Inspection on 05/09/05 for Littlefair

This inspection was carried out on 5th September 2005.

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 12/10/06

Littlefair 17/01/06

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 Unannounced Monday, 5 September 2005, 15:00 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 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 H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Littlefair Address Warburton Close, East Grinstead, West Sussex, RH19 3TX Telephone number Fax number Email 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 Mr Robin Christopher Sherard Kennedy Mrs Susan Dorman CRH(PC) - Care home only 41 Category(ies) of OP - Old age, 41 places registration, with number of places Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named Service User under the age of 65 years may be accommodated. 2. No Service Users under the age of 65 years may be admitted. 3 No more than a total of 41 Service Users may be accommodated. Date of last inspection 10 February 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 also allows Littlefair to accommodate one named service user under the age of 65 years. 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 user’s 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 H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted on Monday 5th September 2005 between 3pm and 7.45pm and was unannounced. The inspector spoke with seven residents individually and two residents sitting together in the lounge. The assistant manager and team leader on duty in the afternoon assisted the inspector and one care assistant spoke with the inspector individually. What the service does well: What has improved since the last inspection? What they could do better: Recommendations focus on Ensuring care plans and risk assessments are established in a timely fashion after a resident comes to live in the home Ensuring residents are involved in the care planning and reviewing process Ensuring all records are completed satisfactorily and accurately maintained Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 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. Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 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 standard(s) 2 & 3 New contracts are issued to service users who move rooms in the home. Prospective residents are assessed prior to their admission to the home. EVIDENCE: One resident was moving room on the day of inspection, in line with the provider response to the last inspection report, the deputy manager told the inspector that a new contract would be agreed to reflect the change. The inspector sampled records in relation to the newest and a recently admitted resident. Both records contained an assessment of the individual’s needs and where applicable National Health Service (NHS) transfer information had been sought. The registered persons must ensure that where an assessment clearly shows that a prospective resident has dementia, which is not within the home’s category of registration, the assessment clearly demonstrates how the residents needs can be met successfully in the home. Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 & 10 Care plans set out residents needs. The timescale for completing care plans could be improved and residents should be involved in the process of care planning and reviewing. Risks to resident’s health and well being should be assessed and monitored. Arrangements for the storage, administration and recording of medicines has improved and protect residents. Staff respect resident’s privacy for the most part. EVIDENCE: The inspector sampled four residents care records and found that three, which had been completed were comprehensive, signed by the resident and set out the input required from staff to support residents with activities of daily living and the associated risks. Moving and handling risk assessments had also been completed for each of the three service users. However, the care plan for the most recently admitted service user had not been completed two weeks following her admission to the home. Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 Page 10 Similarly, a risk assessment and plan for prevention had not been completed for a resident now at risk of skin damage. Two residents who were asked did not know about their care plan and reviews did not suggest that the changes had been discussed with residents. Controlled drug storage and recording has been improved. Medication storage arrangements have also improved to ensure medicines are only administered to residents for whom they have been prescribed. It is still the practise of the home for a senior member of staff to administer medication to a pot for other staff to take with meals on a tray, the senior member of staff signs for the medication and the care assistant feeds back if it is not taken by the resident. Risk assessments for residents who self administer some of their medication were not seen. Medication Administration Records (MARs) are used to show what medication has been given to individual residents to self administer. One resident explained that she liked to spend time alone in her room and she said this choice was respected by staff. The inspector observed staff knocking on doors to residents rooms and asked two residents about this. Feedback indicates that some staff knock every time and some do not always do so. Staff gave good examples of how their respect residents privacy and dignity. Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 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 standard(s) 12, 13 & 15 Activities are organised and offered to residents. Residents are able to maintain their contacts with family, friend and their links in the community. A choice of food is offered and most residents are satisfied with the standard of food. EVIDENCE: Residents said they enjoy a variety of activities provided for them and the inspector noted that the activity organiser also spends time with residents individually. One comment received by the inspector was that more outings would be appreciated. One resident told the inspector how coming into Littlefair had not limited her ability to maintain links with her family, friends and local community groups such as the church. She explained that she often goes out, has visitors and similarly, enjoys joining in with the activities provided by the home. All residents told the inspector that a choice of food is offered to them, one resident was particularly pleased that she could have a cooked breakfast because she likes that. Comments about the food included “I always enjoy my Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 Page 12 food”, “I like it [the food] here” “reasonable” and “variable”. The deputy manager showed the inspector some small questionnaires that have been used following mealtimes to gain feedback about the food and these showed that residents had used the opportunity to let the home know what they enjoyed and what they did not enjoy. Residents also told the inspector that they discuss food at their meetings and the new chef said he would become involved in these. Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 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 standard(s) 18 Residents are protected from abuse. EVIDENCE: Staff received training in abuse awareness and from discussion with staff the inspector concluded that they are aware of their responsibilities under the home’s whistle blowing policy to report any such incident. Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 25 & 26 Residents live in a safe and hygienic home. Surroundings are comfortable. EVIDENCE: Some dorguards have been purchased since the last inspection to facilitate residents to have the door to their bedroom open without posing a health and safety risk. However, the inspector noted that one door was still ‘propped’ open and this was rectified during the inspection to ensure the health and safety of all staff and residents. Lounge areas were adequately furnished for them to be used by residents, one comment received by the inspector was that some more comfortable garden furniture is needed in order for residents to sit in and enjoy the grounds. Cleaning products did not pose a risk to health and safety during the inspection and the home was clean and tidy to a satisfactory standard. Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 & 29 Staffing levels are satisfactory. Staff are trained to do their job. Recruitment practises protect residents. EVIDENCE: The staff rota shows that, during the week of this inspection, five staff work the morning shift and four work the afternoon shift, this number includes a senior member of the team. The registered manager’s hours are in addition to this and the deputy manager has shifts allocated to administrative work. The night duty (9pm-7.30am) operates with three staff for the most part, on occasions two staff cover this shift and daytime staff come in early to assist with times of peak activity. Additional domestic, kitchen and maintenance staff are employed by the home. The registered persons should continue to monitor the dependency levels of residents to ensure staff levels are satisfactory to meet their needs. Discussion with staff indicated that they are offered training opportunities and are supported with training, particularly to achieve NVQ awards. The manager and her deputy are assessors and this enables them to support staff with their NVQ awards. Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 Page 16 The inspector sampled two recruitment records and these demonstrated that the recruitment procedure operated by the home is robust and protects residents. Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 36, 37 & 38 The management are approachable and offer staff and resident opportunities to share their views. Staff are supported, supervised and their performance is appraised. Record keeping could be improved. The health and safety of residents and staff is protected. EVIDENCE: Feedback indicates that staff feel able to put forward imaginative ideas, which are listened to by the management. Residents also said they have meetings, although they have not had one recently, which they use these to raise various issues and voice their opinions. Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 Page 18 Staff said that they enjoy a good team spirit and that they are supported through team meetings, individual supervision sessions and regular appraisals of their performance. Records in relation to the monitoring of food temperatures were not comprehensively complete and a cleaning schedule for the kitchen is not being used. Records must be accurately maintained and kept up to date. Fire and moving and handling equipment is regularly serviced and staff receive regular updates in health and safety training including manual handling. Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 3 3 x x x x 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x 3 x x x 3 2 3 Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 Page 20 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 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 7 7 8 37 Good Practice Recommendations It is recommended that care plans be developed in a timely fashion following a residents admission to the home. It is recommended that residents be involved in the review of their care plan and risk assessments It is recommended that risk assessments and strategies for minimising risks be put in place in relation to pressure areas It is recommended that all records be complete and accurately maintained including kitchen records. Littlefair H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 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 H60-H11 S14612 Littlefair V242688 050905 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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