Inspection on 28/07/08 for Eastfield Care Home

This inspection was carried out on 28th July 2008.

CSCI 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.

Other inspections for this house

Eastfield Care Home 14/03/07

Eastfield Care Home 08/03/06

Eastfield Care Home 11/01/06

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Eastfield Care Home Moss Road Askern Doncaster DN6 0JZ Lead Inspector Christine Rolt Unannounced Inspection 28th July 2008 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 Care Home DS0000065778.V368966.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 Care Home DS0000065778.V368966.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastfield Care Home Address Moss Road Askern Doncaster DN6 0JZ 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) 01302 700810 01302 707009 eastfield.hall@schealthcare.co.uk www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Mr Steven Sullivan Care Home 59 Category(ies) of Dementia (59), Old age, not falling within any registration, with number other category (59), Physical disability (59) of places Eastfield Care Home DS0000065778.V368966.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 with nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Dementia - Code DE; Old age, not falling within any other category - Code OP; Physical disability - Code PD The maximum number of service users who can be accommodated is: 59 14th March 2007 2. Date of last inspection Brief Description of the Service: Eastfield Care Home is on the main bus route in the village of Askern and is within walking distance of shops, churches and other community facilities. The home is set in pleasant landscaped gardens, which include an internal courtyard with a raised fishpond. There are shaded areas and garden furniture where people living in the home and their visitors can sit outside in comfort. There is ample car parking to the front of the home. The home is on two floors with a passenger lift. Bedrooms are single and three of the bedrooms have en-suite facilities. There are sufficient lounges and dining areas. The fees ranged from £390.14 to £674.92 per week. Hairdressing, chiropody and personal newspapers were charged extra. The registered manager supplied this information during the site visit on 28th July 2008. Information about the home was available in the main entrance. Eastfield Care Home DS0000065778.V368966.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. This was a key inspection and comprised information already received from or about the home and a site visit. The site visit was from 9.45 am to 5:15 pm. The registered manager completed an Annual Quality Assurance Assessment before the site visit. This document gave the manager the opportunity to say what the home did well, what had improved and what they were working on to improve. Various aspects of the service were then checked during the site visit. Care practices were observed, a sample of records was examined, a partial inspection of the building was carried out and service provision was discussed with the registered manager. The majority of people living at the home were seen throughout the day and several were chatted to. A visitor was asked for their opinion. The care provided for three people was checked against their records to determine if their individual needs were being met. A member of staff was interviewed. Questionnaires were sent to ten people living in the home and five were returned. All information, opinions and comments were considered for inclusion in this report. The inspector wishes to thank people living at the home, visitors, the staff and the registered manager for their assistance and co-operation. What the service does well: People said that they liked living at the home. Their comments were, “Up to now I’m satisfied with the home and what they do for us.” “I am happy and settled here.” “I am quite happy” “Very good” The home was clean and well maintained. There were no offensive odours. Eastfield Care Home DS0000065778.V368966.R01.S.doc Version 5.2 Page 6 The dementia unit had been decorated to aid orientation. the landscaped gardens with shaded areas and seating. There was access to Care plans provided good information with examples of good practice. Staff were well trained and the system ensured that regular refresher training was available. 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 Care Home DS0000065778.V368966.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 Care Home DS0000065778.V368966.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 and 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using this service had full assessments of their needs. EVIDENCE: People said that this home was chosen because the home was “welcoming and staff were helpful and polite” and “I saw the home and thought, yes, this is the place for me”. Assessments were carried out and copies of the local authority assessments and the home’s own assessments were available on the three files that were checked. These provided detailed information of each person’s needs and wishes. This home does not provide intermediate care. Eastfield Care Home DS0000065778.V368966.R01.S.doc Version 5.2 Page 9 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 and 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People were treated with respect. Medication recording procedures were almost met. Care and health needs were met and recordings of person centred care were almost met. EVIDENCE: People living in the home looked well cared for, clean and appropriately dressed. They said they were happy living in the home. Staff were observed treating people with respect and kindness, and interactions were good. People said that they received the care and support they needed and were treated with respect and dignity. Three care plans were checked in detail. They provided good details of the person’s needs and wishes and information of how the needs were to be met. However, the detail of information in the daily records depended on the person completing the record. Some staff covered the physical, health, emotional Eastfield Care Home DS0000065778.V368966.R01.S.doc Version 5.2 Page 10 and social needs, and provided a holistic view of the person whilst other staff covered only physical and health needs in the daily records. There were activities sheets in the files but these were blank. Consistency on daily records was discussed with the manager. He said that any member of staff could write in the report of any interactions with any particular person. The care plans were reviewed monthly but there was no information to verify that people living in the home or their representatives were consulted. This was discussed with the manager. Files contained risk assessments with details of the identified and associated risks and the action taken to minimise the risks. Accidents were recorded and 24-hour monitoring charts were used for the close monitoring of people who had had an accident or fall where there was no apparent injury at the time of the incident. This is good practice. This home is registered to accommodate 59 people and yet for a home of this size, the home did not have a medication room. Medication trolleys were stored in a cupboard. Controlled medication and the medication refrigerator were stored in the nurses’ office. The nurse on duty said that the medications were booked in and out in the nurses’ office. The manager was requested to consider the feasibility of providing a medication room, preferably with hand washing facilities. The room would need adequate workspace to enable staff to handle and store all medicines securely. Each medication was signed and dated on receipt and quantities were recorded. All handwritten entries were countersigned, which is good practice. For one medication there was a gap on one of the Medication Administration Record sheets. The nurse said that the person dealing with the medication must have forgotten to sign. On another chart a person had been prescribed paracetamol on an ‘as and when required’ basis and there was a shortfall of two tablets. These issues were brought to the manager’s attention. Staff competency for dealing with medication was checked regularly and records were available. This is good practice. Controlled drugs were stored in a controlled drugs cupboard. The controlled drug register was checked. Medication was recorded properly with two signatures and a diminishing total. Medication that needed to be kept cool was kept in a medication refrigerator. The temperature was recorded twice per day, however the temperature was too cold and no one had questioned this. This was brought to the manager’s attention. Eastfield Care Home DS0000065778.V368966.R01.S.doc Version 5.2 Page 11 Each person’s medication was recorded in their own file together with information of why the medication had been prescribed and the common side effects of each medication. This is good practice. Eastfield Care Home DS0000065778.V368966.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 and 15 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People were satisfied with their lifestyles in the home. EVIDENCE: According to information received before this site visit, the home had two activities co-ordinators who provided activities for a total of 30 hours per week. Information in the Annual Quality Assurance Assessment about activities stated, “The activities programme encourages residents to maintain interests and outside links with the community”. People were observed spending the day as they chose and generally considered that there was enough to keep them occupied. Individual activities and preferences were sometimes recorded in people’s care plans (See section on Health and Personal Care). On the afternoon of this site visit, the activities coordinator was helping a group of people on the dementia unit to play dominoes. Music that was playing was appropriate to the age group. One person stated that, Eastfield Care Home DS0000065778.V368966.R01.S.doc Version 5.2 Page 13 “Staff chat and take her out”, whilst another considered, “There should be more staff available for outings, and more things to do”. The notice board in the main entrance was bright and colourful with information of up and coming events and outings that people could elect to participate in. However, there was no information displayed of activities that the activities co-ordinators were providing on a daily basis. The provision of a weekly activities programme was discussed with the manager. This would inform people in the home of any group activities available throughout the week. People’s choices and preferences of how they liked to live were listed in their care plans. Staff were observed and heard to offer choices. A visitor said that he was always made welcome when he came to visit his parent. The dining areas were clean and tidy. people living in the home said that they always or usually enjoyed the meals. A menu board informed people of the choice of meals. On the day of this site visit, people had a choice of lamb stew, toad in the hole and gravy, cheese salad, jacket potato with tuna, or mushroom omelette. For dessert there was a choice of bread and butter pudding, yoghurt and fresh fruit. People were seen to be taking advantage of the choices on offer. Eastfield Care Home DS0000065778.V368966.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 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People felt they were listened to and protected. EVIDENCE: The complaints procedure was seen and the complaints book was checked. People said that they knew how to complain and who to tell if they weren’t happy. One comment received was, “If anything is wrong I just go and ask a nurse.” The Annual Quality Assurance Assessment stated that 98 of all staff had undertaken adult safeguarding training. The home’s trainer confirmed that all staff with the exception of one person had undertaken this training. Eastfield Care Home DS0000065778.V368966.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 and 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People lived in a clean pleasant and safe environment. EVIDENCE: The home was clean and there were no offensive odours. Bathrooms and lavatories were clean, tidy and fit for purpose. Liquid soap and paper towels were available to prevent cross contamination. Bedrooms were attractive and had been personalised by their occupants. manager said that there were plans to replace and update the bedroom furniture. The Aids and adaptations were fitted throughout the home to maintain people’s independence. Eastfield Care Home DS0000065778.V368966.R01.S.doc Version 5.2 Page 16 Within the dementia unit, lavatory doors were painted a different colour to aid orientation and help people maintain their independence. Signs on doors and a display board in the dining room helped with orientation to time and place. From the communal rooms there was access to a large secure garden with seating and a gazebo. People could wander in and out at will. Eastfield Care Home DS0000065778.V368966.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 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People were cared for by a well trained and dedicated staff team. EVIDENCE: There were sufficient staff on duty at the time of this site visit. People considered that the staff were good and treated people living in the home with respect and dignity. The registered manager said that staff undertook Skills for Care induction training. The home’s trainer verified this and also added that National Vocational Qualification (NVQ) in care was also promoted. At the time of this site visit 68 of care staff were trained to Level 2 or above. The home’s trainer was responsible for organising, providing and keeping records of staff training including mandatory health and safety training. (See next section for mandatory health and safety training.) All staff had undertaken dementia awareness training and other skills training relevant to their roles. There were plans to provide extra training in dementia care. The recruitment files for three members of staff were checked. All contained the relevant checks and information including Criminal Records Bureau Eastfield Care Home DS0000065778.V368966.R01.S.doc Version 5.2 Page 18 disclosures. Other correspondence was also available which showed that the system was robust. Eastfield Care Home DS0000065778.V368966.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, 33, 35 and 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The manager promoted and managed the home in the best interests of people living in the home. EVIDENCE: The registered manager had the relevant skills and experience and had achieved the Registered Manager’s Award. The home had a quality assurance system that included audits of systems and records within the home and safety checks of the environment. Residents’ meetings were held regularly and minutes of the meetings were available. Questionnaires were given out annually to people living in the home and their Eastfield Care Home DS0000065778.V368966.R01.S.doc Version 5.2 Page 20 relatives. Results of the questionnaires were collated and copies were seen during this site visit. The registered manager informed the CSCI of any incidents that affected people living in the home and the responsible individual carried out visits to the home and produced reports as required by regulation. Money held on behalf of people who lived at the home was banked in each person’s name with their own account and gaining their own interest. The home kept accounts of all transactions for each person and receipts were available. The home’s trainer was responsible for keeping records of all staff training including mandatory health and safety training (i.e. moving and handling, basic food hygiene, emergency first aid, infection control and fire awareness). Training was ongoing and a training matrix was available with dates of training undertaken. The matrix also highlighted when staff were due to undertake refresher training as per the organisation’s training policy. Records and certificates were available to verify that service and maintenance checks were carried out and a sample of these was checked during the site visit. Eastfield Care Home DS0000065778.V368966.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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 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 X 3 X 3 X X 3 Eastfield Care Home DS0000065778.V368966.R01.S.doc Version 5.2 Page 22 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. 1. Standard OP7 Regulation 15 Requirement Timescale for action 22/09/08 2. OP9 13 Care plans must be reviewed in consultation with the person or their representative unless this is impractical. Staff dealing with medication 01/08/08 must ensure that they follow the correct procedure. Up to date records must be maintained when administering medication. These reduce unnecessary risks. 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 OP9 OP9 OP12 Good Practice Recommendations Consideration should be given to providing a medication room with hand washing facilities and sufficient workspace to enable staff to handle and store all medicines securely. Medication that needs to be kept cool should be stored within the prescribed temperature limits. Displaying a weekly programme of activities would inform people living in the home of the activities on offer. Eastfield Care Home DS0000065778.V368966.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Care Home DS0000065778.V368966.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!