Inspection on 17/01/06 for Littlefair

This inspection was carried out on 17th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 12/10/06

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 Mrs Kerry Leppard Announced Inspection 17th January 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 Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 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.V268402.R01.S.doc Version 5.0 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) of places Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. One named Service User under the age of 65 years may be accommodated. No Service Users under the age of 65 years maybe admitted. No more than a total of 41 Service Users may be accommodated. Date of last inspection 5th September 2005 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. Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and was conducted on Tuesday 17th January 2006 between 9.30am and 5pm. Twenty one residents completed a comment card with assistance from the registered manager. The inspector also received twenty four relative/visitor comment cards. On the day of the inspection the inspector met and spoke with eleven residents including three, with whom the inspector ate lunch. Feedback and comments received through comment cards and discussions will be used in this report. The registered manager and her deputy assisted the inspector. Two care staff and three other members of the staff team spoke with the inspector individually. What the service does well: What has improved since the last inspection? In response to a recommendation made at the last inspection, tools for monitoring risks to residents from pressure areas have been implemented. The inspector sampled a specific care plan that included reference to the actions being taken to minimise the risk of pressure areas developing. Kitchen records were more comprehensively completed than previously noted. Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 Page 6 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. Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 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.V268402.R01.S.doc Version 5.0 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&6 Access to the information needed to make an informed choice about where to live could be improved. Intermediate care services are not provided at Littlefair EVIDENCE: Residents are provided with a copy of the service user’s guide and this is maintained in a folder in each room. Relative/visitor feedback indicates that access to inspection reports could be improved. The registered manager should consider how best to make this information more accessible to support prospective residents and their representatives to make an informed choice about where they live. Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 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 Individual care plans set out residents needs. Residents health needs are monitored. EVIDENCE: Three care records were sampled. They include a social history, which evidence from discussions indicates, that staff and/or relatives complete. The inspector is pleased to note that the care plan for the most recently admitted resident was being progressed in a timely fashion and senior staff review records regularly. The sample of care records seen did not indicate that care records are agreed and signed by residents and/or their relative or representative. Similarly records did not indicate that the review of these records is done in consultation with residents and /or their representative. These findings are reflective of a recommendation made on the last inspection report and some comment card feedback from relatives/visitors who said they have not been consulted about their relatives care. Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 Page 10 Therefore, it remains a recommendation that care plans be established and reviewed in consultation with residents and their relatives to ensure agreement is reached about the ways in which the residents needs will be met, particularly as resident’s needs change. Care records now indicate that risks to residents from pressure areas are being recorded and monitored regularly using a Waterlow score. Actions to reduce the risk are also noted in care records. Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 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, 14 & 15 A varied activity programme is provided. Access to advocacy and support services is facilitated. Residents receive a varied diet the appeal of which could, at times, be improved. EVIDENCE: The home employs an activity coordinator who was praised individually by some residents, one comment was ‘Judy is very good indeed and does an enormous amount to get people involved and moving about.’ The coordinator has access to information about resident’s hobbies and interests and told the inspector about how she adapts activities to ensure residents with communication difficulties are enabled to participate. The activity coordinator also makes records of resident’s participation in group activities and any one to one sessions she has with them. Feedback from residents who completed a comment card indicates that they all think suitable activities are provided, one resident who spoke with the inspector said ‘ there’s something on everyday…keeps you mentally alert’. One resident suggested a game of Shove Ha’penny and feedback from various sources indicates that arranging trips outside of the home is difficult due to Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 Page 12 transport and staffing arrangements. As part of the home’s quality audit and development, it is recommended that this be monitored and addressed. Relative/visitor comments include ‘[relative] has started getting involved in activities, is walking about more and generally looks brighter. So far Littlefair is doing a good job clearly’ Discussions with residents indicate that they are able to maintain contacts within the community, which enable them to go out to church and shopping whilst some have communion brought to them at Littlefair. The registered manager advised the inspector that she has good links with an advocacy service to whom to refers all prospective residents and their relatives for information and support. The registered manager has received positive feedback about this. The home employs one chef who is undertaking an NVQ (National Vocational Qualification) at Level 2 in food preparation and cooking. The chef is responsible for all aspects of the kitchen management and is currently supported by agency chefs throughout the week and kitchen assistants at some times of the day. The majority of residents who completed a comment card indicated that they like the food at Littlefair, one commented ‘love it’. However some feedback indicates that the quality of food served could be improved at times, relative/visitor comments include ‘ food is wasted because it is poorly cooked’ and ‘I am concerned about the quality of food and how it is prepared’. Resident feedback indicates that meat is sometimes tough and the temperature at which food is served does not always make it enjoyable. The inspector also noted that the way in which food is served means that residents seated together are not always able to eat their meals together, this is unfortunate and was fedback to the chef. The chef attends residents meetings to listen to their views and feedback, this should continue and positive steps should be taken to address issues raised by residents. Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 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 Residents know who to speak to if they are unhappy with their care. Relatives and friends are not confident that their complaints will be listened to. EVIDENCE: The homes complaints procedure is posted around the home and comment card feedback from residents indicates that if they are unhappy with their care they know who to talk to. Nineteen relatives/visitors said they were aware of the complaints procedure. However, the inspector received some feedback from relatives/visitors to suggest that there is a lack of openness to concerns and complaints and that the response received at times is brusque. The registered persons should consider how communication at Littlefair can be improved to ensure relatives/visitors feel listened to. Regular communication with residents and relatives to review care records (standard 7) may help resolve some of these issues. Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 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): 19 & 26 The environment is safe and generally well maintained. The environment is clean and pleasant. Systems for ensuring deeper cleanliness could be improved. EVIDENCE: The home’s last fire officer report was satisfactory and action has been taken by the home to address the requirements and recommendation of the Environmental Health Officer who visited following the last inspection. The inspector observed that some communal areas of the home are in need of redecoration to improve the outlook, which is dark and untidy. This was brought to the registered manager’s attention. As part of the home’s own quality assurance system, a programme of redecoration and refurbishment should be in place and available for inspection. The home employs maintenance and domestic staff to ensure the building is safe, well maintained and clean. Residents spoke positively about the attention Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 Page 15 given to keeping the home clean. The inspector discussed with the registered manager the benefit of introducing a system for ‘spring cleaning’ rooms regularly to ensure standards of cleanliness are maintained. The inspector was advised that the home’s quality audit system includes tools that will be used for this and to ‘spot check’ cleanliness. Care staff manage laundry and some feedback indicates that residents are very satisfied with this service. Other feedback indicates this is less than satisfactory at times and residents discussed this with the registered manager at their last meeting. Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 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 & 30 Staffing numbers are sufficient to meet resident needs but deployment of staff should be reviewed to ensure staff are accessible. Staff are trained and competent to do their job. EVIDENCE: Using the Department of Health guidance for calculating staffing levels and dependency levels of residents provided by the registered manager, the care hours provided at Littlefair are satisfactory. The rota provided for inspection indicates that day duties are covered by five care staff and night duties by three waking members of staff. Care staff are responsible for laundry in addition to care tasks. However, feedback from relatives and residents suggests that staff are busy, the implication of which, for residents and relatives/visitors, are that staff forget about things they have been asked and agreed to do, that the response to call bells and requests for assistance is sometimes slow and that it can be difficult to find someone with whom to resolve minor queries and concerns. It is therefore recommended that the deployment of staff be reviewed to ensure they are accessible. The inspector spoke with two staff who confirmed that they had been recruited by the home using a thorough and robust procedure. Following which, they Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 Page 17 had begun supervised employment and had undertaken induction training using Skills for Care (formerly TOPSS) workbooks. Evidence of completed workbooks were not available for inspection. Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 Page 18 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): 31, 33. 35 & 37 The registered manager is experienced and qualified. Systems are in place to ensure the home is run in the best interests of residents. Residents financial interests are safeguarded. Record keeping in the kitchen has improved. EVIDENCE: The registered manager has achieved the NVQ Level 4 Registered Manager’s award to compliment her City and Guilds Advanced Management of Care qualification and provided evidence of her ongoing training and development. The deputy manager is also working on the NVQ at Level 4. Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 Page 19 The home operates a comprehensive quality assurance system that would benefit from development in it’s second year of use (see standard 26). The home has not issued a quality assurance survey to residents since July 2004 to obtain their views of the service. However, regular resident meetings are held and some residents talked with the inspector about such a meeting held the week prior to the inspection. The registered persons should demonstrate the action taken to address concerns and issues raised at these meetings to ensure residents feel listened to. The registered provider must also provide the Commission for Social Care Inspection with monthly Regulation 26 reports of the home. Money stored by the home on behalf of residents is stored securely and records are made of transactions. A sample were checked and found to be accurately maintained. Records are well maintained within the home and particular efforts have been made to ensure kitchen records are maintained satisfactorily. Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 Page 20 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 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 X Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? N/A 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. 2. 3. 4. Refer to Standard OP1 OP7 OP16 OP27 Good Practice Recommendations It is recommended that access to inspection reports be improved. It is recommended that residents and/or their relatives/representatives be involved in the development and review of their care plan. It is recommended that communication be improved to ensure relatives/visitors feel listened to It is recommended that the deployment of staff be reviewed to ensure they are accessible. Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Littlefair DS0000014612.V268402.R01.S.doc Version 5.0 Page 23 - 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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