Inspection on 29/05/08 for Fairview

This inspection was carried out on 29th May 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

Fairview 04/07/07

Fairview 16/01/07

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 23/11/2008.

CARE HOME ADULTS 18-65 Fairview Pinks Lane Baughurst Tadley Hampshire RG26 5NG Lead Inspector Marilyn Lewis Unannounced Inspection 29th May 2008 10:00 Fairview DS0000065821.V363598.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.V363598.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.V363598.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) hannah.sheather@choiceltd.co.uk Community Homes of Intensive Care and Education LTD Post Vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Fairview DS0000065821.V363598.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th July 2007 Brief Description of the Service: Fairview is registered to provide care and accommodation for 6 people aged 18-65 who have a learning disability. 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 home is situated in the village of Baughurst, within walking distance or short drive to the amenities within the village of Tadley, and within a 30-40 minute car journey to the towns of Basingstoke, Newbury and Reading. The range of fees at the home are £1081 to £2874 per week, depending on the needs of the person using the service. Fairview DS0000065821.V363598.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 stars. This means the people who use this service experience good quality outcomes. A visit to the home took place on the 29th of May 2008 when the inspector met with the two service users who were at home, a support worker, senior support worker and the deputy manager who assisted with the inspection process. Information provided in the home’s Annual Quality Assurance Assessment (AQAA) and information obtained during a visit to the home was taken into account when completing this report. A number of records and documents were sampled, including care plans and records relating to medication, staff recruitment and staff training. The inspector would like to thank the service users and staff for their hospitality, time and assistance. What the service does well: The atmosphere in the home was relaxed and welcoming. Service users said that they liked living at the home and that staff were very friendly. Service users said that they were able to ‘do what they wanted to do’ such as attend day centres and go on holidays to the place of their choice. During the visit very good interaction was observed between staff and the two service users who were at the home at the time. Care plans and assessments provide clear information on the support needed and the wishes of the service users. Staff said that they received good training and records seen confirmed that staff received training in mandatory subjects such as health and safety and medication, and also in topics relevant to the service users’ needs, including mental health and epilepsy. Robust recruitment procedures are used when recruiting new staff members. Service users are involved in the selection of new staff. Fairview DS0000065821.V363598.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.V363598.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.V363598.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. The needs of service users have been assessed before they moved into to the home, to ensure that these could be met. EVIDENCE: There have been no new service users admitted to the home since the last inspection. However the home has clear systems in place for the admission of new service users. Information supplied in the AQAA states that ’The last service user who moved to Fairview was included in a long process of assessment/visits/overnight stays etc at Fairview, meeting other service users, staff etc to ascertain his suitability for the home as well as the suitability of the service for his needs. This process involved his family, friends, care managers, CPN, therapists etc. Records seen for the service user confirmed that the assessment process as detailed in the AQAA had taken place before the service user moved into the home. Fairview DS0000065821.V363598.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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user has an individual plan to guide staff to their support and care needs. These include assessments of any risks to service users, to ensure that service users can be as independent as possible. Service users are encouraged to make their own decisions with the support of staff. EVIDENCE: The two service users who were spoken with during the visit said that they knew what was written in their care plans and agreed with them. The service users said that staff discussed their care plans with them and care plans seen confirmed that reviews had taken place monthly or more frequently when needed. Fairview DS0000065821.V363598.R01.S.doc Version 5.2 Page 10 A staff member said that the care plans were discussed with the service user during one to one meetings and also with other people such as therapists and family members. The care plans and reviews had been signed by the service user or a family member to confirm they agreed with any changes being made. The care plans which were seen contained the wishes of the service user, such as things that they liked and disliked. Behaviour plans included the things which may trigger changes to the behaviour patterns of the service user and ways to support the service user when they were anxious. During the visit service users discussed their wishes with staff who responded in a friendly and supportive manner. Service users were encouraged to make their own decisions including what they wanted to do during the day and what they wanted for their meals. One service user said that he had wanted to have budgies (budgerigar birds) as pets. Staff had discussed this with him and had supported the service user to purchase two budgies the previous day. The service user talked with pleasure about the birds and staff chatted with him about how to care for the birds. The other service user said that he had wanted to spend time alone in his room while waiting to go a trampoline session in the afternoon and staff had respected this. Detailed risk assessments were contained in the care plans. Risk assessments had been developed during the assessment and admission period and had been reviewed frequently thereafter. Risk assessments were in place for all aspects of daily living such as cooking and laundry and also for activities such as road awareness. Fairview DS0000065821.V363598.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 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported to take part in a variety of social and leisure activities, to be part of their community and to maintain contact with their families and friends. Support is provided to enable service users to choose and prepare their own meals. EVIDENCE: The deputy manager said that none of the service users followed a faith although two had attended church services for two or three months but had then decided not to go any longer. Fairview DS0000065821.V363598.R01.S.doc Version 5.2 Page 12 Care plans which were seen indicated that the service users were involved in a wide range of activities both at home and in the community. At the time of the visit one service user was visiting relatives, three were at day centres and two were at home. One of the service users at home was due to go for a trampoline session in the afternoon. One of the service users said that he really liked going to funfairs and during the visit a support worker chatted with him about the best time for them to visit a funfair that was currently in the local area. The support worker said that it was ‘always busy’ as service users were supported to follow their choice of leisure activities including visits to places of interest, eating out, attending the local library and shopping. Service users had also recently started attending an evening social club supported by staff as they had asked for more evening activities during a service user meeting. Five of the service users had been on holiday to Blackpool last month. The service users had chosen the resort and staff had supported them to find suitable accommodation. Service users are given a holiday allowance of £250 each year. One service user had not wished to go on holiday and was supported at the home. Records seen indicated that service users are supported to maintain contact with their families. At the time of the visit one service user was spending time at the home of their grandparents and one of the service users spoken with said that he saw family members frequently and had recently spent time with his parents. Visits by family members and friends were documented in the service users records. The deputy manager said that family and friends were welcome at the home at any time. All the service users had a key for their rooms and were able to lock them as they wished. The deputy manager said that Fairview was the service users’ home and staff respected their rights and wishes. Both of the service users spoken with said that staff listened to them and they were able to do as they wished. The deputy manager said that the service users were encouraged to decide what the menus for the week were to be and two of the service users helped to write the shopping lists. During the visit the two service users chose what they wished for lunch and were supported by staff to prepare their meals. Menus and records seen indicated that service users were provided with a choice of meals. Risk assessments were in place for one service user who was allergic to nuts and staff were aware of this and it was noted in the menus. Fairview DS0000065821.V363598.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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Support with personal care is provided to service users in the way that they prefer. Service users’ healthcare needs are well met and the administration of medication is managed appropriately. EVIDENCE: Information in the AQAA states that ‘Service users receive appropriate levels of support with their personal care needs. This is always done whilst respecting individuals dignity and privacy.’ The wishes of the service users about how they wished to be supported with their personal care were documented in their care plans and staff spoken with were aware of the service users wishes. Records seen indicated that service users shopped for their own clothes and toiletries. Fairview DS0000065821.V363598.R01.S.doc Version 5.2 Page 14 Care plans gave details of the service users’ health care needs and records confirmed that advice was sought from health professionals as needed. Visits to doctors, dentists and opticians and assessments from therapists and community psychiatric nurses were included in the records. At the time of the last inspection a requirement was made for the health records of one service user to clearly detail their allergy to nuts. Records seen on this visit included these details. A requirement was also made at the last inspection regarding the safe keeping of the keys for the medicine cupboard. Systems have since been put in place to ensure the keys are kept safe. Medication records which were seen were up to date, and records were also kept of medication which service users took with them when visiting families or attending day centres. An incident form was completed each time medication which was prescribed as ‘when necessary’ was given, so that an audit trail was maintained of when and why the medication was given. Information was available to staff regarding the medication in use at the home. Staff said that they had received training in the administration of medication and records seen confirmed this. Fairview DS0000065821.V363598.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 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There is a complaints procedure in place and service users know who to speak to if they are unhappy. Staff were aware of their responsibilities in the protection of service users. EVIDENCE: The two service users said that they would talk with staff if they were unhappy. Complaints procedures were included in the Statement of Purpose and Service User Guide. The deputy manager said that the service users were asked at each review if they were unhappy with anything at the home and procedures were changed if needed to meet their wishes. The home has clear procedures regarding the prevention of abuse including whistle blowing and Hampshire County Council’s Protection of Vulnerable Adults. Staff spoken with were aware of the procedures to follow should abuse be suspected. The two service users said that they felt safe at the home. The home keeps small amounts of money for service users. The monies are kept in individual containers in a safe place. Records seen for one service user Fairview DS0000065821.V363598.R01.S.doc Version 5.2 Page 16 matched the amount of money held. The deputy manager said that the monies were checked every evening and records seen confirmed this was taking place. Fairview DS0000065821.V363598.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a home that is comfortable and safe, and which is kept clean and hygienic. EVIDENCE: The home looked clean and homely. The building consists of the main house and an adjoining annex. There are four bedrooms, bathrooms, lounge and dining area and kitchen and laundry area in the main house and two bedrooms, bathrooms, lounge with dining area and kitchen in the annex. An office is located in the main house. The gardens of the two areas are separated as this is preferred by the service users, but access is available to both areas for staff and service users. Fairview DS0000065821.V363598.R01.S.doc Version 5.2 Page 18 The service users showed the inspector their rooms and said that they liked them and had everything they needed. All the rooms were clean and looked bright and personal. Since the last inspection the risks of cross infection have been minimised as liquid soap and disposable hand towels are now provided. The flooring in the laundry area has been replaced as the poor condition of the flooring was noted at the last inspection. The deputy manager said that since the last inspection the response from the maintenance team regarding maintenance requests had improved and any requests were now dealt with promptly. The temperature from the hot water taps in the bathrooms had exceeded the level for safety at the last inspection, but the deputy manager said that the water was now thermostatically controlled and the temperature was monitored regularly. Fairview DS0000065821.V363598.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 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a team of staff who have been appropriately recruited and trained. EVIDENCE: Staff spoken with were very aware of the needs and wishes of the service users and service users said that staff were friendly. Good interaction was seen between staff and service users and the atmosphere was relaxed. Staff were aware of their roles and responsibilities. The deputy manager who was acting as manager while a new manager was being recruited, said that all the staff were working well together to support the service users. The deputy manager said that she was receiving good support from the area manager. The home employs the deputy manager, two senior support workers and twelve support workers. Three of the staff members hold a National Vocational Fairview DS0000065821.V363598.R01.S.doc Version 5.2 Page 20 Qualification (NVQ) level 3 in care, two staff members are in the process of obtaining the qualification and four are due to start the course shortly. Staff said that they had good opportunities to attend training courses and records which were seen confirmed that staff had attended mandatory (required by law) training in moving and handling, food hygiene, protection of vulnerable adults, health and safety, anti discriminatory practices and fire training. Staff had also attended training in medication and other topics specific to the needs of the service users, such as epilepsy and mental health needs. Recruitment records which were seen for two staff members indicated that robust procedures were used for the recruitment of staff. Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks had been completed prior to the staff member starting work at the home and the records contained two written references and job descriptions. The deputy manager said that a service user sat on the interview panel for new staff and the applicants spent time at the home, so that all the service users could give their views on whether they would like to be supported by the applicant. Fairview DS0000065821.V363598.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 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 being effectively managed and is being run in the best interests of those who live there. EVIDENCE: The deputy manager has been responsible for the running of the home since the registered manager left in April 2008. The deputy manager said that a new manager had been recruited and she was due to take up her position shortly. Fairview DS0000065821.V363598.R01.S.doc Version 5.2 Page 22 The Commission had not been notified that the registered manager had left the home as is required by The Care Homes Regulations. Records which were seen indicated that service users views were taken into account regarding the running of the home. Weekly service users meetings are held and service users said that they could talk to staff at anytime if they were unhappy about how the home was run. The home also has a comments book for suggestions regarding the running of the home. Staff said that they had the opportunity to give their views on the management of the home during staff meetings. Minutes of the meetings were provided for any staff member unable to attend. The deputy manager said that frequent contact with relatives provided good opportunities to discuss the quality of care provided at the home. Staff had received training in health and safety and improvements had been made to the environment to minimise the risks of cross infection. Fire records which were seen confirmed that checks were made on fire safety equipment as needed, and staff and service users attended fire drills. A service user who was spoken with knew what to do if the fire alarm sounded. The kitchens looked clean and food was stored appropriately. Staff had received training in food hygiene. At the time of the last inspection records seen indicated that the bath chair had not been serviced for a long time. Records seen on this visit confirmed that the bath seat had been serviced recently. Fairview DS0000065821.V363598.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 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 3 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 4 13 4 14 x 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Fairview DS0000065821.V363598.R01.S.doc Version 5.2 Page 24 NO 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. 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.V363598.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 DS0000065821.V363598.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!