Inspection on 08/05/07 for Eastfield

This inspection was carried out on 8th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

Other inspections for this house

Eastfield 06/09/05

Eastfield 17/05/05

Eastfield 09/03/05

Eastfield 02/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Eastfield 76 Sittingbourne Road Maidstone Kent ME14 5HY Lead Inspector Justine Williams Key Unannounced Inspection 8th May 2007 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastfield Address 76 Sittingbourne Road Maidstone Kent ME14 5HY 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) 01622 755153 01622 755153 david.titherington@njch.co.uk Bureaucom Limited Mr David John Titherington Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: Eastfield is a residential care home providing personal care for 43 older people. The home employs care staff, working a roster, which gives twenty-four hour cover. The home also employs staff for management, catering and domestic duties. Eastfield is a large detached property situated on the outskirts of Maidstone. The home is near to public transport services and a Junction of the M20. Shops and other services and facilities are located in the town centre. The home has bedrooms located on the ground and first floor, there is a shaft lift. Seven of the bedrooms offer double accommodation, though these may be used for single occupancy. There is a pleasant, safe and secluded garden and patio area with easy access for residents. The current fees are £332.97 to £600.00 per week, additional charges are made for hairdressing, chiropody, newspapers and toiletries. This information was given in writing in the pre inspection questionnaire. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was carried out on 8th May 2007 between 9.45 am and 3.00 pm by regulatory inspector Justine Williams. During that time the inspector spoke with residents, staff members and the registered manager. Feedback was given during and at the end of the inspection. This report contains assessments made from observation, conversation and records, as well as case tracking. As part of the inspection process comment cards were sent to service users who live at the home and to GP’s, health care professionals, care managers and relatives of residents. The comment cards indicated very good levels of satisfaction with the service Comments made included: “They are prepared to go the extra mile in their care of patients” “Eastfield caters for individual needs and wishes” “I am perfectly happy and feel safe” What the service does well: The home continues to provide a welcoming, clean, homely and well-furnished environment. Prospective residents benefit from thorough admission procedures and residents feel well informed and welcomed to the home. The health care needs of residents are well managed and clearly recorded, in the care plan, visits from and to health care professionals are clearly documented. The rights of residents are respected and there is an emphasis on ensuring the privacy and dignity of residents is of the utmost importance. Residents feel involved in the running of the home and feel and issues they have are listened to and acted on. Residents enjoy the variety of activities on offer, and say the food is “excellent”, “no complaints there” and “cannot be faulted” Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 7 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 Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from thorough admission procedures and move to the home assured their needs can be met. EVIDENCE: Residents said they found the service users guide and the homes brochure given to them prior to moving in useful and clear, and these along with a visit to the home helped them to make an informed choice to move in. Residents said they felt very welcome when they visited the home and were shown around and had lunch at the home. Another resident said his family visited the home unannounced and asked to be shown around, and were very impressed at the cleanliness and attitude of the staff. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 9 Each resident has had their needs fully assessed and the information is clearly documented. Residents said their needs were met by the home. One resident has become very confused and the home is supporting the family to find a more suitable home, registered to meet their needs. Some of the residents came in for respite care and decided to stay at the home permanently. Eastfield does not provide intermediate care. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents health and personal care needs are well managed. EVIDENCE: The home is in the process of changing their paperwork in relation to assessments and care planning, new residents have the new paperwork and the staff are gradually changing existing resident over to the new paperwork. Staff said the new paperwork was clearer. Each resident has a comprehensive plan of care for staff to follow, not all the resident have been involved in the drawing up of their care plans. All the care plans contain detailed risk assessment including one specifically for prevention of falls. The care plans are reviewed monthly or more frequently when needed a care review takes place around 5 weeks after admission and again after 6 months then every 6 months or more frequently if needed, this involves a Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 11 meeting with the resident to discuss all aspects of their care and life at the home, relatives are invited where appropriate with the residents consent, however the residents care manager or key worker is not always invited. Assessments for risk of pressure sores are undertaken by the district nurses and the home enjoys good working relationships with the district nursing service. The home has purchased some pressure relieving equipment for residents to use. Nutrition and continence assessments are undertaken regularly. Residents have a choice of GP to register with and visits to and from health care professionals are clearly recorded. A resident said “my GP is called whenever I ask for him” Residents may self medicate if they wish subject to risk assessment, medication is appropriately stored and the home has a medication policy in place. Staff receive competency based training before administering medicines. Appropriate records are kept for medicines entering and leaving the home as well as those administered. Residents privacy and dignity are protected by the policies and working practices at the home, staff showed sensitivity and were discreet in attending to resident personal care needs. Residents said they never felt embarrassed when being helped with personal care. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents find the lifestyle at the home matches their expectations and wishes. EVIDENCE: The home employs and activities coordinator 2 days per week, the coordinator arranges the programme of activities which includes a range of games, arts and crafts, gardening etc. in addition the home purchases outside entertainment and arranges 2 trips out per month. Decisions about trips and activities are made by the residents at their regular meetings. The residents said “there are plenty of activities” and “we’ve more than enough to occupy us”. One resident was painting garden ornaments provided by the home ready for sale at the summer fete. Others were doing arts and crafts, the home has a large raised bed for the gardeners and the manager plans to purchase a poly tunnel in the near future. A resident is helping the handy man plant the bedding plants. The home is in the process of asking residents or their relatives to complete their life history’s. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 13 Residents said their relatives are always made welcome by the staff, are offered a drink and are encouraged to attend relatives meetings and to lend support on outings. Residents said the food was “excellent”, “can’t fault it”. When any negative feedback from residents is received evidence was seen that any issues are reported to the cook and actions are taken. Residents have flexibility in mealtimes and where they eat, and snacks are offered after the evening meal. Special diets are catered for, and the menu changes regularly. New residents are asked their preferences and efforts are made to incorporate these into the menus. The menus do not always clearly display the choice on offer. Kitchen staff visit each residents daily to ask them what they would like for lunch and evening meal. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to people who listen to any concerns and who will take action to ensure they are protected from abuse. EVIDENCE: The home has a clear complaint policy displayed in the lobby and given to each resident in the service users guide. Residents said they would feel comfortable making a complaint to any of the staff and those who had made a complaint said their complaint was taken seriously and actions were taken to put things right. The complaint file kept by the staff clearly recorded details of complaints made and investigations undertaken and actions taken. Staff have received training in adult protection at their induction and have attended POVA training, staff were aware of the actions they must take in the event of abuse being alleged. The homes policies comply with the Kent and Medway Social Services Policy, a copy of which was also available to staff. The relevant checks are carried out on all staff and new staff do not start work at the home until the manager has received a satisfactory POVA check. There is an ongoing adult protection case open, involving some thefts, the home is working with the police to resolve the matter. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents have a homely, well-maintained and comfortable environment in which to live. EVIDENCE: The home was clean, light and decorated to a good standard throughout. Bedrooms are redecorated as they become vacant, and communal areas are furnished with a variety of good quality seating and furniture. The communal areas are open plan and adjoined with 2 living areas and a dining area. A quiet room is available for use. There is a large lawned garden to the rear of the building and pleasant patio to the side with access from the living areas. The residents enjoy using the patio for drinks or meals in good weather. The access Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 16 is by ramp one ramp is not used by resident as the gradient is too high, the other has a wooden ramp, this was assessed by an occupational therapist who said it should be replaced, this has not yet been addressed. None of the rooms are shared at present though some are registered as double rooms. There are future plans to change one of the bathrooms use into a shower, which is unused as it is not suitable for disabled use. Residents bedrooms were personalised with items of furniture, pictures and other belongings. The radiator covers have now been fitted throughout and new restrictors fitted to all windows. Risk assessments should be done where a resident does not want their window restrictor. With the exception of 1 toilet the skandia frames, and toilet frames have been fixed to the floor, or grab rails and raise toilet seats provided, the remaining toilet must either have the equipment secured or alternative equipment fitted. This was addressed immediately. Toilets and bathrooms had the necessary equipment provided such as liquid soap, disposable hand towels and lidded foot operated pedal bins to help minimise risk of cross infection. The laundry is small but well organised, clean and tidy. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are cared for and supported by properly recruited and trained staff. EVIDENCE: The home operates a shift system providing care staff 24 hours per day, with additional staff on duty at busy times such as the morning from 7.15 to 10.30am. Following the last inspection staff surnames are now recorded on the rota. Residents said they do not have to wait long for assistance, this was confirmed by staff. There are enough domestic, catering and maintenance staff to ensure high standards of cleanliness, cooking and up keep of the building and grounds. 55 of staff have achieve NVQ 2 or above. The home does not use agency staff, staff are asked to cover extra shifts, staff said they were happy with this arrangement and did not feel pressure to work shifts they did not wish to do. All staff have a thorough induction and those with no experience in care shadow experienced staff until they are confident to work alone and be included in the rota. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 18 The home operates a thorough and safe recruitment procedure, files seen included 2 written references, one from the previous employer wherever possible, evidence of CRB and POVA checks, proof of identification etc. Staff have received relevant and core training, which is regularly updated. Staff said they are encouraged to attend other study sessions of interest such as diabetes awareness, and wound care. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe and well managed home. EVIDENCE: The manager has many years experience in running the home and is supported by the resource manager and senior carers. There are clear lines of accountability and residents and staff benefit from the open and inclusive atmosphere at the home Residents and staff said they are listened to, and their ideas are acted on. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 20 Some quality assurance systems are in place with surveys being carried out annually to residents, their relatives and other professionals, regular residents and relatives meetings and staff meetings, and some informal auditing is carried out. The manager must obtain a copy of the amended Care Homes Regulations and ensure his responsibilities as far as quality assurance are being met. The home does not accept responsibility or manage the finances of any residents, an invoicing system is used whereby receipts for chiropody, hairdressing etc are kept, the home pay the bill, then the resident is charged. The health and safety of residents staff and visitors is well managed with equipment being regularly serviced and relevant checks being carried out, alterations to the ramp as recommended by the Occupational Therapist will better assure the safety of residents. Staff receive training in first aid, food hygiene, moving and handling, medication etc and regular training updates are arranged by the manager. Environmental and fire risk assessments are regularly reviewed and the manager is aware of his responsibilities regarding reporting of incidents and accidents etc. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 21 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 X X 4 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 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 4 X X X X X 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 3 3 X 3 X X 3 Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 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. 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 2 3 Refer to Standard OP7 OP19 OP33 Good Practice Recommendations It is recommended that residents be involved in the drawing up of their care plans. It is recommended that alterations to the ramp leading to the patio from the living area be made as advised by the occupational therapist. It is recommended that the manager obtain a copy of the amended regulations and to develop the quality assurance systems. Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Eastfield DS0000023932.V336949.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!