Care Home: Fairfields House

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What the care home does well The social and activity needs of the residents are well supported and enjoyed by all. The home provides a wide range of activities, outings and social events, which are planned to meet individual residents needs and to accommodate their interests and requests. We received 10 surveys from residents and they told us that the home arranges activities for them to take part in. This includes bingo, karaoke, quizzes and music. Fairfield`s is clean comfortable and well maintained. There has been consistent investment in the environment over the past few years and future development planned and under way will enhance the environment for residents. Experienced and trained staff are employed in sufficient numbers to support the people who use the service and thereby ensure the smooth running of the service. Residents told us that they `always` received the care and support needed and that staff were `always` available when needed. We found that there are sufficient staff employed at this care home. Staff were positive on the training and induction they received. One person said ` `They showed me around, introduced all the residents and showed me the tasks I need to know on how to carry out duties and responsibilities about care`. Another staff survey said `I have been here a number of years and have had all the training that I need to do my job`. What has improved since the last inspection? Since the last inspection a number of improvements have taken place. We received the improvement plan and are pleased to see that all requirements from the previous inspection have been met. There are good developments in care planning, access to health care and more robust management of medication which has meant that the support and health care of residents are met. There is a better understanding and experience around safeguarding adults from abuse. All these developments have promoted better safety and protection for the residents. The new manager has been instrumental in the developments within this service and has worked hard to support the service to achieve the new rating of 2 star good. What the care home could do better: The standards of care and the management of the service have been met. The challenge for the future is for the service to maintain the standard that has been achieved. Key inspection report Care homes for older people Name: Address: Fairfields House 21 Tuddenham Road Ipswich Suffolk IP4 2SN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Claire Hutton     Date: 1 9 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Fairfields House 21 Tuddenham Road Ipswich Suffolk IP4 2SN 01473213988 01473785062 ffch@talktalk.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Fairfields House Ltd Name of registered manager (if applicable) Mrs Caroline Jane Joseph Flewitt Type of registration: Number of places registered: care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Fairfield House is a care home providing personal care and accommodation to up to 23 older people. It is a privately run home and is situated in a quiet area of Ipswich, not far from the town centre. The home is a two-storey building with bedrooms on the ground and first floor. The home has a shaft lift and stair lift. Twenty-one bedrooms are single and twelve provide en-suite toilet and wash hand basin. There is also one double en-suite bedroom. There are car-parking facilities at the front of the building and the rear provides an enclosed garden, which is well maintained and sheltered. The fees for accommodation range between £362.00 and £465.00. They do not cover the cost of hairdressing, toiletries, chiropody and newspapers. 1 4 0 7 2 0 0 9 0 Over 65 23 Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place over five hours during a weekday. This inspection focused on the core standards relating to older people. During this inspection the inspector made a tour of the building, had in depth discussions with the homes manager, met the residents and spoke individually with some of them, spoke also with the staff on duty and carried out spot checks on a number of the homes records. The comments in this report reflect the findings made by the inspector during that visit and also take account of information gathered over the past months from the homes manager including an improvement plan and by way of pre-inspection questionnaires completed by 10 of the residents, 8 staff and other professional stake holders in the home. This was a positive inspection. The home had a well-ordered and homely atmosphere Care Homes for Older People Page 5 of 25 where staff and residents were seen to be interacting positively together. The residents looked happy and without exception all said that they were well cared for, with comments such as the home looks after me well. Care at every turn like no ones business. The requirements and recommendations made at the last inspection have all been met; no requirements were made following this inspection. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Informative information is available about this care home and assessments are obtained or completed before a person moves in to allow the service to determine they can meet a persons needs. Evidence: Information about this service is available in the format of a Service Users Guide and can be obtained from the home. A copy is available in the entrance hall for anyone to read. In addition the manager has prepared a welcome pack for residents that includes additional information that people may want such as sample menus, activities available in the service and travel arrangements such as local taxis and local attractions. The manager found in her experience that new people to the area and relatives need this information to initially visit the home. The manager told us that any visitor enquiring about the home would be shown around and given as much information as they needed. Care Homes for Older People Page 9 of 25 Evidence: We looked at how the service determines if they can meet individuals needs before they move in and we found that the manager completes an assessment before hand and meets the individual concerned. In addition information is obtained from Social Workers and family if appropriate. In one case with a person moving to the home from abroad, information was obtained from a Social Worker before the person moved in to enable the home to decide they could meet the persons needs. Care Homes for Older People Page 10 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good care plans that residents have been involved in preparing are maintained identifying health and care needs. Residents can be assured that they will have prompt access to medical services whenever these are needed. The homes medication storage and administration system is robust and gives good protection to the residents. Evidence: The health and personal care needs of the residents are met following an assessment of their individual needs and with due reference to them retaining their dignity and respect. A number of care plans were inspected to track how the care was determined and delivered and to see how the level of support required was ascertained. Each plan was well maintained with all files kept in a uniform manner, with information filed within clearly defined sections. The recording was seen to be up to date and regular care need reviews and reviews of risk assessments could also be evidenced, these accommodating changing care needs. In some cases the residents were seen to have signed these plans thereby evidencing their involvement with this planning process. Care plans stated what individuals did for themselves and what staff needed to do to Care Homes for Older People Page 11 of 25 Evidence: support people with their independence and dignity in meeting health and care needs. The pattern of care for specific health needs such as epilepsy, physiotherapy and continence care and nutritional care could be evidenced via the various recording charts and specific daily notes including, manual handling, and nutritional assessments and weight recording charts which included the management of diabetes. Aids and equipment are provided usually following an OT assessment, these to encourage maximum independence for the residents. Examples included a person being provided with bed leavers, perching stool and walking frame all of which supported their independence. The care records reviewed showed that residents have regular access to doctors, the community nursing service, chiropodists, opticians, dentists, the Audio and Dietitian services and to a Hairdressing service. The manager confirmed that the home benefits from having well-established professional working relationships with local GPs and District Nurses. A new method of written communication with the community nursing service was working well. A GP responded positively to a survey we had provided asking about how Fairfields met the health and social needs of residents. Survey from staff members were completed. One staff member said I think the home looks after the residents well. Another staff member said Im happy enough that the home is doing their best to meet all the needs of the residents and I feel the residents are happy at the home where they live. All the residents were observed to be wearing smartly laundered clothing. Overall the personal hygiene of the residents was very good and supported their dignity. Personal care was seen during this inspection to be being delivered to the residents in a kind and understanding manner by staff who clearly understood their care needs both physical and emotional. Staff were seen to reassuringly intervene when a resident needed them, this being done in a manner which promoted their independence and feeling of well-being. One resident on their surveys told us the home looks after me well. Care at every turn like no ones business. We examined how the home managed medication. We found that storage was appropriate with reference to security and temperatures recorded. The records for ordering and administering medication were examined. These were well maintained. There was clear guidance when to give as and when required medication. We audited the controlled drugs and found that medication is given in line with the prescription, records are good and security is appropriate. In addition the home received an audit Care Homes for Older People Page 12 of 25 Evidence: of there medication system from the supplying pharmacist in December and the home followed up the recommendations made. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The social and activity needs of the residents are well supported and enjoyed by all. The residents receive a healthy diet of freshly prepared good quality food, which is provided with good variety according to individual needs and preferences. Evidence: The home provides a wide range of activities, outings and social events, which are planned to meet individual residents needs and to accommodate their interests and requests. We received 10 surveys from residents and they told us that the home arranges activities for them to take part in. This includes bingo, karaoke, quizzes and music. The manager had applied for travel vouchers for residents to get out and about in the community. In the coming weeks there were 2 outings planned - one to Needham Lake and the other to Felixstowe. Whilst we were at the home we met some relatives and they were very satisfied with the care and support their relative had received. The catering at the home is home cooked and traditional English food with roast meat on a Sunday. During our visit the kitchen was out of action as the ceiling was being Care Homes for Older People Page 14 of 25 Evidence: plastered, therefore at lunch time there was a selection of fish or pie and chips brought in from the local chip shop. This was followed by homemade strawberry trifle. Breakfast for most people is taken in their bedroom when they request it and lunch tends to be in the dining room for the majority of people. The evening meal is lighter and is sandwiches, homemade soup and cakes or similar. All surveys from the residents tell us that they like the meals at Fairfields. We saw that autonomy and choice is offered and respected through the home in several ways. This included choices around meals, social activities and when to awake in a morning. Residents are offered a key to their room and a key to a locked facility to keep private papers etc in their room. A record of this was seen in care plans. We saw that an inventory of all personal items brought to the home is kept. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an open culture that allows the residents to express their views and concerns in a safe and understanding environment. The homes complaints policy is clear and freely available. The home has a good understanding of the policies and procedures concerning Adult Protection and Whistle Blowing and how these give protection to the residents. Evidence: This service has a complaints procedure in place and this is part of the Service Users Guide. This is in the entrance hall of the home.There have been no complaints made since our last inspection of the home. All 6 surveys returned by staff said that they knew what to do if someone had a concern about the home. In relation to safeguarding adults from abuse the manager had obtained Suffolk Social Services policy. Responding to Adult Safeguarding - Referrals/Allegations made against Residential Care Services in Suffolk. Each member of staff had signed to say they had read this document and then the manager told us that this was also followed up in one to one supervision with staff to check their understanding. We tracked all staff on duty that day and found they had received safeguarding adults from abuse training. Recently there had been a safeguarding referral and the home had been involved. We Care Homes for Older People Page 16 of 25 Evidence: received feedback from the Social Worker involved who was positive about the care home and all they did. The matter was fully investigated and resolved. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Fairfields is clean comfortable and maintained and future development planned and under way will enhance the environment for residents. Evidence: We toured the home and found that improvements are taking place. The general maintenance of the home is being looked after with decoration of the external entrance underway, decoration of the dining room, the ceiling in the kitchen was being re plastered to give it a clean finish. Items such as new table clothes, pictures and new bedspreads were being chosen with the help of the residents. The gardens were well maintained with spring on the way. The home was clean, comfortable and maintained with clear plans in place for future developments. In addition to this a new extension to develop the communal space was being built with minimal disruption to residents. Along with this will be a courtyard area for access by residents that will provide a safe and comfortable outside seating area for residents. We found that the manager had completed a risk assessment on the construction access to the home to ensure matters were as safe as possible. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Experienced and trained staff are employed in sufficient numbers to support the people who use the service and thereby ensure the smooth running of the service. Evidence: We were able to examine the roster that clearly showed staffs full name and designation. There were 3 care staff on duty during the day and 2 at night. There is a cook each day and cleaning and maintenance staff employed. The roster showed adjustments made such as annual leave and sickness. All 10 surveys completed by residents told us that they always received the care and support needed and that staff were always available when needed. We found that there are sufficient staff employed at this care home. The staff were observed to be working very well together as a team in a proactive rather than a reactive manner. They were enthusiastic about their work and clearly had very good relationships with the residents several of whom had also been living in the home for many years. The staff demonstrated a thorough understanding of the particular needs of the residents and thereby could deliver effective person centred care. The home has a good training record with over fifty percent of staff having obtained a National Vocational Qualification (NVQ) at either level 2 or 3. We received 8 surveys Care Homes for Older People Page 19 of 25 Evidence: from staff, all were positive on the training and induction they received. One person said They showed me around, introduced all the residents and showed me the tasks I need to know on how to carry out duties and responsibilities about care. Another staff survey said I have been here a number of years and have had all the training that I need to do my job. We examined training records for staff on duty that day and found that they had received training in manual handling, fire, safeguarding adults, 1st aid, safe food handling, dementia and health and safety. We did find that one staff member on nights who had an NVQ 3 did not have evidence of this training that others had in their file, therefore evidence of training should be available for every staff member. The manager told us that 8 staff had received medication training. In addition staff then have a practical assessment to see that they are competent and then from time to time they are supervised to ensure their on going competency. The recruitment records of recently appointed members of staff evidenced that the correct procedures and checks had been carried out and that the new staff had not commenced duties until CRB checks had been made. New staff then work alongside experienced staff whilst undertaking their induction-training programme. New staff told the inspector that they felt well supported by the existing staff team and that they had had time to get to know the residents thoroughly. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives can be assured a competent, experienced and qualified manager and management team leads the home. An effective quality assurance system is in place and peoples views are obtained. Health and safety matters are taken seriously. Evidence: The manager of this service was appointed in August 2009. We are in the process of completing her fit person application. The manager has the appropriate qualifications: NVQ 4 leadership and management award and an NVQ 3 in care certificate. She was also able to demonstrate appropriate training and transferable skills relating to people who are elderly. Relevant training was extensive and included mental capacity act, supervisions training, medicines, infection control training, safeguarding, Manual Handling training, first aid, health and safety training, and fire training. She also has around 10 years relevant experience. Care Homes for Older People Page 21 of 25 Evidence: Feedback from staff and observations made are that they manager is very supportive and has improved this service since being in post. Staff receive regular supervision and this was confirmed from surveys received and records seen. Staff receive a mixture of practical observation that is recorded and formal one to one supervision. Records were supportive of staff and reflected improvements made or actions needed to be taken to develop practice within the care home. In relation to maintaining and monitoring quality within the home the manager has quality audits that she completes on medication and catering. The home uses the format better food better business. In addition the manager is currently surveying the resident and relative groups to ask their experience of the service offered by Fairfields. The survey will ask about meals, environment, activities and care/support given. In relation to residents finances the home does not manage any individual residents money. However, they do keep small amounts of money for safe keeping to which the resident has access. This is kept in a safe with records and receipts should this require to be audited or questioned. The home has a current Liability Insurance Certificate and the Registration Certificate was on display. Records are kept securely and staff are aware of the requirements of the data Protection Act. Residents are able to gain access to their records and to contribute to them if they wish. The good maintenance of these records promotes the safety for the residents. In relation to health and safety within the home we have already noted risk assessments completed by the manager and the staff training offered. The home has a fire risk assessment. There is an eventual evacuation plan should this be needed with equipment available to staff should the need arise. We saw records that showed fire equipment is regularly serviced and checked. The maintenance man regularly checks fire doors, call bells, emergency lighting and hot water temperatures. These records were well kept and easily accessible. We sampled servicing certificates and found up to date certificates for hoists, stand aids and a gas safety certificate. The environmental health officer had visited in February 2010 and was satisfied with matters. The manager has a good understanding of health and safety and ensures people at this service are as safe as can be. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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