Inspection on 06/06/08 for Higham House

This inspection was carried out on 6th June 2008.

CSCI found this care home to be providing an Poor service.

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

Higham House 08/06/09

Higham House 27/08/08

Higham House 15/01/08

Higham House 04/07/06

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 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Fairlawn Nursing Home 87 Higham Road Rushden Northants NN10 6DG Lead Inspector Lesley Allison-White Unannounced Inspection 6th June 2008 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.V366043.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.V366043.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 F/P 01933 314253 Mr Tissa Nihal Atapattu Mrs Nelum Vijayanthi Atapattu Manager post vacant Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (30) of places Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Fairlawn care home is registered to provide personal care with nursing to male and female service users who fall within the following categories: - Old age, not falling within any other category (OP) 30, Dementia, over 65 years of age (DE (E)) 30. The maximum number of persons to be accommodated at Fairlawn nursing home is 30. 15th January 2008 2. Date of last inspection Brief Description of the Service: Fairlawn Nursing Home is situated on the main road through Rushden. The home is a converted building and provides nursing care for up to 30 frail, elderly residents of both sexes with both physical and dementia related illnesses. Accommodation is in both single and shared rooms over two floors. Some of the newer rooms have en suite facilities and there are sufficient additional toilets and bathrooms with assisted bathing facilities. There are two communal sitting rooms, a dining room, kitchen and laundry, with a garden and patio area to the front and side of the property. It is within easy access of the local towns of Rushden and Higham Ferrers. A local bus service is easily accessible. The Statement of Purpose, Residents’ Guide & Inspection Report are available on request (these provide information on how the home is organised and what services they provide). At the time of the inspection, fees ranged from £478.95 to £500.00 per week. Extras include hairdressing, dry cleaning and phone calls made from the foyer. Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is on outcomes for residents and their views of the service provided. The home provides care for up to thirty people. On the day of inspection there were eighteen people living at the home. The inspection took five and a half hours to complete. Preparation included examining inspection records and looking at the service history. This aided the inspection process by providing background information. An expert by experience person assisted the inspector. This is a person who because of their shared experience of using services, and or ways of communication, visits the service with an inspector to help them get a picture of what it is like to live in or use the service. A discussion was held with one person who lived there. Many of the people had memory problems and limited communication skills, some were able to indicate how they felt when asked questions. The expert by experience person looked at some safety issues, activities and staffing levels.’ The primary method of inspection used was “case tracking”. This involved speaking with or observing the people who use the service provided, looking at two peoples care plans and making observations. Care plans are records about the care or support provided for an individual. All the required key standards were inspected during this visit. Previous concerns were dealt with and discussed and new requirements were made at this inspection. There is no Registered Manager at this home and the acting manager and Registered Nurse assisted during the inspection. What the service does well: People seen in bed who were not well were observed to have care charts indicating that they were regularly turned and given appropriate nursing care. Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 6 A relative who spoke to the expert by experience person said things were much better since the new acting manager had been working there. Their relative was receiving much better care and the whole home was a lot cleaner. The relative who they visited was always dressed in clean clothes and seemed to be happy. The staff also said they were much happier and that the conditions were much better. One of the people living at the home continued their hobby of painting pictures their pictures were displayed throughout the home. This person was no longer able to take part in this activity due to recent illness but had enjoyed continuing this hobby at the home and it had been encouraged. 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. The summary of this inspection report can be made available in other formats on request. Fairlawn Nursing Home DS0000045316.V366043.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.V366043.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individuals who decide to move into the home will have their needs assessed. EVIDENCE: On the day of inspection there were eighteen people living at Fairlawn Nursing home. The inspector case tracked two new people who were unable to communicate effectively or slept for long intervals during the inspection. In place is a care plan and assessments for the provision of care and support needed. However their needs were not always met as a result of insufficient staff to meet their individual needs. The Statement of Purpose sets out the aims and objectives of the home, which includes the Service Users Guide this information, is available from the notice board in the hallway and on request. Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 9 A copy of the most recent inspection report is available on request. A copy of the Commission for Social Care Inspection (CSCI) registration certificate and Employers Liability of insurance certificate is displayed in the entrance to the home. Standard 6 intermediate care is not offered at this home. Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 10 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 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Peoples’ health and care is monitored although appropriate action may not always be taken. Improvements must be made in the area of medication practices to ensure safety at all times. EVIDENCE: Care plans had recently been reviewed and reflected both peoples care needs. The two care plans seen at inspection had been made simpler according to the acting manager to make them less complicated to follow. One of the care notes identified the persons care needs and action plan. The other care record failed to record important information. This person had a booked hospital appointment but attendance at the appointment was not recorded although a daily entry had been made in the daily care record. The outcome was unclear for this person. The daily records are written by the nurses/carers many of them have English as a second language. This has led to areas of concern not being identified and addressed in a timely manner by staff. A poorly written account of an event Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 11 was recorded in one of the daily records seen. This was a potential safeguarding issue. The outcome of action taken to prevent further incidents was not clear. Staff were observed providing care. Two incidents were observed where hygiene control and dignity were not preserved. There were other people in the lounge who were observed not to have been moved before or after lunch. One person was seen in their room always calling out to anyone who passed their room. They were alone most of the day. Medications taken orally were checked in a small sample and they were fine. Controlled drug medications were checked and fine. A Controlled Drugs book is now used along with is the medicine kardex. This is good practice. Tubes of prescribed medicines were seen in individual’s rooms. They were not returned to the treatment room for safe keeping neither were bath gels or talcum powder placed out of sight in bedrooms. This is a home for people with dementia who could be at risk from in appropriately placed powders, creams and liquids. A requirement will be issued for this practice to be discontinued. An observation by the Expert by experience person indicated that two people were nursed in bed, as they were not well. They looked clean and comfortable. Staff was seen attending to them at intervals. Both of them had had charts indicating that they were regularly turned and given appropriate nursing care. Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 12 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 and 15 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Activities are only provided when the staff is able to offer this. In this way the lifestyle of the people living at Fairlawn is restricted and unstimulating. EVIDENCE: The expectations of the people who live at this home does not match their lifestyles. One person was seen having one to one activity on the day of inspection; others appeared to sleep for unusually long periods during the day. The stimulation provided for the people living at this home was poor. The television was on in one lounge and no one was watching it and in the other lounge was music again no one seemed to show any interest in it. It was a pleasant summers day but no one was able to go outside to enjoy it. The Expert by experience person noticed that one person was in their room and visible from the lounge and constantly shouting for attention. When asked why they were in their room the staff explained that it was because this person is very noisy and upsets the other people. They had, however, been in the lounge for breakfast. Staff spent some time with them and they seemed content when given constant one to one attention. They became aggressive Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 13 toward one member of staff during this observation. The reason for their aggression was unclear. Friends and family are they free to visit ask the people who live there ask family members. The Expert by experience person noticed that activities consisted of hairdressing and nail care and it was noticeable that the ladies were well groomed. A couple of the men hadn’t yet been shaved but had refused that morning. Generally the atmosphere was peaceful. On Thursdays, someone came in to do physical exercises and to give some mental stimulation. At other times the staff are responsible for organising activities. If someone was off sick this didn’t happen. The expert by experience person found it difficult to have any meaningful conversations with the people who live at Fairlawn due to the degree of dementia they were suffering but one of the relatives was able to explain how much better things were, since the new acting manager had been working there. Their relative was receiving much better care and the whole home was a lot cleaner. The relative was always dressed in clean clothes and seemed to be happy. The Expert by experience person spoke to the staff that said they were much happier and that the conditions were much better. Although the ratio of staff was good for the number of service users, because so many were very dependent, they needed more help to give the one to one care as required by nearly all of them. The Expert by experience person noticed that around the walls were a number of paintings by the same artist. When she asked she was informed that they were the work of one of the residents who was now unwell. On the notice board were many thank you cards for this year and visitors remarked on the improvements that they have seen. Relatives’ comments from the thank you cards included ‘ Thank you to you and the staff for caring for mum so well. It is comforting to see her looking so well.’ ‘We have been visiting Fairlawn for some years now but recently have noticed a real improvement in the atmosphere. Staff seem really positive and purposeful and the environment altogether cleaner and pleasanter. This change, which I feel strongly, is the result of your management abilities it inspires more confidence in us, as visitors who are concerned about our relative and the care they receive.’ ‘Good luck in your efforts to improve the quality of care at Fairlawn. I look forward to the improvements continuing.’ Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 14 People living at this home have dementia and may not always be able to make choices for themselves. The staff members will help to make choices on their behalf. The Expert by experience person observed lunch- time. Some people were taken to the dining room. These were people who could feed themselves with the minimum of help. Others stayed in the lounge. At this time several more staff would have been helpful. One lady had to wait quite a while for someone to be available to assist her with her meal; meanwhile her food was going cold. This seemed to me to be a tasked oriented job rather than an opportunity do interact and create a more social occasion which more staff would allow. The inspection took place on a Friday. A traditional fish and chip meal was served to those able to manage this. Those not able to manage this type of meal was given a softer meal with each serving such as mashed potatoes, mushy peas and steamed fish kept separately and was easily identified on the plate. This was good practice and would be helpful to someone with memory problems. On one occasion a staff member requested help from another member of staff. The staff member went to assist, leaving the person who she was assisting with their meal. The staff member forgot to return the meal to the kitchen for safekeeping and to keep warm. It was noticed that to save staff time both main meal and the sweet was served at the same time. This means that all sweets will end up being given cold. The pleasure from meal times will be reduced in this way. Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff does not fully understand the rights of individuals but are being trained to make improvements in this area. EVIDENCE: The acting manager explained that a training programme is in progress and staff is in the process of undertaking specific training to meet the needs of the people living at Fairlawn. The Commission for Social Care Inspection (CSCI) have not received any complaints since the last inspection report. There were no complaints in the complaints book at the home. Relatives have written compliment letters and thank you cards to the staff and acting manager of the home. They have noticed the improvements. Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management of the home needs to review all aspects of the environment and to create a more pleasant and stimulating environment for the people who live there. EVIDENCE: The first impression is of a ‘tired’ home with a rather unpleasant odour on entering the hallway. However, some areas had been decorated and looked clean and tidy. A domestic person was seen. The acting manager explained that this person will be leaving and the acting manager is aware that a replacement will be essential at this home to improve the environment and reduce the possiblility of infection. The patio garden area to the side and back of the property needs tidying to ensure that it is safe for the people living at Fairlawn to use, weather Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 17 permitting. There is a ramp to the patio door but it is unsafe to use and the patio door has a ridge leading from it, making it difficult to manoeuvre over, if a wheelchair was used. The area has safety locks on the gates however the whole of the outside patio area needs reviewing to ensure that it can be used safely. A maintenance person is not employed by the home and is at the home when required. Individual rooms were seen. They were clean although one person had not had her bed made up and the room appeared untidy in a shared room. A shared room was seen and it had a curtain for privacy between the occupants of the room as required. One person occupied one of the newer ensuite rooms. It was a pleasant room. Radiator protectors were seen on the radiators in the bedrooms seen by the inspector. Parts of the home were being redecorated. Maintenance records such as bath temperatures and water temperatures were taken to ensure the safety of the people having baths at the home. Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The skill mix and number of staff needs to reflect the high dependency care needs of the individuals living at the and that people who live there are in safe hands at all times. The recruitment policy and practice must be reviewed to ensure that it protects the needs of the people who live at Fairlawn. EVIDENCE: The usual staff rota consists of a trained nurse and four carers in the morning, a trained nurse and three carers in the afternoon and a trained nurse and a carer at night. However, one of the problems is that the people living at the care home have high dependency needs and need more help from the staff which takes time. The numbers of staff being employed should be reviewed to ensure that individual’s needs are actively being met when the help is needed. A requirement will be made for this to happen. An activities person could be employed to provide activities at the home other than care staff. In this way regular daily stimulation for the people living at the home would be made possible. Staff at the home has been receiving training the acting manager has used a DVD with a test after to ensure that staff have an awareness of safeguarding Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 19 issues. 15 out of 20 staff has had safeguarding training. (A DVD is a pre recorded information disc). Two staff records were checked at inspection. One of the staff records although historical did not meet current practice. All staff records must be checked for the correct information to ensure that they all comply with the Care Standards Act 2000 Regulations and employment information. As there is no registered manager this responsibility falls on the registered provider to do. This will be a requirement. The acting manger explained that training would be ongoing. The inspector has requested the numbers of staff working at the home with the following training: Dementia awareness, 11 out of 20 staff have this training. Safeguarding adults 15 out of 20, challenging behaviour 6 out of 20 staff, medication updates for the Registered Nurses 3 out of 5 have this training. Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 20 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 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered person needs to take an active interest in the running of the home. At this moment in time the home is not run in the best interests of the people at living at Fairlawn. EVIDENCE: One of the consultants that has been working at the home to improve standards at the home has decided to stay and help on a regular basis and has taken the role of acting manager for the service. There were no copies of the Registered Persons Regulation 26 visits to say how the running of the home is being monitored. A requirement will be issued for this to happen. Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 21 The home still needs to meet the needs of the people who live there by providing the personal care and social care that they need. Visitors have acknowledged the improvements within the home as seen in the many thank you cards and letters on the notice board. Two people living at the home now have advocacy services from the charity Age Concern to ensure that they are able to express choices that will be met. Staff has supervision records on their file. The acting manager has said that she has written supervision records on all the care staff and is working to provide supervision for the Registered Nurses. The acting manager was able to confirm that all equipment has been checked and she will forward copies of the fire checks, gas and electric checks information to the CSCI for the inspector to see. The acting manager has confirmed verbally that they are up to date. The money of anyone who lives there is stored safely when on the premises. Family members are asked to take responsibility for this whenever possible. Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 22 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 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 1 9 2 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 2 2 X X X 2 2 STAFFING Standard No Score 27 1 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 13 & 15 Requirement Care plans must set out in detail the actions which need to be taken by staff to ensure that all aspects of the health, personal and social care needs of residents are fully met. 15/02/08 The Registered Persons must ensure that all staff are trained in, and adhere to, safe medication practices; medications such as creams must also be safely stored. This is a home for people with dementia who could be at risk from in appropriately placed powders, creams and liquids. 3. OP12 16 (m) & (n) Residents must be provided with opportunities for appropriate stimulation, with particular consideration being given to people with dementia and cognitive impairment. Additional professional help and advice must be sought where necessary. 15/02/08 similar requirement was made and not met. DS0000045316.V366043.R01.S.doc Timescale for action 22/08/08 2. OP9 13 22/08/08 22/08/08 Fairlawn Nursing Home Version 5.2 Page 24 4. OP15 16 (1) If staff leaves assisting people with their meals, the meals must be returned to the kitchen for safekeeping and to keep warm. It is poor practice to serve both parts of the meal at the same time, as the meals will end up being given cold. The pleasure from meal times will be reduced in this way. Staff must be made fully aware of their responsibilities in safeguarding vulnerable adults and undertake and apply the training as necessary. 15/02/08 The patio garden area to the side and back of the property needs further attention to ensure that it is fit for purpose and is safe for anyone who may wish to use it. The patio door has a ridge leading from it, making it difficult to manoeuvre over, if a wheelchair was used. All aspects of safety must be considered. The home is not kept sufficiently clean and there are unpleasant house smells Improvements are required to the environment to avoid the risk of cross infection. Washing, drying and disposal facilities must be provided in all resident and public areas where staff or may visitors use. 22/08/08 5. OP18 22 22/08/08 6. OP19 23 (2) (a) & (b) 22/08/08 7. OP26 23 (2) (d) 22/08/08 8. OP27 18 (1) (a) The numbers of staff being employed should be reviewed to ensure that individual’s needs are actively being met when the help is needed. People seen living at the care home have high dependency needs and need more help from the staff that takes time. DS0000045316.V366043.R01.S.doc 22/08/08 Fairlawn Nursing Home Version 5.2 Page 25 9. OP29 19 (1) (b) (i) 10. OP38 26 (1) All staff records must be checked for the correct information to ensure that they all comply with the Care Standards Act 2000 Regulations, and employment information. As there is no registered manager this responsibility falls on the registered provider to do. The Registered Persons is required to visit the care home and prepare a report on the conduct of the care home. 22/08/08 22/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Fairlawn Nursing Home DS0000045316.V366043.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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. 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