Care Home: Fairways, The

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What the care home does well The home provides a service to people who have different cultural and religious needs. The care needs of prospective residents are fully assessed prior to admission. Care plans are appropriately undertaken and regularly reviewed. The healthcare needs of residents are being met promptly and effectively. Health and safety records are satisfactorily maintained and indicative of the health, safety and welfare of residents being protected. A variety of wholesome and appealing meals are offered to residents. They receive cooked choices at breakfast and supper. Drinks and snacks including fresh fruit are regularly served. People spoken with expressed satisfaction with the quantity and quality of food they received. Training and refreshers appropriate for meeting the needs of people who use the are delivered to care staff and they are competent and attentive in their role. Residents were suitably and attractively dressed. They appeared comfortable and content and interacted in a friendly and spontaneous manner with care staff. We spoke with fifteen residents and everyone reported being happy with the care and support they received from care staff. Overall the premises were well maintained. The environment was pleasant, homely and welcoming. What has improved since the last inspection? Two requirements at the last inspection had been complied with. Specifically staffing ratios in relation to residents are adequate for meeting individual needs. Residents receive choice regarding times of retiring at night. What the care home could do better: The service must make sure that residents` medications are at all times administered as prescribed and appropriately signed. Carpets in all areas of the home must be kept clean and free from offensive odours. Key inspection report Care homes for older people Name: Address: Fairways, The 64 Ickenham Road Ruislip Middlesex HA4 7DQ     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: Jean Bovell     Date: 0 6 1 0 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 Older People Page 2 of 27 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) 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 Older People Page 3 of 27 Information about the care home Name of care home: Address: Fairways, The 64 Ickenham Road Ruislip Middlesex HA4 7DQ 01895675885 01895639859 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Farrington Care Homes Ltd care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 27 The registered person may provide the following category 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: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home The Fairways is an established residential home. The proprietors are Farrington Care Homes Limited who own three other homes within the Ruislip/Ickenham area. The Fairways is a converted Edwardian house in Ruislip. There is good parking at the front of the home and it is easily accessed by tube, train and bus routes. Ruislip shopping centre is a short distance away. The Home is registered for 27 older people but there were 17 residents including one person on respite care at the time of the inspection. The Home consists of two separate houses, the main House and the smaller Feather House. However, Feather House was closed temporarily on the 30th August and the unit?s four residents were transferred into the main building. The Main House has six Care Homes for Older People Page 4 of 27 Over 65 27 0 Brief description of the care home bedrooms on the ground floor. A lounge with a quiet area and a rear conservatory/dining area. An assisted shower/bathroom/toilet and a separate toilet. There is a small kitchen to the rear of the house and small office. There is a seating area, one double bedroom, a bathroom/toilet, staff sleep-in room and staff toilet on the first floor which can be accessed via stairs, stair-lift or passenger lift. Feather House is located at the end of the garden. There are six single bedrooms, a lounge/diner area, kitchen, en suite bathroom/toilet and separate toilet. The garden between the two houses is mostly laid to lawn with seating areas. Feather House has it?s own small garden. There is a large shed in the garden that is called the `1st tee? and this is used for staff meetings. Fees for the home are #526 per week for a single room and #505 per week for a double room. Care Homes for Older People Page 5 of 27 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 was carried out between 11:OO and 16:30 on 6th September 2009. The Acting Manager, three care workers, a trained cook, a domestic worker and sixteen residents were at the home. During the course of the inspection: records, documents, policies and procedured in relation to key standards were viewed. A tour of the building was undertaken and observations were made. Discussions were held with five care staff members, the cook and fifteen residents. Requirements made at the last inspection and all key standards were examined. Care Homes for Older People Page 6 of 27 The homes Annual Quality Assurance assessment (AQAA) was considered. The Acting Manager was co-operative and provided appropriate assistance during the majority of the inspection. Care Homes for Older People Page 7 of 27 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. Care Homes for Older People Page 8 of 27 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 9 of 27 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 10 of 27 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. The needs of prospective residents are fully assessed prior to admission. Evidence: There was documented evidence on residents files that pre-admission care needs assessments, based the homes Admissions checklist, had been fully undertaken prior to admission. Confirmation that separate identified needs would be met at the home was included within signed contracts/statement of terms of conditions. Care Homes for Older People Page 11 of 27 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. Care plans are being satisfactorily undertaken and regularly reviewed. The health needs of individuals are being met as required. Medication procedures are not, at all times, accurately followed. People who use the service are treated with respect and their privacy and dignity are being upheld. Evidence: The changing health, personal and social needs of residents were identified within separate care plans. Action plans and set goals were in place. All care plans viewed were reviewed on a monthly basis. Risk assessments in relation to activities identified within care plans had been undertaken. These included, moving and handling and falls. Care Homes for Older People Page 12 of 27 Evidence: Medication procedures were in place and records were indicative of staff training on medication being delivered. Medicines were safely and appropriately stored and records were maintained of medications received and returned to the Pharmacists. There was documented evidence that medication audits were being carried out by the Pharmacist every three months. The medication administration sheets were examined and errors relating to signatures being entered inappropriately and/or prescribed medication not being administered were identified. These issues were brought to the attention of the Acting Manager and confirmed when tablets were counted. We were subsequently assured that appropriate action would be taken. We were informed by the Acting Manager that residents lacked capacity to self administer medication. Care staff were observed interacting with residents in a respectful manner and knocked on bedroom doors prior to entering. Residents spoken with confirmed care staff were polite and that their privacy and dignity were being respected. There were recorded indicators that residents received assistance with personal care. They were, however, able to choose what they wore each day, accessories, hairstyles and make-up. All residents appeared clean, tidy and attractively dressed. The changing healthcare needs of residents were assessed within separate care plans. It was indicated that residents received access to appropriate health professionals as and/or when required and were accompanied by care staff to medical appointments. This occurred at the time of the inspection. Pressure relieving cushions and mattresses were in use. Weight charts were in being maintained. We were informed by the Acting Manager that district nurses and a physiotherapist regularly visited the home. People who use the service appeared healthy and well cared for. Care Homes for Older People Page 13 of 27 Evidence: Care Homes for Older People Page 14 of 27 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 religious needs of individuals are being adequately met. Contact between residents and relatives and/or friends are encouraged and facilitated. People are able to exercise choice in relation to their daily living routines. A variety of nutritional and appealing meals are being provided to residents. Evidence: Individual social, religious and cultural needs of were identified within care plans. We were informed by the Acting Manager that a Cleric from a local Christian denomination visited the home on a monthly basis. Residents were also able to receive Holy Communion. An activities programme was on display. It was reflected that planned activities included movement to music, karaoke, arts and crafts, shopping, gardening and evening clubs. Residents with capacity were able to be independent in the local Care Homes for Older People Page 15 of 27 Evidence: community. People were observed reading and/or listening to music in the main lounge. Others rested and/or watched television in separate bedrooms. There was a shared sing-along session during the afternoon of the inspection while an individual was independently involved in an activity within the community. An open visiting policy is in place. Contact between residents and their respective relatives and/or friends are encouraged and facilitated and residents are able to meet visitors in the privacy of their bedroom or in communal areas. There was documented evidence that an advocacy service is available to residents. A representative from Age Concern visited the home and held discussions with individuals at the time of the inspection. We were informed by the Acting Manager that people received choice in relation daily routines such as activities, personal purchases, meals, clothing/accessories, makeup/hairstyles and when they woke up in the morning and retired at night. Resodents were able to remain in their bedroom where meals can be served or engage in shared or individual activity in the main lounge and/or adjoining small lounge. The garden was also accessible. An abundance of fresh, dried and frozen foods were stored appropriately. There are two trained cooks at the home. Menus were reflective of varied and wholesome meals being provided at lunch and supper and breakfast included cooked options. We spoke to a cook who reported that the home endeavoured to prepare meals that were plain, edible and appealing to the people who use the service. Nutritious and appealing lunch options were offered at the time of the inspection and people were observed enjoying their chosen meal. Those spoken with told us that they were happy with the quality and quantity of food provided. Drinks and snacks such as fresh fruit, home made cakes and a variety of biscuits were readily available. Care Homes for Older People Page 16 of 27 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 complaints procedure is in place, appropriately detailed and accessible. People who use the service are being protected from abuse. Evidence: The complaints procedure was clearly and appropriately detailed and accessible to residents, relatives and/or friends. People spoken with confirmed awareness of the complaints procedure. Incidents and accidents were being recorded and regulation 37 notifications were submitted to the Commission where required. We were informed by the Acting Manager that the service was not responsible for the financial affairs of residents. However, personal allowances were being secured by care staff at the home. Separate financial records in relation to residents cash allowances were inspected at random. Discrepancies were not identified. Policies and procedures regarding the Protection of Vulnerable Adults were in place. Care Homes for Older People Page 17 of 27 Evidence: Training records were indicative of up-to-date staff training on Safeguarding Adults being delivered. There were no reported safeguarding incidents following the last inspection. This was confirmed by the Acting Manager. Care Homes for Older People Page 18 of 27 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. The premises are safe and well maintained. Residents bedrooms are suitably furnished, fitted and personalised. Bathroom and toilet facilities are sufficient for meeting the personal needs of residents. The home provides specialist equipment for maximising the independence of people who use the service. Bedrooms are suitably furnished and fitted and personalised. Overall, the service is safe, pleasant and homely. However, carpets are not satisfactorily maintained in all areas. Evidence: Communal areas within the premises were in good decorative order, spacious and suitable for shared and/or individual activity. Furnishings and equipment were of good quality and appropriate for purpose. Care Homes for Older People Page 19 of 27 Evidence: Lighting was sufficiently bright and positioned to facilitate reading and other activities. The garden was reasonably well maintained and accessible to wheelchair users. No issues were identified in relation to the laundry. Bathroom and toilet facilities were clean and hygienic and sufficient for meeting the personal needs of residents. The home contained a variety of equipment for maximising the independence of residents. These included wheelchairs, walking aids, nurse call systems, a chair lift and a passenger lift. Bedrooms were suitably furnished and fitted, and contained personal items such as framed family photographs, television sets, radios and musical instruments. The home was centrally heated and well ventilated. The gas boiler was being maintained and hot water temperatures were recorded on a regular basis. Although the premises were basically clean and hygienic, carpets in the hallway on the ground floor required cleaning and an unpleasant odour came from the carpet in a residents bedroom. This was discussed with the Acting Manager and were were assured that appropriate action would be taken. Overall, the premises were well maintained. The environment was safe, pleasant, homely and welcoming. People who use the service appeared comfortable and content. Those spoken with confirmed being happily settled at the home. Care Homes for Older People Page 20 of 27 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. The ratios of care staff to residents are adequate for meeting individual needs. Care staff are qualified and receive appropriate training for meeting the needs of people who use the service. The homes policy and procedures on recruitment are satisfactory. Evidence: We were informed by the Acting Manager that twelve care staff were in employment at the home and that ancilliary staff consisted of two trained cooks, two kitchen assistants and three housekeepers. It was indicated on staff rotas that three care staff covered duty during waking hours. This was reflected at the time of the inspection. The Acting Manager confirmed that two care staff - one waking and one sleeping - covered duty at night. There was documented evidence that care staff received induction training. Subsequent staff training and refreshers for meeting the needs of residents were also being delivered and included Demential Awareness. We were informed by the Acting Manager that seven care staff members achieved Care Homes for Older People Page 21 of 27 Evidence: NVQ level 2 in Health and Social Care and one was receiving NVQ training. Staff recruitment files were examined at random. Each file contained all documents required under Schedule 2 of the Care Homes Regulations. Care staff spoken with expressed satisfaction with the levels of training and support they received in their role. Care workers who covered duty during the course of the inspection were observed being competent and attentive in meeting the needs of resident. Care Homes for Older People Page 22 of 27 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. The Acting Manager is appropriately experienced. Quality assurance has been undertaken effectively. The cash allowances of residents are being satisfactorily secured. The health, safefty and welfare of people who use the service are safeguarded. Evidence: The Acting Manager has been experienced in the care field for 14 years and has been in her current position for sixteen months. We were informed by the Acting Manager that the Organisation was in the process of recruiting a Manager for the home. Care staff spoken with reported that the Acting Manager was open, approachable and Care Homes for Older People Page 23 of 27 Evidence: often provided practical support. This was evidenced at the beginning of the inspection when a resident was accompanied by the Acting Manager to a GP appointment. An annual quality assurance assessment (AQAA) was submitted to the Commission. It was clearly detailed and provided all required information. We were informed by the Acting Manager that the home did not hold responsibility for the financial affairs of residents. However, the personal cash allowances of individuals were being secured at the home. Separate financial records in relation to cash allowances were examined and there were no discrepancies. Health and safety records were up-to-date. These included fire safety and water temperature checks, portable appliances tests, gas maintenance and legionnaires testing. Fire drills were carried out on a regular basis and clearly recorded. Environmental risk assessments had been undertaken. Records were reflective of staff training and refreshers on Moving and Handling, Food Hygiene and Infection control being delivered. Policies and procedures on Health and Safety were in place. Care Homes for Older People Page 24 of 27 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 25 of 27 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 9 13 The Registered Person must make sure that prescribed medication is at all times administered and appropriately signed. This is to ensure that the health, safety and welfare of residents are protected. 05/11/2009 2 26 16 The Registered Person must ensure that all carpets are reasonably maintained and free from offensive odour. To prevent unnecessary risks to the health and safety of residents. 05/11/2009 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 26 of 27 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 Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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