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Inspection on 13/08/09 for Field House Rest Home

Also see our care home review for Field House Rest Home for more information

This is the latest available inspection report for this service, carried out on 13th August 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Field House is set in very attractive grounds, providing picturesque views from the home and pleasant areas for people to use when the weather permits. There is an informal, relaxed and friendly atmosphere in all areas of the home, and staff were observed talking and laughing with the residents. We were told by relatives and residents that they had been provided with sufficient information about the home to assist them make an informed choice prior to moving in. The manager encourages people to visit the home before making up their minds. All people are assessed before moving into the home to ensure that the home can meet their health and physical needs safely. People are able to bring their own belongings into their bedrooms to help them make and feel it is theirs. They are also able to bring pets with them when they move in. One person told us that they would never have moved into a home if they had not been able to take their dog. They also complimented the care for the dog who had also settled well into the Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 home. Other residents told us that they were never disturbed by the dogs living in the home. Residents told us that they have their health and personal care needs provided in a polite and courteous way, and their preferences about their care is respected. The staff told us that the home is committed to them receiving training, and that they have the skills and knowledge to meet the care needs of the residents. People living at the home receive a well-balanced and varied diet that meets their nutritional and dietary needs The information we received in our surveys and when we spoke to people was complementary about the staff, food and the facilities available at the home. Comments included: `Staff are pleasant and caring` `standards are excellent but they are constantly looking to see what improvements can be made on a daily basis` `staff are all kind and hard working`

What has improved since the last inspection?

Since the last Key inspection the home have continued to improve their written care records to give clear directives for the staff delivering the care and respect the individuals` wishes on how their care is delivered. The management of medication was well organised and no errors were identified during the inspection. Some changes to the environment to provide more en suite toilets for people living there. The home continues to prioritise staff training to ensure that all staff have the knowledge and understanding to care for the people living in the home. Comments from the staff included: "we all get on very well, the manager is working hard and the standards have definitely improved for the people living here."

What the care home could do better:

It was recommended that when care plans are reviewed, a more meaningful statement is made. For example for a diabetic person staff had recorded, `no change`. To assist staff in monitoring the individual, reference to whether blood sugars had been stable, if the district nurse had called. The normal range of blood sugar recordings for that person when they present signs of a low blood sugar or a high blood sugar should be included. A more structured plan for activities suitable for all the people living in the home, based on their choice and capabilities. Comments received included: `more stimulating activities` `perhaps more activities but given the health of some of the residents this would be difficult` It was recommended that the home review the signs around the home to assist people with short term memory problems find their way around the home.Field House Rest HomeDS0000018505.V377164.R01.S.docVersion 5.2

Key inspection report CARE HOMES FOR OLDER PEOPLE Field House Rest Home Off Western Road Hagley Clent, Near Stourbridge West Midlands DY9 0HL Lead Inspector Chris Potter Key Unannounced Inspection 13th August 2009 09:30 DS0000018505.V377164.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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. Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 2 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 Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Field House Rest Home Address Off Western Road Hagley Clent, Near Stourbridge West Midlands DY9 0HL 01562 885211 01562 700417 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) Mr Ernest Michael Lane Mrs Jermaine Kathleen Emily Lane Tania Mary Hilda Bradley Care Home 54 Category(ies) of Dementia (54), Old age, not falling within any registration, with number other category (54), Physical disability (54) of places Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 (OP) 54 Physical disability (PD) 54 Dementia (DE) 54 The maximum number of service users who can be accommodated is: 54 6th August 2008 2. Date of last inspection Brief Description of the Service: Field House is owned by Mr and Mrs Lane and is a care home registered to provide care and accommodation for up to fifty-four older people who may have physical disabilities and/or illnesses of the dementia type. The registered manager is Tania Bradley who is a first level registered nurse with many years experience in caring for elderly people. Field House is a Georgian style building in ten acres of grounds. The setting is rural with village facilities nearby. The Home was first registered in 1983 and is divided into three areas known as the main house, the coach house and the cottage. The main house has large rooms, high ceilings and a large wide staircase while the coach house and cottage are smaller and more domestic in style. People who live at the Home all have their own bedroom unless they are couples or friends who wish to share a room. The Home has large lawns at the front of the building and as well as a pleasant courtyard garden at the back. There are plenty of parking spaces for visitors cars. Information regarding the home can be obtained from the Statement of Purpose and Service Users Guide, which are available from the home. A copy of the inspection report can be viewed at the home. For up to date information regarding the charges for the Home, it is recommended that the Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 5 information is requested direct from the manager or from the owners. Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use the service experience good outcomes. We, the commission, undertook an unannounced inspection of this service, which means that the home did not know we were coming. This was a key inspection – which is an inspection where we look at a wide range of areas. Before the inspection an Annual Quality Assurance Assessment (AQAA) document was posted to the service for completion. The AQAA is a self-assessment and a dataset that each registered provider has to complete each year and send to us within agreed timescales. The document tells us about how providers of services are meeting outcomes for people who use the service and is an opportunity for them to share with us what aspects of the service they believe they are doing well. Some of the providers comments have been included within this inspection report. Information was gathered from speaking to and observing people who lived at the home. Three people were case tracked, and this involved discovering their experiences of living at the home by meeting and observing them, looking at medication and care files, and reviewing areas of the home relevant to these people in order to focus on outcomes. Case tracking helps us understand the experiences of people who use the service. Surveys were sent out and received from residents (eight). We spoke to the owners, the manager and some staff who assisted us throughout the inspection process. We would like to thank everyone for their help and some comments have been included in the inspection report. What the service does well: Field House is set in very attractive grounds, providing picturesque views from the home and pleasant areas for people to use when the weather permits. There is an informal, relaxed and friendly atmosphere in all areas of the home, and staff were observed talking and laughing with the residents. We were told by relatives and residents that they had been provided with sufficient information about the home to assist them make an informed choice prior to moving in. The manager encourages people to visit the home before making up their minds. All people are assessed before moving into the home to ensure that the home can meet their health and physical needs safely. People are able to bring their own belongings into their bedrooms to help them make and feel it is theirs. They are also able to bring pets with them when they move in. One person told us that they would never have moved into a home if they had not been able to take their dog. They also complimented the care for the dog who had also settled well into the Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 7 home. Other residents told us that they were never disturbed by the dogs living in the home. Residents told us that they have their health and personal care needs provided in a polite and courteous way, and their preferences about their care is respected. The staff told us that the home is committed to them receiving training, and that they have the skills and knowledge to meet the care needs of the residents. People living at the home receive a well-balanced and varied diet that meets their nutritional and dietary needs The information we received in our surveys and when we spoke to people was complementary about the staff, food and the facilities available at the home. Comments included: Staff are pleasant and caring standards are excellent but they are constantly looking to see what improvements can be made on a daily basis staff are all kind and hard working What has improved since the last inspection? What they could do better: It was recommended that when care plans are reviewed, a more meaningful statement is made. For example for a diabetic person staff had recorded, no change. To assist staff in monitoring the individual, reference to whether blood sugars had been stable, if the district nurse had called. The normal range of blood sugar recordings for that person when they present signs of a low blood sugar or a high blood sugar should be included. A more structured plan for activities suitable for all the people living in the home, based on their choice and capabilities. Comments received included: more stimulating activities perhaps more activities but given the health of some of the residents this would be difficult It was recommended that the home review the signs around the home to assist people with short term memory problems find their way around the home. Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 8 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 9 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 Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,3 and 4 People using the 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 sufficient information to enable them to make an informed decision about whether they would like to live at the home. There are opportunities for people to visit the home before making up their minds. The home carries out assessments of peoples needs before they move in, so that staff can provide the care that is needed. EVIDENCE: The last inspection report in August 2008 rated these standards as good, and gave no requirements or recommendations. The Annual Quality Assurance Assessment received for this inspection told us that they have improved in these standards by updating the preassessment forms. This ensures that the information remains detailed and comprehensive about the person. The manager told us that the planned improvement to request feedback from people about the admission process is still to be introduced. Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 11 The home provides written information in the form of a Service User Guide to help people decide whether they wish to live at Field House. A resident told us that they had received the information and came on a trial visit prior to moving into the home. We saw copies of the Service Users Guide in the reception area of the home. The home has the ability to have the documents translated and made available in other formats including large print. The manager goes out to assess people who are thinking of moving into the home to find out about their care needs. We looked at the information for three people who were living at the home. The information was detailed and provided staff with the information about why the person needed to move into a care home. The information from the assessment is then used to assist in writing a care plan for the individuals care and the things that they need staff to help them with. The surveys received from the eight people confirmed that they had received enough information to assist them with their choice prior to moving in. They also confirmed that they had received a written contract about the homes terms and conditions and a copy of this was saved in the care file. Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People using the 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 health and personal care people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The last key inspection in August 2008 rated these standards as adequate and it was recommended that the information in the written plans describing peoples care needs to be detailed enough to guide staff in the care that each person needs. A requirement was made in respect of bedrail assessments for the service to ensure that the use of bedrails for people are continually reviewed including how and why decisions have been for their use and they must be updated when circumstances change. The Annual Quality Assurance Assessment received for this inspection told us the requirement had been addressed following the last key inspection. It also stated that care staff had received additional training to assist them in improving the quality of care plans. Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 13 As part of the inspection three peoples care records were reviewed. These showed us that the information in the care records has improved since the last key inspection. Care staff were able to provide us with information as to why the person had been admitted to Field House and clearly describe their care needs. Staff also demonstrated a good knowledge and understanding of each persons preferences in how they wished their care to be provided. The care plans showed that since the last key inspection the quality of the information about the individuals has improved. Information about the persons personal healthcare needs including specialist health, and dietary requirements are clearly recorded in their care record. It was recommended that the care staff record a clearer evaluation for the person in their monthly review. For example on a diabetic persons care record staff had recorded, no change every month. To assist in monitoring the individuals health the entry should reference whether blood glucose levels had been stable during that time, if the district nurse had called in to see them. The care plan should show the normal range of blood glucose levels for that person and at what point they present signs of a low blood sugar or a high blood sugar. The people being case tracked were pleased with the level of care at the home, and felt that all their needs were being met. One person told us nothing is too much trouble for them they are all marvellous, the home is home from home. Peoples privacy was seen to be respected by the staff, they were knocking on doors before entering and speaking to people courteously. Residents and relatives confirmed that all staff respect their privacy and dignity. Everyone appeared contented during the inspection and people were seen in their bedrooms, the gardens, wandering in the corridors, sitting in the lounges. There was a relaxed informal atmosphere throughout the home. The home has good procedures in place for the management of medication. Medication is stored safely, and accurate record keeping enables the home to know which medications have been given and at what times. We looked at three peoples medication records and they had been completed by the senior carers. Field House Rest Home DS0000018505.V377164.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some people using the service have the opportunities to be involved in interesting activities and access the gardens. The dietary needs of people using the service are well catered for with a balanced diet and a varied selection of foods. EVIDENCE: During our visit, the manager told us that a senior carer has been delegated the responsibility of organising and co-ordinating activities for people using the service. They have set up a folder to monitor the planned activities and are aware of which individuals take part in the arranged activities. We were told the types of activities for people include exercises to music, and this happens each week. A variety of outside entertainers also visit the home, and these include a guitarist and an organ player. Staff take part in a range of games and activities with people, and these include, for example, skittles, cards and reminiscence sessions. Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 15 People living in the home are able to bring their family pets with them when they move into the home, and these bring enjoyment to their owners and other people living in the home. One person told us they would never have moved into the home if they could not take their dog with them. They confirmed that they both settled well in the home, and staff were looking after them both really well. People told us that staff respect their wishes about what time they go to bed, and what time they get up in the morning. Staff told us that they would like to see people have more opportunities to go out more, and were hoping that this could be arranged. It was pleasing to note the dedication of staff, who provide help and support to people when an outing is arranged. On the day of the inspection we saw people in their bedrooms watching television, sitting chatting in quiet areas, outside in the grounds and sitting in the lounges. Religious needs are assessed individually and the vicar from Broome visits people who wish to see them. The home gives people a choice of male or female carers, and this preference is clearly recorded in each persons care plan. Comments from people using the service include: would like to see more stimulating activities, (we would like to) take the residents out more in the better weather and if we had transport we could take people out more. The menus showed a varied and nutritious diet, and people that we spoke to all commented favourably about the quality of food provided with one person stating The food is excellent, while another person said I enjoy all the food and my Guinness! Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People using the 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 who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. They are protected from abuse, and have their rights protected. EVIDENCE: We looked at the homes complaints records and found that just one complaint had been recorded since the time of our last inspection, and this was in relation to a persons duvet cover going missing in the wash. This was subsequently replaced by the home. We talked to the home manager and staff about a complaint we had recently received, and we were given the homes viewpoint about the scenario presented by the complainant. We were confident in the homes processes and culture to leave the concern with the home to formally and objectively explore the issue raised. Staff spoken with were aware of their responsibilities for reporting any concerns about poor practice, and they confirmed that they had received training in safeguarding vulnerable people. This was underpinned by the homes vulnerable adults policy and a copy of the Department of Healths publication entitled No Secrets being held within the home for reference and guidance purposes. Staff were aware of the aforementioned documents. The vast majority of people who returned questionnaires back to us confirmed that they knew about the homes complaints procedure and to whom they could complain if ever the Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 17 need arose. However, a minority of people were not fully aware of the correct procedures or processes to follow. The manager and proprietor have attended training on the Deprivation of Liberty Safeguards (DoLS) put on by the county council, and they are in the process of cascading the information to staff working in the home. DoLS promotes the rights of individuals to make choices and decisions, and links in with the Mental Capacity Act. It requires the home manager to refer any situation whereby an individuals liberty may be compromised to the Local Authority for review - thereby helping to safeguard the best interests and rights of people using care services. The culture within the home is open and enables people to raise concerns without fear of reprisals or repercussions. Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23, 24 and 26. People using the 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 physical design and layout of the home enables residents to live in a safe, well maintained and comfortable environment. EVIDENCE: During our visit, we took the opportunity to look around the home. Peoples bedrooms are very spacious and are able to be comfortably furnished with, for example, double beds, three-piece suites, and personal items of furniture which helps to promote individuality, identity, ownership and homeliness. We did notice that some areas within the home were lit with fluorescent lighting. This detracted somewhat from the homeliness (domesticity) of these areas. We noticed that, since the time of our previous visit, there has been some noticeable investment in the homes environment. A new laundry had been provided and one of the Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 19 bedrooms was in the process of being converted into a lounge area to increase the amount of communal space available to people using the service, while other areas had been tastefully redecorated and new furnishings had been provided. One questionnaire that had been returned to us expressed concern that the central lift is unreliable. We raised this point with the manager who confirmed that plans were being looked at to replace the lift. People that we spoke with were happy with the environmental standards within the home, and were very happy with the overall service provided by the home. At the time of our visit, the home was clean and tidy throughout with no offensive odours. We did note, however, that there was a lack of appropriate signage to help people with memory loss to easily find their way around the home. The local fire authority has recently written to the home to confirm that the fire safety audit undertaken is now considered to be satisfactory, and appropriate systems are in place to detect and contain any potential fire outbreak. Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident staff numbers on duty, and skill-mix, are sufficient to meet their assessed care needs, and that recruitment and employment practices are consistent with safeguarding them from abuse. EVIDENCE: We looked at the homes recruitment process and the process undertaken when new staff are recruited. Without exception, all staff files contained a completed application form, written references, a completed enhanced CRB (Criminal Records Bureau) check, induction records and training records. The process and pre-employment undertaken by the home regarding staff recruitment helps to ensure that people using the home are protected from abuse. We looked at staffing levels within the home. These appeared suitable in helping staff to meet the needs of people using the service. Staff confirmed that staffing levels were suitable, and stated that standards had improved within the home. This feeling was echoed by the people using the service, who commented; The staff are very caring and create a home from home atmosphere, Standards are excellent but they are constantly looking to see what improvements can be made on a daily basis, Staff are all kind and hard working, (they) look after the residents very well and (the home) treats residents well, cares for their well-being. Relatives are always informed if there is a problem. Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 21 The overwhelming consensus of opinion from people who provided comment about the home was positive about the standard of staffing and care provided. All staff receive mandatory training, and over 50 of staff have achieved a National Vocational Qualification in Care at level 2. Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 22 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. People using the 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 Field House can be confident that the management and administration of the home is based on openness and respect, and has effective quality assurance systems developed by a competent manager. EVIDENCE: Since the time of the previous inspection, Ms Bradley has been registered as manager of Field House. Ms Bradley is a first level registered nurse, and has extensive experience of care home management. Ms Bradley is also registered as the manager of The Coach House, the other care service owned by Mr and Mrs Lane. This means that she is not Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 23 deployed full time at either service. However, information received about the home since the time of the last inspection confirm that standards at Field House have improved since Ms Bradley took the role of manager at the Home, and these are evidenced in other sections of this report. Ms Bradley has made concerted efforts to seek out and respond to the views of people using the service at Field House. A small number of people have their personal spending money looked after by the Home. There are good records kept which show how much is spent on their behalf. However, the Home makes a clear commitment to minimising and limiting its involvement in the financial affairs of people using the service. The maintenance records we sampled showed that regular servicing and repairs are arranged so that essential equipment is kept in good working order. The training staff are having includes health and safety related topics. Staff have an annual appraisal, but have not been receiving supervision on a 1:1 basis. It is important for all staff to receive regular, formal supervision to enable management to monitor the quality of work of staff, for staff to raise issues about performance and performance difficulties with management, and to look at professional development issues which all help to influence quality outcomes for people using the service. Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 24 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 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X 3 2 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations The information in the written plans describing people’s care needs should be routinely reviewed in detail to ensure that the plan of care is effective in achieving the outcomes agreed with the individual. Opportunity should be taken to seek the views and preferences of people using the service (and their relatives) about the social, recreational, occupational and leisure activities provided, and attempt to match the service delivered to peoples expectations. Opportunity should be taken to ensure that everybody using the service and their representatives are aware of the procedure to be followed should anybody wish to raise a complaint or concern. Consideration should be given to the provision of suitable (pictorial) signage/imagery for people with memory loss to help them find their way around the home. Opportunity should be taken to review the types of lighting DS0000018505.V377164.R01.S.doc Version 5.2 Page 26 2. OP12 3. OP16 4. 5. OP24 OP24 Field House Rest Home 6. OP36 provided in all areas within the home to ensure that lighting is as domestic in character as possible. Opportunity should be taken to ensure that all staff receive formal supervision at least six times each year. Field House Rest Home DS0000018505.V377164.R01.S.doc Version 5.2 Page 27 Care Quality Commission Care Quality Commission West Midlands Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. 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