Inspection on 24/05/05 for Fairview House

This inspection was carried out on 24th May 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fairview House 28/08/08

Fairview House 04/03/08

Fairview House 19/09/07

Fairview House 30/04/07

Fairview House 08/06/06

Fairview House 10/10/05

Fairview House 16/12/04

Fairview House 30/07/04

Fairview House 14/01/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Fairview House 14 Fairview Drive Westcliff on Sea Essex SS0 0NY Lead Inspector Christine Bennett Unannounced 24th May 2005 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Fairview House Address 14 Fairview Drive Westcliff on Sea Essex SS0 0NY 01702 437555 01702 432835 info@strathmorecare.com Strathmore Care Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Kornelia Boorman Care home 55 Category(ies) of DE(E) Dementia - over 65 registration, with number OP Old age of places Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of service users for whom personal care can be provided shall not exceed 55. 2. Personal care is to be provided to service users who are over the age of 65. 3. Personal care to be provided to no more than 55 service users with dementia over the age of 65. Date of last inspection 16th December 2004 Brief Description of the Service: Fairview House is a large purpose built home situated in a residential area of Westcliff on Sea. Accommodation is provided on three floors for 55 residents in 49 single bedrooms and 3 shared bedrooms, 28 of which have en suite facilities. A passenger lift provides access to all three floors. Communal facilities are situated throughout the home with the main dining and lounge area being located on the ground floor. Fairview House is within easy reach of local shops and a bus route. There is ample parking space and gardens to the front and rear of the property. The home is registered for older people and older people who have dementia. Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection by two inspectors, Christine Bennett and Kathryn Moss. It took place on 24/5/05 over a period of 9 hours, which equates to 18 hours input. The inspection process included discussions with the manager, 6 care staff, 1 domestic staff, 1 district nurse, 6 residents and 3 visitors. A tour of the premises was conducted and samples of records were inspected. The CSCI has recently received a complaint, which the proprietor is currently investigating. The inspectors would like to thank the manager, staff, residents and visitors to the home for their cooperation throughout the day. What the service does well: What has improved since the last inspection? The manager has made changes to how residents’ care is reviewed and this has improved the information on record. She now plans to include residents and relatives in these reviews whenever possible, and she is planning to have relatives’ meetings to get their views on the home. The activities programme is being developed to try to get residents out more and offer them more things to occupy their time. Staff are becoming more involved in all round care of residents, such as activities and GP visits. They have the opportunity for discussion at each shift change and as a result, have a good understanding of each resident’s care needs. Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 5 The omission of a pre admission assessment does not ensure a resident’s care needs will be met. EVIDENCE: A pre admission assessment is done by the Placement Coordinator or occasionally the manager, to ensure that a resident’s needs will be met in the home. A pre admission assessment form is completed, showing the outcome of this assessment. However this was omitted in two of the three care plans seen, one of whom had been admitted this year. There was evidence in the care plans of detailed reviews, which the manager said she had implemented. Visitors confirmed that they were able to view the home prior to the resident moving in and regular reviews involving them are held to ensure the continued suitability of the home. Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Shortfalls in the completion of care plans and medication records could mean that the care needs of residents are not fully met. EVIDENCE: A random sample of care plans was seen for three residents. There were shortfalls in the recording of information in these care plans. One care plan had recorded that a resident was epileptic, incontinent and at risk of pressure sores but there were no further details with regard to care required and no risk assessment in place relating to these issues. Nutrition records were being maintained and weights recorded. However one person who had fragile skin and was at risk of pressure sores appeared to have only been weighed yearly and did not have amounts recorded of what they had eaten. There was good evidence of regular monthly reviews, with appropriate comments being recorded, although no evidence that the residents or relatives had been involved in these reviews. The completion of care plans was discussed with the manager who recognised the shortfalls and agreed that further training of staff was necessary surrounding the completion of care plans. A carer confirmed that plans have been made to include residents and relatives in the review process. Residents appeared well cared for and all those spoken to Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 10 were positive about the care and support they received from the staff. Staff had a good awareness of individual residents and their needs, likes and dislikes. Evidence was seen in care plans of appointments with outside professionals and the district nurse confirmed that she visits the home twice a day to perform nursing duties. She has been visiting the home for many years and said that the care in the home has improved since the manager came into post, and there is much better communication. A resident spoke of a problem with her ears and that an appointment had been arranged at the local hospital. Residents were very complimentary with regards to the way they are treated by staff, and visitors confirmed that they have always found the staff respectful. One visitor commented “all the staff are very good” and another said “ the staff seem to be very patient”. One resident said that she was able to choose whether or not to join in activities provided by the home and she had a phone in her room enabling her privacy when phoning her family each night. Another resident has a key to enable him to lock his room if he chooses. The manager has involved the home in a years pilot scheme initiated by the local PCT in relation to falls prevention. Sensors are placed under the mattress of people who are at risk of falling and staff hold a pager which alarms if the resident gets up. Part of the falls prevention is that the home is also due to be provided with some hip protectors. This is good practice. Medication received by the home and medication administered was generally well recorded, but there were a few omissions to MAR sheets, occasions when medication had not been fully signed in on receipt, and some occasions where changes to medication instructions had not been signed and dated by the person making the entry. Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 Social activities are being developed to ensure all residents lead a fulfilling life in the home. The quantity and quality of the food provided, meets the individual needs of the residents. EVIDENCE: A variety of activities are provided on a daily basis within the home. These activities are organised by individual carers and include exercise, sing a longs, foot massage and bingo. The manager explained that she likes the carers to be involved in activities, as they know the individual likes and dislikes of the residents and it varies their day. Residents also spoke of outings outside the home and one resident spoke of a recent outing to the seafront, however other residents felt that life in the home can sometimes be boring. The manager recognised that this is an area that still needs to be developed and spoke of her plans to organise more outings and activities aimed at people with dementia such as card making and painting. Future plans include a barbeque, storytelling, a clothes party and a Halloween party. Visitors to the home were very complimentary and said they are made to feel welcome. One of the visitors commented that the staff are “always cheerful” and that they always make her welcome. Residents, visitors and the district nurse spoke positively about the food provided. Lunch was served in the dining room and looked appetising. Special diets are provided and staff were seen to assist residents sensitively with their Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 12 meals. One staff member described how she made a drink and a snack for an individual resident before bedtime to help her settle. This shows good attention to individual needs. Nutritional records are kept and the manager will develop them further to detail amounts eaten by individuals. Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Appropriate arrangements are in place to protect residents from abuse. The complaints procedure is satisfactory. EVIDENCE: Residents spoken to were all clear and confident that they could speak to the manager at any time with any concerns that they had. However, all residents spoken to said that they had no complaints about the home. Visitors to the home also said that if they were unhappy with anything they could speak to the manager. The home has had two complaints since the last inspection. One is currently being investigated by an independent care consultant appointed by the home. A senior carer spoken to confirmed that she had attended an external workshop in the protection of vulnerable adults. All staff spoken with had a good understanding of abuse, and how to report it. Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,21,26 The home provides a clean environment. Replacing worn or damaged furniture and improvements to bathrooms would enhance the quality of the residents’ lives. Some areas of health and safety could leave the residents at risk. EVIDENCE: The home has a housekeeper allocated to each floor of the home on a daily basis and the home is cleaned to a high standard. There were no unpleasant odours. A visitor said, “ it is nice and clean and never smells”. A housekeeper showed great care and interest in the residents and said that she enjoyed working in the home as it gave her great satisfaction. The home has a good range of communal areas and bedrooms viewed were in a satisfactory state of decoration. Some items of furniture were worn or damaged. These included some armchairs in the lounges and some chests of drawers in the bedrooms. The home has a range of bathrooms, containing a variety of assisted bathing facilities, and bathing equipment has been serviced within the last year. Some bathrooms contained shower units that staff reported were no longer used. A ground floor bathroom with a toilet did not Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 15 contain a wash hand basin. This bathroom and residents’ bedrooms did not contain liquid soap or paper towels. A carer reported that if they gave personal care in the bedroom, they would remove their gloves, and go down the corridor to the nearest facilities to wash their hands. Bars of soap were seen in various toilets and in two separate toilet/bath areas on the ground floor were un-named jars of Sudocrem and also another ointment prescribed for an individual, both without lids. Sluice rooms were separate from residents’ facilities and those viewed contained hand washing facilities. The laundry and kitchen in the home were clean, tidy and well organised. The home was visited by the local fire authority in May 2005 who have made requirements for the home to carry out a risk assessment to identify additional matters which may need addressing. The manager confirmed that this is being actioned. Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 Staffing levels and hours worked must be monitored to ensure the wellbeing of staff and safety of residents. Staff training is provided in a planned way to give them the skills to care for the residents. EVIDENCE: The home was not currently fully staffed but staff reported that agency staff are rarely used as permanent staff volunteer for extra shifts. Staff rotas showed that some staff work long days, sometimes three or four times a week, with only one day off per week. This was discussed with the manager, who was advised to closely monitor the welfare of staff working such long hours, and to ensure this did not impact on the care of the residents. Staff confirmed that it was their choice to work long days and that there was no pressure to do extra hours. The home was generally maintaining the agreed staffing levels although there were occasional shifts that were short staffed. It was also noted that the manager is not supernumerary, although she is not fully part of the shift due to her management tasks. She feels it is beneficial to regularly be involved in working alongside staff caring for residents, and also felt that the current staffing levels meet the residents’ needs. One resident said that the staff haven’t got time to chat. An additional factor is that as many staff are doing long shifts, there are times in the day when there are less staff on the floor while 45 minute lunch breaks were being taken. These are staggered to minimise the impact on residents but it still means there are quite long periods when the staffing levels are lower Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 17 than agreed. Night staff commence at 8.15pm reducing staffing levels further, but the manager felt that this met current residents’ needs and residents confirmed that they can choose when they go to bed. However many residents are frail and choose to go to bed early. The manager confirmed that staff training has always been supported by the company. One carer described a structured induction programme and other staff spoke of various courses they had attended and that they are paid for the time taken. Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33 The manager provides leadership, guidance and direction to staff to ensure residents receive consistent quality care. EVIDENCE: The manager has been in post since October 2004, having worked in the home for many years. She is currently completing her NVQ level 4, and stated that she feels very committed to the home. She felt that she had made big changes in the way the home functioned, by developing staff roles and responsibilities, and making better use of staff handover time as a forum for staff to raise issues. The falls prevention pilot project showed that the manager was innovative, and open to opportunities presented by the community to improve care to residents. Staff spoken with felt that the manager was supportive and approachable, firm but fair. They said that she is frequently around the home and observes their work, correcting them in an appropriate way if necessary. Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 19 ] A resident reported that the home has residents’ meetings every three months, when they are invited to voice their opinions and raise any concerns. Residents and visitors spoken with confirmed that they felt able to speak to the manager at any time. Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x 2 x x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x x x x Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 21 Yes 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. 2. 3. Standard 3 7 9 Regulation 14(b) 15 13(2) Requirement The registered person shall carry out a pre admission assessment and record it appropriately The registered person shall prepare a written plan as to how a residents needs are to be met The registered person shall ensure that medication received and administered in the home is fully recorded, and that any changes to medication details or instructions are signed and dated. The registered person complies with the requirements of the local fire service. The registered person shall ensure that creams are labelled and only used for specific individuals and not left in communal areas. The registered person shall provide a wash basin in the downstairs bathroom with liquid soap and paper towels The registered person shall monitor staffing levels on an ongoing basis.This refers to hours worked, numbers on the floor during breaks and length of the working day. Timescale for action 1/8/05 1/8/05 1/8/05 4. 19 4(a)13(4) 1/8/05 5. 21 23(2)(j) 1/10/05 6. 27 18(1)(a) 1/10/05 Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard 8 12 20 21 26 Good Practice Recommendations To develop nutritional screening to include quantities eaten and weigh residents more frequently To continue to develop activities, especially for residents with dementia to ensure all residents have regular time spent with them To replace worn and damaged furniture To consider re activating shower units that are no longer in use To replace bars of soap with liquid soap in all communal areas and consider putting liquid soap and paper towels in individual bedrooms Fairview House I56 I06 S15435 Fairview House V227641 240505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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. 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