CARE HOMES FOR OLDER PEOPLE
Field Farm House Field Farm House Hampton Bishop Herefordshire HR1 4JP Lead Inspector
Denise Reynolds Unannounced Inspection 19th October 2005 10:00 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.V260413.R01.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. Field Farm House DS0000052987.V260413.R01.S.doc Version 5.0 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.V260413.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 1. To accommodate one named service user who is aged below 65 years of age. 19th January 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.V260413.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a planned inspection on a weekday in late autumn. Information was gathered in several ways. This included speaking to the residents during the day including over lunch at the weekly ‘Luncheon Club’, observation of activities and staff contact with residents during the day, a meeting with the management team and a tour of the building. Other information gathered during preceding months included the notifications of incidents and the Provider’s monthly reports both of which care homes have to send to the Commission. CSCI comment cards for residents and relatives were left at the Home for distribution so that any returned can be used to plan the next inspection. What the service does well: What has improved since the last inspection?
Field Farm House DS0000052987.V260413.R01.S.doc Version 5.0 Page 6 A requirement to provide more staff with Food Hygiene training had been met. The Luncheon Club had become well established as part of the life of the Home. The Registered Provider and Registered Manager had continued to build on the good start made when they took over the Home in December 2003. Commendable progress has been made in developing the service at the Home; this now exceeds the desired outcomes of the National Minimum Standards in a number of areas 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.V260413.R01.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 Field Farm House DS0000052987.V260413.R01.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): 1,2,3 Detailed information is available to prospective residents to help them decide if Field Farm House is the right Home for them. Terms and conditions documents are provided to all residents so that they know what they care and services they can expect to receive. Thorough assessments are undertaken to ensure that the Home only offers a place to people whose needs they can meet appropriately. EVIDENCE: The Statement of Purpose and Service User Guide are made available to prospective residents and their relatives. Copies of these were seen on display in the Home together with the monthly report by the Responsible Individual, the most recent inspection report and information about local advocacy arrangements. An assessment for a resident due to move in was seen – this was excellent and would form a sound foundation for staff to be able to give the person the correct care from the moment they arrive and to develop a comprehensive care plan.
Field Farm House DS0000052987.V260413.R01.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): 7,8,10 The care and attention given to residents ensures that their health care needs are well attended to. People living at Field farm House are treated with warmth and respect. EVIDENCE: Regulation 37 notifications and Regulation 26 reports received in the months prior to the inspection provided evidence of conscientious attention to the heath and personal care needs of the residents. The thoroughness of the information detailed in these notifications and reports increases confidence in the ability of the service to address problems and to seek help from relevant professionals when this is needed. The content of the pre admission assessment seen also showed that appropriate consideration is given to essential aspects of care such as the prevention of pressure area damage. Observation of staff helping residents provided a very positive impression of their attitude towards them. Without exception staff were friendly and polite and numerous examples were observed of the warm and trusting relationships between them and the residents. It was also very nice to hear lots of laughter
Field Farm House DS0000052987.V260413.R01.S.doc Version 5.0 Page 10 and to see that residents were treated and spoken to with respect. During lunch the inspector had the opportunity to spend time with six of the residents and in conversation they confirmed that they feel safe and well treated. Field Farm House DS0000052987.V260413.R01.S.doc Version 5.0 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): 13,14,15,16 A wide range of activities in the Home and out in the community provide an enjoyable and varied lifestyle that helps residents get to know each other and keep in touch with the outside world. EVIDENCE: The provision of a wide range of activities has become well established at the Home due to the hard work and commitment of the full time Activity Organiser. In recent months there has been a trip to the seaside for residents accompanied by relatives and staff, a Storyteller at a resident’s birthday party, a strawberry and cream tea with an entertainer, and regular exercise sessions. In July sixteen residents went to a concert at a local school. On the day of the inspection a group of residents met in the recreation lounge for a game of darts and most gathered in one of the sitting rooms in the afternoon for a ‘Chocolate Party’ (two ladies who brought lots of chocolate samples to taste and gave a talk about the history of chocolate). On two occasions residents, relatives and staff have taken a stall in Hereford Butter Market to sell crafts to raise money for yet more activities. During the morning of the inspection the Activity Organiser spent time outside in the garden with a few of the ladies picking flowers to arrange for the house. A particularly successful initiative is the weekly ‘Luncheon Club’. Groups of six residents take it in turns to have lunch separately after the other residents.
Field Farm House DS0000052987.V260413.R01.S.doc Version 5.0 Page 12 They meet first for a glass of sherry in the recreation lounge and then have a three-course meal served by staff in restaurant style with special table linen and candles. Wine is served for those who would like it and the third course is a cheeseboard with a selection of cheeses that would put many restaurants to shame. Coffee and after dinner mints round the occasion off and residents are encouraged to linger as long as they like before leaving the table. The residents clearly enjoy this event very much and were at pains to say that the excellent quality of food served is what they have come to expect at all meals. Field Farm House DS0000052987.V260413.R01.S.doc Version 5.0 Page 13 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): 16 The rights of residents to be safeguarded are taken seriously by the Home and arrangements are in place for residents to speak to someone if they feel the need. EVIDENCE: The Home has regular contact from the local Advocacy service and information about this is displayed in the Home. There is a written complaints procedure and this is readily available. On two occasions in recent months the Manager has made complaints on behalf of residents in respect of services provided by another agency and by a supplier. The Responsible Individual speaks to residents about their care when doing her Regulation 26 visits to the Home. Field Farm House DS0000052987.V260413.R01.S.doc Version 5.0 Page 14 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 The house is kept clean and warm and improvements to the building are ongoing, this and the attractive location provide residents with a pleasant and comfortable place to live. EVIDENCE: The house was clean and warm and comfortably furnished. Continued upgrading is planned in conjunction with the extension to the premises. This is due to start when negotiations with the Planning Department have been concluded. As well as additional bedrooms and overall upgrading, new facilities such as the provision of a hairdressing salon and additional communal space are planned. The designation of one of the sitting rooms as a recreational room was proving popular and residents were already viewing it as a meeting place. The sensory garden at the front of the house is a very positive addition to the facilities for residents.
Field Farm House DS0000052987.V260413.R01.S.doc Version 5.0 Page 15 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): 27, 28, 30 Staffing arrangements are well organised with high priority given to staff training to ensure the staff are competent and knowledgeable and therefore better equipped to provide a high standard of care. EVIDENCE: The Home was fully staffed and it was reported that thanks to the good will of the staff team, recent shortages due to compassionate leave had been covered without difficulty. Staff training is well established with two care staff doing NVQ 2, three doing NVQ 3 and one doing NVQ 4. The Manager has completed her Registered Managers Award and her A1 NVQ Assessor training. In addition she has embarked on an MSc in Dementia Studies with Bradford University; the Responsible Individual is also doing an MSc in Dementia Studies with Stirling University. Both institutions are recognised as being at the forefront of excellence in Dementia related studies and it is commendable that two members of the management team have committed themselves to study at this level. The Home’s Administrator has done an advanced Food Hygiene course which will enable him to provide training to staff in house. The cook is booked to do an intermediate Food Hygiene course and all but the two newest care staff have done the basic level course. Field Farm House DS0000052987.V260413.R01.S.doc Version 5.0 Page 16 The Manager and Responsible Individual are both trained as Moving and Handling trainers and are therefore able to provide in-house training for staff and carry out the necessary risk assessments in relation to individual residents. The Home has been proactive in arranging Recognition of Death training for staff with a local General Practitioner. Staff who have done this training are able to confirm that a resident has died without having to wait for a doctor to attend. This has the benefit of enabling the removal of a deceased resident from the Home by a funeral director and avoids the possible long delays in this happening during the hours that the ‘out of hours’ GP service operates. Field Farm House DS0000052987.V260413.R01.S.doc Version 5.0 Page 17 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): 31,32,33 The Home is well managed by friendly, competent, and knowledgeable management team who use both structured Quality Assurance methods and a ‘hands on’ approach to improve the quality of the service provided for the benefit of the people who live at the Home. EVIDENCE: The Registered Manager is already experienced and well qualified but as already described is continuing to develop her knowledge and skills in the specialist area of Dementia care by undertaking a Masters Degree. Discussion about the Manager and the rest of the management team with residents showed they are seen as approachable and well liked. Observation of them with residents provided further evidence of this. The Manager, Administrator and Responsible Individual appear to work very well as a team putting their complementary skills to good use in the areas where their individual skills lie. The content of the monthly Regulation 26
Field Farm House DS0000052987.V260413.R01.S.doc Version 5.0 Page 18 reports and the twice-yearly Quality Assurance reports show a sound understanding of good residential care practice and provide evidence of a strong commitment to the Home by the Registered Provider. Field Farm House DS0000052987.V260413.R01.S.doc Version 5.0 Page 19 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 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 x x x x x x x STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 x x x x x Field Farm House DS0000052987.V260413.R01.S.doc Version 5.0 Page 20 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.V260413.R01.S.doc Version 5.0 Page 21 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
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