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Inspection on 31/08/05 for East Fields (Royal Mencap Society)

Also see our care home review for East Fields (Royal Mencap Society) for more information

This inspection was carried out on 31st August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

The service provided at Eastfields clearly focused on the needs, preferences and choices of the guests. The home actively sought after the views of guests using the service and took action accordingly to improve the service. The home was clean and pleasant with a homely atmosphere and good interaction between guests and staff. Staff at the home were well supported by the training and supervision programmes in place. The manager was experienced and competent and this was reflected in the commendable organisation of the home.

What has improved since the last inspection?

What the care home could do better:

There was a proposal that a room in the home could be used as a games room for guests. However, there was a gas boiler and pipework in this room which must be boxed in, or made safe in some other way, before the room can be used by guests. Although staff had undergone some training in infection control as part of the health and safety training, more in depth training would ensure their knowledge was sufficient to safeguard guests. The job description for the support workers referred to "lifting". As this is now an outdated practice in care homes, the job description should be amended accordingly.

CARE HOME ADULTS 18-65 Eastfields (Royal Mencap Society) 24a East Crescent Duckmanton Chesterfield S44 5ET Lead Inspector Rose Veale Unannounced Inspection 31st August 2005 11.15am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Eastfields (Royal Mencap Society) Address 24a East Crescent, Duckmanton, Chesterfield, Derbyshire, S44 5ET Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01246 540671 and 01246 824511 01246 540671 Royal Mencap Society Miss Claire Marie Thompson Care Home 8 Category(ies) of Learning Disability (8) registration, with number of places Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 28/02/2005 Brief Description of the Service: Eastfields is situated in the village of Duckmanton on the outskirts of Chesterfield and Bolsover, close to local shops, a pub, and public transport. Eastfields provides personal care and accommodation for up to 8 adults with learning disabilities. The home provides short-term respite care for service users, their carers and families and does not provide long term care. The home is owned by MENCAP, which is a registered charity. Eastfields was opened in 2000 and consists of a two-storey building with 3 downstairs bedrooms and 5 upstairs bedrooms. All the bedrooms are single occupancy. There are 2 lounges, a conservatory and a ‘quiet’ room. There are attractive enclosed gardens to the front and rear of the property that are well maintained and accessible. Car parking space is provided. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 3½ hours on one day. It was noted that people using this service prefer to be referred to as guests. There were three guests accommodated in the home on the day of the inspection. During the inspection, guests and staff were spoken with, care records and other records relating to the staffing and management of the home were examined, and a tour of the building was undertaken. The manager was available and very helpful throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: There was a proposal that a room in the home could be used as a games room for guests. However, there was a gas boiler and pipework in this room which must be boxed in, or made safe in some other way, before the room can be used by guests. Although staff had undergone some training in infection control as part of the health and safety training, more in depth training would ensure their knowledge was sufficient to safeguard guests. The job description for the support workers referred to “lifting”. As this is now an outdated practice in care homes, the job description should be amended accordingly. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 5 The assessment process and the practice of encouraging trial visits ensured that guests could make an informed choice about staying at the home, and that the home could fully meet the needs of guests. EVIDENCE: The Statement of Purpose for the home was seen to follow up a recommendation made at the last inspection that room sizes should be included. The Statement of Purpose had been amended to include this information. The care records of two guests were examined. Both contained assessment information obtained from social workers / care managers, and others involved in the care and support of the guests. The manager explained that people interested in using the service are invited for visits and an overnight stay before making a decision about a longer stay. During these visits, guests were assessed by staff regarding their care needs, response to the service and compatibility with other guests. When people had visited, existing guests were asked for their views regarding compatibility. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 8 and 9 Care plans and risk assessments were clear and detailed, ensuring that staff were aware of the action required to fully meet the needs of guests. Guests were involved in care planning and reviews, and in the running of the home, ensuring that their views and choices were respected. EVIDENCE: The two care records seen contained individual care plans. These were called ‘summaries’ of the support needed with activities of daily living. The summaries were detailed and comprehensive. In addition to the support needed with personal care, there were details of family and friends, leisure activities enjoyed, faith needs, and understanding of using money. Information was included about the preferences of residents regarding daily routines, likes and dislikes, and preference as to the sex of carers helping with personal care. The summaries had been reviewed at least every three months. The summaries and the reviews had been signed by the guest. The care records included a daily report which had information about the choices the guest had made each day regarding clothes, meals and activities. One record seen had some entries made by the guest. The care records were well organised and easy to follow. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 10 Extensive and detailed risk assessments were completed for all guests. The risk assessments were seen for two guests. These were appropriate to the assessed needs of the guests, such as using the kitchen, going out of the home, and using the bath / shower. The home asked guests to complete satisfaction questionnaires during each stay. Any issues raised in the questionnaires were discussed at weekly meetings with guests and staff. Guests were encouraged to be involved in the day to day running of the home, for example, choosing meals and activities, and helping with domestic tasks. Guests were involved in the selection of new staff by showing prospective staff around the home, spending some time with them and giving feedback to the manager. On the day of the inspection, two goldfish had recently been purchased in response to guests’ requests for a pet, and the guests in the home were involved in choosing names. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 14, 15 and 17 Guests were enabled to maintain appropriate and fulfilling lifestyles inside and outside the home. EVIDENCE: Guests were encouraged to help with preparation of meals and other domestic tasks if they wanted to. Through the assessment process, staff were aware of the existing skills of guests and of the aims of other services they attend regarding promoting independent living skills. Guests’ leisure interests were detailed in their care records so that staff could offer appropriate activities. The home provided televisions in some bedrooms and in the communal lounges, facilities to play music, videos, DVDs and computer games, pool and table football, and a computer for guests to use. Guests and staff sometimes visited the local pub. Guests were supported to continue with their usual day care arrangements whilst staying in the home. Information about family and friends was included in the guests’ care records, plus details of any contact during their stay. Guests were able to take or make ‘phone calls to family and friends in private using the home’s cordless ‘phone. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 12 The home had a four-week menu, but the manager explained that this was treated as a guide only to allow guests as much choice as possible. Records were kept of the actual meals prepared and of the food and drink consumed by each guest. The lunchtime meal on the day of the inspection was relaxed and unhurried with guests and staff eating together. One guest helped to prepare a fruit flan for teatime. Any special requirements regarding food and drink were detailed in the care plans. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 There was a clear focus on the preferences and choices of guests regarding personal support with daily activities. EVIDENCE: The care records seen clearly detailed guests’ preferences regarding support with personal care, for example, noting a preference regarding the sex of the carer assisting them. Routines in the home were flexible and guests’ preferences were recorded. Guests’ choice of clothes each day was recorded. Guests had designated keyworkers. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The complaints procedure was clear and robust to ensure effective use by guests or their representatives. EVIDENCE: The home’s complaints procedure was included in the Service User Guide which was provided in a printed format suitable for guests and was also available on audio tape. The complaints procedure included all the required information and was explained to guests as part of their induction to the home. Records were seen of complaints made, the action taken by the home and the outcome. It was clear from the records seen that guests complaints were taken seriously and appropriate action taken. No complaints about the home had been received by CSCI since the last inspection. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 28 and 30 The home was clean, comfortable and appeared well maintained, providing a safe and pleasant environment for guests. EVIDENCE: Two requirements made at the last inspection had been met – to repair and make good the external paintwork, and to redecorate the dining room and one of the lounges. On the day of the inspection the home was clean, bright and free from offensive odours. The home appeared well maintained and well decorated. Furniture and fittings were domestic and appeared of good quality. The ground floor of the home was fully accessible to guests using wheelchairs. There was a pleasant patio area accessible to all guests and a mature garden. The bedrooms seen were all clean and well decorated. Since the last inspection, pictures had been put on the bedroom walls to make them less stark. Guests were provided with keys for their bedroom doors if they wished and there was a lockable drawer in each room. There were two lounges, a dining room, a Snoezelen room, and a conservatory with pool table and computer, all available for communal use by guests. There was another room which the manager explained was proposed to be used as a Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 16 games room with table football. A gas central heating boiler with pipe-work was installed in this room and needed to be made safe by boxing in before the room could be used by guests. Staff were provided with a sleeping-in room with en-suite bathroom. The laundry was appropriately sited and was clean and tidy. Cleaning products were stored in a locked cupboard in the laundry. Staff at the home had undergone some training in infection control as part of induction, health and safety and NVQ training, but had not undertaken specific training. Hand washing facilities were sited throughout the home and were clearly signed. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 and 36 Guests using the home were supported and protected by the robust recruitment procedures, and the appropriate training and supervision of staff. EVIDENCE: There were two support staff plus the manager on duty on the day of the inspection. The rota was seen which showed that there were always two support workers on duty during the day and two at night, one waking and one sleeping-in. The manager explained that the home was always staffed in this way and that respite stays were planned around the staffing levels and the assessed needs of guests. For example, with the set staffing levels, the home could accommodate up to 8 guests assessed as low needs, or 2 guests assessed as high needs, or various combinations of high, medium and low needs guests. Staff meetings were held in the home at least every 3 months, and more frequently if needed. The records were seen for two members of staff. Both files were well organised, clear and easy to follow. Both files included all the information required, such as a photograph, recent form of identification, Criminal Records Bureau check, and two written references. Job descriptions were included. These needed amending as they included the now outdated phrase “Lifting will be required”. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 18 The staff training records were seen, including the annual plan for staff training in the home. There was evidence of induction training for new staff appropriate to the needs of guests. There were details of training undertaken by each member of staff, including fire safety, health and safety, moving and handling, and safe handling of medication. Training appropriate to the individual needs of guests had also been undertaken, covering areas such as epilepsy, autism, and advocacy. Records were seen of staff supervision sessions which had been held every 2 months. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 39 The home was well run and well organised, including an effective quality assurance system in place to monitor and improve the service offered to guests. EVIDENCE: The registered manager had been in post for several years and had recently achieved NVQ Level 4 in care and management. Evidence was seen that the manager was pro-active in improving standards of care for the guests. For example, the manager had chased up outstanding care reviews with other professionals to ensure that the current needs of guests were properly assessed and met. The manager was knowledgeable about the needs of the guests using Eastfields. Guests in the home were asked to complete a satisfaction questionnaire each time they stayed. The information collected was audited by the manager and any issues raised were discussed at the weekly meeting with guests and staff. Records were seen of the visits by a lay person recruited by the providers to visit the home every two months. The person visiting had experience of using Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 20 services such as that provided by Eastfields, (although not as a guest at Eastfields). Any issues and suggestions raised by the lay visitor were discussed and put into action as appropriate. Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x 3 x 3 Standard No 11 12 13 14 15 16 17 3 x x 3 3 x 3 Standard No 31 32 33 34 35 36 Score x x x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Eastfields (Royal Mencap Society) Score 3 x x x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x x x C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 28 Regulation 13(4) Requirement The boiler and pipe work in the proposed games room must be boxed in, or otherwise made safe, before the room is used by guests Timescale for action 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 30 34 Good Practice Recommendations All staff should have training in infection control The job description for support workers should be amended to change the outdated wording regarding lifting Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby, DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Eastfields (Royal Mencap Society) C52 C02 S19977 East Field V237805 150705 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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