Inspection on 06/09/05 for Fairview House

This inspection was carried out on 6th September 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Fairview House 30/01/09

Fairview House 09/01/08

Fairview House 18/08/06

Fairview House 01/02/06

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 6 September 2005 th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 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 Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Rethink Mr Brent Peplow Care Home with Nursing 10 Category(ies) of MD Mental Disorder (10) registration, with number of places Fairview House Nursing Home D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 2nd February 2005 Brief Description of the Service: Fairview House is registered to provide nursing care for ten adults with mental health problems, although it is planned that the service will in future be a care home with no nursing. 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 D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon in September. There were nine permanent residents living in the house, and one respite resident had been staying for a few days. Several residents were spoken to, as well as the manager and care staff on duty. Records examined included care plans, assessments and staff training records. What the service does well: What has improved since the last inspection? What they could do better: The recording of violent or aggressive incidents in the home is good, although staff were unaware of the need for them to inform the CSCI about these. The manager has been asked to ensure that this is done. Fairview House Nursing Home D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 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 D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Fairview House Nursing Home D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 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 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: All residents are referred to Fairview House by staff of other mental health services, for example the Community Mental Health Team (CMHT). This referral includes a detailed application form, risk assessments where present and details of the current multidisciplinary care plan. The home’s manager then conducts a referral interview, at which stage residents 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 D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 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 standard(s) 6 and 8 Care plans reflect the needs and personal goals of residents, which means that staff are able to support them in the way they wish. Residents are consulted on and participate in all aspects of the home’s life. EVIDENCE: Each resident has a care plan which is reviewed on a regular basis by the resident and their key-worker. Care plans focus on individual’s strengths as well as any need or problem, and contain sections on communication abilities, domestic abilities, mental health, physical health and sleep patterns, among others. Residents have the opportunity to record their comments on the reviewed care plan. A daily dairy is also kept for each resident, and this records what they have done during the day. Each resident also has a care plan meeting (CPA) on a regular basis with the local Community Mental Health Team (CMHT). The care plan formats are to be reviewed with residents and the new Recovery plan will take its place. These will be examined in more detail at the next inspection. Regular resident meetings are held, and these give people the opportunity to discuss how the home is run. Fairview House has recently submitted an application to the Commission for Social Care Inspection (CSCI) for a variation Fairview House Nursing Home D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 Page 10 in their registration from being a care home with nursing to becoming a residential care home without nursing. Residents will then be supported by trained social care staff, instead of nurses. Residents views have been sought, and meetings with staff and various external professionals have been set up so that they can voice their opinions. Some residents have expressed anxiety at the changes, and the manager and staff have made sure that any questions have been answered as fully as possible. Fairview House Nursing Home D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 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 standard(s) 12, 13 and 15 Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. Residents can have as much or as little contact with family and friends as they wish, and are supported to do so by staff. EVIDENCE: Residents attend a range of activities, including day centres, sheltered workshops, activity centres and college courses. One resident who used to be a cook spoke of her enjoyment of baking cakes for the others, and a delicious selection was on offer that afternoon. Another resident had just returned from attending a day centre, and spoke about the activities she enjoyed, including a catering course and helping others at a day centre. Several residents felt that they were unable to take part in outside activities, but took pride in helping staff around the house. Residents are also encouraged to prepare meals and snacks for themselves independently. Friendships both inside and outside the home are encouraged, and staff support links between residents and their family and friends, although the Fairview House Nursing Home D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 Page 12 frequency of contact varies depending on the individual circumstances. Residents are free to visit friends outside the house at any time, and can entertain and choose to see who they like either in the privacy of their own bedrooms or in the communal areas available. The fiancé of one resident who was in hospital kept in touch with the home and continued to visit other residents. Fairview House Nursing Home D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 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 standard(s) 18 and 19 and 20 Healthcare needs of residents are written in care plans so that they can receive support in the way they need and prefer. EVIDENCE: All residents are registered with a GP whilst living in the home, and all other medical professionals are seen as and when required. This varies according to the needs of individuals. The home has good links with local mental health teams, and can call for support if any crisis periods arise. All residents attend mental health reviews on a regular basis, and care plans can be amended at this time. Although Fairview House caters for people with mental health needs, one resident has had major physical problems which has necessitated having personal care support from staff, who have supported all the district nurse, GP and hospital appointments needed. The medication errors found at the last inspection had been rectified. As a result of the proposed staffing changes, a new medication administration recording system is due to be put in place soon. This will mean that medication comes dispensed from the local pharmacy in dosette boxes, and training in the new system will be given to all care staff. This standard will therefore be examined in more depth at the next inspection. Fairview House Nursing Home D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 Page 14 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 standard(s) 23 The policies and procedures the home has in place try to ensure that residents are safeguarded from abuse and harm. EVIDENCE: The home has copies of the “No Secrets” document, as well as the organisational policy and procedure on responding to allegations of abuse. All staff members have received Vulnerable Adults training, and all are encouraged to report any incidences of poor practice. A “Whistle Blowing” procedure is also available for all staff, and risk assessments are in place for all residents. All staff have Criminal Records Bureau (CRB) checks and are checked against the Protection of Vulnerable Adults (POVA) register. Several incidents had been recorded of aggressive interactions between service users and staff and service users, although these had not been notified to CSCI. Discussion was held about when this would be appropriate to do so, and the manager has been asked to ensure that these incidents are reported. Fairview House Nursing Home D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 Page 15 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 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. The home was mainly in good order, although the wallpaper in the dining room was loose, and there were marks on the kitchen walls. It is recommended that the décor of the home should be improved in the kitchen and the dining room as it would make the house feel more homely for residents. The home was clean and hygienic, with policies and procedures in place for the maintenance of the building. Fairview House Nursing Home D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Residents’ individual and joint needs are met by staff who have had induction and some specialist training, and are undertaking NVQ. EVIDENCE: All staff have standard induction training which includes Health and Safety, Anti Discriminatory Practice and Basic Mental Health Awareness. Training records showed that staff had training in First Aid, fire training, emergency life support and Protection of Vulnerable Adults. Specialist training on Challenging Behaviour had recently been given to staff by a local psychologist. Staff members spoken to, although uncertain about their future role, were complimentary about the training opportunities which they were offered while working at Fairview House. Fairview House Nursing Home D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 Residents know that their views, and those of their families, underpin the monitoring and review of care practice. EVIDENCE: There are various quality assurance methods used in the home, including regular monthly visits to the home by the provider’ representative. Comprehensive reports of these visits are sent to the CSCI. A service user survey has been conducted, and it is planned to introduce a similar survey for relatives. One respite resident spoken to said that Fairview House was the best home she had stayed in. Fairview House Nursing Home D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 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 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fairview House Nursing Home Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 Page 19 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 23 Regulation 37 (e) Requirement The registered person must ensure that all incidents of violence or aggression between residents or staff and residents are reported to CSCI. Timescale for action 06/09/05 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. Refer to Standard 24 Good Practice Recommendations The décor of the home should be improved in the kitchen and the dining room as it would make the house feel more homely for residents. Fairview House Nursing Home D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 Page 20 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, 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 D51_D01_S28080_FairviewHouse_V245541_060905_Stage4.doc Version 1.40 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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