Inspection on 04/07/06 for Higham House

This inspection was carried out on 4th July 2006.

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

Higham House 08/06/09

Higham House 27/08/08

Higham House 06/06/08

Higham House 15/01/08

Higham House 20/10/05

Higham House 16/06/05

Higham House 10/05/05

Higham House 09/09/04

Higham House 15/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Fairlawn Nursing Home 87 Higham Road Rushden Northants NN10 6DG Lead Inspector Mrs Linda Preen Unannounced Inspection 4th July 2006 09:30 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 Fairlawn Nursing Home DS0000045316.V302748.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. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairlawn Nursing Home Address 87 Higham Road Rushden Northants NN10 6DG 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) 01933 314253 01933 413187 Mr Tissa Nihal Atapattu Mrs Nelum Vijayanthi Atapattu Clutilda Skinner Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (24) of places Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th October 2005 Brief Description of the Service: Fairlawn Nursing Home is situated on the main road through Rushden. It is within easy access of the local towns of Rushden and Higham Ferrers. A local bus service is easily accessible. The Home is a converted local building and provides accommodation for 24 service users in single and shared rooms and caters for elderly residents of both sexes with both physical and dementia related illness. Fees range from £442 and £490 according to resident’s needs. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Four hours were spent prior to the inspection reviewing previous requirements and recommendations, comments from residents and relatives and collating information provided by the service. The inspection took place over a period of five and quarter hours as part of the statutory inspection programme. Three residents were chosen in order that their experience in the home could be monitored. This included looking at their records, talking to them and also to the staff concerning the care received. In addition to this staff records, accident records, complaint records, Health and Safety records and medication records were seen. 3 comment cards had been received from residents, 2 comment cards from relatives and 2 comment cards from General Practitioners. All of these comment cards recorded satisfaction with the service provided. In addition, information was available from a questionnaire completed by the providers of the service. What the service does well: What has improved since the last inspection? Staff recruitment practices have been improved to ensure residents are protected from potential harm, and the required pre-employment checks are now in place. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 6 As stated above, a new system of care planning has ensured that resident’s individual needs are better identified and catered for. Staff have received updates on the feeding of residents, particularly those with a diagnosis of dementia, and meal times are relaxed, unhurried occasions in which residents are encouraged to eat a nutritious diet. Two bedrooms and the front lounge have been redecorated since the last inspection, to provide a pleasant place in which to live. A new fire alarm and call bell system has been installed to improve resident safety. 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. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Thorough assessments and Terms and Conditions ensure that residents are confident that their needs may be met in the home. EVIDENCE: An up to date Statement of Purpose and Service User Guide are available to prospective residents along with a copy of the last inspection report. Copies of signed Terms and Conditions of residence were seen in the files case tracked. Relative’s signatures were observed on care plan and assessment documentation, to demonstrate that they had been consulted in these processes. Excellent assessments are in place for each resident and these are reviewed on a monthly basis to ensure any changes can be included in the care planning process. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Good systems are in place to ensure that all aspects of resident need are identified and documented for staff guidance, to ensure that these needs may be met in the home. EVIDENCE: Three residents were chosen in order that their experience in the home could be monitored. All of these residents had a diagnosis of dementia in addition to physical problems and it was therefore difficult to hold a meaningful conversation with them. They were however still spoken to and their appearance and body language used to inform an opinion of their care in the home. Two ladies and one gentleman were chosen in order to monitor a representative group of residents. Care plans were comprehensive and included specific personal detail for each resident. They contained information on personal likes, dislikes, lifestyle, hobbies and interests to enable staff to tailor individual service. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 10 Residents seen appeared well cared for and were relaxed in the presence of staff and visitors. Interaction between staff and residents was observed to be friendly and residents were treated with respect and due regard to their privacy and dignity. Specialist equipment is provided and referrals to Health Care Professionals are made where a need is identified. For example, pressure relieving equipment and referral to the Tissue Viability Nurse. Staff were aware of residents needs. For example one resident likes to have a chat before settling for the night and this is implemented. Medication systems were seen to be well organised. A contract is in place for the disposal of unused medication. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome group is adequate. This judgement has been made using available evidence, including a visit to the service. The provision of food and mealtimes is good but more work is needed to provide meaningful activities suitable for individual residents. EVIDENCE: Records are available concerning resident’s previous lifestyle and their preferred hobbies and interests but there is little evidence that these records are considered when organising activities. Some activities are arranged such as a lady who comes to play the piano, a company who do motivational therapy, clothing sales and barbeques, but stimulation on a daily basis is limited. One of the care staff on duty attempted to engage residents in a game with a beanbag but none of them was interested. One lady was reading a magazine but when the carer offered a magazine to another lady, although she was interested, no suitable magazine was available as all of the ones in the lounge were professional journals or supply catalogues. The radio was playing in the rear lounge. This was tuned to a Radio 4 play, which of course was of little interest to these residents with dementia. In the front lounge, the radio was tuned to a German station. Staff stated that a CD had been playing but that it must have finished and reverted to the radio. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 12 A discussion with staff concerning activities demonstrated a lack of knowledge concerning suitable activities for this group. This has been made the subject of a recommendation. Visitors are welcome at any time, but none were present during the time of the inspection. Records of individual choice concerning rising and retiring, food, clothing and personal hygiene were recorded in the files case tracked. Residents were observed to be moving freely about the home and got up according to individual preference during the inspection. One gentleman had a lie in and was given his breakfast at 10am when he came to the lounge. Menus provided as part of the pre-inspection questionnaire, demonstrated that a varied, nutritious diet is provided. Lunch was observed to both look and smell appetising and was served in good quantities. Residents sit at small family sized tables and meal times are designed to be relaxed, unhurried occasions. Those residents who required assistance with their meals were given this on a one to one basis. Recent research on providing ambient settings for good food intake was available for staff guidance. All staff have received training in the feeding of residents with particular emphasis on feeding difficulties encountered when a diagnosis of dementia is made. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 13 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 and 18 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents may be confidant that their concerns will be addressed and that they will be protected from abuse. EVIDENCE: There have been no new complaints since the last inspection. One ongoing complaint has now been concluded with the assistance of Northamptonshire County Council Commissioning team. A complaints procedure is available in the home to guide any one with a concern. Staff have received Protection Of Vulnerable Adults training and were aware of the types of abuse and their responsibility in reporting any such incidences. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. A safe, clean, well-maintained environment is provided for the residents. Specialist equipment is provided to meet their needs. EVIDENCE: A limited tour of the environment demonstrated that the home was clean and tidy and well maintained. Staff hand washing facilities were available throughout the home. Resident rooms showed evidence of personalisation, with ornaments pictures and other personal items in evidence. Some rooms have been redecorated since the last inspection and a new extension that is currently under development will provide additional facilities such as a hairdressing room for resident’s use. An enclosed patio garden is provided so that residents may sit outside when the weather permits. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 15 A new fire alarm and nurse call bell system have been installed as part of the upgrading programme to ensure the continuing safety of the residents. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Procedures for the recruitment of staff provide safeguards necessary to offer protection to the people living in the home. Staff are provided with training and in sufficient numbers to meet the needs of the residents. EVIDENCE: Staff files sampled, showed safe recruitment practices in place. An Equal Opportunities Policy is in place, and staff of both sexes, from five different nationalities are employed in the home. Staff records demonstrated that statutory training was kept up to date and that staff attended specialist training to help them better care for the residents. 50 of care staff already hold a National Vocational Qualification in care and a further three staff are working towards this award. Staffing levels are calculated according to resident dependency and appear to be adequate to meet the current resident’s needs. Duty rotas demonstrated that there are five members of staff in the morning, four in the afternoon and two at night, one of which is always a Registered Nurse, to care for the eighteen residents currently in the home. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Management systems are in place to ensure that the home is run with the best interests of the residents foremost. EVIDENCE: An experienced First Level Registered Nurse who also holds the Registered Manager’s Award manages the home. The home has an open, friendly atmosphere in which resident’s needs are put first. A formal quality Assurance programme is in place in which all aspects of the service provided are audited. The results of the last audit were available for inspection. Thirteen questionnaires had been returned by relatives, all of who recorded their satisfaction with the service provided. Comments such as “We have no complaints and are happy with the care given” were made. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 18 Records of resident pocket money accounts were seen. These included receipts for transactions but advice was given that two signatures should be obtained in order to protect residents and staff. Records of the testing of fire alarms and emergency lighting were seen and found to be satisfactory. Regular servicing of fire fighting equipment is also undertaken. As previously mentioned, a new fire alarm system has been installed since the last inspection. Records of staff supervision were seen in the staff files monitored. Staff spoken to confirmed that an induction programme is in place for new staff and that the Registered Manager personally carries out formal supervision of all staff. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 3 3 3 3 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 3 X 3 Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No 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. 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 OP12 Good Practice Recommendations Advice should be obtained from the relevant organisations concerning the provision of activities for residents with a diagnosis of dementia in order that day-to-day activity and stimulation may be provided. Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Fairlawn Nursing Home DS0000045316.V302748.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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