Inspection on 22/04/05 for Fallowfield

This inspection was carried out on 22nd April 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 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

Fallowfield 12/08/08

Fallowfield 20/09/06

Fallowfield 16/11/05

Fallowfield 26/01/05

Fallowfield 20/08/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Fallowfields 14 Great Preston Road Ryde Isle of Wight PO33 1DR Lead Inspector Annie Kentfield Unannounced 22 April 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Fallowfields Address 14 Great Preston Road, Ryde, Isle of Wight, PO33 1DR 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) 01983 611531 01983 868446 Mr Keith John Betteley Mrs Jennifer Ann Betteley Carole Ann Montague Care Home 21 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (21). of places Physical disability over 65 years of age (9) Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26/1/2005 Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Fallowfields is registered to provide residential care to twenty-one older people, including eight people with dementia. The home was formerly a Victorian residence, converted to provide accommodation on the ground and first floors with access to the upper floor via a passenger lift or stair lift. Set in a pleasant residential area of Ryde there is a garden and seating area for the residents at the front and to the rear of the building. The current owners took over the home four years ago and have made many improvements to the homes environment and bedrooms are being decorated and refurbished as part of an ongoing improvement plan. The owners are actively involved in the management of the home with the day-to-day running of the home undertaken by the registered manager. The home also provides respite day care and respite residential care. Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took place between 11.00 am and 3.30 pm on a Friday. The inspection included a tour of the premises and inspection of some of the home’s records. The inspector spoke to six of the eighteen residents, two members of the care staff, the cleaner, the manager and one of the proprietors. There were three care staff on duty with the manager, cook, cleaner and maintenance person in addition. The home was clean and warm and some of the residents were enjoying a music session in the sitting room with a specialist who comes into the home on a regular basis to do music activities. All of the requirements from the previous inspection have been met within the agreed timescales for action. What the service does well: Comments from residents were very positive; that the staff are friendly and very caring, and the atmosphere in the home is relaxed and informal. It was evident that there is a good staff team with low staff turnover and the manager is positive and supportive to both the needs of the residents and to the staff in the home. Some of the residents spoken to enjoy the opportunity to go out on trips in the home’s own transport occasionally and look forward to this starting again in the warmer months of the year. The sitting room, dining room, and the manager’s office are in the immediate vicinity of the main entrance and this suits those residents who like to be part of the day-to-day activities in the home. Some of the rooms are large enough to provide a bed/sitting room, and this suits those residents who prefer more privacy. The manager has two deputy managers/senior carers and the rota is arranged to ensure that there is a senior person on duty every day of the week. Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 Page 7 There is a commitment to ensuring that staff have the opportunity to develop their training needs and to meet the needs of the residents. The needs of the residents are varied and changing and the manager has become quite skilled at sourcing training resources to meet this need. 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. Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 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 standard(s) 3 and 4 The manager is clear that new residents are only admitted to the home following an assessment of care needs and if individual care needs can be met by the home. The manager is able to demonstrate that residents have access to the specialised services necessary to meeting their assessed care needs. EVIDENCE: Initial care assessments are carried out by the registered manager, or in her absence, by the two senior/deputy managers. The manager is aware of the home’s categories of registration and this, and the needs of the existing residents, and the staff team, are always taken into consideration before a new resident is admitted to the home. The care needs assessment looked at during the inspection demonstrated that that physical, emotional, and social care needs are recorded and any risks identified. Additional information is requested from relatives, care managers and others involved in a prospective resident’s care. Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 Page 10 Since the last inspection all of the care staff have completed training in dementia awareness. The manager is committed to ensuring that all of the care staff have the skills and qualifications necessary to meeting the assessed needs of the residents and feels this has positive benefits for the residents and staff, who feel more valued. Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 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 standard(s) 7 and 8 All residents have an individual plan of care that provides guidance for staff on the care to be provided. The health care needs of the residents are regularly monitored and reviewed and residents are supported to access the health care services that they need. EVIDENCE: The individual care plans are agreed and signed, whenever practicable, with the residents and are reviewed every month. Care plans looked at contained relevant information and risk assessments on all action that needs to be taken by care staff to ensure that the health and care needs of residents are met. Some of the residents have agreed to take part in a local falls assessment and intervention project and this has had some positive outcomes. Residents can register with the GP practice of their choice and most specialist services are accessed via the GP. The manager is in the process of working with the GP practices to ensure that all medication is regularly reviewed. The manager has also been contacted by the Medication Review Pharmacist who is due to visit the home in the near future. The manager demonstrated a good knowledge of Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 Page 12 specialist support services that are available and ensures that residents are able to access hearing and sight tests and dental services as required. Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 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 standard(s) 12,13 & 15 Residents have the opportunity to enjoy a range of social activities and occasional trips out. Visitors are always welcome in the home. Residents are offered a varied menu with alternative choices always available. EVIDENCE: At the time of the inspection there was a music session for the residents in the sitting room. The weekly programme of arranged activities is displayed in the entrance hall and staff will remind residents each day if there is an activity they may want to join. The home has transport that is occasionally used to take small groups of residents on local trips to places of interest, or to go shopping. The manager said that they were looking into getting transport that would accommodate more wheelchair users as the current transport is limited. Residents spoken to could not think of any other social activities that they would like to see going on. There is a three-week menu of four meals each day with alternatives offered if residents don’t want the main cooked lunch of the day. Residents are encouraged to take their meals in the pleasant and attractive dining room or Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 Page 14 they can take their meals in their room if they wish. Residents spoken to expressed satisfaction with the meals provided. Tea, coffee and cold drinks are always available and snacks and drinks provided in the evening for tea and supper. Some of the staff have undertaken training in nutritional awareness and have found this useful. There is a notice in the entrance that welcomes visitors to the home but asks visitors to respect residents’ mealtimes. Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 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 standard(s) 18 Residents are protected from abuse through the home’s policies and procedures and staff training. EVIDENCE: The manager has acquired the guidance on the Protection of Vulnerable Adults Scheme that was introduced in July 2004 and has done training in adult protection awareness and ensures that all staff are aware of the relevant policies and procedures. Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 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 standard(s) 19 - 25 The home is generally well maintained and decorated. The communal areas of the home are on the ground floor although there are some bedrooms and areas of the home that are only accessible for residents who are fully mobile. There are aids and equipment in place for those residents who need support to be mobile around the home. EVIDENCE: At the time of the inspection another bedroom was being renovated on the ground floor. Whilst this was being done, the small ground floor sitting room was being used as a bedroom. Unfortunately this room provides the only ramped access from the drive and is usually used as the designated area for those residents who smoke. Alternative arrangements should be made for offering another sitting space for residents and for a designated smoking area whilst the room is being temporarily used as a bedroom. Plans are still being considered to build a conservatory extension onto the sitting room, at the front of the building. This would greatly enhance the Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 Page 17 communal space offered and it is hoped that this will go ahead in the near future. The grounds are tidy and provide several sitting areas for residents in the warmer weather. There are sufficient toilet and bathroom facilities to meet the needs of the residents, and two of the bathrooms have an assisted bath. There is a call alarm system in all bedrooms and residents spoken to confirmed that it works. Bedrooms vary in size but are comfortably furnished and personalised and residents are able to move rooms if they wish when a room is available. Most of the doors are fitted with locks that are accessible to staff in an emergency. Two of the locks were reported to be not working and the manager made a note of this. The home was very clean and tidy and staff have procedures and training in infection control. Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 - 30 Residents and staff spoken to confirmed that there are always sufficient numbers of care staff on duty. EVIDENCE: The staff rota showed that there are usually three care staff on duty during the day and two care staff on duty at night between 9.00 pm and 8.00 am. The manager has introduced a key worker system and it is hoped that residents will benefit from this arrangement. Staff spoken to felt that the system encourages staff to take more responsibility and particularly benefits those residents who are unable to verbally communicate their needs due to cognitive impairment. The home has achieved higher than the recommended 50 of staff with at least NVQ level 2 in care and staff were very positive that they receive the training and support necessary to carry out their care tasks. The manager is pro-active in developing the staff training to ensure that staff are skilled and qualified and since the last inspection has taken advice from the Health and Safety Executive on the appropriate level of staff training in First Aid. As the recommendations are about to change, training has yet to be arranged. Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 38 The registered manager is qualified and competent and the management approach of the home is open, positive, and inclusive. The health, safety and welfare of the residents and staff are promoted and protected. EVIDENCE: The manager has completed the NVQ level 4 in care and the NVQ level 3 in management and is about to complete the level 4 in management. The manager has achieved the assessor’s award and is enrolled for the internal verifier’s award. Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 Page 20 There are clear lines of accountability within the home and systems in place for supervision and support for staff via regular staff meetings and 1:1 supervision. The registered manager ensures the health, safety and welfare of residents and staff through ongoing training; staff have just completed a course in health and safety awareness in the workplace. The manager confirmed that there is a fire safety risk assessment of the premises in place and fire safety awareness training for all staff will be arranged four times per year. Since the last inspection the recommendation to review the risk assessments on the use of portable electric heaters has been undertaken. Residents and relatives are encouraged to feedback their views about the service through a written questionnaire. Resident meetings have not been well attended but in discussion it was agreed that the manager has an open approach to seeking the views, choices and preferences of the residents about all aspects of daily living in the home and the many ways of achieving this could be encouraged and developed. Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 4 3 x x x x 3 Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 Page 22 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Mill Court Furrlongs Newport Isle of Wight, PO30 2AA 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 Fallowfields H55_H04_S12490_Fallowfields_V218453_220405_Stage 4.doc Version 1.30 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!