Inspection on 08/07/05 for Fairways

This inspection was carried out on 8th July 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

Fairways 16/08/07

Fairways 25/07/06

Fairways 01/11/05

Fairways 01/03/05

Fairways 03/08/04

Fairways 22/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Blenheim House

Prince Bishop Court

Park View (15)

Craigmore House

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

CARE HOME ADULTS 18-65 Fairways Easedale Gardens Wrekenton Gateshead Tyne and Wear NE9 7EE Lead Inspector Steve Tuck Unannounced 8 & 27 July 2005 at 10.00 am th 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. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Fairways Address Easedale Gardens Wrekenton Gateshead Tyne and Wear NE9 7EE 0191 491 0518 0191 491 0518 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) Dr Vayalil Pillai Mrs Julia Short Care Home 6 Category(ies) of LD Learning Disability (6) registration, with number PD Physical Disability (2) of places Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 01 March 2005 Brief Description of the Service: Fairways can provide personal care for six people who have a learning disability, two of whom may have a physical disability. The service cannot provide for those people who require nursing care. The service is run by Clifford House Homes. The home itself is a large corner detached house. It is situated in the centre of Wrekenton and is close to local services, shops and a variety of community facilities. The home is near to public transport routes and also has its own transport available. There is a garden around the home and a large car park at the rear. The house has kitchen and dining rooms and a large lounge area with bedrooms arranged on first and ground floors. There are two downstairs bedrooms which are more suitable for those people who have a physical disability. All necessary facilities are provided and are suitable for people who live there such as an emergency call system. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 2 days and was a scheduled unannounced inspection. The inspection process involved spending time talking to a number of the people who live in the home as well as the manager and staff. A sample of records were examined including care plans and rotas. A tour of the building took place, which included all communal areas and a selection of service users bedrooms. The inspector was invited to join service users at teatime and observations were made of the support the staff offered to service users this time. The judgements made are based on the evidence available on the day of the inspection. What the service does well: The home has good care plans, which show how service users needs will be met and reflect the practices of staff and the manager, which were observed throughout the inspection. There is a low turnover of staff at the home so staff and service users know each other well. There is a good atmosphere at the home where service users and staff get on well with each other, share jokes, experiences and views and clearly enjoy each others company. Service users receive the support that they require from staff to ensure that their personal, physical and emotional health needs are met. Staff also help service users to develop and sustain their interests and take up opportunities so that they have an interesting and stimulating lifestyle. The home has a competent manager who knows the service users well and is able to successfully direct and demonstrate to staff how service users are to be supported. There is a choice of meals offered, chosen by service users and the food is fresh and of a good quality. The environment offers service users a homely, clean and comfortable place in which to live. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 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. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.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 Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.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) 1, 2, 3, 4, 5 A range of information is available which enables service users to make a fully informed choice about where they would like to live. Detailed assessment information is consistently available about perspective service users which confirms that the home can meet their needs and helps staff to design care plans. EVIDENCE: All current service users have had thorough assessments carried out by the local authority social worker and a further assessment carried out by the manager prior to their admission to the home. One service user had recently been admitted to the home and the manager was able to demonstrate the procedure that she had taken to ensure that the service users needs could be met there and that they were supported and reassured that the home was suitable the for them. For example by offering visits and overnight stays. All service users have a current contract which describes the services that will be provided by the home. This is kept with service users’ care planning records and can be accessed by them. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.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, 7, 8, 9, 10 Each service user has an individual care plan, which clearly sets out their preferences and how assessed needs will be met. These provide guidance for staffs’ care practice. Service users are encouraged to be independent, and make choices and decisions about their lives and take calculated risks but the proprietor does not regularly visit the service to gain service user views. EVIDENCE: Comprehensive records are kept which detail the strategies that staff use to support the physical, emotional and lifestyle needs of service users. These are regularly updated by staff, overseen by the manager and reviewed at least every six months. Service users are actively involved in the compiling and maintenance of their care plans and staff help service users to make decisions and choices about their opportunities. Service users talk about their ‘plans’ or ‘files’, which they can view at any time. Some staff have undertaken training about how to write and maintain care plans which they have put into practice at the home. Service users are treated with respect by staff and the atmosphere at the home is supportive and described by one service user as ‘good fun’. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 10 Service users are encouraged to take appropriate risks, for example to promote their independence. Concise records are kept of all planned risks for example independent taxi travel which include the ways that have been devised to reduce the potential for harm. These are agreed with each service user as well as key-worker, social worker and family members where this is appropriate. Information kept in the home is secure and staff protocols are in place so that service users personal information is safeguarded. The home has a confidentiality policy and examples of how this works in practice were given by the manager. Although the manager and staff routinely ensure that the views of service users are respected in their day-to-day practice, there is no evidence that the proprietor visits the home on a monthly basis to ensure that the service is being run properly and ask service users their views. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.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) 11, 12, 13, 14, 16, 17 Service users are assisted to lead active and fulfilling lifestyles by accessing a range of opportunities in the local and wider community. This assists them to lead a full and enjoyable life. People who live at the home are respected, and routines are flexible. This can help to promote service users’ choices and preferences. Service users are supported to keep in contact with their relatives and friends and are able to spend time together outside of the home. The food is of good quality and sufficient to meet the needs of service users. EVIDENCE: All service users have active lifestyles and their own routines and activities many of which occur outside of the home. Service users spoken to said that they had the opportunity to take part in the activities and opportunities and staff were observed offering choices, and helping them to organise their commitments and opportunities. Staff demonstrated that they knew of the activities which were taking place locally for example the Tall Ships Race and the Sunderland Air show and had Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 12 ensured that support was available for those people who wanted to take part. Photographs of service users taking part in activities and during visits are displayed. Service users have the opportunity to use the ‘Links in Gateshead’ befriending scheme run by the local authority and can find employment opportunities and can get support if this is what they wish to do. Others have successfully undertaken a variety of college courses dependent on their interests and have received certificates which acknowledge their commitment and skills. Although the provision of a holiday is not yet available from the proprietor, service users recently decided to pay for their own expenses to take a holiday. Several choices of alternative meals are available at all times and service users demonstrated that they make informed choices about their meal preference. Service users are involved in menu planning each taking a turn in listing their preference and they are also involved in the preparation of meals at the home. Attempts to offer a balanced diet whilst still responding to service user choices were noted. Where necessary and as identified in the individual assessment, special diets and food supplements are made available and as part of the ongoing process of monitoring health records of weight loss/gain are recorded in service users files. Staff joined service users at mealtimes to offer support and assistance where needed. Mealtimes are pleasant sociable events at the home where people meet, talk, and exchange views and experiences. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.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, 19, 20 Service users health care needs are identified and arrangements are made to help ensure they are promoted and met. Staff will also advocate, or seek additional advocacy support, to ensure that each service users’ rights of access to health care services and treatment are met. Systems for storing and administering service users medication are in place to ensure that service users get the treatment which they have been prescribed. EVIDENCE: Guidance regarding personal care is detailed in care plans and household routines are demonstrably dependent on service users lifestyles and commitments. Any personal care or discussion is carried out in private with staff encouraging service users to be discrete where this is required. Records of healthcare needs are available in service users files and all have access to a General Practitioner who can also refer to other health care professionals when required. The manager has previously taken action so that she could successfully gain information from health specialists in order to support service users to make informed decisions about their healthcare options. Staff demonstrate that they are skilled in ensuring that the monitoring of healthcare needs of service users who do not use language to communicate is undertaken. And ensuring that they receive appropriate personal care and Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 14 specific medical treatment where this is required for example, ensuring that pressure sores are avoided. This is recorded in service users’ files. Due to their levels of need, service users are not able to administer their own medicines, and designated staff therefore assist in this area. Staff at the home have undergone training in relation to medication administration. Medication is securely stored and records are accurate which enable checks to be made so that errors are minimised. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 Service users can use the homes complaints procedure if they are unhappy, have a grievance or dispute. They can also give feedback when they are happy with the service. The home has measures in place which protect service users from being harmed. EVIDENCE: A comprehensive complaints procedure detailing specific timescales and responsibilities of the service is in operation and meets with the requirements of this standard. On a day-to-day basis most service users were seen to actively express their wishes and views to those staff supporting their needs. One to one time is available for service users where concerns can be explored and the manager instigates meetings with service users as a group whenever there are issues that need to be discussed. Informal discussions take place regularly, usually at mealtimes, where staff explore service users views about the service and their lifestyles. The home has an adult protection procedure which is robust and complies with the Public Disclosure Act and the Department of Health Guidance. Information about the co-ordinating role of the local authority is available and included in the homes procedures. The manager has devised a staff guide which gives clear instructions to staff of the actions which they must take if abuse is disclosed or witnessed and ensure that all staff are knowledgeable of these procedures and staff have undertaken specific or NVQ training. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29, 30 Service users are provided with a homely, clean, comfortable environment, which promotes their privacy and independence. Aids and adaptations have been provided to promote service users’ independence and safety. EVIDENCE: There is evidence of recent repairs, ongoing maintenance and a programme of redecoration, maintenance and renewal has also been drawn up. There are effective cleaning regimes at the home and appropriate measures are taken to manage any unpleasant odours. Service users are encouraged to maintain their own rooms with the assistance of staff when required. Appropriate locks are fitted to the bedroom doors and some service users choose to use their own keys. The bedrooms are pleasant areas containing a range of furniture and facilities including appropriate heating and lighting. All service users have personalised their rooms, and furniture possessions and decorations in each bedroom reflect the personalities and lifestyles of those living there. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 17 There are sufficient toilet and bathroom facilities available, some of which are appropriately adapted for use by people who have mobility needs. Specific and additional adaptations for individuals have been carried out in response to ongoing occupational therapy support. Water temperatures have been successfully regulated so that service users are not at risk of scalding and all service users have areas where they can receive visitors in private. The manager has developed a policy and procedures that provide adequate guidance for staff on how to minimise the risks of infection and communicable diseases and laundry facilities and procedures support these. The building is also subject to inspection by the Fire Prevention Service and the local authority to ensure that risks from an accidental fire are minimised and a safe and healthy environment is promoted for service users and staff. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 18 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) 33, 35 Service users are supported by sufficient numbers of competent and qualified staff and consequently the service users needs are appropriately met. EVIDENCE: There are sufficient staff available to meet the needs of service users currently living at the home. This enables service users to have their personal and healthcare needs met and also to be supported where required to take part in social, education and employment opportunities as they wish. There is a low turnover so existing staff can demonstrate longstanding relationships with service users and they are knowledgeable of their personal histories and needs. When staff and service users meet, they get on well together have positive relationships and clearly enjoy each other’s company. Almost all of the staff team have now attained NVQ awards in care at level 2 and a number have enrolled on level 3 courses. Staff are able to describe the needs of service users, both in terms of their practice and the principles which underpin the service that they give. And the home’s training record indicates that they have received training relevant to their job roles and the specific needs of service users. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 19 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) 37, 38, 42, 43 The manager offers clear leadership and direction to the staff so that they can consistently meet the needs of service users. All required policies and procedures are in place, which help staff and the manager run the home efficiently and for the benefit of service users. The financial viability of the home has not been demonstrated which would give assurance to service users that the home will remain open. Staff and service users are not exposed to any undue health and safety risk at the home. EVIDENCE: The registered manger has a number of years experience in a variety of care roles as well as several years’ management experience at this care home. From observations and discussions, it is evident that the manager is sufficiently competent and skilled to carry out this role and has demonstrated the capacity to undertake additional training in order to update and expand her knowledge. She is currently undertaking an NVQ Level 4 qualification, which Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 20 she plans to complete by the end of 2005. There are clear lines of accountability within the home however there is no evidence that the proprietor visits frequently enough to carry out his legal responsibilities. There were no noticeable hazards apparent at this inspection and the manager has taken steps to ensure that all areas of the home are appropriately maintained so that these are minimised. The proprietor has declined to provide details which demonstrate that the home is viable nor is there any evidence of financial planning. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 21 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 2 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 2 x 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fairways Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 2 3 x x x 3 2 B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 22 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. Standard 8 24 43 Regulation 26 Requirement Timescale for action 01/09/05 2. 3. 37 41 43 9 25 The responsible individual must carry out visits to the home, complete duties specified by this Regulation and provide a report to the regulatory authority on a monthly basis (Previous requirement from 15/04/2005). The manager must have a 31/12/05 qualification at level 4 NVQ, in management and in care. The responsible person must 01/09/05 submit a copy of the annual business and financial plan to the Commission. (Previous requirement from 01/04/2005). 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 14 Good Practice Recommendations Service users in long term placements have as part of the basic contract price the option of a minimum seven-day holiday outside the home, which they help choose and plan. Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Fairways B52-B02 S7427 Fairways V219260 080705 stage 4.doc Version 1.40 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!