Care Home: Fairfield

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What the care home does well Generally, people expressed satisfaction with the care and support they receive. People who returned surveys said: `I think it is alright here;` `It is a good home and is well run;` `I like living here and don`t want to move. The staff are good to me.`The provider has developed a strategy that sets out how people will be involved in the development of the service. Mental Health Matters (MHM) also produces a quarterly newsletter that informs people what is going on within their various services. MHM conducts robust monitoring visits to ensure that the care and support provided in the home is in line with the National Minimum Standards and its internal policies and procedures. The home has devised a detailed business plan that sets out the ways in which Fairfield House aims to improve the care and support it provides to people living at the home. The plan places particular emphasis on the need to ensure that people and their families are given opportunities to influence the way in which the home is run and managed. People are supported to develop their independent living skills in areas such as food shopping and meal preparation. The manager and her staff team are willing to engage with the inspection process in a very positive manner. People wishing to use the service are provided with a copy of the tenant`s handbook. This contains useful information about the services provided. People live in a well maintained home. A detailed decoration, maintenance, renewal and replacement rolling programme is in place. A senior member of staff has attended a NHS infection control course. There are good arrangements for supporting people to retain responsibility for taking their own medication. People are encouraged to attend tenant meetings so that they can express their views about how the home is run. Staff do not work alone at the home until they have completed their mandatory training. Staff who work at the service said: `The induction was very clear about what MHM expect from me and also what I can expect from them;` `Since starting work with MHM I have had to do lots of different training all of which has been extremely useful towards becoming a better support worker;` `The service is very well run. The manager is extremely efficient and continuously prompts her staff and encourages us to always see the needs of the service user;` Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 7The service `promotes independence and provides plenty of training;` `My induction was very detailed and allowed me to become familiar with the methods of working within the service. I have been made familiar with policies and procedures. I have been well supported during my induction;` `The way that information is passed between the manager and the staff team is good. There is always a handover when staff start a shift. There is a well used staff communication book and the personal files for each service user are updated daily;` `Staff communicate well with service users. organised;` The service is very well Staff are totally`This is undoubtedly the best place I have worked at. supported by management.` What has improved since the last inspection? What the care home could do better: Ensure that the Criminal Records Bureau disclosure certificates obtained for staff appointed between inspections are kept to allow them to be checked by the home`s inspector. This will help to confirm that only suitable staff are employed at the home. CARE HOME ADULTS 18-65 Fairfield 40 Grainger Park Road Newcastle Upon Tyne Tyne & Wear NE4 8RY Lead Inspector Glynis Gaffney Key Unannounced Inspection 29 & 30 May and 06 June 2008 11:15 Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 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 Fairfield DS0000000444.V365379.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 Adults 18-65. 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. Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairfield Address 40 Grainger Park Road Newcastle Upon Tyne Tyne & Wear NE4 8RY 0191 273 4614 F/P 0191 2734614 derekon6@aol.com 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) Mental Health Matters Mrs Constance Milton Care Home 11 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (11) of places Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th June 2006 Brief Description of the Service: Fairfield is set in a residential street in the Grainger Park area of Newcastle. It consists of a large, older style detached house that has been adapted to meet the needs of 11 adults with mental health care needs. Nursing care is not provided. A bus route, pub and local shops are within easy walking distance. People are able to access all parts of the premises, including attractive garden areas. The home has a kitchen, laundry, lounge, dining room and a small kitchen area that can be used by people living at Fairfield House. There are 11 single bedrooms. En-suite facilities are not provided. Off street parking is available. The home currently charges £379 per place per week. Copies of the Commission’s inspection reports were available to visitors, staff and people living at the home. Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. How the inspection was carried out: Before the visit: We looked at: • • • • • Information we have received since the last key inspection visit on the 12 June 2006; How the service dealt with any complaints and concerns since the last visit; Any changes to how the home is run; The manager’s view of how well they care for people. We also interviewed three people who use the service and three staff; The views of relatives and other professionals. The Visit: An unannounced visit was made on the 29 May 2008. During the inspection we: • • • • • • Talked with the manager; Looked at information about the people who use the service and how well their needs are met; Looked at other records which must be kept; Checked that staff have the knowledge, skills and training to meet the needs of the people they care for; Looked around the building to make sure it was clean, safe and comfortable; Checked what improvements had been made since the last visit. What the service does well: Generally, people expressed satisfaction with the care and support they receive. People who returned surveys said: ‘I think it is alright here;’ ‘It is a good home and is well run;’ ‘I like living here and don’t want to move. The staff are good to me.’ Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 6 The provider has developed a strategy that sets out how people will be involved in the development of the service. Mental Health Matters (MHM) also produces a quarterly newsletter that informs people what is going on within their various services. MHM conducts robust monitoring visits to ensure that the care and support provided in the home is in line with the National Minimum Standards and its internal policies and procedures. The home has devised a detailed business plan that sets out the ways in which Fairfield House aims to improve the care and support it provides to people living at the home. The plan places particular emphasis on the need to ensure that people and their families are given opportunities to influence the way in which the home is run and managed. People are supported to develop their independent living skills in areas such as food shopping and meal preparation. The manager and her staff team are willing to engage with the inspection process in a very positive manner. People wishing to use the service are provided with a copy of the tenant’s handbook. This contains useful information about the services provided. People live in a well maintained home. A detailed decoration, maintenance, renewal and replacement rolling programme is in place. A senior member of staff has attended a NHS infection control course. There are good arrangements for supporting people to retain responsibility for taking their own medication. People are encouraged to attend tenant meetings so that they can express their views about how the home is run. Staff do not work alone at the home until they have completed their mandatory training. Staff who work at the service said: ‘The induction was very clear about what MHM expect from me and also what I can expect from them;’ ‘Since starting work with MHM I have had to do lots of different training all of which has been extremely useful towards becoming a better support worker;’ ‘The service is very well run. The manager is extremely efficient and continuously prompts her staff and encourages us to always see the needs of the service user;’ Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 7 The service ‘promotes independence and provides plenty of training;’ ‘My induction was very detailed and allowed me to become familiar with the methods of working within the service. I have been made familiar with policies and procedures. I have been well supported during my induction;’ ‘The way that information is passed between the manager and the staff team is good. There is always a handover when staff start a shift. There is a well used staff communication book and the personal files for each service user are updated daily;’ ‘Staff communicate well with service users. organised;’ The service is very well Staff are totally ‘This is undoubtedly the best place I have worked at. supported by management.’ What has improved since the last inspection? People using the service said that they had been given a copy of the home’s tenant handbook before they moved into Fairfield House. The provider has reviewed and restructured the way in which services are delivered. This has helped to make services more person focussed and cost effective. The MHM Quality and Strategy Group meetings have reviewed a range of policies and procedures. Lone workers have access to ‘Guardian 24’ which is an emergency mobile telephone contact service that enables staff who are working by themselves to log in and out of activities both within the home and outside of it. All staff have been supplied with personal attack alarms. Equal opportunities training is now part of the provider’s foundation training programme. People using the service now receive support to budget, shop, plan and cook their own meals. A cook is no longer employed at the home. Improvements have been made to the premises. For example: • • • Fairfield The attic staircase has been redecorated and new carpet has been fitted; The main staircase, the front and back entrances and the hallway have been redecorated; The dining room has been redecorated and the curtains dry cleaned; DS0000000444.V365379.R01.S.doc Version 5.2 Page 8 • The lounge has been redecorated and new flooring laid. The curtains have been dry-cleaned and new furnishings have been purchased. A range of workplace risk assessments have been completed. Those checked were up to date. Satisfactory pre-admission assessment information is obtained about people’s needs before they move into the home. The premises related concerns identified in the last inspection report have been addressed. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are suitable arrangements for making sure that people’s needs are assessed before they are admitted into the home. This helps to ensure that staff will be able to meet the needs of people who are admitted into Fairfield House. EVIDENCE: MHM obtains a copy of each person’s social services assessment and care plan before deciding whether to offer them a placement at Fairfield House. Prospective applicants complete an application form that provides staff with extra information about their needs. People are invited to attend an interview and an initial in-house assessment is also carried out by Fairfield House staff to ensure that the home is able to meet their assessed needs. There is clear guidance setting out how admissions into Fairfield House should be handled. A sample of three people’s care records was examined. Each record contained a social services assessment and care plan, and a MHM application form. Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good arrangements for assessing and planning how to meet people’s individual needs and for ensuring that people are supported to take appropriate risks as part of their lifestyle. People’s changing needs and personal goals are reflected in their individual care plans and they know the content of these care plans. These plans help staff to be clear about what they must do to meet people’s needs. EVIDENCE: People are consulted about how their assessed needs will be met. The sample of care records examined contained: • Information about how people have lived their lives before they move into Fairfield House; DS0000000444.V365379.R01.S.doc Version 5.2 Page 12 Fairfield • A range of care plans for each person. People said that staff had consulted them about the information included in their care plans. Care plans are written in plain language and easy to understand. Generally, they have been reviewed on a monthly basis. The quality of information contained in the monthly reviews was variable. However, the manager had already identified this as an issue and had formulated a plan to address it. People said that they had been offered the opportunity to attend their care plan review meeting. People said that they are supported to make decisions about how they live their lives at Fairfield House. For example, one person said that they could choose: • • • When and where to see their visitors; Whether or not to spend time alone in their bedroom or mix with other people living at Fairfield House; Not to have their bedroom re-decorated or flooring replaced. One person told the inspector that the manager had respected their decision not to have improvements made to their bedroom; When to have a bath and what time to get up and go to bed. • Of the eight people who returned surveys: • Four said that they could make their own decisions about what they do each day. One said that this is ‘usually’ the case and two others said that this was ‘sometimes’ the case. One person said that this ‘never’ happened; Six said that they could do what they wanted during the day and evening. Seven said that this was the case at the weekends. • People are encouraged to participate in the daily life of the home. For example, tenant meetings are held on a regular basis allowing opportunities for discussion over such matters as problems with the household chores rota. An agenda is kept in the dining area and there was evidence that people had entered items that they wished to see discussed at the next meeting. MHM provides people using the service with the opportunity to sit on a committee that enables them to comment on how services are managed and developed. People are encouraged to take appropriate risks as they go about their daily lives. Risks are carefully assessed and monitored by staff. Copies of risk assessments carried out by social services and mental health professionals are obtained before an admission into the home takes place. The MHM preadmission interview is used to establish how identified risks will be managed within and outside of the home. Risk assessment information obtained at the point of admission is used to help devise initial care plans. In the sample of Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 13 care records examined: • • The home had obtained copies of specialist mental health risk assessments; A range of risk assessments had been completed for each person. For example, the assessments for one person covered the risks associated with self-medication, using the small kitchen facilities independently and preparing and cooking their own food. People’s smoking behaviour had also been individually assessed. People said that they had been consulted about their risk assessments and had been invited to read and sign them. The risk assessments checked had been regularly reviewed. Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are able to choose how they want to live their lives. There are good opportunities for personal development and people are encouraged to make use of local community facilities. This means that people are able to lead fulfilling lives with the level of staff support that suits them. EVIDENCE: Staff help people to live more independently by supporting them to practise the skills they will need to move back into their own accommodation. For example: • Since the last inspection, the home no longer employs a cook. People now buy their own food and prepare their own meals. Staff support is available as and when needed; DS0000000444.V365379.R01.S.doc Version 5.2 Page 15 Fairfield • • People manage their own money and take responsibility for keeping their room clean and laundering their own clothes; People are supported to take their medication with varying levels of staff support. People are supported to seek employment with the help of the MHM employment advice service. One person said that staff are supporting them to find voluntary work and to participate in a local college course. This person also said that when their mental health deteriorates, ‘staff support me to do things around the house and encourage me to go out with a friend who also lives at Fairfield House.’ They said that ‘staff never force me to do anything. I feel well supported.’ Another person said that staff were exploring the possibility of them working at a local supermarket. People said that visitors are made to feel welcome. One person said that their relative could visit at any reasonable time’ and it was ‘up to them where they saw their visitor.’ People are encouraged to build relationships with other people living at the home. One person said that ‘having friends at the home has helped me to get better. I go out regularly with another person living at the home. We go to a local café. Sometimes we go into the shops.’ Another person said that any disagreements that arose were ‘handled ok’ by the manager and always got sorted out.’ People said that staff respect their privacy and encourage them to take on personal responsibilities for the running of the home. One person said that staff never enter their bed-sit without first knocking. Another person said that they always receive their mail unopened. Someone else said that staff do not speak to them about private matters when there are other people around. People using the service are encouraged to attend and participate in tenant meetings. An agenda book is kept in the dining room that people can use to raise issues which they feel need resolving. Each person has a care plan that identifies what support they require with preparing and cooking their own meals. People expressed satisfaction with the decision reached by MHM to provide them with opportunities to cook their own meals. People have access to a small kitchen in which they can store food and prepare their own meals. This facility is well used and is kept clean and tidy. There is also a large central kitchen that has recently received a satisfactory rating from the local authority for cleanliness and hygiene. People living at the home can also use this kitchen. One person commented that people should be able to access the small kitchen 24 hours a day. Another person said they agreed with the decision that had been made to restrict access to the small kitchen during the night to keep people safe. . None of the people accommodated at Fairfield House have specialist dietary needs or need physical support with eating. Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive personal and healthcare support and assistance with medication that meets their assessed needs. This helps people to feel well cared for, healthy and in control of their lives. EVIDENCE: People do not require physical support with personal care. People said that: • • • Staff consult them about what is written in their care plans. They said that staff had taken their views into account; They felt their needs were well met by staff; They felt safe living at the home. People said that their healthcare needs are met. One person had attended a diabetic clinic appointment in the last six months. Another person had seen their dentist on three occasions during the previous month. Two other people had recently received a sight health check. People spoken to said that they Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 17 had been supported to register with a local GP. They all said that staff supported them if they needed help with a medical appointment. The home has a medication policy that is followed by staff. Each person’s ability to take responsibility for their own medication has been assessed and a supportive care plan devised. The home’s medication records are generally well completed. Each record contains an identification photograph to help ensure that people receive the correct medication. All medicines are locked away to keep people safe from harm. There were no controlled drugs stored on the premises at the time of the inspection. Lockable facilities are provided in people’s bedrooms to help them store their medication safely. There has been one mis-administration of medication since the last inspection. The manager took immediate steps to address the issues raised by this incident. The last inspection completed by the home’s pharmacist was generally satisfactory. Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good arrangements for keeping people safe and responding to complaints. This means that people can be confident that they will be protected from harm, and that their views will be listened to and their concerns acted upon. EVIDENCE: The home has a complaints procedure that is written in plain English and easy to understand. The procedure can be made available in other formats on request. A copy of the complaints procedure is available in the home’s reception area and in the tenant’s handbook. Of the eight people using the service who returned surveys, seven said that they had been told how to make a complaint. Of the five staff that returned surveys, all said that they would know what to do if a relative made a complaint. The service has received one complaint since the last inspection. The manager handled the complaint in a satisfactory manner and carried out a thorough investigation. All staff have received training in the protection of vulnerable adults. The Commission has been notified of one safeguarding concern since the last inspection. This matter was satisfactorily handled by the manager. People spoken with said that they felt safe living at the home. Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a home that is well maintained, clean and suitable for meeting their needs. Good facilities are provided and the building has been adapted to meet people’s lifestyles and promote their independence. EVIDENCE: The home is well maintained, safe, comfortable and provides an attractive environment. The layout and design of the home are suitable for the people currently using the service. Access to the first and second floors is by way of stairs only. All bedrooms provide useable floor space that is in excess of the measurements referred to in the National Minimum Standards for existing homes. People said that they are satisfied with their bedroom accommodation. However, none of the home’s bedrooms have en-suite facilities. Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 20 People have access to a large lounge, a dining area, the main kitchen and a smaller kitchen where they can cook and prepare meals. Both kitchens were clean and tidy. The home had recently been awarded a satisfactory rating for kitchen hygiene and cleanliness. There is a range of bathing facilities including showers. The communal areas of the home were generally clean, hygienic and tidy. The home is close to local shops, transport links, the general hospital, a dental practice, a health care centre and various leisure facilities. The appearance of Fairfield House is in keeping with the local community and it does not stand out as a care home. Fairfield House has attractive gardens that people living at the home can access. The laundry is situated away from the main kitchen and is accessed by way of a separate corridor. This means that soiled articles and clothing are not carried through areas where food is stored and prepared. Hand wash facilities are provided. All equipment is in good working order. The home has an infection control policy and all staff have received training in this area. The manager has taken steps to ensure that the home complies with the new smoking regulations. People are permitted to smoke in their bedrooms, but only on the understanding that they respect the safeguards that have been put in place. Smoking risk assessments have been carried out and metal bins provided to reduce the risk of a fire breaking out. A number of minor concerns were identified during the inspection: • • First floor toilet: the wall area around the hand wash basin was in need of repainting; First floor shower room: the wall area by the tiles was in need of repainting. The shower mat was unclean. Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are cared for by appropriately trained staff. This means that people can feel confident that staff will provide them with safe care that meets their assessed needs. However, staff records did not always contain sufficient documentary evidence demonstrating that robust pre-employment checks had been carried out. EVIDENCE: Staffing levels remain unchanged since the last inspection. A minimum of two staff are always on duty between 9 am to 9 pm. The night time is covered by one member of staff who ‘sleeps over’. There are occasions when more than two staff are scheduled on duty to cover the daytime. Although the manager felt that staffing levels are sufficient to meet people’s assessed needs, it was acknowledged that in 2007, unfilled vacancies had caused difficulties in covering the rota. Staff had mixed opinions about the suitability of current staffing levels. One person said that staffing levels are sufficient as long as you plan your work. However, another person said that it is difficult to support Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 22 people using community facilities when there are only two staff in the building. People using the service felt that staffing levels were sufficient and raised no concerns about this. At the time of the inspection, two staff had just handed in their notice and plans were underway to recruit to these posts. Of the five staff that returned surveys, one said that there are ‘always’ enough staff on duty and four said that this is ‘usually’ the case. During the three months preceding the completion of the Commission’s Annual Quality Assurance Assessment (AQAA) 47 shifts were covered by temporary staff. Although this figure is considered high, the staff that covered these shifts are employed by the provider and are generally familiar with Fairfield House. People’s opinions of staff were generally positive. the service who returned surveys: • • Of the eight people using Six said that staff treated them well. One person said that this was ‘usually’ the case and one other that it was ‘sometimes’ the case;’ Five said that staff ‘always’ listened to and acted upon what they said. Two said that this was ‘usually’ the case and one said this was only ‘sometimes’ the case. There was evidence that pre-employment checks had been carried out for some staff before they commenced working at the home. For example, in two of the staff files checked there was evidence that: • • • Each person had completed an application form and provided employment history details; Two written references had been obtained for each person; People had supplied statements about their current health status and whether they had any convictions or cautions. However, for one person, there was no documentary evidence that the provider had obtained a full employment history or obtained statements about their health or whether they had any convictions or cautions. Also, there was no verification of identity or identity photograph. The inspector was told that the information for this person was held at the provider’s head office. Criminal Records Bureau checks are carried out to ensure that people are safe to work with vulnerable adults. However, a copy of the disclosure obtained for a person appointed since the last inspection had been destroyed. The manager said that this had been done to comply with the provider’s responsibilities under the Data Protection Act. Three of the seven staff employed at the home have obtained a relevant care qualification. Two other staff are in the process of doing so. All staff have either completed statutory training or are about to do so. For example, all staff have completed training in moving and handling, first aid and health and Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 23 safety. Staff have also completed more specialised training that helps them to meet the needs of people with a mental illness. For example, in the sample of staff records checked, two staff had completed mental health awareness training. All staff had completed training in how to manage physical aggression in a non-confrontational manner. Of the five staff that returned surveys: • • • • • • • All said the provider had carried out employment checks such as obtaining a Criminal Records Bureau disclosure before they started work at the home; Four said that their induction covered everything that they needed to know to do the job. One person said this was ‘mostly’ the case; All said that their training was relevant to their role, helped them to understand the needs of people using the service and kept them up to date with new ways of working; Three said that their manager met with them ‘regularly’. One person said that this happened ‘often’ and one other said this took place ‘sometimes;’ One said that there are ‘always’ enough staff on duty to meet people’s needs. Four people said that this is ‘usually’ the case; All said that they felt they had the right support, experience, and knowledge to meet the different needs of people using the service; Three said they are ‘always’ given up to date information about people’s needs. Two said that this is ‘usually’ the case. Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are suitable arrangements to protect people from harm or injury. This means that people can be confident that their health and safety will be taken seriously and their welfare promoted. EVIDENCE: The home is run by a manager that has relevant experience in caring for people with mental health care needs within a residential care setting. The manager has obtained the required care and management qualifications and demonstrated managerial competence in running the home. She also completes training to update her professional knowledge and competencies. For example, since the last inspection, the manager has completed Mental Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 25 Capacity Act and NHS Infection Control training. Staff who returned surveys said: ‘I feel that my boss is very good at communicating with her staff team. My needs have always been taken into account. If there are problems she is very quick to approach me and discuss and then give advice;’ ‘I can talk to the manager or her deputy at any time about concerns. They are both extremely approachable.’ Arrangements are in place to review the home’s performance against the National Minimum Standards for Adult Care Homes and MHM internal policies and procedures. For example: • • • A MHM senior manager visits Fairfield House on a monthly basis to review the home’s day to day practice and performance; The manager has prepared a detailed business plan. This document contains targets aimed at developing the home’s performance as well as the quality of services offered; The provider’s Quality and Strategy Group carry out reviews of in-house policies and procedures. The home’s tenant handbook and statement of purpose are currently being reviewed. A good quality AQAA was submitted as part of the inspection. This contained robust evidence to support the self-assessment judgements that had been reached. People’s health and safety is promoted. For example: • • • • • The home’s electrical equipment has been safety checked and there is a current electrical safety certificate; A range of workplace risk assessments has been carried out. These are up to date; No health and safety concerns were identified during the inspection; The provider has devised a robust health and safety policy; The temperature of hot water supplied to people’s bathing areas is checked on a regular basis. Arrangements had been made to renew the home’s gas safety certificate. Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001, and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA19 Regulation 23(2) Requirement Ensure that: • The wall area around the hand wash basin in the first floor toilet is repainted; The wall area by the tiles in the first floor shower room is re-painted. The shower mat should be replaced. 01/08/08 Timescale for action 01/10/08 • 2. YA34 Schedule 2 Ensure that: • • Staff records contain proof of identity; Criminal Records Bureau (CRB) disclosure certificates are kept for staff employed in between inspections to enable them to be checked by the home’s inspector. Original certificates can then be destroyed in line with guidance issued by the CRB and Commission for Social Care Inspection. This will help to confirm that Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 28 only suitable people employed within the home. are (The previous timescale for complying with this requirement expired on 01/09/06) 3. YA34 Schedule 2 Ensure that staff files contain: • • An identity photograph; Statements about people’s current health status and whether they have any convictions or cautions. 01/11/08 This will help to confirm that only suitable people are employed within the home. 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. Refer to Standard YA33 Good Practice Recommendations Regularly review staffing levels to ensure that they are sufficient to support people using the service to access local community activities and facilities. Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Fairfield DS0000000444.V365379.R01.S.doc Version 5.2 Page 30 - 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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