Inspection on 07/02/06 for Fairways, The

This inspection was carried out on 7th February 2006.

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 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, The 22/11/07

Fairways, The 01/12/06

Fairways, The 06/10/05

Fairways, The 02/09/04

Fairways, The 05/04/04

Fairways, The 27/10/03

Fairways, The 31/07/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Fairways, The 64 Ickenham Road Ruislip Middlesex HA4 7DQ Lead Inspector Ms Pauline Griffin Unannounced Inspection 11:00 7 & 8 February 2006 th th 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 Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fairways, The Address 64 Ickenham Road Ruislip Middlesex HA4 7DQ 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) 01895 675885 Farrington Care Homes Ltd Mrs Julia Ann Palmer Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th October 2005 Brief Description of the Service: The Fairways is an established residential home. The proprietors are Farrington Care Homes Limited who own three other homes in the area. The Fairways is a converted Edwardian house, which is situated on a road linking Ickenham and Ruislip. There is good parking at the front of the Home and it is easily accessed by tube, train and bus routes. Ruislip shopping centre is a short distance away. The Home is registered for 27 older people and there are currently three vacancies. The Home consists of two separate houses, the main House and the smaller Feather House. The Main House has six bedrooms on the ground floor and an assisted shower/bathroom/toilet and a separate toilet. There is a small kitchen to the rear of the House on the ground floor and small office, which the Manager uses. The ground floor also houses the day lounge that has a quite area and rear conservatory where meals are served overlooking the garden. The first floor is accessed by both stairs and lift and has nine bedrooms and a bathroom and two toilets. The second floor can only be accessed by stairs or a stair lift. On the second floor there is a seating area and one double bedroom, a bathroom/toilet, staff sleepover room and staff toilet. All bedrooms in the home have a pedestal sink. Feather House is located at the end of the garden set at the edge of the golf course. Feather House accommodates 6 service users in single rooms. One of the rooms was previously used as a double room but does not meet the National Minimum Standards size requirements and is currently being used as a single room. The six service users in this unit are more independent and prefer not to join the activities in the Main House. There are two bedrooms and a toilet on the ground floor, which also accommodates the lounge/dining area and the kitchen which serves both Houses. The first floor has four Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 5 bedrooms and a bathroom and a stairlift has been installed to access the ground to first floors. . The garden between the two houses is mostly laid to lawn with two gazebos and seating areas. Feather House has it’s own small garden which is adjacent to the golf course. Staff have a large shed in the garden that is called the ‘1st tee’’ ‘ and this is used for staff meetings and as a staff room3 The staff team consists of the Registered Manager, Assistant Manager, 3 Senior Careworkers and about 27 Careworkers (who work various hours on a rota). There is a Cook and an Assistant Cook, 2 full time Housekeepters, a Handyman and a Laundress. The staff team work across both Houses. Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over two days for a total of approximately 9 hours. Six Service Users and two Staff members were interviewed including the Registered Manager. Two Service Users and a Staff file chosen at random were examined. The files, policies, records and logs seen were in satisfactory order. The home is well managed and the Staff team work well together. The majority of the Service Users were sitting in their chairs asleep in the lounge when the inspection commenced at around 11 am. Staff and Service Users said that mid morning after coffee was served, was a time that people liked to take a nap. The hairdresser was visiting in the morning and the activities co-ordinator was working with some of the Service Users in the afternoon. The emphasis of the inspection was, again, to assess the impact the number of people with confusion in the home have on the overall quality of the service provision. A visit to the home from the Pharmacy Inspector for the CSCI has been arranged in March to ensure that medication is stored and administered correctly. What the service does well: The service provides good care to the Service users who are clean, well groomed and neatly dressed. The personal care and health related care provided by the home is very good. The food provided by the home is excellent. The menu is designed to appeal to the Service User group and includes traditional food that is well presented, balanced and healthy. There are two choices of main meal and dessert at lunch time and two choices of hot supper and a sweet in the evening. The Service Users spoken to said that the meat was always well cooked, easy to eat and tasty. The cook bakes her own cakes and produces very attractive puddings. On the first day of the unannounced inspection, the midday meal was a choice of baked ham or lamb steak with potatoes and a choice of three fresh vegetables. The dessert choice included a very attractively presented fruit trifle. The home is clean and the bedrooms are comfortably furnished. Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 7 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, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 8 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 Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 9 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): 2,3,4 & 6 Service Users have a copy of the Terms and Conditions of the home which they sign and are kept on file. The Service Users files include full up to date assessments including health monitoring, weight charts, risk assessments, records of property, referral information and correspondence with family or professionals. Assessments include the home’s ability to meet needs. EVIDENCE: Two files were chosen at random and found satisfactory. Prospective Service Users are visited by the Registered Manager at hospital or at home and a full assessment made as well as obtaining all other professional assessments. The Registered Manager said that prospective Service Users and their families visit the home prior to making a decision. The Registered Manager said that most of the referrals are for people with some degree of confusion but without a medical diagnosis of dementia. The Registered Manager confirmed that she assessed prospective Service Users to include the home’s ability to meet their needs and to ensure that they will ‘fit Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 10 in’ with the existing Service Users in the home. The home has a policy of a 4 week trial or ‘settling in’ period that is included in the terms and conditions. The Registered Manager said that the home offered respite care rather than intermediate care. Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 11 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): 9,10 & 11 A request has been made for the CSCI Pharmacy Inspector to make a visit and provide advice on the storage of medicines and identify any other shortfalls. Staff treat Service Users with respect and their right to privacy and choice is upheld. EVIDENCE: Although the home has no history of maladministration of medication and the recording system used is satisfactory, a request has been made for the CSCI Pharmacy Inspector to make a visit and provide advice on the storage of medicines and identify any other shortfalls. The home uses Boots the Chemist who provide a blister pack monitored dosage system. A Boots Pharmacist calls every three months to ensure the Boots system is being maintained. Staff receive accredited training for administration of medication and only Staff who have received the training are allowed to administer drugs. Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 12 Staff were observed to treat Service Users with care and respect. Both of the files examined included information regarding the Service User’s wishes for arrangements for death and dying. Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 13 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, 14 & 15 The activities offered by the Activities Co-ordinator attempted to reach too many Service Users whose abilities differed. The home has regular visits by a Church of England Minister. There are no arrangements for Service Users from other religious persuasions to practice their own religious observances. The home provides several means by which Service Users can express choice but Service Users spoken to indicated that they had no vehicle available to express wishes or make queries to influence the day to day running of the home. The food offered in the home is excellent. The menus are varied, well balanced and provide good choices. EVIDENCE: The list of activities provided each day by the Activities Co-ordinator lacked opportunities for people to converse and reminisce. Activities taking place on the day of the inspection consisted of ‘colouring in’ and decorating ‘pom poms’. Most of the Service Users were not participating. The pitch of the activities attempted to reach too many Service Users whose abilities differed. Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 14 Activities should consist of a programme to ensure that it reaches as many people as possible in ability/interests groups. Service Users can then choose from a selection of daily exercises and things that catch their interest like bingo, cards and games like ‘Play your cards right’, sing songs and reminiscence sessions. The Registered Manager said that although activities were pitched to reach as many people as possible, one Service User has volunteered to act as ‘Spokes Person’ to input popular choices on the other Service Users behalf. The home has a visiting Anglican Minister but there is no arrangement for similar visits for the people in the home who follow other faiths. The Registered Manager said that Service Users were asked if they wish to follow their faith when they entered the home but that she would make sure that all Service Users were asked again. The home provides several means by which Service Users can express their opinions but Service Users spoken to indicated that they had no method available to express wishes or make queries to influence the day to day running of the home. Service Users said they knew how to make a complaint or could approach the Registered Manager direct but they said a more structured means of presenting everyday issues would be welcomed. The home offers very good food with two meat choices at the main meal and two desserts. The cook makes all her own sauces and bakes her own cakes for tea and suppertime. Supper consists of two hot choices and soup each day. Menu records with notes of choice by Service Users are maintained and stored for reference. Service Users said that their choice of meal was not always recorded accurately by Staff and they, therefore, did not get the food they wanted. This was the type of issue they wished to raise in a regular Service User’s forum of some kind. Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 15 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 & 17 The home’s complaints procedure is displayed in a prominent place in the hall and it is in the Service Users Guide. Service Users were aware that they could use the complaints procedure if necessary. Service Users legal rights are protected. EVIDENCE: The complaints procedure is on clear display in the hall and is included in the home’s literature with a clear procedure and timescales. Service Users are aware that they can use the complaints procedure and are aware that they can also contact the Commission for Social Care Inspection (CSCI) at any time. The home maintains a complaints log details of the nature of the complaint or concern and the actions taken. Four complaints were received from January 2005 and were all dealt with within the timescales to the satisfaction of the complainants. The Inspection Report produced by the CSCI in October 2005 was on display in the hall. Service Users participate in the electoral process either by postal vote or are taken to vote if they wish. Age Concern have a link with the home and provide advocates. There are advocacy leaflets displayed ion the hall which include information regarding legal assistance. Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 16 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): 20,22 & 26 . Communal rooms are well furnished and comfortable and the home is clean and hygienic throughout. EVIDENCE: The main house has a long lounge leading onto a conservatory area which is used as a dining room with separate tables overlooking the garden. Feather House has a communal lounge/dining area overlooking the golf course. The room has comfortable seating around an inglenook fireplace. The gardens are lawned with two gazebos and seating. Service Users have tea together in the garden when the weather is fine. Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 17 The home is well decorated and furnished. The home has a hoist for emergency use and Staff use turntables, sliding sheets and lifting belts. The bathrooms and toilets are fitted with grab rails. The ground floor of the home is suitable for people who use wheelchairs. There is a passenger lift from the ground floor to the first floor and a chair lift from the first to second floors. Feather House also has a stair lift from the ground to the first floor. The home has maintenance contracts for the lifts and wheelchairs. Each of the bedrooms is fitted with a ‘call system’ by means of an emergency buzzer. The home is free from unpleasant smells and is clean and hygienic throughout. The laundry was not inspected on this occasion but there are designated Staff to deal with laundry. The home has a contract with a company who collect clinical waste each week. Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 18 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 & 30 Service Users benefit from a well trained Staff team, who are supervised on both a formal and informal basis. EVIDENCE: The Staff compliment consist of a group of about 27 members working various part time or full time hours. The Registered Manager said that 12 Staff had completed or are completing the NVQ level 2 and 5 Staff have completed the NVQ level 3. The Registered Manager maintains a chart of the mandatory and specialist training courses undertaken with update reminders. Staff had completed up to date mandatory training. Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 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): 31,32,33,34 & 36 The management structure of the homes includes a newly appointed Deputy Manager to assist the Registered Manager. The service provision must be monitored to ensure an overview is maintained of staffing level requirements. Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 20 EVIDENCE: The Registered Manager has the qualifications and experience to manage the home. The appointment of a Deputy Manager has strengthened the management structure but this has been by the promotion of one of the Senior Carers who has not been replaced. The Registered Manager said that the Deputy Manager and 2 Senior Carers have 2 hours administrative time each day and the Deputy Manager is supernumerary and felt the structure was adequate. Staff shortages are covered by the use of bank Staff or overtime. The service provision must be monitored to ensure an overview is maintained of staff level requirements. The Registered Manager operates an ‘open door’ policy. Staff have regular meetings and one to one supervision 6 times per annum. Service Users have two residents meetings per annum and quality questionnaires. Service Users spoken to felt they needed more opportunity to express their opinions or make queries. The quality assurance system has not yet been fully developed and although Service Users and their representatives receive questionnaires, more work needs to be undertaken to collate feedback from all available sources and used to improve the service. Feedback obtained from Service Users, visiting professionals and advocates and information from complaints, accidents, incidents should be included in an annual audit survey. Copies of this should be published and made available to Service Users and prospective Service Users and a copy sent to the CSCI (Regulation 24 of the Care Homes Regulations 2001). The home has monthly management review visits from representatives of the Farrington Care Homes Group (under Regulation 26 of the Care Homes Regulations 2001) and copies of these reports are forwarded to the CSCI. Farrington Care Homes Limited has provided information from their Chartered Accountants that the company is trading on a sound financial footing. The home’s insurance cover includes, Public Liability, Employers Liability and Medical Malpractice. Staff supervision is carried out at two monthly intervals with details of subjects covered and are signed and dated. Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 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 X 3 3 3 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 2 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X X 3 X 3 X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 3 X 3 X X Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 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 OP12 Regulation 16 (2) (m) & (n) Requirement Evidence must be provided that Service Users have choice in relation to leisure and social activities and cultural interests. Activities must match their ability and be pitched at their interest and cultural background. Evidence must be provided that Service Users of different faiths have the opportunity to practice their own religious observances. A system by which Service Users can express a view of make a query on a regular basis must be put in place to enable them to exercise choice and control over their lives. Evidence must be provided that the current management structure of the home is adequate to ensure accountability and day to day control of the home. An annual summary of the results of the information collated from quality assurance surveys and other statistics must be produced. The information DS0000044518.V261399.R01.S.doc Timescale for action 10/04/06 2 OP12 16 (3) 10/04/06 3 OP14OP32 12 (3) 10/04/06 4 OP31 18 (1)(a) 22/03/06 5 OP33 24 10/04/06 Fairways, The Version 5.0 Page 23 must be gathered to ensure that the home is run in the best interests of the Service Users. These outcomes must be published and a copy sent to the CSCI each year. 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 Refer to Standard OP9 OP12 Good Practice Recommendations A visit from the CSCI Pharmacy Inspector has been requested to provide advice on the storage of medication and identify any other shortfalls. Regular excursions outside the home should be offered at regular intervals. Excursions should be pitched to appeal to Service User’s capabilities and preferences. Service Users should be provided with a selection of choices from small to larger scale outings. Service User’s choices of food should be recorded by members of Staff who are competent to do so accurately. 3 OP15 Fairways, The DS0000044518.V261399.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection West London Area Office 58 Uxbridge Road Ealing London W5 2ST 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, The DS0000044518.V261399.R01.S.doc Version 5.0 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. 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