CARE HOMES FOR OLDER PEOPLE
Eastfield House Eastfield Lane Whitchurch on Thames Oxfordshire RG8 7EJ Lead Inspector
Annette Miller Unannounced Inspection 21st October 2005 12.00p 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 House DS0000037997.V260408.R02.S.doc Version 5.0 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 House DS0000037997.V260408.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Eastfield House Address Eastfield Lane Whitchurch on Thames Oxfordshire RG8 7EJ 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) 01189 842586 01189 842179 Eastfield House Limited Mrs Mary Bayliss Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27), Physical disability (2) of places Eastfield House DS0000037997.V260408.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The total number of persons that may be accommodated at any one time must not exceed 27 The PD category refers to one named resident under the age of 65. Date of last inspection 8th December 2004 Brief Description of the Service: Eastfield House is situated in the village of Whitchurch-on-Thames. The home is registered to provide personal care for up to 27 male and female service users aged 65 years and over. District nurses visit the home to provide nursing care. Communal space consisting of two lounges and a separate dining room is located on the ground floor. Bedroom accommodation is provided on the ground and first floors and there are also five flats for independent living in the grounds of the home. Room sizes and amenities are listed in the home’s Statement of Purpose and Service Users’ Guide. A good range of activities is provided and regular trips out to places of interest are arranged. The gardens surrounding the home are well maintained and provide extremely pleasant outdoor amenities. Eastfield House DS0000037997.V260408.R02.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by one inspector from 12 midday to 4.00pm. The inspector spoke to residents and staff to obtain their views of the home. A tour of the building and inspection of documents also took place. The registered manager was present during the inspection. The Commission for Social Care Inspection (CSCI) received five comment cards from health and social care professionals and good comments were made, for example: • “I have no hesitation in placing clients here. This is a superb, friendly, caring home with excellent management and staff. Very professional and pleasant environment. My clients are very happy here” “Eastfield House demonstrates how care should be provided” “Very helpful manager” • • What the service does well: What has improved since the last inspection?
Redecoration and refurbishment of some bedrooms has been completed as part of the company’s ongoing redecoration programme. The level of heating is monitored to ensure that it is sufficient for residents’ needs. Eastfield House DS0000037997.V260408.R02.S.doc Version 5.0 Page 6 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. Eastfield House DS0000037997.V260408.R02.S.doc Version 5.0 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 House DS0000037997.V260408.R02.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards was inspected. EVIDENCE: Eastfield House DS0000037997.V260408.R02.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 and 10 The residents’ health and personal care needs are well met with evidence of good multi-disciplinary working taking place on a regular basis. EVIDENCE: Doctors and nurses from the local surgery regularly visit the home to provide health care. All aspects of residents’ health and social care needs are assessed on admission and records are kept. Pressure-relieving mattresses and cushions are appropriately provided to meet individual needs. At the time of inspection none of the residents had a pressure sore. Staff demonstrated good awareness of privacy and dignity issues. These matters are covered in induction training and during subsequent updates. Eastfield House DS0000037997.V260408.R02.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 14 Social and recreational activities are particularly good in this home and, as a result, residents’ lives are enriched. Links with the community are good providing residents with regular contact with local people. EVIDENCE: The activity organiser is an enthusiastic and committed member of staff. She was sitting with five residents in the lounge and was clearly skilled at involving each resident in conversation. Crafts are a particular feature of the activities programme and residents said they took pleasure in making items to keep, or to sell at one of the fetes held periodically at the home. The money raised from sales is added to the residents’ recreational fund. In the small lounge three residents were sitting talking together and they told the inspector that they were very happy in the home and could not fault it. Personal possessions can be brought in for residents to have in their rooms and all the bedrooms inspected looked comfortable and homely. The home operates open visiting. Eastfield House DS0000037997.V260408.R02.S.doc Version 5.0 Page 11 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards was inspected. EVIDENCE: Eastfield House DS0000037997.V260408.R02.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 26 The standard of environment within this home is good, providing residents with an attractive and homely place to live. A shortfall related to hot water that was above the recommended safe temperature at some sinks, and this placed residents at risk from scalds. EVIDENCE: The home’s communal living rooms are particularly attractive and are very well maintained. There was a nice homely atmosphere and cleanliness in all areas was good. There is a large garden that is extremely pleasant. A ramp from the small lounge to the garden is provided for wheelchair users. The hot water at three sinks was found to be significantly above the recommended safe temperature level of 43°C. An immediate requirement was made that water temperatures must be reduced and the company has confirmed in writing that action was taken. Eastfield House DS0000037997.V260408.R02.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 and 30 The arrangements for the induction of staff are good with the staff demonstrating a clear understanding of their roles. EVIDENCE: Four of the twelve carers have an NVQ care qualification at Level 2 or above, and one carer has a midwifery qualification obtained abroad. Therefore, the number of carers with NVQ in Care (or equivalent) is 42 . The company encourages and supports staff through NVQ training, but Standard 28 cannot be assessed as fully met until 50 of carers working at the home have the necessary care qualification. New employees are not at first counted in staffing numbers and work initially with an experienced member of staff. The company provides good induction training for new staff and has an extensive training programme for existing staff. Training records are kept. Eastfield House DS0000037997.V260408.R02.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 and 38. The manager is supported well by the company and her senior staff in providing clear leadership throughout the home, with all staff demonstrating an awareness of their roles and responsibilities. Three bedroom doors were wedged open and, if fire had broken out, residents would potentially have been at risk. EVIDENCE: The registered manager has worked in the home for several years and was promoted to the role of manager in 2002 by the present owners. She has an ‘open-door’ approach and her staff team confirmed that they could see her at all reasonable times, and that she took an interest in their welfare and working conditions. It was clear that staff members are motivated to provide good standards of care, which reflects well on the manager and the company. Eastfield House DS0000037997.V260408.R02.S.doc Version 5.0 Page 15 The registered manager has completed Level 4 NVQ in Management. She does not have Level 4 NVQ in Care and this is required before Standard 31 can be assessed as ‘fully met’. The manager said she had started this training. The comments made on the feedback sheets returned to CSCI by health care professionals showed respondents were, overall, very pleased with the home’s standards. One respondent thought that senior staff consistently demonstrated a good understanding of residents care needs, but that this situation depended on who was on duty. Two comments were received about the home’s good management. Three bedroom doors were wedged open and this compromised residents’ safety, should a fire have occurred. Wedges were removed and an immediate requirement was made that the manager must seek advice from the fire service with regard to fitting approved devices that keep doors open, but release automatically if the home’s fire alarm sounds. The company has since confirmed in writing that ‘door closures’ are being fitted. Eastfield House DS0000037997.V260408.R02.S.doc Version 5.0 Page 16 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 4 X X X X X 3 STAFFING Standard No Score 27 X 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 X X X X X 2 Eastfield House DS0000037997.V260408.R02.S.doc Version 5.0 Page 17 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 OP25 Regulation 13 Requirement The manager must ensure that hot water to water outlets accessible to service users is controlled at a safe temperature. (Previous timescale of 08.12.04 not met). The manager must take advice from Oxfordshire Fire Service with regard to fitting automatic door closures. Timescale for action 21/10/05 2 OP38 23 24/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Eastfield House DS0000037997.V260408.R02.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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