is situated within the heart of Kingswood and many residents lived within this community before they moved there. It has spacious grounds which are well maintained. It was noted that there is a small step and lip to the front door. When questioned staff said that this does cause difficulties when manoeuvring wheelchairs in and out. Action needs to be taken to get ramped access for those with mobility difficulties. There was a strong odour in a bedroom downstairs, which was also filtering in to the hallway. Action needs to be taken to reduce this. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 17 Opportunity was taken to view all the bedrooms. They are all lockable and the radiators had guards. All residents, apart from one, said they were satisfied with the furniture and fittings in their room. One resident is currently waiting for a new sink and wardrobe. It was observed that some of the vanity units are old and appeared jaded in appearance, it is recommended that there be a planned programme of replacing these. All rooms seen were personalised and reflected individual tastes, indicating that choice and independence are promoted. Residents said they could bring in small items of furniture, which made it more homely. The carpet in Room 12 requires stretching and refitting, as it could be a trip hazard. Discussion took place with one resident who was concerned about her bedroom door, which, being a fire door is very heavy. She said she had great difficulties opening this, particularly because she uses a Zimmer. This was discussed with the manager who undertook to try and resolve this problem. She also advised the resident that she could ask for assistance from staff at any time. One of the fire doors was not fully closing. The manager was advised to have this adjusted and to conduct a routine maintenance of all other fire doors on the premises. The home was found to be cleaned to a high standard and staff should be commended for their efforts in this respect. The laundry room is small and not ideally suited to the needs of the home. The washing machine has a sluicing facility and reaches high temperatures. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,30 The training programme has improved and so residents can now be assured that staff will have the skills to meet their needs. EVIDENCE: At the time of this inspection there were two care assistants on duty and a deputy manager. In addition to this the home employs a cook, kitchen assistant and housekeeper. Two staff perform waking duties throughout the night. At present these are adequate to meet the needs of those residents currently accommodated. They should, however, be kept under review and be adjusted according to dependency levels. The manager said that a major focus of the last few months has been to consolidate the training programme within the home and there have been many positive developments in this respect. Certificates were seen to demonstrate that new staff are receiving a more comprehensive induction programme. They have purchased a video package which has enabled home to achieve this. In addition to the above there was evidence that significant progress has been made to ensure that all staff have had their statutory training. This meets with a requirement made at the last visit. All staff should have received this by the time of the next inspection and this will continue to be a focus of forthcoming visits. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,36,38 Residents benefit from strong leadership from the management team and there are good systems in place for health and safety. EVIDENCE: The manager displayed a clear sense of her role and responsibilities and it was apparent that she is able to give good direction to the staff team. She was aware of the strengths and weaknesses of the home and was enthusiastic about continuing to improve standards. A positive development has been the introduction of formal supervision for staff that is now taking place regularly. Minutes of these meetings were seen and it provides a useful formal forum for staff to discuss concerns and developmental issues. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 20 The fire logbook evidenced that the relevant tests and checks of the system are being carried out at the appropriate intervals. The manager has begun to develop workplace risk assessments – in line with health and safety legislation. These were limited in scope but she intends to continue develop these. There was information available about the Control of Substances Hazardous to Health (COSHH), which was signed by staff and included chemical data sheets for cleaning products. Fridge and freezer temperatures are being monitored regularly by the cook who also checks the temperature of cooked food. A hand test of hot water indicated that temperatures are maintained to within safe levels. The manager must ensure that hot water outlets are checked regularly and temperatures should be recorded. The boiler had a sticker on it which indicated that it was serviced on 19\8\04 – the manager said that this had been serviced more recently than this – she should send written confirmation of this to the CSCI. In addition to this it was not clear whether the hoists had been recently serviced and the same applies to these. It was noted that the home’s insurance policy, displayed on the wall, had expired in July. The manager needs to confirm that the home is covered. Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 2 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 x 18 3 2 3 3 x 3 2 2 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x x 3 x 2 Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 22 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. 1 Standard OP4 Regulation 12 Requirement Make application to vary the registration certificate for two residents with identified mental health needs. Maintain regular and accurate stock check of all medication given on an as and when basis Ensure that residents wishes in the event of their death are clearly recorded Ensure all complaints are fully investigated and recorded. Send a summary of investigation and actions taken of the most recent complaint to the CSCI Reduce odour in identified bedroom Stretch and securely fit the carpet in Room 12 Conduct routine maintenance of all fire doors Provide ramped access to front of property Ensure the boiler and hoists have been serviced Ensure the home is fully insured Timescale for action 15/10/05 2 3 4 OP9 OP11 OP16 2 12(2) 22(3)(8) 15/10/05 30/10/05 30/10/05 5 6 7 8 9 10 OP24 OP24 OP25 OP19 OP38 OP38 16(2)(k) 12(4)(c) 23(4)(c) 23 (2)(n) 23(2)(c) 25(2)(e) 15/10/05 15/10/05 15/10/05 30/11/05 30/09/05 30/09/05 Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 23 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 Refer to Standard OP7 OP24 Good Practice Recommendations Further develop care plans Implement planned programme of replacing vanity units Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Fairview DS0000034844.V249767.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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