Inspection on 20/04/07 for The Fairway

This inspection was carried out on 20th April 2007.

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

The Fairway 02/05/06

The Fairway 27/01/06

The Fairway 10/10/05

The Fairway 31/01/05

The Fairway 15/07/04

The Fairway 04/03/04

The Fairway 19/08/02

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Fairway Green Lane Highlands Oxhey Hertfordshire WD19 4LX Lead Inspector Marian Byrne Unannounced Inspection 10:00 20th and 27th April 2007 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 The Fairway DS0000019568.V335912.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. The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Fairway Address Green Lane Highlands Oxhey Hertfordshire WD19 4LX 01923 221345 01923 209997 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) www.quantumcare.co.uk Quantum Care Limited James Antwi Care Home 45 Category(ies) of Dementia - over 65 years of age (45), Old age, registration, with number not falling within any other category (45), of places Physical disability over 65 years of age (45) The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd May 2006 Brief Description of the Service: The Fairway is operated by Quantum Care Limited and is a purpose - built residential care home for service users in the Old Age and Dementia category. It is owned by Hertfordshire County Council. The home is situated in Oxhey, close to Watford town centre. There is parking space in the front of the building. The surrounding grounds are mainly laid to lawn. Accommodation is provided on all the floors arranged as four separate units. Each unit has a small kitchenette, where service users and their relatives can make drinks and snacks. Quantum Care Limited operates a non-smoking policy in all its care homes. The Fairway charges £400-£505 per week. The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over two days by one inspector. The home is presently being managed in a temporary capacity by a relief manager; she was present on day one of the inspection. The inspector spent two hours in the lounge with very vulnerable service users observing their care and the interaction between them with staff and their surroundings. At the time of the inspection the home was full. The inspector had a full discussion with the manager and three staff members. On the second day of the inspection the inspector spoke to service users and their visitors, toured the premises and inspected documentation on care planning, health and safety and recruitment of staff. Medication was not inspected on this visit, as the home was mid way in a transition from one system to another. There were no problems with the administration of medication at the previous inspection carried out on the 2nd and 7th of June 2006. What the service does well: What has improved since the last inspection? What they could do better: Care plans must be followed in the delivery of care. One individuals care plan states that she must always be sitting up straight and supervised while eating. This did not happen. The home must explore different ways of ensuring service users receive optimum nutrition. The serving of lunch at a given time does not The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 6 suit all service users, some of who were woken to have lunch. Food must be served at an appropriate temperature. The floor covering in the dining room on the first floor must be made safe to ensure the safety of service users. Unpleasant odours must be eradicated. Staff must be aware of service user’s dignity and only use protective clothing where appropriate. A staff member was observed to wear protective gloves when giving a hand massage. 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. The Fairway DS0000019568.V335912.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 The Fairway DS0000019568.V335912.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service user’s needs are fully assessed prior to admission. EVIDENCE: Four service users assessments were inspected and they contained full information on the service users needs and wishes. The pre-admission assessment was documented and kept in the service user’s file. The home will only admit a service user whose needs can be met. A copy of the contract was given to each service user on admission. The registered manager confirmed that each service user is given a Service User Guide on admission and that information is provided to all prospective service users. The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans were detailed but not always followed. Service users were mostly treated with respect. EVIDENCE: The care plans contain good detail on the care of service users. One service users care plan indicated that she had difficulty swallowing and that she must be supervised at all times this did not happen. When she was seated for lunch she was put with her back to the area where staff were working from. At one point she needed a spoon and the person sitting next to her had to ask on her behalf, as the service users could not attract the staff herself. Staff were good in their interaction with service user and were not task led, they took time to respond to service users and to initiate good contact. However, when it came to lunch staff reverted to task led actions. Those service users who were asleep were not woken to be included in the general activity and interaction in the room earlier. At lunchtime one service users had a ‘bib’ put on her while she was asleep and another was woken to have lunch. The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 10 The home must review how nutrition is provided for service users bearing in mind that those people who use the service may not thrive on the existing meal routines. The inspector observed a member of staff offering a hand massage to service users, which was very much appreciated by them. The member of staff was wearing protective gloves while massaging, this was unnecessary and could have been seen as disrespectful to the service users. All service users are registered with a general practitioner and a district nurse visits regularly. The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The daily life and social activity in the home is limited. Very few of the people who use the service were engaged on useful occupation. Visitors are welcome at reasonable times. Food was served at designated times which did not suit all the service users. EVIDENCE: Some of the service users who live in the home are usefully occupied during the day others have no useful occupation. One service user spoken with stated that she spends the morning in her room for peace and quiet she doesn’t like the television on every day. It was not switched on, on the day of the inspection. Service users were sitting in their chairs listening to music. The day of the inspection was a sunny day none of the service users had access to the grounds. Visitors are welcome at all reasonable times and there was a flow of visitors to the home on the day of the inspection. The inspector was informed that the food though good could occasionally be served cold. As already stated The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 12 earlier in this report there is what appears to be a rigid routine regarding the times lunch is served this must be looked into to ascertain if this meets the nutritional needs of the service users. The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. 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. People who use the service are protected from abuse. Complaints are listened to and responded to within the home’s complaints procedure. EVIDENCE: All staff spoken with were aware of the procedures in dealing with safe guarding adults. Complaints were recorded and responded to appropriately. The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is in need of maintenance. Some area of the home while clean had an odour that could be associated with incontinence. EVIDENCE: The inspector toured the premises. The rooms of people who use the service were mostly clean, fresh and odour free. Some rooms did have an odour that could be associated with incontinence. The manager was aware of this and the domestic staff were endeavouring to eradicate this odour. The floor covering in the dining room area on the ground floor is uneven and could cause service users with poor mobility to fall. There is a quiet room on the ground floor on the day of the inspection the door was closed and it appeared not to be in use. This is a good facility and should by used for those who want to pursue quiet pastimes. The home would benefit from re-decoration. Service users rooms were decorated and furnished to reflect their personalities. The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are recruited appropriately. They are safe and are looked after by staff trained to carry out their duties. The home is sufficiently staffed. EVIDENCE: Four recruitment files were inspected; they contained all the appropriate documentation, including a Criminal Record Bureau check and two references. All staff receive an introduction to caring for people with a dementia as part of their induction, a further two days training is then carried out within their first six months. To date 17 of the 38 staff members have completed intermediate training. The Deputy Manager has completed one year’s training in the care of people who have dementia. Staff must follow instructions in care plans to ensure the safety of the service users. Moving and handling was observed and was carried out safely. Staffing levels were reviewed and staffing levels were increased. The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is adequate. This would have been good had the manager been permanently appointed to the home. This judgement has been made using available evidence including a visit to this service. The home is well managed and is run in the best interests of the service users. Health and safety of the service users is promoted and protected. EVIDENCE: The home is being run by a relief manager at the moment awaiting the appointment of a new manager. The home is well run and is run in the best interests of the service users. The service users are safeguarded. Safety checks were carried out on equipment and machinery. Fire drills were carried out. The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 17 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 X 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X X X 3 The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 18 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. Standard OP8 OP19 Regulation 12 (1)(b) 23(2)(b) Requirement The Registered Provider must ensure that the care home is conducted so as: to promote and make proper provision for the supervision of service users at risk of falling. By ensuring that the flooring in the dining room on the ground floor is even. The Registered Provider must ensure that food is served at an appropriate temperature. The Registered Provider must ensure that food is served at a time and in a manner that meets the needs of very vulnerable and frail service users. The Registered Provider must ensure that the dignity of service users in preserved through the appropriate user of protective clothing. The Registered Provider must ensure that the home is free from odours that could be associated with incontinence. Timescale for action 27/05/07 2. OP15 16(2)(1) 27/05/07 3. OP10 12(4)(a) 27/05/07 4. OP26 16 (2)(k) 27/05/07 The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 19 5 OP7 15(2)(b) The Registered Provider must ensure that staff has a working knowledge of each service users care plan and that the care of the service users in carried out according to the care plan. 27/04/07 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 The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Hertfordshire Area 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. Extracts may not be used or reproduced without the express permission of CSCI The Fairway DS0000019568.V335912.R01.S.doc Version 5.2 Page 21 - 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. 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