Inspection on 21/09/06 for Fallowfield House

This inspection was carried out on 21st September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 House 24/05/07

Fallowfield House 30/01/06

Fallowfield House 04/07/05

Fallowfield House 18/11/04

Fallowfield House 09/07/04

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

CARE HOMES FOR OLDER PEOPLE Fallowfield House Fallowfield House Malvins Close Blyth Northumberland NE24 5HN Lead Inspector Karena M Reed Key Unannounced Inspection 21st September 2006 11:00 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 DS0000000520.V289849.R01.S.doc Version 5.2 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. DS0000000520.V289849.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fallowfield House Address Fallowfield House Malvins Close Blyth Northumberland NE24 5HN 01670-356775 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) Mrs M Powers Mr R Powers Mrs Diane May Care Home 12 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (5), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (1), Old age, not falling within any other category (5) DS0000000520.V289849.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registration DE is specific to a named resident. The CSCI must be notified when this person leaves the home at which time the registration will revert to OP(6). 30th January 2006 Date of last inspection Brief Description of the Service: Fallowfield House is a large, detached house situated in a residential area in the town of Blyth, it is close to the town centre. It is also very close to the Northumbrian coast and the nearby countryside. It is registered to provide personal care to twelve older residents, whose needs may include memory loss or mental health problems, past or present. The home does not provide nursing care. All bedrooms are for single occupancy. A passenger lift is not available but some bedrooms are located on the ground floor of the property. There are two lounges and a separate dining room that is also used as a quiet area when meals are not being served. Both living rooms overlook a large, well - maintained garden to the back of the building. There are two bathrooms one contains equipment that can be used to assist with getting in and out of the bath. A Statement of Purpose and service user guide are available for prospective residents and their relatives to give them information about the services provided by the home and the relevant charges. Fees payable for living at the home at the time of inspection in September 2006 vary between £331 and £383.52. Additional charges are payable for hairdressing, private chiropody, and personal newspapers. DS0000000520.V289849.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was unannounced and took place over three hours. A partial tour of the premises took place and a sample of records were inspected which included: The home’s Statement of Purpose and service user guide, 5 care plans, the fire log, accident book, admission /discharge book, complaints record, 2 personal allowance records, staff communication book, staff meeting minutes and 2 staff files. The proprietor, manager, handyman, cook, two support workers and 8 residents were spoken to at the time of inspection. A questionnaire was also completed by the home before the inspection to provide information. What the service does well: The home is welcoming and well maintained with an excellent standard of hygiene. There is a committed staff team who have worked at the home for some years thus providing continuity of care to residents. It was good to see residents are involved in the running of the home and their own lives, being asked to contribute to menu changes and being given assessment documents to complete if they were willing and able to complete the forms. Residents spoken to said they liked living at Fallowfield House: “Home as good as my mother’s and father’s. I hope I never leave here.” “I am very happy and have no complaints.” “I have no complaints I am happy here.” “Good staff, good home, excellent meals, staff always helpful and willing to listen to anything I have to say.” “I always speak to staff if I am not happy.” Feedback from relatives was extremely positive about all aspects of care and support provided by the staff team: DS0000000520.V289849.R01.S.doc Version 5.2 Page 6 “As soon as there is a problem the G.P is sent for.” “ Staff are very helpful and encouraging.” There is an excellent standard of hygiene. Comments included: “The home is very clean.” “Very happy with the care.” “… is as happy as a sandman in the home.” “ I find this home very professional but very caring. Management work closely with Social Services staff to ensure clients best interests and needs are met.” What has improved since the last inspection? What they could do better: The Statement of Purpose and service user guide must be updated and made more interesting and easier to read to give prospective residents information about the home. DS0000000520.V289849.R01.S.doc Version 5.2 Page 7 The complaints procedure needs to be updated to assist residents to bring matters of concern and complaint to the attention of CSCI if required. More activities and outings should be made available if residents wish to take part. A procedure must be made available within the Home for the safe storage of oxygen. Consideration should be given to introducing a monitored dosage system for drugs in the home in the interests of health and safety. 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. The summary of this inspection report can be made available in other formats on request. DS0000000520.V289849.R01.S.doc Version 5.2 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 DS0000000520.V289849.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before this visit to this service. The home does not have update information to provide to prospective residents about the home and its facilities to enable them to make an informed choice about where to live. The home collects enough information about the needs of residents before they move in to help ensure staff are aware of the amount of care and support needs of the resident as they settle in. Staff receive training to give them the knowledge and insight to help understand the needs of residents and to provide the necessary levels of care and support to individual residents. The home is welcoming and there are opportunities are available for prospective residents and their families to visit to decide if the home is suitable. DS0000000520.V289849.R01.S.doc Version 5.2 Page 10 EVIDENCE: The Home’s Statement of Purpose and service user guide were examined and although they contained the necessary information as required by the Care Homes Regulations 2001 they did not contain accurate up to date information. The records for a resident recently admitted to the home showed that an assessment of their care needs had been carried out before their admission. The resident and their family were involved in the initial assessment. This information and the care manager’s assessment of the resident’s care needs was used to ensure all the needs of the resident could be met by staff. The records contained a range of information. Two staffing files showed staff receive training so that they know how to meet the specialist needs of the residents. Staff have recently received training about dementia care and working with behaviour that may be challenging. Recent staff training includes: Vulnerable Adults Awareness, Challenging Behaviour, Dementia Care, Health and Safety. Future training planned includes Infection Control and a Moving and Handling Refresher Course. Residents’ feedback cards all showed their needs were met and they were happy with the care offered to them. Comments included: “I am very happy and have no complaints.” “Good home.” “Home as good as my mother’s and father’s.” “ I have no complaints I am happy here.” “Very happy with the care.” “…as happy as a sandman in the home.” Residents have the opportunity to visit the home as many times as they like to decide if they wish to live there. This may involve tea- time visits, day and overnight stays and can be adjusted to the pace of the individual. “ I came to visit the home before I moved in.” DS0000000520.V289849.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is excellent. This judgement has been made from evidence gathered both during and before this visit to this service. There are excellent arrangements in place to ensure that residents’ health and social care needs are met. A system is in place to review the changing needs of residents. Residents’ care plans reflect the amount of care and support that staff are providing to residents. Staff receive training before they are able to administer medication to residents. There are very full arrangements in place to ensure residents health care needs are met. Service users are treated with respect and their right to privacy is upheld. DS0000000520.V289849.R01.S.doc Version 5.2 Page 12 EVIDENCE: A resident spoken to was completing their own assessment and providing information to the home so a plan of care could be made to show staff the amount of support and care they required in some areas. There are comprehensive assessments in the residents’ care plans. Personal support needs are well documented and give clear instructions to staff on how to support people in tasks such as washing, bathing, dressing, remaining mobile in order to help retain some independence. Care plans are amended and reviewed on a monthly basis by the resident’s key workers, that is staff who have special responsibility for each resident. Residents and their families or representatives are involved in the process. Moving and handling assessments are in place. Technical aids and equipment is available for residents. Residents care records showed that they have access to external health care services. GPs and Community Nurses were regularly consulted for advice and treatment. Records show district nurses visit the home as required and service users are assisted to access chiropody and optical services at least annually or as often as required. Comment cards included: “As soon as there is a problem the G.P is sent for. Recent visits to a specialist have resulted in an improvement in ---’s awareness.” “Since change in medication ---is enjoying all their meals.” A random inspection of medication held within the home took place and everything was in order. A monitored dosage system is not in use within the home rather senior staff count the drugs individually held on the premises. A system is in place should residents be able to handle their own medication. Training records showed senior staff members receive training about medication before they are able to administer it to residents. Risk assessments are in place. DS0000000520.V289849.R01.S.doc Version 5.2 Page 13 Care records, conversation with staff and observation showed the privacy and dignity of residents are respected. All of those residents spoken to, who could comment, said that they were treated well by the staff and well cared for. DS0000000520.V289849.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before this visit to this service. Limited recreational activities and outings are available to residents. Residents maintain contact with family and friends as they wish. Staff help more dependent residents to exercise choice and control over their lives. The diet of residents is wholesome. EVIDENCE: A programme of activities is in place for residents this includes: bingo, videos, sing-a-long, memory lane bingo, board games, floor games, manicurist, DS0000000520.V289849.R01.S.doc Version 5.2 Page 15 dominoes, hairdressing, “broth day”. Residents enjoy sitting in the large welltended garden when the weather is suitable. Various seasonal parties are also arranged, which are well supported by relatives and families e.g Halloween Guy Fawkes, Christmas. Some residents were positive about the activities provided and other people would like more variety. Comment cards included: “Any games going on I can take part in.” “Few meaningful activities.” Some residents have the opportunity to visit the local community with relatives. Staff ask each resident about their wishes, interests and choices. As stated in the previous section under Standard 7 it is excellent practice to involve residents as much as possible in the running of their lives and to encourage residents where able to complete their own assessments to supply information to the home is very empowering. The cook and chef meet with the residents to collect up to date ideas for making the menus and finding out about the food likes and dislikes of residents. At least two hot meals are provided daily and a substantial alternative is available at each mealtime. Residents were very positive about the food: “Excellent meals.” On the day of inspection, the lunch served was corned beef bake, butterbeans and carrots and peaches with whipped cream or Spanish omelette, potato wedges and rice pudding. Tea was quiche and tossed salad, bread and butter and Angel Delight or sandwiches and cake. DS0000000520.V289849.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before this visit to this service. The complaints procedure is out of date which could mean that issues are not raised outside of the home. Residents are protected from abuse. EVIDENCE: There is a complaints procedure. If complainants are not happy with the homes investigation and response however it does not provide details of how to contact CSCI to make a complaint. The home keeps a record of complaints. Comment card: “I am very happy and have no complaints.” “Never had a complaint but if I had I would see staff.” “I have no complaints I am happy here.” DS0000000520.V289849.R01.S.doc Version 5.2 Page 17 Residents and their families are also asked at residents’ reviews if they have any complaints. Staff have received training about Protection of Vulnerable Adults and Prevention of Abuse. Staff have received training about working with behaviour that may be challenging. Staff have completed a Dementia Care course which has given them more insight into the needs of people with memory loss. Staff enjoyed the course and felt it provided them with more understanding about the care of people with different forms of dementia. DS0000000520.V289849.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before this visit to this service. Residents live in a homely, comfortable and mainly safe environment. There is a good standard of hygiene around the home, but better ventilation is required. EVIDENCE: There is a programme of redecoration and improvement around the home. DS0000000520.V289849.R01.S.doc Version 5.2 Page 19 Since the last inspection some bedrooms have been decorated. The hallway and corridors have also been decorated. Some bedrooms have been recarpeted. A bathroom and lavatory have been refurbished. The lounge and dining room have also been redecorated. The home is clean, well decorated and very well maintained. The garden is well maintained and attractive. The home has sufficient sitting and dining space. Residents can see visitors in private in their own rooms. Oxygen was being used in one of the bedrooms but a procedure was not available outlining its safe storage within the home. There was a smell of smoke from the smoking room around the rest of the home. Comment cards: “The home is very clean, but to accommodate smokers sometimes the smell of smoke permeates through the house. It is difficult to meet the needs of smokers and non smokers at the same time.” DS0000000520.V289849.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before this visit to this service. Residents’ needs are met by the numbers and skill mix of staff . Systems are in place to ensure residents are in safe hands at all times. Residents are protected by the home’s recruitment policy and practices. Staff are trained to meet the care needs of residents EVIDENCE: Examination of staff rotas and discussion with the person in charge and members of the staff team showed that the numbers of staff are as follows: 9.00am- 3.00pm 3 care staff DS0000000520.V289849.R01.S.doc Version 5.2 Page 21 3.00 pm- 9.00pm 9.00pm-9. 00 am 2 care staff 2 care staff These numbers include the manager who works some supernumerary hours. The proprietor is also available and working at the home certain days of the week. There are 342 care hours provided to residents. There is a senior staff member on each shift. Other staff members are employed for duties such as food preparation, cleaning and gardening. The necessary checks are being carried out prior to the workers being appointed. Two written references were available on the staff files examined from the most recent employers. An application form had been completed for each staff member. CRB checks are carried out before a person is appointed. There is a stable committed staff team and there is a low turnover of staff. Staff stated that they enjoyed working in the home and were observed to be kind, caring and respectful to residents. Staff receive Skills for Care induction previously TOPSS. 99 of the care staff team have now achieved National Vocational Qualifications at level 2 several are also studying or have obtained level 3. Catering and house keeping staff are also following relevant NVQs. The home and its sister home, Astley House have been re awarded the Investors In People Award in recognition of management’s investment and commitment to staff training and personal development. Staff and their records showed that they also receive advice and /or training in other areas. Staff have received training in dementia care, challenging behaviour, health and safety, Medication and use of oxygen. Future training planned is to update Moving and Handling training for staff and Infection Control. DS0000000520.V289849.R01.S.doc Version 5.2 Page 22 Comment cards:” Good staff.” “Staff always helpful and willing to listen to anything I have to say.” “Staff excellent.” “ Staff always around.” “ I always speak to staff if I am not happy.” “Staff are always helpful and encouraging.” “ I find this home very professional but very caring.” DS0000000520.V289849.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before this visit to this service. Residents’ live in a home which is well run and managed for the benefit of residents. Residents’ financial interests are safe guarded. The health, safety and welfare of residents and staff are promoted and protected. DS0000000520.V289849.R01.S.doc Version 5.2 Page 24 EVIDENCE: The registered manager has almost completed the Registered Manager’s award. Discussion and observation maintain that she puts the needs of the residents first and promotes an ethos amongst staff of involving staff and residents in decision making within the home. Comment card: ” I find this home very professional but caring. Management work closely with social services staff to ensure residents’ best interests and needs are met.” Lockable facilities are available for residents to keep their own money if they wish. If a resident does not wish to keep control of their own money, the home is able to provide the facility to hold a small amount of money on behalf of the resident for everyday living. Individual records show the home has a suitable system for accounting any monies held on behalf of a resident. Documents detailing fire safety, risk assessments in the environment, water temperatures, maintenance contracts for equipment for moving and handling were all up to date. Staff training relating to health and safety was up to date and training being planned to renew any that required updating such as Moving and Handling training. DS0000000520.V289849.R01.S.doc Version 5.2 Page 25 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 2 x 3 3 4 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 4 2 x x x x x 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 DS0000000520.V289849.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? N0 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. 2 3. 4. Standard OP1 OP16 OP19 OP26 Regulation 6(a) 22(7)(6)( a) 13(4)c 23(p) Requirement The Home’s Statement of Purpose and service user guide must be reviewed and updated. The complaints procedure must be updated. A procedure must be made available for the safe storage of oxygen. Better ventilation must be provided in the smoking room. Timescale for action 01/12/06 01/10/06 22/09/06 01/11/06 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 Refer to Standard OP12 OP9 Good Practice Recommendations To keep the range of activities available to residents under review. To consider the use of a monitored dosage system for medication after discussion with community pharmacist. DS0000000520.V289849.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000000520.V289849.R01.S.doc Version 5.2 Page 28 - 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!