Inspection on 01/02/06 for Fairview House

This inspection was carried out on 1st 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 House 30/01/09

Fairview House 09/01/08

Fairview House 18/08/06

Fairview House 06/09/05

Fairview House 26/05/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Fairview House Nursing Home Gypsy Lane Warminster Wiltshire BA12 9AR Lead Inspector Alyson Fairweather Unannounced Inspection 1:00 1 February 2006 st Fairview House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 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 House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fairview House Nursing Home Address Gypsy Lane Warminster Wiltshire BA12 9AR 01985 847680 01985 847680 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) www.rethink.org Rethink Mr Brent Peplow Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10) of places Fairview House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: Fairview House is registered to provide nursing care for ten adults with mental health problems. It is located in a residential area in the town of Warminster, Wiltshire, and has a local shop within walking distance. The home is domestic in character and offers comfortable single room accommodation. All communal rooms are light and airy, and furnishings are of good quality. A separate room is provided for people who wish to smoke. There is a large, secluded garden at the back of the house, with far reaching views over the local countryside and several seating areas as well as a paved patio. There are car parking spaces at the front of the house. Fairview House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon in early February 2006. Several residents were spoken to, as well as the manager and two care staff. Written comments about the home have been received from ten residents and five family members. The inspector walked round the premises and examined several records, including risk assessments, health and safety, the complaints procedure and staff training. What the service does well: What has improved since the last inspection? What they could do better: There had been recorded incidents involving a break-in to the shed in the garden, and another where the boiler had broken down and needed to be replaced. Staff were unaware of the need for them to inform the CSCI about these incidents, and the manager has been asked to ensure that this is done in future. Fairview House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 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 House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 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 House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 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 Prospective service users have their needs, hopes and goals assessed and recorded before they move in to the home so that staff know how best to support them. EVIDENCE: One new resident had moved in to the home, and had been referred to Fairview House by staff of the Community Mental Health Team (CMHT). This referral included a detailed application form, risk assessments and details of the current multidisciplinary care plan. The home’s manager conducts a referral interview with all potential residents, at which stage they are able to say what they feel their needs and goals are, and to assess whether the home might be able to help with these. A psychiatric and social functioning assessment is made and the potential residents work with staff on how they might achieve their goals in life. Fairview House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 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): 7 and 9 Residents are assisted where necessary to make decisions about their own lives, and are supported to risks as part of an independent lifestyle. EVIDENCE: Residents are supported to make decisions about their own lives with guidance from the staff. They are encouraged to manage their own finances wherever possible, although some have family involvement or other support. Where restrictions are in place, for example to limit self harm or harm to others, this is clearly recorded and guidelines are drawn up for staff to follow. Risk assessments were on file for all service users, and these are reviewed regularly. They included things like smoking, bathing and mobility. Risk assessments completed at CPA meetings are also on file. Staff place great emphasis on encouraging residents to be as independent as possible, while trying to minimise any risk to their safety. Fairview House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 10 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 Residents’ rights are respected and responsibilities recognised in their daily lives. Residents are offered a healthy diet and enjoy their meals and mealtimes. EVIDENCE: Residents can choose when to be alone or in company, and when not to join an activity. They have unrestricted access to the home and grounds, and can come and go as they please. Several residents had gone out to day services on the day of the inspection, but some were at home. Staff enter residents’ bedrooms only with the individual’s permission, and were seen to knock on the bedroom door and wait for response. Residents’ responsibility for housekeeping tasks, such as doing their laundry or tidying their room is specified in their care plan. Residents who are out all day open their own mail when they come home. The way that meals are prepared has changed. The home used to have a cook who prepared residents’ meals, but now residents are encouraged to be more independent and to cook their own meals and prepare their own snacks. Fairview House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 11 Residents’ care plans outlined the support each person needed with this task. Healthy options are encouraged, and fresh vegetables, juices and yoghurts were available. One resident spoke of her enjoyment of quorn mince, vegetables and potato. She also enjoys cake making, and often makes them for the other residents. Several residents were looking forward to a takeaway meal that night. There is a large, domestic style kitchen, with a dining room which is light and airy and comfortably furnished, so people can enjoy mealtimes. Fairview House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 12 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): 20 Residents are encouraged to self administer medication wherever possible, and there are policies and procedures in place in relation to medication support. EVIDENCE: All residents have their medication supplied in blister packs, with other medication being stored in dossette boxes. New staff have medication induction training, and shadow an experienced member of staff until they are deemed competent. It is planned that all staff will have training in Administration of Medication from a local college. Staff are also given information about the side effects of various medication which residents might experience. Fairview House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 13 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): 22 Residents’ views are listened to, and any concerns are acted on. EVIDENCE: There is a complaints procedure in the home which outlines the steps to take if any one has a complaint. This gives details of how residents and families can contact the Commission for Social Care Inspection (CSCI) if they prefer to complain to an outside person. The current accommodation review of mental health services has led to some residents feeling unsettled, and regular residents’ meetings have been held in order to keep people informed of any changes. One family member had expressed some concerns about impending changes, and the manager had written to her explaining what was happening. No formal complaints have been received by CSCI about Fairview House. Fairview House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 14 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): 24 and 30 The care which residents and staff take to maintain the home means that residents live in a homely, comfortable safe environment, which is clean and hygienic. EVIDENCE: Fairview House is a large, comfortably furnished home with bright, airy rooms. Residents’ bedrooms were homely and each contained individual personal items, such as stereos and TVs. A separate room is provided for people who wish to smoke. There is a large, secluded garden at the back of the house, with far reaching views over the local countryside and several seating areas as well as a paved patio. Since the last inspection, several areas have been decorated, with new flooring in the smoking room, the kitchen and downstairs toilet painted, new flooring in one resident’s bedroom, a new boiler and plans to redecorate the dining room. The home was clean and hygienic, with policies and procedures in place for the maintenance of the building. In discussion with the manager, it was noted that the previous boiler had been broken for some time, and that there had been a break-in to the shed in the Fairview House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 15 garden. These incidents had not been reported to the CSCI. The manager was reminded of the need to do so, and advised to talk to staff about what would be appropriate information to send. Guidance on this matter has been given to the home. Fairview House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 16 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 and 34 Residents are supported by competent and qualified staff, and by the home’s recruitment policy and practices. EVIDENCE: The staffing structure is changing at Fairview House, although the current registration status means that nursing staff must still be used. Several mental health workers have been recruited, and will go on to do NVQ Level 3. One current staff member is also doing NVQ Level 3 Staff recruitment is assisted by Rethink’s human resources department. All potential staff members meet with residents informally and it is hoped that some will become more involved in the formal interview. Staff are interviewed using a standardised set of questions and a scoring system. All staff have Criminal Records Bureau (CRB) checks and are checked against the Protection of Vulnerable Adults (POVA) register. Two written references are also required. There is a six month probationary period, and the manager meets with staff half way through this period to review progress. All the staff files looked at contained the appropriate documentation. Fairview House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 17 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 42 Residents benefit from a well run home, and their health safety and welfare is promoted and protected. EVIDENCE: The manager/provider has been registered with CSCI for some years, and is a qualified RMN. He has a great deal of experience of working with people with mental ill health, and has almost completed his Registered Managers Award. He has also completed training in Leadership and Team Building. All staff have had food hygiene training and food temperatures are recorded on a daily basis. The fire bell is tested weekly and the emergency lights and fire fighting equipment are tested monthly. Food and water temperatures are recorded regularly and an annual Legionella test is done. Portable electrical appliances are tested annually, and the gas cooker serviced annually. The home has two designated fire wardens, and fire drills are conducted on a quarterly basis. Fairview House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fairview House Nursing Home Score X X 3 x Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 X DS0000028080.V266811.R01.S.doc Version 5.0 Page 19 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 YA24 Regulation 37 (e) (f) Requirement Any event of burglary on the property must be reported to CSCI. Timescale for action 01/02/06 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 House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 House Nursing Home DS0000028080.V266811.R01.S.doc Version 5.0 Page 21 - 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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