Care Home: Fairkytes

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What the care home does well Feedback from the people spoken to was that they liked living at Fairkytes and were happy there. Feedback from quality assurance surveys was, "My relative is very happy there. I feel welcome and the staff are very nice." "I am satisfied with the overall service but the staff turnover has been very disruptive for my relative." Staff said, "this is a really good place to work, everyone treats everyone as an equal and people seem to like living here. They go out a lot". "The new manager has changed things a lot and it is much better." "Activities are good and things are settling down now." What has improved since the last inspection? Due to circumstances out of the control of the organisation there have been a lot of changes at the service. However there is now a new permanent manager and new staff have been recruited. Therefore there is a lot more stability and consistency in the service than there has been for some time. People are being supported to voice their views and opinions, to be involved in the day-to-day running of the home and to participate in activities in the community. The requirements of the previous inspection have been addressed. Portable appliances have been tested and the fire risk assessments and training updated. What the care home could do better: The organisation, manager and staff team are aware that they need to continue to develop ways of supporting the complex needs of those using this service. This will not only help to keep people safe but also to enable them to have as good a quality of life as is possible. Fire call points need to be tested regularly and some fire drills need to be held. This will ensure that fire alarm systems are working properly and that staff know what to do in the event of the alarm being activated. This will help to keep everyone in the house safe in the event of a fire. The manager has requested some redecoration and this will help to make the house a nicer environment for those that live there. Detailed guidance for the administration of PRN (when required) medication will help to ensure that people receive this medication appropriately and as safely as possible. Reconciliation and closer monitoring of individual bank accounts will offer additional protection to people`s finances. Key inspection report Care homes for adults (18-65 years) Name: Address: Fairkytes 42 Fairkytes Avenue Hornchurch Essex RM11 1XS     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: Jackie Date     Date: 2 3 1 1 2 0 0 9 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 Adults (18-65 years) Page 2 of 28 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 Adults (18-65 years) 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) 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Fairkytes 42 Fairkytes Avenue Hornchurch Essex RM11 1XS 01708503686 TBC joyce@clearwatercare.co.uk(temporaryemailcon tact) Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Clearwater Care (Hackney) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 5 The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Date of last inspection Brief description of the care home The home is a small family type residential house in central Hornchurch, next door to another learning disability service run by the same provider. The home is situated a short walking distance from Hornchurch town centre which has a selection of shops and leisure facilities and access to transport networks. On the ground floor there is an open plan lounge/kitchen diner and also one of the bedrooms. This room has an ensuite toilet and shower. The remainder of the bedrooms are upstairs. As is the office. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 5 Brief description of the care home In the garden there is a separate building that is used as an activities room. People living here are supported to attend activities of their choice in the community. At the time of this inspection three men and one lady were living there. The fees range from 1353.99 pounds and 1943.39 pounds. Information about the service provided is available in the service user guide. Care Homes for Adults (18-65 years) Page 5 of 28 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection of this service was on 12th November 2007. This inspection was unannounced and started at 9:45 am. It took place over seven hours. This was a key inspection and all of the key inspection standards were tested. Staff were asked about the care that people receive, and were also observed carrying out their duties. People using the service were asked to give their views on the service and their experience of living in the home. All of the shared areas and two bedrooms were seen. Staff, care and other records were checked. Services are now required to complete an AQAA (Annual Quality Assurance Assessment) and the completed form was received in September 2009. Information provided in this document also formed part of the overall inspection. The inspector would like to thank the people living at Fairkytes and the staff for their input during the inspection. Care Homes for Adults (18-65 years) Page 6 of 28 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 Care Homes for Adults (18-65 years) Page 7 of 28 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 Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. Assessments completed by the home and information and reports received from other professionals mean that staff have detailed information to enable them to determine whether or not the home can meet a persons needs. People and their representatives have a written contract/statement of terms and conditions and will therefore be aware of what they are entitled to. Evidence: Standards 2, 4 & 5 were tested At the time of the last inspection there were only two people living in the home. Since that time two more people have moved in. The organisation, Clearwater Care, has an assessment and referral manager who takes the lead in carrying out the assessments of any people wishing to move into the service. She also takes a lead in planning any transition. The files seen contained appropriate assessment information that was gathered when people first moved in and confirms that where practical people had the opportunity to visit the service and have a transition period. Therefore the service Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: obtained the necessary information about an individuals needs before they offered the service to them. Each person has a contract/terms and conditions of residence and copies of these were seen in individual files. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. People are involved, as far as they are able, in developing and reviewing their care plans and these give staff the information needed to meet individual needs. Risk assessments are appropriate and people are supported to take risks according to their needs and to have the opportunity to try things as safely as possible. People are encouraged and supported to be involved in decisions about what they do and what happens in the home. Evidence: Standards 6, 7, 8, 9 & 10 were tested. Each person had a care plan and these contained information about them and the support that they need. Plans seen had been regularly updated and contained appropriate information. This included important things to know about me when you work at night, what support and assistance I need, how I communicate and also Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: behaviour management. The plans seen were appropriately detailed and up to date and had been signed by those concerned. Behaviour management plans were clear and stated what should be done and why. Information was available to enable staff to work with each person to meet their individual needs Each person has a daily log and these contained detailed information about how people had been, what they had done and also included reports from the night staff. Therefore there is information about each person, which can be used as part of the review process and to identify ongoing and changing needs. The risk assessments were up to date and identified risks to people and ways in which the risks can be reduced to enable people to be supported as safely as possible. Risk assessments seen were relevant to each individual, the activities they do and their own specific behaviours. The people living at Fairkytes can and do say what they like and dont like and make decisions about what they do and what happens in their lives. People are consulted about a variety of things including the menu and activities. During the course of inspection the people that were in the home that day spent time talking to staff about Christmas and planning what they would do and what they would have to eat. Personal records and other information are stored securely in the office and staff are aware of issues of confidentiality. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. People are encouraged to be as independent as possible, to take part in activities and to be part of the community. People are supported to keep in contact with their friends and relatives. People have meals that they have chosen, like, and that meet their needs and preferences. Evidence: Standards 11, 12, 13, 14, 15, 16 & 17 were tested. All of the people living at this home can and do choose what they want to do. Activity plans reflect that people frequently go to the local shops, use public transport and use Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: the local amenities such as bowling, cinema and bingo. Two people go to college and a third works in a charity shopping for most afternoons. He said that he enjoyed doing this. In addition to this there is an activity room in the garden. One of the people living at the home said that they used this for arts and craft and music and also that they do interviews in there. He also spoke about his birthday celebrations and was planning who to invite to his party. Another persons care plan said that they like to draw, listen to music, to go out for meals and to go bowling. Staff spoken to said that the people living there are offered a lot of different things to do. People participate in household tasks and are encouraged to tidy their own rooms. Some people are more independent than others. For example, some can make drinks and simple snacks. People are also encouraged and supported to help with the food preparation and take it in turns to do this and to do the shopping. People have different amounts of contact with their relatives. Feedback from one relative was that they felt welcome at the home. Relatives are invited to celebrations and some people visit their families and contact them on the telephone. The organisation has another home next door and one person in particular likes to visit to see his friends and sometimes have dinner with them. People can and do choose what they want to eat. They are involved with developing the menu and on the day of the visit some people were helping to plan the Christmas menu. Fresh fruit and various drinks and snacks were available. One person got up later than the others and was assisted to prepare some tea and toast. Care plans contain information about the food and drinks that people like and also any allergies. For example one person is allergic to Coke, cherry aid, chocolate and coffee. People are encouraged to eat a balanced diet and are given meals that meet their needs and likes. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. People using this service receive personal care that meets their needs and preferences and staff support them to get the healthcare that they need. They are given their prescribed medication appropriately Evidence: Standards 18, 19 & 20 were tested. People living at Fairkytes require differing amounts of support with their personal care and details of the help that they need and how they prefer to be supported are in their individual plans. The plans also show ways in which people are encouraged to be as independent as possible. For example, being prompted to clean their teeth as opposed to having their teeth cleaned. Care plans also include a section on how I like to look. People have been successfully supported with continence issues. Therefore people are supported to receive the personal care that they need in a way that they prefer. Each person is registered with a local GP and receives specialist input as and when required. Specialist help is received from the community learning disabilities team and includes input from the psychiatrist, community nurse and psychologist. Staff support Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: people to all of their medical appointments. Files also contained confirmation of checks from the optician, dentist and when required chiropodist. Each person has a health action plan and these were all up to date and show that staff follow up any health concerns. The outcomes of all the visits are documented and show that peoples healthcare needs are monitored and addressed. There are policies and procedures for the handling the recording of medication. Medication is stored in an appropriate lockable metal cabinet in the office and the temperatures of the room this is in are checked daily as are the medication fridge temperatures. None of the people living at the home are able to self medicate and medication is administered by staff that have been trained to do this. In October there was an issue with regards to medication and the process has been tightened up as a result of this. The manager has re assessed the staff that administer medication. In addition to medication training staff have had training to administer buccal midazolam to enable them to support people who need this medication due to their epilepsy. Most medication is administered via monitored dosage system and the remainder are kept on individual shelves for each person. There are guidelines in place for the administration of buccal midazolam and these are clear with the appropriate detail and have been devised by the epilepsy specialist nurse. However in some cases people have other PRN (when required) medication and protocols for these are not sufficiently detailed. These protocols need to include the frequency/minimum period before repeating a dose, the maximum number of doses in a time span, and the action to be taken in the event of the persons symptoms inadequately responding to the medication. Medication administration records are kept and were up to date. There was a handwritten entry on the medication records and for accountability any hand written entries or changes made by staff must be endorsed with the date and signed initials or signature of the person. Overall people are now receiving their required medication safely and addressing the requirements will make this more robust. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. People have not been consistently safeguarded since the last inspection. However the working practices and support from the current manager, staff and the organisation is more robust and offers better safeguards to them. Evidence: Standards 22 & 23 were tested. There is a complaints procedure and a pictorial complaints procedure to help people understand how to complain. This is displayed around the home and also each person has their own copy. Most people are able to say if they are not happy about something and have the specific opportunity to do this at key working sessions. Also a representative of the organisation talks to people during the monitoring visits and asks opinions of the service provided and if they have any concerns or complaints. Most staff have received POVA (Protection of Vulnerable Adults) training and further safeguarding training has been booked in March 2010. During the past year there have been a number of safeguarding issues and these were reported to, and addressed, by the local authority. Recently the local authority arranged a meeting with the manager and the organisation to discuss concerns and to seek reassurances that the appropriate action was being taken. At that time the local authority said that the issues from the start of the year had been satisfactorily resolved and they were looking at recent issues. Due to circumstances beyond the control of the service there Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: have been a lot of staff changes and this was unsettled the people living at the home and has resulted in some aggressive outbursts. There is now a new manager and a staff team in place and they are receiving training and gradually getting to know the people using the service. One person has been exhibiting some very aggressive and threatening behaviour which has necessitated the police being called to the home on occasions. As result of this the service has put a very specific action plan in place as to how to deal with the person, how to recognise signs that there is likely to be a problem and what action to take. There are ongoing meetings with the local authority and input from other professionals to support this. In addition the organisation have appointed a peripatetic manager/trainer with experience of working with people with complex and challenging behaviour. It is also planned that staff will receive training in conflict management. The service therefore has put systems in place to safeguard the people and the staff at the home as far as possible. The section on staffing later in this report gives information that confirms there is an appropriate recruitment procedure and this also helps to safeguard people living at the home. Two people living at the home have bank accounts and for the other people the London Borough of Havering is a corporate appointee. Most of the money is stored in individual wallets in the safe in the office. Small amounts for everyday use are kept in a locked tin which staff have access to. Money kept downstairs is checked at each handover and the senior is present when money is taken out. Records are kept of this. Statements from peoples bank accounts come to the home and are filed. The manager does look at these to check everything is okay but they are not reconciled in any way. It is recommended that systems are put in place to reconcile peoples bank accounts. This will offer a more robust safeguard for their finances. Care Homes for Adults (18-65 years) Page 19 of 28 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. People living a clean and comfortable home is suitable for their needs. Evidence: Standards 24, 25, 26, 27, 28, 29 & 30 were tested. The home is situated a short walking distance from Hornchurch town centre which has selection of shops and leisure facilities and access to transport networks. On the ground floor there is an open plan lounge/kitchen diner and also one of the bedrooms. This room has an ensuite toilet and shower. The remainder of the bedrooms are upstairs. As is the office. In the garden there is a separate building that is used as an activities room. There are some ensuite facilities and also a shared bathroom for people want to use this facility. None of the people living at the service currently require any additional aids or adaptations. Overall the house was homely and comfortable and in a good state of repair. Some of the bedrooms and the hallway are starting to look quite shabby and the manager has requested that these been redecorated. It is anticipated that this will be done in the near future and therefore a requirement has not been in relation to this. Therefore overall people are living in a clean and comfortable home is suitable for their needs. Care Homes for Adults (18-65 years) Page 20 of 28 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. People are supported and protected by the recruitment practices of the service. Staff have or are receiving the necessary training and support to meet peoples current needs and provide an appropriate service for them. Staff have the opportunity collectively and individually to discuss their own development and are any problems and developments within the service. Evidence: Standards 31, 32, 33, 34, 35 & 36 were tested There have been several staff changes this year and this included a new manager. The changes did present difficulties as some of the people living there are unable to cope with changes and this did affect their behaviour. One relative said that overall he was satisfied with the service but that the staff turnover had been very disruptive for his son. However staff have been recruited and are settling in. Any vacancies are being covered by regular bank staff. This in addition to a new manager has given the service far more stability recently and staff are getting to know the people and how to work with them. Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: There are usually two staff on duty during the daytime and at night there is one waking staff and one sleep in staff. Additional staff are on duty to cover appointments and activities such as the youth club. When possible a third member staff is also on at the weekend to facilitate additional activities. The manager is supernumerary. From observations on the day, examination of the rota and discussions with staff it was evident that there were sufficient staff on duty to meet peoples needs and that there was flexibility when required. Some staff have NVQ level II and others are doing this qualification. Two of the staff spoken to were in the process of doing NVQ level III. From discussions with staff and checking files it was evident that staff are receiving induction and mandatory training. This included infection control, medication, the administration of buccal midazolam and protection of vulnerable adults. Training needs have been identified, for example conflict management and updating safeguarding. These are being arranged. Staff said that they were doing extra training. Therefore systems are in place to ensure that the staff team have the skills and training needed to work with the people using this service. The organisation operates an appropriate recruitment procedure. Jobs are advertised, application forms completed and interviews held. One of the people living at this home said that he helped with interviews. A random sample of staff records were checked during the inspection and they contained the required information to demonstrate that staff had been appropriately recruited. This included application forms, references, proof of identification and CRB (Criminal Records Bureau) checks. Staff spoke very positively about the new manager. They said that she was very supportive and approachable, fair and flexible. Also that shes clear about what needs to be done but if you are wrong she will tell you what is wrong and help you and discuss any training that is needed. The new manager has held staff meetings and started supervision of the staff team. Staff feel involved in the development of the home and said that they felt clear about what needs to be done. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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. People living at Fairkytes are now benefiting from a service that is well managed and where their opinions are sought. They live in a safe environment. Evidence: Standards 37, 38, 39 & 42 were tested. Due to circumstances outside the control of the organisation there has not been stability or consistency with regard to the management of the service. In addition there have also been major changes in the staff team. However a new manager has been in the post since September and this has already given stability to the service. The new manager is appropriately qualified and experienced to manage this service. Feedback from staff was that the manager was very approachable, flexible and supportive and that they are clear as to what needs to be done. Staff also said that systems and paperwork are much clearer, that things are under control and that the staff are working together as a team. The quality of the service is monitored by the manager and by the organisation. A Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: senior manager carries out monthly monitoring visits and also checks on the progress of the service. Copies of the reports of these visits are available at the home. As part of the visits feedback is sought from the people living at Fairkytes. From discussions with a senior manager it was evident that he visits regularly, is very familiar with the workings of the service and the issues there and that he is able to support the manager and the staff team. Portable appliances were tested in March 2009, the gas safety in February 2009 and the electrical intake in July 2007. Emergency procedures had been reviewed in September 2009. Appropriate servicing is carried out on the fire system and fire equipment and this was last checked in July 2009. The necessary health and safety checks are now being carried out and records are kept of these checks. Hot water temperatures are being checked but there had been a gap whilst the service was waiting for new temperature probe. Fridge and freezer temperatures are checked daily. There were three fire drills in January and March. However as there is a new manager and a lot of new staff it is recommended that a fire drill be carried out to ensure that everybody is clear the action that they need to take in the event of the fire alarm being activated. Fire alarms had been tested but this wasnt always regular. Fire alarm call points must be tested on a weekly basis to ensure that they are working correctly. Overall a safe environment is now provided for the people living there and holding fire drills and ensuring that the fire alarm call points are tested weekly will strengthen this. Care Homes for Adults (18-65 years) Page 24 of 28 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 Adults (18-65 years) Page 25 of 28 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 1 20 13 Any hand written entries or 31/01/2010 changes made to MAR (Medication Administration Records) made by staff must be endorsed with the date and signed initials or signature of the person. For accountability. 2 20 13 The protocols for any PRN (when required) medication must include the frequency/minimum period before repeating a dose, the maximum number of doses in a time span, and the action to be taken in the event of the persons symptoms inadequately responding to the medication. To ensure that staff are clear as to when and how to administer this medication. 31/01/2010 Care Homes for Adults (18-65 years) Page 26 of 28 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 3 42 23 Fire alarm call points must be tested on a weekly basis and a record kept of the checks. This will ensure that the system is working correctly and help to safeguard people when they are in the house. 31/01/2010 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 1 23 It is recommended that systems are put in place to reconcile peoples bank accounts. This will offer a more robust safeguard for their finances. It is recommended that a fire drill be carried out to ensure that everybody is clear as to the action that needs to take in the event of the alarm sounding. 2 42 Care Homes for Adults (18-65 years) Page 27 of 28 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!