Inspection on 12/10/06 for Littlefair

This inspection was carried out on 12th October 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

Littlefair 10/12/08

Littlefair 13/12/07

Littlefair 17/01/06

Littlefair 05/09/05

Littlefair 10/02/05

Littlefair 12/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Littlefair Warburton Close East Grinstead West Sussex RH19 3TX Lead Inspector Ms J Hartley Unannounced Inspection 12th October 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 Littlefair DS0000014612.V319074.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. Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Littlefair Address Warburton Close East Grinstead West Sussex RH19 3TX 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) 01342 318008 01342 300017 sue.dorman@littlefair.net www.littlefair.net Mr Robin Christopher Sherard Kennedy Mrs Orosia Lilianne Kennedy Mrs Susan Dorman Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41), Physical disability (3), Physical disability of places over 65 years of age (3) Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Up to 3 persons in the category physical disability (PD), age 60 years and over requiring personal care may be accommodated. Up to 3 persons in the category physical disability elderly (PD(E)) requiring personal care may be accommodated. No more than a total of 41 service users may be accommodated. Date of last inspection 17th January 2006 Brief Description of the Service: Littlefair is a privately owned care establishment registered to accommodate forty-one service users in the category OP (Old age, not falling within any other category.) The registration has recently been altered to allow Littlefair to accommodate a maximum of three service users under the age of 65 years in the category of Physical Disability (PD). Littlefair is purpose built, and situated in a residential area close to East Grinstead town centre, shops, train station and other amenities. There are gardens to the front and side of the building and a central secluded garden area. There is a large car park at the rear. Service users accommodation consists of forty-one single rooms arranged on three floors of the property accessible by lifts. Communal space is provided in two lounges and a dining room on the ground floor. The registered providers are Mr R and Mrs O Kennedy and Mrs S Dorman is the registered manager in charge of the day to day running of the establishment. The fees range from between £345 and £525. Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced visit took place over five hours. The registered manager Mrs Dorman was present throughout part of the visit and provided the information required. The inspector examined information held on the service file since the last inspection in January 2006, and read the previous two inspection reports, the Service User Guide and the Statement of Purpose. Evidence was also gathered from the pre-inspection questionnaire. During the visit the inspector spoke with many of the residents, care assistants, the activities coordinator and the chef. The inspector undertook a tour of the premises and looked at three care plans and three staff files. Various record books, policies and procedures were also examined. What the service does well: What has improved since the last inspection? What they could do better: Care needs to be taken to ensure that medication administration is accurately recorded at all times. Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 6 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. Littlefair DS0000014612.V319074.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 Littlefair DS0000014612.V319074.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): 1, 3, 5, and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have the information they need to make an informed choice about where to live. Residents’ needs are assessed prior to moving into the home. Prospective residents are able to visit Littlefair prior to making a decision about moving in. Littlefair does not provide intermediate care; therefore Standard Six does not apply to the home. EVIDENCE: The home has an up-to date Statement Of Purpose and Service Users Guide, (updated September 2006), that provides the information prospective residents need to make an informed choice about where to live. Residents have a copy of the Service User Guide in their rooms. Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 9 The inspector examined the files of three residents. Each file contained a full needs assessment undertaken prior to the resident moving into the home and a plan of care for daily living. Each resident also has a personal profile completed by the resident or relative to provide further information to assist staff to meet individual needs. Residents told the inspector that they were able to visit the home prior to moving in. Littlefair DS0000014612.V319074.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, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are set out in individual care plans that are reviewed regularly. Residents have access to health services to meet their assessed needs. Medication polices are in place and residents are able to tale responsibility for their own medication if they wish. Residents feel that they are treated with respect and dignity. EVIDENCE: Residents’ files seen during the inspection contained care plans that detailed action to be taken by staff to meet peoples’ individual needs. Evidence was seen that residents and relatives were involved in the drawing up of care plans, particularly in the use of the personal profile mentioned in the previous section. Care plans clearly recorded religious preferences and the diverse needs of the individual residents. Some care plans were signed by residents. Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 11 Daily records show evidence that health needs are met by community health services. A chiropodist visits the home every six weeks and a district nurse sees individual residents as required. Assessments were seen to be in place for pressure sores and mobility. Clear medication guidelines were seen to be in place. Medication records were inspected. Records were generally well maintained, however, three gaps were found in the administration records. When these were pointed out the senior care worker immediately spoke to the staff member concerned and explained the importance of accurate recording. Only staff who have received training in medication are allowed administer medication. Staff spoken with confirmed this. Certificates were seen to evidence this. Risk assessments were seen to be in place for the residents who self medicate. Lockable storage is provided in their bedrooms for the storage of medication. Residents spoken to said that staff treat them with respect and maintain their dignity whilst giving personal care. One resident said “It’s embarrassing having someone to help you with these things but the staff understand this and put you at ease as much as they can”. Littlefair DS0000014612.V319074.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, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents find that the lifestyle that they experience in the home matches their expectations and meets their needs. Residents are able to maintain contact with family, friends and the community and are able to exercise choice and control over their lives. The majority of residents enjoy the food provided by the home and say that the food has improved since last inspection. EVIDENCE: Littlefair employs an Activity Organiser who arranges daily activities in the home. A list of the week’s activities was seen on each table in the dining room. The Activity Organiser spoke to the inspector and had a good knowledge of individual residents’ preferences regarding social activities. Residents said that there is a good range of activities that they are able to join in with if they wish. Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 13 It was clear from the daily records and observations during the inspection that residents are able to exercise choice in their daily lives. For example during the inspection one resident asked for the time of their bath to be changed. Staff on duty addressed this immediately. During the inspection the inspector spoke with two visitors, both confirmed that they are made welcome in the home and are able to visit their relatives in private if they wish. Residents are able to handle their own financial affairs if they want and are able to. Information on how to contact advocacy services, CSCI and the Care Aware Helpline were prominently displayed in the hall. It was clear from a tour of the home that residents are able to bring their own possessions into the home. The majority of residents spoken to said that they enjoyed the food provided for them at Littlefair. One resident said that she found the meat too tough at times. The manager said she would look into this. The inspector ate dinner with the residents and found the meal tasty and well presented. There was a choice of two main courses and two puddings. The three residents the inspector sat with during dinner said that they are asked each evening what they want for dinner the next day. After dinner residents were asked to make their choices for supper. Residents were able to choose from two starters, two snack type meals, (for example jacket potatoes or sandwiches), and two puddings. The menu seen by the inspector was varied and nutritious. Residents felt that the food at Littlefair has improved since the last inspection. The manager said that following feedback from the Residents’ Satisfaction Survey and the last inspection the home has employed a catering manager to improve the standard of food. Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 14 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 good. This judgement has been made using available evidence including a visit to this service. Residents are confident that their complaints will be listened to, taken seriously and acted upon. The home’s policies, procedures and staff training protect residents, as far as possible, from abuse. EVIDENCE: The home has a clear, accessible complaints procedure in place that includes timescales for action. The home’s record of complaints was inspected; there have been no complaints since the last inspection. Residents spoken to felt confident that any complaints they made would be listened to and acted upon. The home has robust procedures in place regarding abuse and whistle blowing. Staff training records were examined. They show that all staff receive Adult Protection Training plus regular updates. Staff spoken with conformed this. Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 15 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 good. This judgement has been made using available evidence including a visit to this service. Littlefair provides a safe well-maintained environment that is clean, pleasant and hygienic. EVIDENCE: Littlefair is a detached property situated in a residential area of East Grinstead. Accommodation is provided on three floors. The home has two lifts. One lift services all three floors and the other services the lower two floors. A tour of the premises found the home to be in good decorative order. Communal areas are homely with comfortable chairs, pictures, plants and flowers. The dining room has recently been redecorated. Fresh fruit and flowers were arranged on the dining room tables. The grounds were seen to be Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 16 tidy, safe, and accessible. The garden is planted with trees and shrubs. Tables, chairs and potted plants are arranged around the garden. On the day of the inspection the home was seen to be clean, hygienic, and free from offensive odours. Laundry facilities are sited away from food preparation and storage areas and have easy to clean surfaces. One resident said that the home “is kept clean and tidy all the time”. Another resident said, “I have all my own things around me. My room is lovely.” Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 17 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 using available evidence including a visit to this service. Residents’ needs are met by the numbers and skill mix of staff, who are well trained and competent to do their jobs. Residents are protected as far as possible by the home’s recruitment policy and practices. EVIDENCE: The rota seen by the inspector recorded staffing levels of five care staff in the mornings, four to five staff in the afternoons and evenings, and three wakingnight staff. Residents felt that there are enough staff on duty to meet their needs. One resident said staff are very busy and don’t always have time to stop and chat. This was fed back to the manager. Staff training records show that staff receive mandatory training in Health and Safety, plus training relevant to the specific needs of residents. Staff receive induction training at the start of their employment. Over fifty percent of care staff have an NVQ Level 2 qualification or above. The home has a thorough recruitment procedure in place. Three staff files were examined and found to include all the required documentation, including an application form, two written references, and a Criminal Records Bureau Check. Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 18 Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. 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 using available evidence including a visit to this service. The registered manager has the qualification and experience needed to run the home and meet it’s stated objectives. The home has a quality assurance and monitoring system in place. The home does not manage the financial affairs of the residents. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: Evidence held on the Commission’s files show that the registered manager has the required qualifications and experience to run the home. Training certificates seen during the inspection show that the registered manager has Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 20 undertaken training to update her knowledge, skills and competence. She is also a qualified NVQ and Manual Handling Assessor. The home’s quality assurance and quality monitoring systems were seen during the inspection. The inspector was given a copy of the most recent Resident Satisfaction Survey undertaken in April 2006. This included the actions that the home has taken in response to the survey results. The home also holds regular residents meetings to seek the views of the residents. The home does not manage the financial affairs of any residents. The residents themselves, relatives or solicitors, undertake this. During the inspection documentary evidence was seen that regular safety checks and services are made on the equipment and appliances at the home. Staff training records show was also seen that staff receive training in safe working practices such as Fire Safety, Infection Control, First Aid and Moving and Handling. Staff confirmed that they have attended Health and Safety training. The accident book was seen during the inspection and found to be clearly recorded. Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 X X 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 X X 3 Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 22 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. Refer to Standard Good Practice Recommendations Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Littlefair DS0000014612.V319074.R01.S.doc Version 5.2 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!