Inspection on 09/02/06 for Fairview

This inspection was carried out on 9th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fairview 29/05/08

Fairview 04/07/07

Fairview 16/01/07

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 Ms Wendy Thomas Unannounced Inspection 10th February 2006 13:10 Fairview DS0000065821.V282583.R01.S.doc Version 5.1 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.V282583.R01.S.doc Version 5.1 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.V282583.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Fairview Address Pinks Lane Baughurst Tadley Hampshire RG26 5NG 0151 420 3637 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.V282583.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1:9:05 Brief Description of the Service: The ownership of Fairview transferred from Southern Archway Trust to C.H.O.I.C.E. Ltd. shortly after the last inspection, in September 2005. The home continues much as before with the same manager, staff team and service users. The care home provides personal care and accommodation for 6 Young Adults aged 18–65 who have a learning disability. The home is situated in the village of Baughurst, within walking distance or short drive to the amenities within the village of Tadley, and within 30/40-minute car journey to the towns of Basingstoke, Newbury and Reading. Fairview is a two storey four-bedroomed 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 has an en-suite facility. The ground floor has a separate toilet with washbasin, large lounge, kitchen/dinning room, laundry, sleep-in room and a conservatory that is used as an office. 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. Fairview DS0000065821.V282583.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 13:10 and 17:00 on Thursday 9 February 2006. The inspector spent time with a group of three service users from the main house and chatted with one of the service users in the annex. The latter allowed the inspector to look around the bungalow and showed her their bedroom with en suite. The inspector also had discussions with the manager and deputy manager and separately with a member of the care staff. Service users’ files and pertinent policies, procedure and recording were also studied. What the service does well: What has improved since the last inspection? What they could do better: Risk assessment processes should be improved. Some areas of risk were not being assessed and having management strategies developed. Where a restrictive practice was in place there was no documentation assessing the appropriateness of this action or evidence of involvement of other professionals in developing the strategy. Fairview DS0000065821.V282583.R01.S.doc Version 5.1 Page 6 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 DS0000065821.V282583.R01.S.doc Version 5.1 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.V282583.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. The admissions procedure ensures that any new service users are compatible with the other service users. A planned introduction into the home with lots of visits promotes a smooth transition for all concerned. EVIDENCE: The deputy manager reported that not all Community Homes of Intensive Care and Education Ltd. (C.H.O.I.C.E. Ltd.) policies and procedures have been supplied to the home, although they are expected shortly. There have been no new admissions since C.H.O.I.C.E. Ltd. have taken over ownership of the home. An admission procedure from Southern Archway Trust Ltd. was seen. Although short, this had all the necessary information. The deputy manager described the admission process for the last service user to be admitted to the home. This had taken into consideration the specific needs of the new and existing service users and had been undertaken with great care. A number of visits had been made to the home prior to a decision being made. There followed further visits and introductory stays prior to the final move. Fairview DS0000065821.V282583.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Service users’ needs are being appropriately met due to detailed pen pictures recording what staff need to know in order to support them effectively. These are regularly reviewed and updated. Consultation with service users on an individual and group basis ensures that they are involved in the decision-making processes in the home. In order to ensure that service users have the least restriction imposed upon them as possible they would benefit from the risk assessing processes being improved. EVIDENCE: Detailed pen-pictures of service users provide information about each person with an assessment of their needs and descriptions of how to meet those needs (care plan). The one sampled in detail gave a good level of detail, highlighting particular issues staff needed to be aware of and strategies for working with the person. A member of staff said that pen pictures were reviewed every three months. Fairview DS0000065821.V282583.R01.S.doc Version 5.1 Page 10 Every month, or three months, depending on the needs of the service user, the home produces a report on the progress of each service user. This details such issues as health, incidents, charts, emotional and social, family connections, activities and an action plan. In this way service users are regularly assessed and any necessary changes to their care are implemented. These reports are circulated to other professionals and funding authorities involved with the service user. Staff spoke of service users in a valuing way and explained that service users were consulted in all aspects of the running of the home. There was specific time scheduled once a week between service users and their key worker to discuss any concerns or issues. The manager explained that they aimed to have service user meetings once a week but that service users were not keen to have formal meetings this often, suggesting that they felt sufficiently well involved in decision making on a daily basis. The menus are decided daily, service users buy their own clothes and toiletries with staff support, and service users determine how they spend their time. Four have a regular weekly timetable. Two others decide from day to day what, if any, activities they wish to participate in. One of the service users said that when they needed toiletries the staff would take them out to buy them. The previous inspection report commented that risk assessments would benefit from more detail. On this occasion it was also found that not all risk issues were being formally assessed. For example, access to food in the annex was restricted with little food being kept there and some being locked away. A member of staff explained why this was the case. However there were no risk assessments to demonstrate why such restrictive practices were necessary and who had been involved in determining that this level of action was needed, such as care managers, members of the specialist health care team etc. Three service user’s risk assessments were examined and included risks regarding their finances, what to do in event of a fire, the use of hot water bottles and where appropriate, in relation to absconding, travelling in the house vehicle and in relation to fires. These were being reviewed six-monthly. Fairview DS0000065821.V282583.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17. Service users benefit from being encouraged to take responsibility for themselves. Their views are sought and their rights respected. Service users receive balanced and nutritious meals that they like. EVIDENCE: The manager and deputy manager explained that service users are encouraged to take responsibility in the day-to-day operation of the home. Time was spent with three service users in the kitchen as they participated in the preparation of the evening meal, stirring food as it cooked, laying the table and making drinks. They said that they enjoyed this involvement and appeared happy in their chores. One service user, when asked what was the best thing about living in the home, said, “I like helping with dinner.” One explained that if they did not want what the others were having to eat, they would cook their own variation. One service user described how they liked salt but that it had been explained to them that it was bad for their heart, and now they tried to eat less. Fairview DS0000065821.V282583.R01.S.doc Version 5.1 Page 12 The deputy manager explained that taking personal responsibility was encouraged and rewarded, and that in this way service users were learning to take more responsibility for themselves. It was reported that service users could suggest items they want for the weekly shop. A variety of ingredients are then bought and service users decide day by day what they want to eat. The main meal is cooked for all six in the kitchen of the house and carried next door via the garden for the two service users living in the annex. Variations can be provided for those who do not want the meal agreed by the majority. The food records were seen and demonstrated a range of balanced and nutritious meals. It was reported that a mixture of homemade and pre-prepared meals are included. The service users said that they liked the food. Those service users who attend day services or activities during the day take a packed lunch. One service user who attends college buys their lunch there. Fairview DS0000065821.V282583.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 20. The details in the service user plans ensure that service users receive personal care in ways they are happy with. Service users’ medication is administered to them in a satisfactory manner, however recording and storage could be further improved. EVIDENCE: Files for three service users were examined. They gave clear and specific guidelines for personal care support. The group of service users spoken with were happy with the way they received their personal care support. Where necessary the home receives good support from the specialist healthcare team. In the kitchen of the annex there was on display a list of things one of the service users likes, things they did not like and ways to support their emotional needs. This was useful and easily available information that staff needed to support the person successfully. Each service user’s file has recording sheets that are completed every shift with details of how they have been and what they have done during that time. The medication records were examined following a recommendation in the previous inspection report that recording should be improved. The deputy Fairview DS0000065821.V282583.R01.S.doc Version 5.1 Page 14 manager was able to explain any apparent anomalies. It is suggested that for clarity these explanations are included in the medication recording. The previous inspection report had suggested that the Royal Pharmaceutical Society of Great Britain’s guidelines for administering medication in care homes should be followed in relation to the separate storage of internal and external medications. This was not happening. However the monthly provider’s reports (Reg 26) sent to the Commission for Social Care Inspection and discussion with the manager at the time of this inspection indicate that there are ongoing discussions about replacing the current medication cabinets and improving the storage of service users’ medication. Fairview DS0000065821.V282583.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23. Staff training, awareness, policies and procedures ensure that measures are being taken to ensure that service users are protected from abuse, and any instances dealt with appropriately. EVIDENCE: The Southern Archway Trust Ltd. one page policy on protection from abuse and whistle blowing was seen. The C.H.O.I.C.E. Ltd. policy/procedure was not yet available, although expected shortly. However, there was sufficient guidance available for staff to respond appropriately, and a copy of the Hampshire (and Hillingdon) guidelines for the Protection of Vulnerable Adults was held in the home. The deputy manager explained that staff keep vigilant for indicators of abuse and that service users have opportunities in regular consultations with their key workers to raise any concerns. A member of staff said that they had been on vulnerable adults training in the last year and described it as being a “good eye-opener.” The manager reported that all staff had had this training since the last inspection. Fairview DS0000065821.V282583.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Fairview DS0000065821.V282583.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32. The provision of a well-trained staff group ensures that competent staff support service users. EVIDENCE: The manager reported that four of the care staff are qualified to at least NVQ level two in care. She herself is undertaking level four and will then go on to do the Registered Managers Award. Five of the staff team do not hold NVQ level two but it was explained that they were all enrolled to start this shortly. It was reported that since the last inspection all staff had had scip training and training in relation to the protection of vulnerable adults, four staff have had medication and equality and diversity training, and three, Makaton, food hygiene and first aid. Those staff with refresher training due before May 2006 have been booked on this. Now that the home has been taken over by C.H.O.I.C.E. Ltd there is a training department responsible for commissioning and providing training. A member of staff thought that this was good as it meant that there were lots of courses available. The manager and deputy manager explained that previously they had been able to commission training specific to the needs of the home in a timely manner. They hoped that this would still be the case as well as gaining from being part of a larger organisation. Fairview DS0000065821.V282583.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39. Service users benefit from a well run home and a competent manager. The quality assurance process ensures that service users’ views are taken into account when plans are made for the home. EVIDENCE: The home is undergoing a period of transition following the transfer of ownership from a small three service group to a much larger group of residential services for people with learning difficulties. The transition is going smoothly with little impact on the quality or delivery of the service, which continues to be of a high standard. For care staff and service users the impact has been negligible. For the manager some processes and systems are changing. Having training and human resources departments also has an impact. Fairview DS0000065821.V282583.R01.S.doc Version 5.1 Page 19 Hannah Sheather has been the registered manager since October 2002 and is currently working towards her NVQ level 4 in care and the Registered Managers Award. The quality assurance process involves service users completing questionnaires. Service users at Fairview do not have advocates so staff support them to complete their questionnaires. The shortcomings of this were discussed. Questionnaires are also sent to other people involved with the service users such as their families, care managers and any specialist healthcare professionals. Staff also receive a questionnaire. The results of all the questionnaires are collated and circulated to the home where the manager is then expected to develop a business plan. Fairview DS0000065821.V282583.R01.S.doc Version 5.1 Page 20 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 X 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X 3 X 3 X X X X Fairview DS0000065821.V282583.R01.S.doc Version 5.1 Page 21 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. 1 Standard YA9 Regulation Requirement Timescale for action 04/05/06 13(4)17 Areas of potential risk should (1a)Sc3(3q) be thoroughly documented along with strategies to manage that risk. 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.V282583.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 DS0000065821.V282583.R01.S.doc Version 5.1 Page 23 - 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. 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