Care Home: Fairhaven Care Home

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What the care home does well This inspection found much good practice at the home. Fairhaven Care Home provides the people who use the service with a clean, safe comfortable, homely environment to live in. The manager and staff have successfully met the needs of the residents by treating the people who use the service with dignity and respect and giving them the support they need to make decisions about their own lives. The staff team work well together and show a good understanding of the needs of the people living at the home. Residents and relatives spoken with and comments on the surveys returned all said they liked living at the home and felt they were being well cared for by the staff. One relative had written, " All aspects of care are professional and extremely caring". Another relative wrote, "We were worried when my sister-in-law had to enter residential accommodation as she could be very difficult. In the event, she was welcomed by all staff, quickly made some friends and settled down. We appreciate the support and care she receives and she seems happy there".Residents spoken to said that they or their relatives had received sufficient information before they came into the home to help them decide if they wanted to live at Fairhaven Care Home. Evidence was seen during the visit that following an assessment, carried out before any resident was admitted, they received written confirmation that home could meet their needs. The manager at the home and members of the care staff team are all well qualified and National Vocational Qualification (NVQ) training for the number of staff trained far exceeds the minimum standard recommended. This is to be commended. All residents spoken to said that they were aware of the home`s complaints procedure and felt confident that the manager would act appropriately if they had cause to make a complaint. The home has been decorated and furnished for the comfort of residents. Residents spoken to were very happy with the standard of accommodation provided. Resident were also very pleased with the meals served and the quality of the food provided. What has improved since the last inspection? Since the last inspection the manager has fully reviewed and updated the information guide for the people who use the service. This means that the people who use the service and their families have accurate up to date information about the home and know what services to expect on moving into the home. All care staff have received a variety of relevant training that include adult protection training. This means that the care staff team are aware of abusive practices and will know how to report suspected abuse. The home is maintained to a good environmental standard. Since the last inspection some furniture has been replaced, new carpets fitted throughout, and a new roof been provided. The home has a maintenance programme that is ongoing to ensure that the residents live in a safe and comfortable environment. Regular checks of the medication records and the medication stocks take place and help to minimise any mistakes. What the care home could do better: The majority of written care plans would be improved if they were more detailed to ensure that all care needs and requirement are recorded in order toguide and direct staff. However it was evident that in practice staff were providing a very good service and resident`s needs and requirements were bring met. It was recommended the all bedroom doors be provided with a lock to ensure privacy for the occupant. It was also recommended that if a new occupant makes a positive choice not to have a lock on their bedroom door this should be recorded and regularly reviewed. Staff are constantly informally supervised as part of the management role. However it is recommended that the planned programme of formal one to one staff supervision takes place as soon as practical. Planned formal one to one supervision should then take place at least six times a year. CARE HOMES FOR OLDER PEOPLE Fairhaven Nursing Home 43/44 Laidleys Walk Fleetwood Lancashire FY7 7JL Lead Inspector Denise Upton Unannounced Inspection 15th May 2008 09:00 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 Fairhaven Nursing Home DS0000062791.V360844.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. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairhaven Nursing Home Address 43/44 Laidleys Walk Fleetwood Lancashire FY7 7JL 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) 01253 772341 01253 772018 North Fylde Care Ltd Mrs Toni Ann Davidson Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2007 Brief Description of the Service: Fairhaven Care Home is registered to provide accommodation for up to twentyfour older people who do not require nursing care. Fairhaven Care Home is situated on the promenade at Fleetwood overlooking the boating lake and sea and in close proximity to local community facilities and resources. Fleetwood town centre is approximately five minutes away by car. The home is arranged over three floors with the majority of residents accommodated in single bedroom accommodation. Only two bedrooms are for shared occupancy. Communal areas of the home consist of a lounge, separate dining room and two conservatories that overlook the sea. Although bedroom accommodation does not provide an en-suite facility, bathing and toilet facilities are sufficient in number, conveniently situated and provided with appropriate aids to promote independence. A passenger lift is provided to enable ease of access throughout the building. Visitors are welcome at any time of the resident’s choice and can be entertained in the privacy of the residents individual bedroom accommodation or any communal area of the home. The current fee for residential care at Fairhaven Nursing Home is £412.00 per week. There is an additional charge for such items as personal newspapers and magazines, hairdressing, chiropody, yoga and personal toiletries. Fairhaven Nursing Home DS0000062791.V360844.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 star. This means the people who use this service experience good quality outcomes. This inspection took place during the course of one day and looked at all the key National Minimum Standards plus supervision arrangements for staff. At the time of this inspection there were 19 people resident at the home. Discussions took place with, the registered manager, two members of staff, two people living at the home and two relatives who were visiting. Records and documentation were viewed and a tour of the building took place that included all communal areas of the home, kitchen and laundry facilities, the medication storage area, and some random bedroom accommodation. Time was also spent observing staff and those living at the home as they engaged daily dialogue. Commission for Social Care Inspection questionnaires inviting feedback about Fairhaven Care Home were received from two people living at the home, four relatives and six members of staff. What the service does well: This inspection found much good practice at the home. Fairhaven Care Home provides the people who use the service with a clean, safe comfortable, homely environment to live in. The manager and staff have successfully met the needs of the residents by treating the people who use the service with dignity and respect and giving them the support they need to make decisions about their own lives. The staff team work well together and show a good understanding of the needs of the people living at the home. Residents and relatives spoken with and comments on the surveys returned all said they liked living at the home and felt they were being well cared for by the staff. One relative had written, “ All aspects of care are professional and extremely caring”. Another relative wrote, “We were worried when my sister-in-law had to enter residential accommodation as she could be very difficult. In the event, she was welcomed by all staff, quickly made some friends and settled down. We appreciate the support and care she receives and she seems happy there”. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 6 Residents spoken to said that they or their relatives had received sufficient information before they came into the home to help them decide if they wanted to live at Fairhaven Care Home. Evidence was seen during the visit that following an assessment, carried out before any resident was admitted, they received written confirmation that home could meet their needs. The manager at the home and members of the care staff team are all well qualified and National Vocational Qualification (NVQ) training for the number of staff trained far exceeds the minimum standard recommended. This is to be commended. All residents spoken to said that they were aware of the home’s complaints procedure and felt confident that the manager would act appropriately if they had cause to make a complaint. The home has been decorated and furnished for the comfort of residents. Residents spoken to were very happy with the standard of accommodation provided. Resident were also very pleased with the meals served and the quality of the food provided. What has improved since the last inspection? What they could do better: The majority of written care plans would be improved if they were more detailed to ensure that all care needs and requirement are recorded in order to Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 7 guide and direct staff. However it was evident that in practice staff were providing a very good service and resident’s needs and requirements were bring met. It was recommended the all bedroom doors be provided with a lock to ensure privacy for the occupant. It was also recommended that if a new occupant makes a positive choice not to have a lock on their bedroom door this should be recorded and regularly reviewed. Staff are constantly informally supervised as part of the management role. However it is recommended that the planned programme of formal one to one staff supervision takes place as soon as practical. Planned formal one to one supervision should then take place at least six times a year. 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. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 8 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 Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 9 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): 1&3 Quality in this outcome area is good. The admission and assessment procedures were clear to ensure the care needs of residents could be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plan records of two residents recently admitted to the home had full assessment information including the physical, emotional, dietary and religious/cultural needs of residents. These assessments are done by the manager and agreed by the resident and/or their family. All residents are assessed by the same assessment format, thus promoting equality of assessment and the provision of care. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 10 The individual resident’s had been informed in writing that following their assessment, that the home could meet their needs. Although a master copy of the letter was seen, it is understood that a copy of the actual personal letter confirming current needs and requirements could be met, is not retained at the home. It is recommended that this be done to enable a copy of all correspondence to residents to be maintained. One of the resident’s spoken with and her relative who was visiting, confirmed they had been involved in the assessment process and were very happy with the care and support received. Staff members spoken with said they had access to this information and could describe in detail the care needs of the residents. Since the last inspection the home’s Statement of Purpose and Service Users Guide have been amended and updated. The information provided was clear and easy to understand and if required, could be provided in large print or an audio version for people who have a visual disability. This home does not provide intermediate care. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 11 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, 9, & 10 Quality in this outcome area is good. There is a routine care planning system in place. However not all care plans give sufficient detail or guidance to staff in order for them to provide a holistic or consistent service. Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs were met. Residents feel respected by the staff team and their right to privacy is up held. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 12 Through case tracking and discussion with the registered manager it was evident that each resident had a plan of care. One recently developed care plan in respect of a newly admitted resident was viewed. This care plan included sufficient details for care staff to meet the identified needs. It was person centred, comprehensive and held relevant information that included, day to day living, comfort and mobility, communication, social and recreational interests, religious needs, diet and nutrition, personal care and hygiene, mental health, continence and a specific medical problem. Resident’s needs were properly addressed through these records and the registered manager said these documents were subject to review on at least a monthly basis or more frequently if required. Daily records were written clearly and were up to date. Risk assessments included in the care plans were reviewed regularly. Any restrictions and limitations were thoroughly discussed with the individual resident prior to their agreement and recording. However two other care plans were also reviewed of residents who had lived at the home for a longer period of time. These care plans were in an ‘old’ format, unchanged from the last inspection and focused primarily on health and personal care needs with little of no specific information about social, religious or cultural care needs and preferences or the specific wishes of the individual resident. These did not provide a holistic care plan that would inform or guide staff about the whole person. There was evidence of monthly reviews of these care plans but, as previously stated, the actual care plan had not been extended to provide a holistic account of strengths and needs or further appropriate risk assessments developed. As at the last inspection, there was again no suggestion that residents were not receiving the level of care and support appropriate to their ongoing or changing assessed needs and requirements. Staff spoken with were all very clearly aware of current individual strengths and needs and how to fulfil these requirements. The registered manager explained that two senior members of staff are about to commence a National Vocation Qualification Level 4 management course. In view of this, the registered manager staffed that the ‘older’ type of written care plan had not been updated as she wanted these two members of staff to re assess, expand, update and amend the ‘older’ care plans as part of their course work. Whilst it is commendable that staff are given opportunity for their personal development and that their training needs are being addressed, there is never the less, a requirement that individual plan’s of care be kept under review and updated and amended as required. All care plans must be comprehensive, detailed in content and address all areas of identified need as well as the wishes and requirements if the individual. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 13 Care must also be taken to ensure as far as possible that individual resident’s, or their relatives if appropriate, sign their care plan as acknowledgement and understanding of the content. If a resident does not have capacity to sign their care plan or does not wish to become involved, this should be clearly recorded. It is also important that all entries in documentation records be signed and dated by the member of staff making the entry to confirm that an accurate record has been made. A relative spoken with confirmed that she had seen her mother’s care plan and was always informed of any changes. Daughter also confirmed that mum was “happy and content” and that her physical, medical and emotional needs were being fully met however her mother had no interest what so ever in social activities. Daughter also stated that the home was usually calm and relaxed and even when the staff were very busy, “Mums care never wavers, she always gets the care she needs”. Another person wrote on a survey form that, “The staff treat me as well as my mother” One resident individually spoken with said that he was “very happy with everything”, had no complaints and that he was “looked after very well”. Care plans viewed clearly described individual healthcare needs so that they can be met by the home. Discussion with the registered manager and two members of staff spoken with confirmed there is full awareness of the healthcare needs of residents and the importance of keeping records so that any changes can be identified and responded to. Entries made on professional visits document showed there is good communication between the home and healthcare professionals. During the course of the site visit, observations were made of the caring approach and caring attitude of staff towards residents and practices within the home ensured that residents were treated with respect and dignity and their right to privacy was upheld. One resident confirmed this and also said that staff were, “very kind and helpful, staff very nice – smashing”. Privacy and dignity training are incorporated in induction and National Vocational Qualification (NVQ) training to ensure staff have the necessary skills to uphold these values. There is an efficient medication policy supported by procedures and practice guidance, which care staff understand and follow. Medication records are fully completed, contained the required entries and were signed by appropriate staff. Medication is stored appropriately and there are regular management checks to ensure compliance. All staff with responsibility for the administration of medication have received appropriate training. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 14 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 good. Social, cultural and recreational activities in the main, meet resident’s needs and expectations. Residents enjoy a healthy and varied diet according to their assessed needs and choice This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two residents spoken with said routines within the home were flexible and they were able to make their own decisions about how to live their lives. From comments and observations made, confirmation was gained that the home promoted equality by treating residents as individuals and ensuring people with differing wants and needs, enjoyed the life style of their choice. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 15 There are some indoor leisure activities in place including: weekly yoga that the manager explained has improved general well-being, circulation and physical and mental ability, bingo, board games and an in-house’ library. There is an entertainer who visits every six or eight weeks and a summer fair is planned. Several residents enjoy sitting outside on the promenade in good weather with one gentleman very regularly sitting in his wheelchair on the promenade across the road from the care home enjoying discussion with several residents from other care homes in the immediate area. Another gentleman regularly enjoys going to see a local football match with a member of staff. A lot of staff time is spent in talking and generally sitting down and chatting to residents. In addition, a number of residents very much enjoy watching television with one member of staff saying “there are loads of telly addicts here” who would be most upset if they could not watch television all day. Currently a student from a local college who is completing on a course in care, visits the home once a week and get involved in leisure activities. Families are encouraged to go along when trips are organised to shows and to stay for lunch or dinner for special events such as birthdays or Christmas. There is also regular weekly communal worship that takes place in the home for residents who would like to attend. One resident who completed a survey form said that sometimes activities were arranged that she could take part in and confirmed that she enjoyed the yoga in chairs and would like more. Another resident said that, “I enjoy the bingo and yoga in chair”. However a relative stated in answer to the question, ‘How do you think the care home could improve’ said, “Perhaps a range of activities for residents/occasional outings”. The registered manager is aware that this is an area that could be developed and is looking at other methods of relaxation such as aromatherapy, external activities away from the home and more alternatives for others that may choose not to participate or are unable to take part. Residents spoken with said they were happy with arrangements in place for receiving their visitors. The relative of one resident said, “ Very caring, welcoming staff who treat you like friends”. Residents at the home, who are able, handle their own financial affairs or these are handled by their relatives/representatives. Records being kept by the home in respect of residents unable to manage their own finances were being well maintained. Meals and mealtimes are flexible to meet the needs of residents living there. Staff were familiar with the likes and dislikes of each resident. The menu was balanced and fresh produce is used whenever possible to ensure a nutritional Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 16 diet. The staff member responsible for the preparation of meals was able to confirm they had information about residents with special diets and personal preferences. Most residents enjoy a cooked breakfast and although the menu for the midday and evening meal is a set meal, there is always an alternative of the resident’s choice made available if required. On the day of the site visit scones with cream was being served with the mid afternoon drink. As seen, snacks and drinks are available at any time of the resident’s choice. The evening meal was served in a relaxed and unhurried manner. Staff members were observed being very attentive to residents needs. Specialist diets in respect of medical need are provided and diets in respect of religious or cultural requirements could also be accommodated. Residents spoken to said they enjoyed the meals served with one resident saying that the food was, “very pleasing, good choice, filling, will offer alternatives if you do not like choice on menu”. And a relative said that her mother “Eats everything put in front of her”. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 17 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. The arrangements in place for handling complaints and safeguarding adults ensure that people feel confident that their complaints will be listened to and taken seriously and that they are adequately protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents on their admission. Residents spoken with were aware of how to make a complaint and felt these would be listened to and acted upon. One resident said that “All staff are approachable” and a relative commented that she knew who to complain to, confirmed that management and staff within the home were very approachable, she had a good rapport with them all and would have no hesitation in raising a concern but, “I haven’t had any cause to make a complaint about the home”. At the time of this site visit, no complaints had been received by the home or referred to the Commission for Social Care Inspection. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 18 The home has a procedure in place for dealing with allegations of abuse. The manager and staff spoken with had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. All staff undertake mandatory adult protection training. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 19 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): 19 & 26 Quality in this outcome area is good. The home’s environment is well maintained and safe for the comfort and benefit of residents living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has been well maintained and decorated for the comfort of residents. Since the last inspection some furniture has been replaced and the home re-carpeted throughout. New toilets and a number of hand washbasins have been replaced. A new roof has improved insulation. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 20 Communal space is welcoming, suitable for a variety of social and cultural activities, and consists of a lounge area, separate dining room and two conservatories that look out towards the promenade and sea. There is easy access to all areas of the home for residents and visitors through the provision of a passenger lift. There are also aids and adaptations in place to promote independence and to provide equal acces for residents that may require assistance with their toilet and bathing needs. Bedrooms were very much individualised by personal possessions and equipped to meet individual needs. Residents can choose the wallpaper they preferred for their own bedroom. Radiators throughout the home are fitted with an appropriate guard to protect residents from the risk of burning. Hot water temperatures throughout the home are checked and delivered at a safe temperature in line with health and safety guidelines. It was observed during the site visit that the home was clean and hygienic ensuring a pleasant environment in which to live. It was confirmed through discussion with residents and relatives that the home was always fresh and clean. At the last inspection there was a recommendation that all bedroom doors be provided with an appropriate lock to ensure privacy for the occupant. Residents were asked if they would like a lock on their bedroom door. Residents who preferred this option were provided with a lock following the successful outcome of a risk assessment. This process is still ongoing. One gentleman spoken with could see no reason to have a lock and had declined the offer. There is, never the less, an expectation that an appropriate lock would be provided to all bedroom doors when the bedroom becomes vacant. The only exception would be if a risk assessment suggested a lock to be inappropriate for an incoming resident or if the incoming resident had refused to have a lock provided. In this instance the decision of the resident should be clearly recorded and regularly reviewed. Laundry facilities are sited away from the main area of the home and do not intrude on residents accommodated. The industrial washing machine has the capacity to meet disinfection standards and wall and floor finishes are easily cleanable. An infection control policy was available. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 21 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): 27, 28, 29 & 30 Quality in this outcome area is good. Staff are trained, skilled and sufficient in number to support the people who use the service and to ensure the smooth running of the service. The home’s recruitment policy and procedure are robust to make sure residents are protected from risk or harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the course of the site visit, three recently recruited members staff files were viewed. Examination of their file confirmed that the home’s robust recruitment procedures had been followed correctly to ensure that residents were safeguarded. Staff spoken with were clear about their role and worked as a team to ensure that the individual and collective needs of the residents were met. From examination of rotas and the number of staff on duty at the time of the visit, the needs of the residents were being met. One member of staff spoken with Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 22 said that she had worked at the home for a number of years and seen many changes for the better. This same person went on to say that there was a good staff team who got on well together and supported each other. Another member of staff said that the best bit of working at the home was the residents and staff and that he was happy in his job. Residents and relatives were also very complementary about the staff team. One resident stated that the “Care is regular and good. Staff have a caring attitude at all times” and that she was “Quite happy at Fairhaven”. A relative said “Staff etc all very kind and helpful. I am very happy with the service provided and my mother is looked after and very happy in the environment.” A third relative stated on a survey form, “comfortable room, pleasant lounges and friendly attention from staff make her stay as comfortable as possible. Staff are attentive and try to give individual attention to residents. A mix of sexes of residents is dealt with effectively. Staff also deal with residents of varying abilities and disabilities effectively”. The same person went on to say, “Makes residents very welcome and provides as near as possible a home for elderly and disabled residents”. All newly appointed staff are provided with induction training at the start of their employment to ensure basic skills are met. The registered manager explained that the home’s induction training programme had now been mapped against ‘Skills for Care’ nationally recognised induction standards for care staff to ensure compliance. National Vocational Qualification (NVQ) training has been provided and all but one member of the care staff team have achieved this qualification at Level 2 or 3. The remaining member of staff is currently undertaking this award. Two senior carers are about to commence an NVQ Level 4 management qualification. This level of sucessfully completed NVQ training is commendable. In addition to the excellent level of NVQ qualifications, staff have received other training in care relevant to their role. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 23 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): 31, 33, 35, 36 & 38 Quality in this outcome area is good. The home is run in the best interests of residents. The home’s financial records are well maintained ensuring residents financial interests are safeguarded. The home has policies and procedures in place to ensure the health and safety of residents and staff are promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 24 The registered manager is a first level nurse, who has also achieved a Certificate in Management in Health and Social Care, a Bachelor of Science degree in Health Studies and has obtained a D32/33 trainers certificate. In addition, the registered manager has many years experience in caring for the elderly, holds a relevant management qualification, is about to commence an external verifiers award. The home’s administrator is hoping to undertake a foundation degree in business management beginning in September 2008. Residents, relatives and staff all spoke very highly of the registered manager and her personal and professional abilities. The home has effective quality assurance systems in place to monitor the level of service being provided for its residents. A resident questionnaire is provided once every two years. There is also a relative questionnaire that has recently been developed however the response to this was disappointing with relatives preferring to express there views through regular dialogue with staff. Residents and relatives spoken with confirmed they were consulted about any changes taking place within the home and kept fully informed about important matters. The home has achieved the ‘Investors in People’ award. The monitoring systems in place suit the needs and requirement of residents and relatives at this present time. Inspection of records for resident’s finances were well maintained and up to date ensuring residents interests are safeguarded. Resident’s monies held in safekeeping are regularly audited with good systems in place to ensure accuracy. One to one formal staff supervision has now been introduced that is planned to take place every two months. However not all staff, as yet, have received one to one supervision, as this is still work in progress. It is anticipated that all staff will have received at least their first formal one to one supervision within the near future. Regular formal supervision allows the manager and the member of staff to look in detail at their work practice, skills, areas for development and future training. This enables all aspects of the supervisee’s practice and the home’s care practices to be examined to help improve resident care. All staff have received an annual appraisal. Inspection of maintenance records confirmed facilities and equipment was being maintained as required by health and safety legislation to provide a safe environment for residents and staff. All staff have received mandatory training consisting of fire safety, infection control, first aid, dementia care, manual handling and food hygiene training. Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 2 X 3 Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO 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 OP7 Regulation 15 (1)(b) Requirement All written care plans must be holistic in content, regularly reviewed and updated in order to provided clear guidance and direction to care staff Timescale for action 30/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. Refer to Standard OP1 OP7 Good Practice Recommendations It is recommended that a copy of all correspondence to residents or their relatives be retained on that resident’s personal file. Whenever a risk has been identified, a formal risk assessment should be completed with significant outcomes incorporated in the care plan. Care plans should be written in a style that residents could easily understand. All bedroom doors should be fitted with an appropriate lock with the resident retaining the key unless the risk assessment suggests otherwise or the resident makes a positive choice not to have a lock provided. All care staff should receive formal one to one supervision as soon as practical. Planned one to one supervision should take place at least six times a year. 3. OP19 4 OP36 Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Fairhaven Nursing Home DS0000062791.V360844.R01.S.doc Version 5.2 Page 28 - 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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