Inspection on 08/06/06 for Fairview House

This inspection was carried out on 8th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 10/10/05

Fairview House 24/05/05

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 Inspection 08 June 2006 10:00 X10015.doc Version 1.40 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 DS0000015435.V293213.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 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 DS0000015435.V293213.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Fairview House Address 14 Fairview Drive Westcliff On Sea Essex SS0 0NY 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) 01702 437555 01702 432835 Strathmore Care Mrs Kornelia Boorman Care Home 55 Category(ies) of Dementia - over 65 years of age (55), Old age, registration, with number not falling within any other category (55) of places Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The number of service users for whom personal care can be provided shall not exceed 55. (Total number not to exceed fifty five). Personal care is to be provided to service users who are over the age of 65. (Total number not to exceed fifty five). Personal care to be provided to no more than 55 service users with dementia over the age of 65. (Total number not to exceed fifty five). 10/10/05 Date of last inspection 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. The current scale of charges as at May 2006 is between £362.32 - £430.99 per week, based on dependency needs. Extra charges are made for hairdressing, chiropody, toiletries and newspapers. The home has an up to date Statement of Purpose, Service User Guide, and a copy of the last CSCI inspection report in the entrance hall. Each new resident will receive an individual copy of the Service User Guide. Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key visit was unannounced and took place on 8th June 2006 and lasted over a seven hour period. At this inspection all the key standards and the progress made since the last inspection were assessed. A pre inspection questionnaire had been completed by the home prior to this visit, and questionnaires had been sent to eleven residents, twelve visitors and two general practitioners who visit the home. Two responses were received from residents, eleven from visitors and one from a general practitioner. At the site visit, time was spent with the residents in the lounge, and some residents and visitors were spoken with individually, either in the lounge or in their bedrooms. Care practices were observed throughout the day. The manager assisted during the inspection and staff were given the opportunity to speak to the inspector. Feedback was given to the manager throughout the inspection. What the service does well: The staff team are kind and helpful and the residents and visitors were very happy with the care that is given. One resident said, “the home is run at a very high standard, myself and my family are very pleased with every aspect of the home” and a relative said, “quite excellent care provided”. The home has regular meetings with the residents, their relatives and staff to get their views on how the home should be run. Residents were happy with the food in the home and comments made were “excellent”, “plenty to eat” and “very good”. Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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 DS0000015435.V293213.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 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 the following standard(s): 1,3,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. The needs assessment is not personalised enough to ensure that individual diverse needs are identified and planned before they move into the home. EVIDENCE: An updated version of the Statement of Purpose and Service User Guide is on display in the hall entrance to the home. A copy of the last inspection report is also on display. The manager said that people admitted to the home will be given a copy of the Service User Guide. Most of the admissions to the home are arranged by the company head office. The paperwork relating to any admission has recently been revised and allows for a more detailed history to be taken from a prospective resident to ensure that their needs can be met. This form and the referral form from Social Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 9 Services are often not completed sufficiently and are not particularly personalised to confirm that individual needs can be met. Residents and their visitors have the opportunity to visit the home before admission, and a review is carried out approximately one month after admission to make sure that all parties are happy with the placement. The home does not provide intermediate care. Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care planning does not always provide all the information to ensure a resident’s needs are met. EVIDENCE: The care plans were examined for three residents. All of the plans examined had shortfalls in the information needed to meet a resident’s needs. Care planning meetings are held monthly for the staff and the manager discusses the completion of care plans at staff supervision. She has also introduced a review system that involves the family and the resident. The registered provider is in the process of introducing a new care plan and is incorporating the views of other health professionals before introducing it into the home. The new plan is intended to be a more comprehensive document for staff to use. Residents and relatives were generally positive about the care being given. One relative commented, “Quite excellent care provided”. A resident said that Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 11 sometimes staff are not available when needed with the comment, “Staff are very good but sometimes cannot come straight away as someone else is more urgent, but as a rule excellent”. The manager confirmed that outside professionals are consulted when necessary with regular input from GPs and district nurses. One GP responded to the survey and had no concerns about the care provided and said the staff are cooperative. During the site visit, a community psychiatric nurse was visiting a resident. Residents felt that the staff treat them respectfully. A visitor commented that they are “polite and friendly”. Three residents have their own phone line and one resident chooses to have a key to her bedroom door. Visitors can see their relative in one of the small lounges if they choose to have privacy. Medication was stored correctly in the home. The home must ensure that the medication policy and procedure are regularly reviewed and updated if necessary. Staff who administer medication had received training in November/December 2005. Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A limited range of activities within the home and the community means the residents do not have a range of opportunity to keep them occupied. EVIDENCE: The activities programme of the home is dependant on the individual staff members having the time and the ability to carry it out. Some residents were seen to spend long periods in the lounge area with no stimulation or occupation. When asked about any activities, one resident said, “This is the only downside to this home, I think it could improve”. The manager has arranged for one resident to play cards on a weekly basis with a visitor to the home. This resident spoke positively about this and how he looks forward to it. A summer barbecue had been arranged with a guitarist, a “Cockney Queen” was coming to the home and a group had been booked to entertain at Christmas. Holy communion is arranged twice a month for residents who choose to receive it. Staff were seen to interact well with residents and chatted to them whilst performing tasks but did not appear to have the time to sit with them. Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 13 Visitors confirmed that they are able to visit the home at any time and are always made to feel welcome. One visitor said, “I can’t fault it, I am always offered a cup of tea”. The residents were happy with the food offered in the home and confirmed that they are offered a choice and there is “plenty to eat”. One relative commented that they felt that residents who are slow eaters could be helped a little more by the staff. Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 16,18 Quality in this outcome is good. This outcome has been made using available evidence including a visit to the service. Residents are protected by the home’s complaint procedure and staff knowledge of POVA. EVIDENCE: The complaints procedure of the company is presently under review. There have been no complaints since the last inspection but there has been an allegation by the ambulance service regarding a resident who had left the home without staff knowledge. This had been investigated by Social Services and was not upheld. A relative commented, “The manager has dealt with any issues I have raised satisfactorily”. Staff have received training in the protection of vulnerable adults and had a good knowledge of different forms of abuse and how to report it. Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 19,26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Areas of the home are in need of redecoration and refurbishment. EVIDENCE: There has been some painting of communal areas and some new furniture since the last inspection. A new security system has been fitted to the front door to make the home a safer environment for residents who are inclined to wander. Some areas of the home are still in need of attention, this includes a bathroom and toilet on the ground floor, which does not have a hand washbasin but is in constant use. This is an area that poses concern regarding infection control and must be addressed. The bedrooms of the residents have been personalised with their own belongings and pictures. Some items of furniture need to be replaced and a report received from the director of the company after the inspection indicated Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 16 that there will be a review of furniture and carpeting and windows will gradually be replaced. The home was clean and tidy and generally there were no unpleasant odours. Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 17 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is poor. This outcome has been made using available evidence including a visit to the service. Shortfalls in staff recruitment could put residents at risk. Staffing levels or deployment mean residents’ needs are not always being met. EVIDENCE: The rota over a four week period was examined. This must accurately reflect staff on duty and the hours that they work. The home has been sent a memo by the director of the company to ensure that they do not work excessively long hours. Some staff are still working in excess of 60 hours a week and the home must evidence that these hours are monitored and it does not have a detrimental effect on care provided to the residents. One member of staff said that sickness means they are often short staffed and a relative said, “the weekends are short of staff sometimes”. One survey returned by a relative said there are not enough staff on duty. The recruitment files of four new members of staff were examined. All of these records had shortfalls in information gained prior to employment. One was using a CRB obtained in a previous employment, which had not been mentioned on the application form, and had only one reference, which was not from that employer. Another had an application form that had no dates of previous employment and it was not possible therefore to know if there had been any gaps that needed explanation. This file also had no references. A system that is not robust could potentially place residents at risk. Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 18 The home has a training officer who arranges an induction and training programme for each individual member of staff. A portfolio system has been introduced to record this training. One member of staff said, “There is a lot of opportunity for training”. Evidence was seen staff training in many areas including infection control, POVA, fire awareness, continence and food hygiene. Three members of staff have achieved NVQ level 2 or above in care. Staff who have been recruited from overseas have often obtained a care related qualification in their own country and the home must evidence if this equates to an NVQ qualification. Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 19 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is adequate. EVIDENCE: The manager has been in post since October 2004 and has achieved NVQ level 4 in care and management. A relative spoke of the manager saying, “She is brilliant, so approachable”. The deputy manager left at the end of April 2006 and the company are looking to recruit a replacement. Evidence was seen of various meetings held at the home for staff, residents and relatives. One relative confirmed that she is invited to attend the relatives meetings, which are held every three months. Discussion included suggestions for entertainment, involvement in care plans and availability of inspection reports. Residents and staff meetings are held monthly. Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 20 A fire drill is held weekly in the home. It was carried out during the site visit and staff were aware of their role and responsibilities. Policies and procedures need to be reviewed and updated where necessary. Residents’ money is held securely by the home and is documented individually. This was checked at random for two residents and was found to be correct with receipts and documentation in place. Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 21 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X X Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP3 Regulation 14(b) Timescale for action The registered person must carry 01/10/06 out a pre admission assessment and record it appropriately This is a repeat requirement The registered person must prepare a written plan as to how a resident’s needs will be met This is a repeat requirement The registered person must consult with residents and provide recreation to occupy their time The registered person must replace old and worn furniture and ensure the environment is refurbished to a good standard The registered person must provide a washbasin in the downstairs bathroom with liquid soap and paper towels This is a repeat requirement The registered person must monitor staffing levels. This refers to hours worked and the DS0000015435.V293213.R01.S.doc Requirement 2. OP7 15 01/10/06 3. OP12 16 01/10/06 4. OP19 13,16,23 01/10/06 5. OP26 23(2)(j) 01/10/06 6. OP27 18(1)(a) 01/10/06 Fairview House Version 5.1 Page 23 length of the working day and an accurate rota. This is a repeat requirement 7. OP29 19 The registered person must operate a thorough recruitment programme. This refers to requirements set out in Schedule 2 This is a repeat requirement 01/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP9 OP28 OP38 Good Practice Recommendations Medication that has been handwritten on the MAR sheet should be countersigned by two people to avoid errors. A minimum of 50 of staff should obtain NVQ2 or above or the equivalent. Policies and procedures should be reviewed and updated if necessary annually. Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection South Essex Local Office 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. Extracts may not be used or reproduced without the express permission of CSCI Fairview House DS0000015435.V293213.R01.S.doc Version 5.1 Page 25 - 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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