Inspection on 04/07/07 for Fairview

This inspection was carried out on 4th July 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 29/05/08

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 08/07/2008.

CARE HOME ADULTS 18-65 Fairview Pinks Lane Baughurst Tadley Hampshire RG26 5NG Lead Inspector Christine Walsh Unannounced Inspection 4th July 2007 10:20 Fairview DS0000065821.V341320.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.V341320.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.V341320.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.V341320.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th January 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 30/40minute car journey to the towns of Basingstoke, Newbury and Reading. The range of fees at the home are £1035 to £2658.72 per week, depending on the needs of the person using the service. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit formed part of the key inspection process and was carried over one day by Mrs C Walsh, regulatory inspector. The manager completed an Annual Quality Assurance Assessment (AQAA) document, which was returned to the Commission for Social Care Inspection prior to the visit to the home. In addition “Have Your Say” resident comment cards were sent of which six residents comment cards were received. The information obtained to inform this report was based on viewing the records of the people who use and work at the service, speaking with the residents, and staff and observing care and support practices. A tour of the home took place and documents pertaining to health and safety were viewed. What the service does well: The home does well in all areas of its care and support, providing this using a person centred approach, recognising the residents as individuals with individual needs and rights and encouraging them to take control as far as feasibly possible over their lives. This was demonstrated through the quality of the assessment and transition process, resident’s personal plans, risk assessments, resident’s involvement in developing their plans and their reviews and the positive interactions between residents and staff. The manager and staff spoke of the importance of empowering residents to take control over their lives, make decisions about their daily and future needs and by offering choices to develop everyday life skills, experiences and new challenges. Examples of these are provided within the body of the report. One resident said: “I like living at Fairview because I can choose what to do and the staff help me” A member of staff said: “Its important to treat the residents with respect and empower them”. The manager and her staff do well to ensure the residents are supported in all areas of the physical and mental health care needs. The home has good links with a number of health care professionals including primary and specialist health care professionals. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 6 The home provides and open and inclusive environment where the residents are encouraged through monthly review and residents meetings to express how they are feeling, share their views or relay any concerns. The manager has an open door policy and is in regular contact with residents, staff and visitors. The home considers risks to the residents and reminds them of potential risks when carrying daily activities. They make sure staff receive abuse awareness training and have checks carried out on before commencing employment in the home. A resident said: “I like my keyworker she is very nice, she helps me to do the things I like to do”. Fairview is a spacious and airy two-storey building; it has been tastefully decorated and furnished throughout. Each resident has a room of their own, which are personalised and reflect the personality of the individual residents. The manager does well to appoint staff with good skills and values to carry out their roles and responsibilities. The staff undergo a robust recruitment procedure including an interview and providing all necessary checks before commencing work in the home. The staff receive a comprehensive induction and training package and are encouraged to further their skills and knowledge by undertaking a national vocational award (NVQ). As far as feasibly possible the home protects the residents form environmental hazards by ensuring all staff receive up to date training in health and safety procedures including fire safety, this is extended to residents who are encouraged to participate in the training. Serviceable utilities are regularly serviced and fire fighting equipment and appliances meet the fire safety regulations and standards. What has improved since the last inspection? What they could do better: Residents receive full health care support, however the home must safeguard residents who have specific health care needs such as allergies by ensuring that staff are clearly alerted to the risks and minimised. The home has good systems in place for the safe administration of medication however the home must extend this to the safe keeping of the medication keys Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 7 to prevent residents coming to harm if they were to gain unsupported access to medications. The home is clean and tidy and residents are supported to take pride in their environment, however the manager must consider how it can maintain hygienic standards of cleanliness to safeguard the residents from the potential risk of cross infection. Staff would benefit with infection control training. The home does well to ensure there are systems in place to safeguard the residents and staff from risks presented in the home, however the manager must take steps to regulate hot water to a safe temperature and seek advice when and how often the bath hoist must be serviced. 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.V341320.R01.S.doc Version 5.2 Page 8 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.V341320.R01.S.doc Version 5.2 Page 9 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 home does well to undertake a thorough assessment process to ensure it can meet prospective residents needs. EVIDENCE: The annual quality assurance assessment (AQAA) tool stated under “What we do well” To undertake a thorough and effective admission process. This was tested by viewing assessment documents of two residents and speaking with the manager. Two residents assessments documents were viewed and included the residents social, emotional and physical wellbeing, including mobility, communication, nutritional needs, health, likes and dislikes and behaviours to name but a few. There was evidence of annual assessment and placement reviews taking place with placing authorities, each review identifying areas of strength and are of need. Goals are set at these assessment reviews and link into the resident’s personal plans. The manager spoke of the process used to assess and support the transition of new residents to the service, this process is comprehensive and involves others Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 10 who play an important role in the residents’ lives such as relatives, care managers and health care professionals. Residents are invited to visit the service as many times as they see fit before making a decision to move in. They are invited to tea and overnight stays and during these visits continuous assessment takes place and the compatibility of other residents is considered. In the AQAA the manager states the home will improve its assessment reviewing process by undertaking them 6 monthly. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 11 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. The home does well to support the people who use the service to have an important role in planning and developing their personal plans, whilst making decisions about their lives when needed. The people who use the service are supported to take everyday risks within a risk management framework. EVIDENCE: The annual quality assurance assessment (AQAA) tool stated that “they do well” To involve service users in developing their care plans, providing input regarding their wishes and other professionals are consulted if their service is required such as physiotherapy. The home provides a wide range of activities and experiences to service users and risk assess accordingly. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 12 This was tested by viewing the personal plans and risk assessments of two residents, speaking at length with a resident, speaking with staff, observing their interactions with residents and observing activity in the home throughout the day. The personal plan of the one of the residents was viewed with the resident and another was seen, the resident had a good insight to the information that had been written down and what this meant for them in terms of the care and support they required. Plans are clearly written and describe the resident’s areas of strength and need, providing staff with good information on how to support them. There is evidence of regular reviews taking place with the resident and their keyworker and goals being set for the next month. The home has adopted a person centred approach to the care and support they provide for the residents and this was evident in every day activity observed at the time of the visit, in information held on them and in the way that the staff interacted and supported them. The home has gone through a number of changes in corporate management and in doing so a number of changes to the way information is being recorded and held on residents is changing, the manager is advised to ensure that the person centred approach the home has adopted is not lost in the transition of this information. Through the course of the day residents were observed making and encouraged to make decisions about how they would like to spend their day. Their personal plans reflect their likes and dislikes, preferences and wishes. Monthly individual meetings with the residents keyworker give the residents an opportunity to say how they are feeling, review goals set at previous meetings and plans goals for the next month or their future. There is evidence of a link of needs and wishes identified at the assessment process, the review, care plans and residents monthly meetings with their keyworker. This provides good evidence that the needs and the wishes of the residents are under regular review. As for care plans the residents have clear and descriptive risk assessments in place that have been identified during the assessment and care planning process. The two residents risk assessment viewed includes many aspects of their daily lives such as cooking, laundry, road awareness, money awareness and specific risk assessments linked to inappropriate behaviours. A resident said: “I would like to go out on my own, but I need help crossing the road”, “Hannah (Manager) is helping me with this”. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 13 There is evidence that risk assessments are being reviewed however the manager must ensure out of date or risk assessments not longer applicable are held separately to the current ones. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 14 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. The people who use the service are supported and encouraged to take part in everyday life activities and experiences that are age, peer and culturally appropriate, as well as having an integral role in their local community and maintaining and developing relationships with family and friends. The rights of the people who use the service are respected and they are supported to take responsibilities in their every day lives. The people who use the service are encouraged to take an active part in planning and preparing meals that are healthy and well balanced. EVIDENCE: The annual quality assurance assessment (AQAA) tool stated under “What we do well” We do well to source and access college, work placements, activities, Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 15 make use of the community, supporting service users to maintain links with family and friends and to encourage service users to be independent with regards to the up keep of their home and meal provision. This was tested by speaking with residents, viewing residents daily activity plans, observing activity at the time of the visit and observing interactions and support provided by staff and speaking with staff and the manager. The home is a hive of activity and at the time of the visit only two residents were in the home whilst others were attending day services, college and work placements. The residents remaining home were engaged in a number of activities with the support of staff such as preparing a lunchtime snack and the evening meal and carrying out household chores such laundry and vacuuming communal areas and attending the local library. A resident said: “Fair view is a good place to live we gets lots of support to do things, I really like cooking and my Keyworker helps me”. In the evening the residents were asked if they would like to do a group activity such as going to the gym or swimming. Residents were observed making decisions as to what they wanted to do. The manager said the home has done a lot to resource alternative day services and work placements that integrate the residents into the community. This was confirmed by two residents who said they both had jobs. The manager also stated that the home has good relationships with the local community such as the post office, local church and has a good relationship with a neighbour who occasionally invites them to BBQ’s. A member of staff said: “The home does really well to involve service users in activities of their choice and to give choices to all service users in respect of their daily living”. The manager spoke about how they encourage and support the residents to maintain regular contact with family and friends, evidence in personal files and on the activity sheets provided evidence that regular contact is made. Residents are supported to visit friends and family and make overnight stays. This was confirmed by a resident who said that regular contact was made with her family and a special friend. Despite regular contact with friends and family the manager hopes in the next twelve months to hold family days at the home such as BBQ’s and to celebrate special events. The manager stated this would need to take careful planning as not to upset some resident’s routines and associated behaviours. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 16 Through observation of interactions between residents and staff demonstrated that residents are afforded respect, offered choices and encouraged to participate in everyday activities to maintain and develop new skills. The residents personal plans are written using a person centred approach and remind staff of the importance of respecting the residents’ rights and choices. A member of staff said: “Its important to make sure the residents receive a good quality of life and we do this by adopting a person centred approach”. A resident said: “I can choose what I want to do”. “I have a key to my room and the staff respect my privacy”. This resident and another were aware of what was in their personal plans and spoke of how staff support them once a month to review their goals and care plans. The home provides a healthy and well balanced diet. The residents are asked what they would like to eat and help to plan the weekly menu. Residents are encouraged to plan, purchase goods and prepare the evening meal. At the time of the visit a resident was assisted to prepare the evening meal and made lunch for all residents and staff at home at the time. A staff member could be heard offering support, giving encouragement and giving praise throughout the preparation of the meal. The residents said: “I like to do the cooking and I can choose what I want to eat”. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 17 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 adequate. This judgement has been made using available evidence including a visit to this service. The home does well to support the people who use the service with their personal care in the way that they prefer. The home has good links and net works with health care professionals to assist them to meet the residents’ physical and health care needs. However the home must be mindful to ensure specific health care needs are prominently reflected in the residents personal plans. The home has good systems in place to assist residents to take their medications as prescribed. However the home must be mindful to ensure personal risk assessments reflect individual residents abilities and ensure medication keys are safely held. EVIDENCE: Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 18 The annual quality assurance assessment (AQAA) tool stated under “What we do well” Do well to keep good admin and records of medication, to access various health care services and to provide personal care. This was tested by viewing residents’ personal plans and medication administration records, and by meeting with residents, staff and the manager. Throughout the course of the visit the staff and the manager demonstrated that they implement the homes philosophy of care as reflected in the homes Service User Guide and support and encourage the residents to have control within safe parameters over their daily lives, the care and support being carried out in the way that they prefer. The residents care plans have been developed using a person centred approach and clearly details the residents preferred lifestyle choices. The manager stated that the home has very good links with primary and specialist health professionals, especially specialist health care teams in respect of supporting the home with managing challenging behaviour. Care plans reflect the residents’ specific health care needs and records of outcomes of appointments and actions required by staff were clearly written to provide a clear audit trail of care. However the home must ensure that life threatening conditions such as nut allergies must be clearly displayed in the resident’s care plans. The manager reflected in the AQAA that the home could do better to complete “CHOICE” health care action plans. Two of these were viewed and found to be in their early stage of completion. The manager feels realistically these will be completed in the next couple of months. The AQAA also stated the recording and administration of medication has become more efficient and staff have received training. Good practice was observed in the administration, recording and management of stock, which was carried out in accordance with the Royal Pharmaceutical Guidelines. However the manager must ensure staff safely handle the medication keys as they were left in the medication keys were left in the cupboard for the duration of the visit. The home must also ensure risk assessments correctly reflect the residents currents needs in respect of managing their own medication. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service feel that their views and concerns are listened to and acted upon. The homes adult protection policies and procedures and training of staff protect the people who use the service from potential risk of abuse. EVIDENCE: The annual quality assurance assessment (AQAA) tool stated under “What we do well” To provide an accessible complaint procedure, dealing with complaints, managing aggressive behaviours and incidents, dealing with money and providing POVA training for staff. This was tested by speaking with residents and staff, viewing the complaints procedure; complaints log book and staff training records. The home has developed an accessible complaints procedure, which is prominently displayed on the residents’ notice board. The residents with whom were spoken with said: “If I am unhappy I will speak with my keyworker or Hannah” “Hannah is very nice she always listens to me”. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 20 The home keeps a complaint logbook, which clearly states the concern raised, the action taken and the outcome of the complaint. Staff demonstrated verbally that they are aware of the homes complaints procedure and what they would do if a resident raised a concern with them. The manager stated that all her staff have received protection of vulnerable adults (POVA) training and this was confirmed by records viewed and meeting with staff. The three staff with whom were spoken with knew what their roles and responsibilities are in respect of identifying, responding and reporting incidents of abuse. “If I witnessed abuse I would tell my manager immediately” A resident said: “I am not forced to do anything I don’t want to, the staff are lovely”. The home supports residents with complex needs and behaviours, which at times challenges the understanding of the staff and others. The home is well supported by behaviour support teams who have assisted the home to develop “methods of approach” management plans, provided additional support when required and who regularly review data and management plans with the home. The staff have recieved specialist training in managing challenging behaviour that has been devised to meet the individual residents needs and challenges. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 21 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, 26 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home does well to provide a homely, clean and comfortable environment to live. However the slow response by the company to make repairs places the residents at risk of potential harm. The people who use the service each have a room of their own which promotes their individuality and independence. EVIDENCE: The annual quality assurance assessment (AQAA) tool stated under “What we do well” To provide a clean and conformable environment for all with quality furnishings which are well maintained and do well to provide a tidy and spacious garden. This was tested by touring the home, viewing a residents bedroom with their permission, seeking the views of the residents and speaking with the manager. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 22 A resident assisted the inspector in touring the home and viewing their bedroom. The resident appeared proud of the home, its décor and furnishings all of which are of a good quality and finished to a high standard. The home is spacious, airy and provides amble communal room for the residents including a large enclosed garden. The residents each have a room of their own a couple have en suite facilities. The resident’s bedrooms are roomy and individualised, which reflect their personalities and hobbies and interests. A resident said that she had been involved in choosing the colour for her room and furnishings it. The home was clean throughout, with reminder notices to wash hands, and uses liquid soap and hand towels to assist in the prevention of cross infection. The home has a semi industrial washing machine, which has a sluice action and can wash at high temperatures. However the lack of hand soap, hand towels and ripped lino in the utility room does not fully protect the residents from the risk of cross infection. The manager states in the AQAA that the home could do better to ensure maintenance requests are completed as quickly as possible. The manager has evidence since February 2007 that she has requested the ripped lino in the utility room to be replaced, demonstrating that the service is slow to respond to maintenance requests, however since completing this report the manager has confirmed the lino has been replaced. This will be monitored during the next review of the service. The residents are encouraged to undertake cleaning tasks in the home and on the day of the visit a residents was observed hoovering the lounge and dining room. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 23 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 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service are supported and protected by competent, qualified, supervised, trained and appropriately recruited staff. EVIDENCE: The annual quality assurance assessment (AQAA) tool stated under “What we do well” Is to undertake pre employment checks, hold staff meetings and provide staff with training. This was tested by viewing the homes duty rota, staff recruitment and training records, speaking with staff and observing their interactions with the residents. On the day of the visit the staff on duty and staff arriving on duty were observed to be happy, enthusiastic, polite and aware of their roles and responsibilities for the day. The interactions between staff and the residents was relaxed, encouraging and supportive. The staff spoken with spoke positively about working at Fairview Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 24 where they enjoy working with the client group and working as a team with a good supportive manager. One said: “I like working here its like home from home, we are like one big family”. The home has twelve fulltime staff seven of which have undertaken a national vocational qualification (NVQ) and two who are working towards it. This award provides staff with the skills, competencies and experience to undertake their roles and responsibilities confidently. The service has a human resource department that holds all original recruitment documentation centrally, however the manager must provide evidence that all staff have had the appropriate recruitment checks undertaken on them prior to commencing working in the home, such as criminal record bureau (CRB) and protection of vulnerable adult (POVA) checks. Three staff files were looked at and found to have all relevant information held on them including evidence of an interview-taking place. The staff spoken with confirmed that they had received an interview, completed an application and provided identification in order that checks could be carried out. The manager said she and her deputy are involved in the recruitment process and have considered involving the residents in the interview process. The home currently has a small number of vacancies, which is mainly covered by the homes own staff and agency when necessary. The manager stated that they use the same agency staff where possible and all agency staff are inducted into the home. A member of staff said she had worked in the home regularly as an agency member of staff and liked working in the home so much that when a vacancy came about she applied and got the job. The manager said she is hoping to recruit to vacancies very soon. The staff spoken with said they feel well supported by their manager and receive supervision, however the manager admitted that these were not as regular as she would like them to be and is considering training her senior staff to assist in this process. The manager stated that the deputy manager is responsible for organising staff training and that there is a rolling schedule of training for staff. The programme of training is comprehensive and includes all mandatory training such as moving and handling, fire safety and food hygiene and specialised training such as managing challenging behaviour, epilepsy, medication and protection of vulnerable adults. Staff spoken with at the time of the visit confirmed that they had received regular and updated training. The manager said if there is a specific need or concern in respect of resident such as dealing Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 25 with specific medical conditions and staff require training then assistance will be requested from health care professionals. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 26 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 adequate. This judgement has been made using available evidence including a visit to this service. The home does well to provide the people who use the service with a home that is well run, considers their views and expectations when developing the home and in the main protects their health, welfare and safety. Consideration must be given to the risk presented to residents from hot water outlets and none serviced moving and handling appliances. EVIDENCE: The annual quality assurance assessment (AQAA) tool stated under “What we do well” To have a qualified and experienced manager, to quality assure the service, have polices and procedures in place and provide a safe working environment. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 27 This was tested by speaking with the manager throughout the visit, residents and staff, viewing quality review documents and health and safety policies and procedures. The manager was observed to go about her management duties confidently, providing clear instructions for staff and spending time showing an interest in what the residents were doing or had done with their day. Both staff and residents spoke highly of the manager: A resident said: “I like Hannah, she is very nice and helps me to do things” A staff member said: “Hannah is a good manager she is very understanding and is good to the residents and staff”. The manager appeared very busy and explained that she has limited hours each week to undertake all of her administrative duties such as completing person centred plans with residents, undertaking supervisions with staff on top of ensuring all time sheets are signed and shifts are covered and would benefit from more admin hours. The manager is advised to speak with her line manager. The home provided several examples of how they regularly review the quality of the service and seek the views of the residents. A review took place in February 2007, which included comments from residents, relatives, staff and care managers of which described positive outcomes for the people living at Fairview. The home is visited monthly unannounced by a senior manager of the service to undertake a quality audit review of the service (Regulation 26). Information in reports are detailed and demonstrate a thorough review takes place. The residents and staff confirmed that the manager held regular meetings where information is exchanged and ideas and views are sought. This was demonstrated by the purchase of a pool for the garden, which a resident had requested in a residents meeting. The manager admits further work is required to make the residents meetings accessible for all residents. In addition to monthly house meetings the residents meet with their keyworkers monthly to review their personal plans and set goals for the following months. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 28 On the whole the service provides a safe environment for the residents to live, where fire records, servicing and fire training for staff is up together. Residents receive training also and one resident was able to clearly detail what she would do if there were a fire in the home. The majority of serviceable equipment such as electric and gas appliances have evidence of being regularly serviced. However there was no evidence of a service contract or other engineer arrangements for the bath hoist since 2003. The manager is advised to establish when the hoist should be serviced by and make arrangements for it to be serviced. When touring the home all areas were found to be clean and tidy, however the home must ensure that residents are safe from the risk of scolding from hot water outlets. The upstairs bathroom used independently by some residents hot water tap from the bath exceeded the recommended temperature of 43 centigrade. The manager was informed she must consider how she will ensure the residents are made safe until such time the temperature of the water can be reduced. Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 29 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 3 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 3 X X 2 X Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 30 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 YA19 Regulation 13(4)(b)(c) Requirement Where a person who is identified as having a nut allergy there must be a risk assessment and an alert on their records to reduce the risk. The home must adopt safe systems for the handling of keys to the medication cupboard to safeguard the people who use the service from potential risk of harm. To ensure the people who use the service are safeguarded from the potential risk of cross infection the utility floor must be repaired or replaced; liquid soap and disposable hand towels must be available at all times to improve infection control. Timescale for action 06/08/07 2 YA20 13(2) 06/08/07 3 YA30 13(3) 31/08/07 4 YA42 13(4)(a)(b)(c) To safeguard the people who use the service from the potential risk of scolding the manager must ensure hot water outlets from baths do not exceed the recommended DS0000065821.V341320.R01.S.doc 06/08/07 Fairview Version 5.2 Page 31 temperature. 5 YA42 13(4)(a)(c) 23(2)(c) To safeguard the people who use the service from potential risk of harm the manager must seek advice from the manufacturers of the bathroom hoist to establish when and how often it must be serviced. 06/08/07 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.V341320.R01.S.doc Version 5.2 Page 32 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. Extracts may not be used or reproduced without the express permission of CSCI Fairview DS0000065821.V341320.R01.S.doc Version 5.2 Page 33 - 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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