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Inspection on 01/03/06 for Field Farm House

Also see our care home review for Field Farm House for more information

This inspection was carried out on 1st March 2006.

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.

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 management team is competent and knowledgeable and are continuing to develop their skills by doing further training. There are clear procedures in place to make sure that all aspects of the service are regularly checked. When these checks identify a need for additional attention this is addressed promptly. Residents express considerable satisfaction with their experiences at the home and are able to continue enjoying their preferred lifestyles in a safe environment. There is an open management approach and the Commission is kept fully informed of events in between inspections. This helps maintain the overall protection of the residents.

What has improved since the last inspection?

The Administrator has completed further training so that he has the knowledge he needs to oversee the catering arrangements. All kitchen staff have been trained in accordance with new regulations relating to this aspect of the service. The management staff have continued to develop ways of monitoring the service and gathering the views of others about the running of the home e.g. devising a staff questionnaire. The Provider has purchased new equipment to prevent pressure sores.

What the care home could do better:

The last inspection report referred to the challenges for the Provider, management team and staff to sustain the improvements previously made and to continue to improve the quality of life for people who go to live at the home. The current evidence indicates that this challenge is being met.

CARE HOMES FOR OLDER PEOPLE Field Farm House Field Farm House Hampton Bishop Herefordshire HR1 4JP Lead Inspector Wendy Barrett Unannounced Inspection 1st March 2006 02:00 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 Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 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. Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Field Farm House Address Field Farm House Hampton Bishop Herefordshire HR1 4JP 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) 01432 273064 manager.fieldfarm@tesco.net Advent Estates Limited Ms Jane Barrington Care Home 27 Category(ies) of Dementia - over 65 years of age (27), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (27), Old age, not falling within any other category (27), Physical disability (1), Physical disability over 65 years of age (27) Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1. To accommodate one named service user who is aged below 65 years of age. 19th October 2005 Date of last inspection Brief Description of the Service: The Providers and Manager are registered in respect of the Home to accommodate residents aged over 65 years. The care needs catered for are those resulting from the ageing process, because of a physical disability or because of a mental disorder or dementia illness. The Home does not set out to provide for the needs of highly dependent people. Field Farm House is a converted farmhouse with an extension in a rural location just outside the city of Hereford. The accommodation is on two floors and there is a passenger lift to provide access to the first floor. There are 24 bedrooms, 21 single rooms and 3 twin rooms. Some have en-suite facilities. There are 2 lounges and a separate dining room. To the front of the house there is an attractive sensory garden with level paths and places to sit. Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced but at 2 days short notice. It took place between 2pm and 5.45pm. There were no requirements or recommendations arising from the last inspection that was undertaken in October 2005. Feedback cards for residents and relatives have been supplied to the home and the Care Manager intends to distribute these with the next in-house newsletter. Comments arising from this exercise will be used as part of future regulatory work. There are a number of key National Minimum Standards that have not been inspected during the current inspection year. These were the focus of this inspection. The registered Care Manager and Administrator were at work in the home and assisted with the inspection. A care assistant was interviewed about her recent introduction to employment at the home. Residents were observed in a communal lounge enjoying a live musical entertainment and party tea. Others were met briefly in their bedrooms during a tour of the accommodation. There was an inspection of some records and documentation maintained at the home. There was also reference to information submitted by the home’s management personnel to the Commission between inspections. What the service does well: The management team is competent and knowledgeable and are continuing to develop their skills by doing further training. There are clear procedures in place to make sure that all aspects of the service are regularly checked. When these checks identify a need for additional attention this is addressed promptly. Residents express considerable satisfaction with their experiences at the home and are able to continue enjoying their preferred lifestyles in a safe environment. There is an open management approach and the Commission is kept fully informed of events in between inspections. This helps maintain the overall protection of the residents. Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 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. Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 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 Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 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): EVIDENCE: Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 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): 9 Residents are able to administer their own medication if they wish to do so. Their safety, and that of other residents, is protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: The Care Manager assisted with an inspection of the medication arrangements. The home uses the vena link system of blister packed medication. Storage arrangements are satisfactory e.g. approved bolt for controlled drugs cupboard, medication trolley secured to an internal, solid wall. Receipt, administration and disposal records were fully completed with additional checks to ensure resident safety e.g. completion of allergy boxes, check of transcribed instructions by second staff member, recording of actual doses administered for those medications with variable prescribed dosages. The method of recording was sufficiently robust to provide an audit trail. When medication was prescribed ‘as required’ for individual residents there was clear, written guidance to inform staff when to use it. Residents who chose to self medicate were subject to a recorded risk assessment so that they, and other residents, would not be put at risk. The resident and the Care Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 Page 10 Manager appropriately signed the records of these exercises. The risk assessments were being regularly reviewed in case ability or other factors changed the level of risk. A list of specimen staff signatures/initials was available so that entries made on medication records could be easily identified. A copy of a medication policy and associated procedures was kept in the medication cupboard as well as in a central file so that it was readily accessible to staff as they work. Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 Page 11 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): Residents are supported in maintaining the lifestyle that suits them, and are given varied opportunities to pursue an active social life. EVIDENCE: Reports of monthly monitoring visits to the home by the Provider’s representative include details of a variety of activities at the home e.g. written care plans that describe attention to individual interests and preferences. Examples of this flexible approach include comments about the husband of a resident who was able to spend most days with his wife at the home, Bonfire night and Christmas festivities and a luncheon club. During this inspection residents were observed enjoying a group activity. The wish of others to remain in their bedrooms pursuing individual interests was being respected. The monthly reports also include examples of appreciative comments from residents and their relatives about life at the home. Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 Page 12 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): 18 Residents are protected from abuse through an open management approach and a well-informed staff group. EVIDENCE: The Care Manager has demonstrated a good awareness of abuse and adult protection in her communications with the Commission between inspections. This open approach is an essential aspect of protection. The recently recruited care assistant had attended a talk by the co-ordinator of the local multi-agency protocol for adult protection. She had also been supplied with a copy of the home’s policy and procedures addressing adult protection and whistle blowing. This specialist worker has been invited to the home on a number of occasions so that all staff are supported in their responsibility to protect the vulnerable adults in their care. Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 Page 13 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): EVIDENCE: Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 Page 14 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): 29 There are thorough procedures in place to make sure new staff will be suitable and safe to work with the residents. EVIDENCE: The home has implemented relevant policies and procedures for recruitment work. The recently employed care assistant described how she was recruited to work at the home. Documentation kept in her personal file was inspected. The evidence confirmed a through process of recruitment that was in line with current legislative requirements e.g. full employment and personal history, written references (including one from most recent employer), checks of Criminal Records and Protection of Vulnerable Adults register. The care assistant was receiving additional supervision and support from experienced staff during her introduction period. Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 Page 15 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): 35 and 38 Residents’ financial interests are safeguarded. There is thorough and ongoing attention to the health and safety of residents and staff. EVIDENCE: Residents or their representatives are being encouraged to deal with the safekeeping of personal money and valuables. This is appropriate. For those residents who need the support of the home, there is a secure safe for storage on the premises. A sample of the contents was accurately reflected in records seen. Monthly audits have been introduced to identify any minor discrepancies. There are many examples of good attention to health and safety of residents and staff. An external specialist company is employed to oversee this work. Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 Page 16 The Administrator obtained an Advanced Food Hygiene certificate in November 2005. The newly recruited staff member had been provided with manual handling, food hygiene and fire safety training when first employed. Previous inspections have confirmed a rolling programme of health and safety training for all staff. The Provider’s representative undertakes various checks of health and safety aspects during monthly monitoring visits e.g. risk assessments, accident records (including compliance with legislation requiring notifications to be made), and condition of the premises. Relevant policies and procedures have been implemented and are subject to regular review as part of the Provider’s quality assurance system. Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 Page 17 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 4 x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x 3 Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN 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 Field Farm House DS0000052987.V285514.R01.S.doc Version 5.1 Page 20 - 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!