Inspection on 28/07/08 for Field Farm House

This inspection was carried out on 28th July 2008.

CSCI found this care home to be providing an Excellent 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

Field Farm House 10/04/07

Field Farm House 01/03/06

Field Farm House 19/10/05

Field Farm House 19/01/05

Field Farm House 23/08/04

Field Farm House 01/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Field Farm House Field Farm House Hampton Bishop Herefordshire HR1 4JP Lead Inspector Denise Reynolds Key Unannounced Inspection 28th July 2008 09:30 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.V369118.R02.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. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 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@fieldfarmhouse.net www.fieldfarmhouse.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.V369118.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1. To accommodate one named service user who is aged below 65 years of age. 10th April 2007 Date of last inspection Brief Description of the Service: Field Farm House provides a service for older people who need care due to physical difficulties resulting from the ageing process, because of a mental health need or a dementia type illness. The latter is an area of care which the service is developing as a specialism. The manager is studying for a masters degrees in dementia care and one of the company directors has a Diploma in Dementia Care. Field Farm House is a converted and extended farmhouse in a rural location just outside the city of Hereford. The accommodation is on two floors with a lift to the first floor. Three of the 24 bedrooms are twin rooms; these are never used for more than one person unless people have specifically chosen to share a room. Some bedrooms have en-suite facilities. There are two lounges, a separate dining room and a conservatory style room outside reached via a covered area. To the front of the house there is an attractive sensory garden with level paths and places to sit and smaller garden areas at the back of the house where rooms have their own doors leading outside. A further extension to the building is in progress; this will increase the number of places to 60 when it is completed late in 2008. The provider and manager recognise the importance of keeping the current homely atmosphere and say this is being given priority in the new development. People living in the Home are being involved in decisions about décor and furnishings including choosing the exterior colour scheme. The range of fees in the Home’s current published information is £366.45 to £550 a week. The service includes the summary section of our inspection reports in its guide for people thinking of moving there and will give people a copy of the full report on request. In addition, their website has a link to their inspection report on the CSCI website. Field Farm House DS0000052987.V369118.R02.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 3 star. This means the people who use this service experience excellent quality outcomes. This was a full inspection of Field Farm House to look at how well the it is doing in respect of the core national minimum standards (the report says which these standards are), and the quality of the service this results in for the people who live there. We call this type of inspection a key inspection. We did the inspection on a weekday starting at 9.30am and finishing at 5pm. We did not tell the owners or the manager when the inspection would be. The Manager completed a statutory Annual Quality Assurance Assessment (AQAA) earlier in the year. An AQAA is a document which asks services to describe what they do well, what improvements they have made and their plans for any improvements they intend to make. We used this information to add to what we know about Field Farm House and to help us plan our inspection. Other information was available in the reports on monthly visits to the Home by one of the directors and in the information sent to us by the Home about events such as accidents. During the inspection we spoke with Jane Barrington, the registered manager and with a director of the company that owns the Home. We met people who live at the Home, speaking to two in private and to a group of eight people who were sitting in the garden. We interviewed three staff and spoke to others in passing. We also took into account what people told us in our survey forms; we received these from eight people who live there, five relatives and six staff. We looked at some parts of the premises and various records such as care records and staff files. During the inspection we had opportunities to see and hear the way staff were treating people who live in the Home. What the service does well: People thinking of moving to live at Field Farm House are given useful information about the Home which tells them about the Home and what it will cost to live there. People are encouraged to spend time at the Home to see what life there is like. This helps people decide if it is going to suit them. Staff make sure the Home will be able to give them the level of care they need. before someone decides to move in. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 6 People are valued as individuals and cared for with respect. One person told us that she had not wanted to move into a Home but discovered it was nothing like she expected. She told us that it would be a perfect home for anyone scared of moving to a care home. Staff deal with people’s personal and health care needs conscientiously and communicate well to make sure all the staff know what is happening. The Home provides lots of activities. For people who want to, this gives a chance to socialise and get to know other people. People who choose to spend their time on their own can; we met two people who told us they enjoy their own company and are pleased no one makes them join in. Visitors are made welcome and people are encouraged and supported to keep in touch with family and friends. If people are not happy with something, their concerns will be listened to and taken seriously by staff. Their right to be safe from abuse or neglect is important to staff and they understand the procedures to be used if abuse is suspected. People are provided with clean, safe and well-maintained accommodation. Further improvements to the décor and furnishings are planned as part of the upgrading of the premises. An extension is being built which will make the Home bigger. The staff told us it is important to them to keep the homely atmosphere they have created. There is a good training programme for staff which equips them with the knowledge and skills they need to look after people well. Recruitment procedures are thorough to reduce the opportunities for unsuitable staff obtaining employment in the Home. The Home is managed in a way that values the people who live and work there. The management team are competent and knowledgeable and look for ways to improve and develop the quality of care they provide. People who live there are safeguarded by a responsible and well managed approach to health and safety. What has improved since the last inspection? Recruitment procedures for staff from overseas have been tightened to include criminal records bureau checks so the manager can assure herself that applicants have not been convicted of any offences in this country or had their names put on the protection of vulnerable adults list. The manager recently encountered problems getting suitable references from previous employers. Because of this the Home now asks for a larger number of references than the law requires and has decided to follow all written references up with phone calls to assure themselves they are genuine. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 7 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. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 8 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.V369118.R02.S.doc Version 5.2 Page 9 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): 1, 3 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People thinking of moving to live at Field Farm House are given clear information, in a suitable format, explaining the care and services they can expect to receive and how much they have to pay. People can spend time at the Home to see what life there is like to help them decide if it is going to suit them. Before being offered a place, people have their care needs carefully checked to make sure the Home can provide the right level of support. EVIDENCE: People are given clear written information about the service in the form of a guidebook and information pamphlet. This includes details about how to find out more about the Home from the full statement of purpose, from the Home’s website and from our inspection reports. An audio version is provided if needed. Comments in surveys showed that people found this information helpful, for example Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 10 ‘The information was excellent.’ ‘I received enough information about the Home before I moved here.’ The manager is planning to develop further information about day-to-day life at the Home to answer the questions many people have about life in a care home. She is also looking at introducing a scheme to involve current residents in welcoming new people. The manager uses a detailed form when speaking to people about the care they will need if they move in. This is used to help staff be sure the Home is the right place for someone. The information tells staff what they need to know, for example, why a person has needed to move to a care home, and what their individual care needs, preferences and concerns are. We saw the information that had been obtained about two people who have moved to the Home in recent months. This was very detailed and provided an excellent picture of the people’s wishes, their concerns about living in a care home and the specific care that they need staff to provide. A section in one of these illustrates the individualised approach well – ‘Please be guided by amount of help and support that you offer to X by X herself. The level of help and assistance will be determined by the way in which X is feeling. Never assume that as you had to offer minimal assistance one day, the next day will be the same – always ensure that you ask X how much support she requires before offering your assistance.’ During the inspection we noted that one of the care coordinators spent most of an afternoon with a person talking to them about their future plans for moving in. This person was visiting the Home three times a week for an extended period before making a decision. All six staff who sent surveys back confirmed that they get the information they need to look after people. We learned from surveys and from speaking to people that they have been happy with their choice of home. Remarks included – ‘Happy with everything – thought I wouldn’t like it but I do.’ ‘I love it here ………. It is the perfect home for anyone who is scared of going into a home’ The manager has identified that whilst at present all the residents are of white, British ethnic origin the Home may in the future need to understand and accommodate the culture and beliefs of people of different origin moving into the Home in the future. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People living at Field Farm House are valued as individuals and cared for with respect. Staff deal with their personal and health care needs conscientiously. The Home has policies and procedures for dealing with medicines safely and if people are able to, staff will help them to manage their own medication. EVIDENCE: Everyone who lives at the Home has a written plan describing the care they need help with and any concerns and preferences they may have. During our inspection we looked at this information for three of the people there. Each plan was different giving staff a personalised picture to help them treat each person as an individual. The staff use daily records and written and verbal handovers to keep each other up to date with how each person is. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 12 During the inspection we observed several discussions between staff had about people’s health and what needed to be done; for example a dentist came to see someone because staff noticed they had a pain in their jaw. Another discussion was about asking for a person’s doctor to see them because staff felt that a health problem had not been resolved. We heard from staff in their surveys and when we interviewed them that there are good arrangements for passing on information and making sure they all know what needs to be done. These are two of the comments made – ‘Because our reports are completed twice daily (after night and day shifts) information on our service users is kept up to date and handed over from each shift to the next. Also our care plans are updated on a monthly basis after being reviewed for any changes in the needs of each individual.’ ‘I’m always confident that even if there is a situation that arises that I’m not sure how to deal with, there is someone to advise and support me.’ We saw letters and cards of thanks at the Home which reflected very positive experiences of the care provided. One of these said – ‘I don’t know how to thank you all for the way you have looked after me. Nothing too much trouble for you all.’ Comments in the surveys included – ‘I am always looked after well.’ ‘The staff always listen to what I have to say.’ ‘The staff are always busy but they help me when I need them.’ We saw and staff being friendly and respectful and people we spoke to were positive about the staff team, for example one person said ‘The girls are lovely – I can ask for anything and Jane is a wonderful person.’ The information we had from relatives was generally positive although some people mentioned that staff are sometimes very busy. ‘My mother has received good care. The Home atmosphere is good, staff very pleasant.’ ‘Staff are very efficient in caring for physical need, do not always have time for emotional ones…Physical care is very good…. appropriate medications given and securely controlled’ We saw that medication is kept secure and careful records made. The Home has policies and procedures to make sure that medication is dealt with safely. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 13 Staff who deal with medication have training to ensure they are competent to do this. The Home sends us information about situations at the Home through the notifications they have to send. These show us that when people are unwell, have accidents or when there are other problems staff deal with them promptly and inform people who need to know. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People who live at Field Farm House have the chance to take part in a wide range of activities to pass the time and get to know other people or can choose to spend their time on their own if they prefer. A nutritious diet is provided which offers people choices and variety at every mealtime. EVIDENCE: During our inspection we saw people taking part in an exercise session and a card game and saw staff spending time talking to people. There was a lot of conversation between people and a friendly atmosphere. After lunch several people came outside to sit in the sensory garden under the shade of several parasols. Staff brought people who needed help to walk or to be pushed in a wheelchair to join them. An extra parasol was unpacked and put up to provide more shade. Side tables were provided and staff brought out jugs of iced soft drinks. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 15 People who do not want to take part in communal activities are encouraged to continue to do the things they enjoy such as reading, knitting or watching TV. One person showed us the books that she has borrowed from one of the two library areas in the Home. The activity organiser that works at the Home keeps a diary of the things that happen each day and this provided information about a wide range of activities and events. It was interesting to see how some activities had led to people talking about life, for example an activity when people decorated Easter eggs as a wedding party resulted in - ‘Conversation flowed all afternoon. Interesting chat regarding brides and the fact ours look a little plump! Contraception and morals were discussed eg their hey day compared to now.’ Another session involved in comparing magazines from different decades ‘We had a lovely afternoon, chatting, reading and remembering.’ The variety of things to do was confirmed in the following responses from relatives – ‘There are a range of activities, craft and exercise sessions, musical entertainment. All residents are included at special events. Menus are planned and on various occasions buffet teas are arranged at which family members are welcome.’ ‘My mother is very happy at Field Farm House. She enjoys being stimulated by what goes on at the Home.’ Although we found lots of evidence about activities at the Home, two relatives remarked on the lack of things to do in the evenings and at weekends. We asked the manager about this and she agreed that this is the case. The plan is to develop this when the additional places are available at the Home as they will be able to increase staffing levels to make this possible. She also explained that they are planning to develop the way they provide activities for people with dementia who find it difficult to join in with things because of their lack of concentration or poor memory. People told us they like the food. We spoke to the cook who was well informed about the care needs of people in the Home. She said that she orders all of the food and is always able to get what she needs to provide appetising and varied meals. There is a good choice of food for all meals including a choice between two main meals at lunchtime and a selection at tea time that usually includes a hot choice as well as sandwiches, cakes, fruit and yoghurts. One of the activities that took place during the spring was a ‘health and vitality’ initiative which encouraged residents and staff to choose healthier foods and get more exercise. Good nutrition is recognised as an essential part of the care at the Home and the cook is involved in meeting everyone who moves in to find out about their dietary needs and likes and dislikes. She also involves them in talking about what should be included on the menu. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 16 We asked someone who lives in the Home if the regular luncheon club (where small groups of residents have a restaurant style meal with extra courses and silver service at the table) has continued. She told us it has and that she enjoys it a lot. She added that she always takes advantage of the glass of wine and ‘after-dinner’ mints that are served as part of the meal. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. If people who live at the Home are concerned about their care, their concerns will be listened to and taken seriously by staff. People’s right to be safe from abuse or neglect is safeguarded by a management team and staff group who understand the procedures to be used if abuse is suspected. EVIDENCE: People at Field Farm House have regular contact from the local Advocacy service and information about this is displayed in the Home. There is a written complaints procedure which is readily available and one of the company directors speaks to people about their care when doing her regular monthly visits to the Home. All but one of the people who responded to our surveys said they know how to make a complaint if they needed to, for example – ‘I would find one of the staff ….I would go and find Jane.’ When we asked one person what she would do if there was something she felt was not right she told us – ‘Anyone who complains must expect something that doesn’t exist’ Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 18 Staff are aware of the complaints procedure and have been trained to understand that it is part of quality assurance – ‘We are all made aware of the complaints procedure and what action should be carried out.’ ‘Depending on the concerns, if it was an issue that I could not deal with. I would inform the care manager. If this was not appropriate, the relevant organisation to deal with the concern. Or if they wanted to make a complaint I would ensure that they are aware of how to use our complaints procedure. This form of feedback can prove useful to us by highlighting where we may need to make changes or improvements.’ The Manager has a good awareness of abuse and safeguarding (adult protection) and most staff have attended training arranged through Herefordshire Council. Refresher training is scheduled to keep all staff alert to the issue and the topic is covered in staff induction. One of the staff we interviewed had been at the Home for just over a month and had already done this training. She was able to explain to us what she should do if she had a concern about the safety or well being of a resident. CSCI has received one allegation relating to Field Farm House during the last four years and two complaints have been made direct to the Home during the same period. The last of these was over a year ago and was dealt with appropriately. The allegation we received was made earlier in 2008. It was about the conduct of a member of staff. The same person was involved in an incident which the manager had already referred to the local authority to be investigated under local safeguarding procedures. This concerned an allegation against the member of staff who was subsequently dismissed from the Home and referred for inclusion on the list of people considered unsuitable to work in care settings. The incident referred to above has resulted in the manager strengthening staff recruitment procedures at the Home beyond those expected under the Care Homes Regulations. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are provided with clean, safe and well-maintained accommodation. Improvements to the décor and furnishings are planned as part of the upgrading of the premises. The building project includes an extension to the building which will result in the Home being able to provide a service to more people in accommodation designed with their needs in mind. EVIDENCE: The house is kept clean, warm and comfortably furnished. Building work on a new extension is underway and due to be completed later in the year. The extension will create additional bedrooms and new facilities such as a hairdressing salon and additional communal space. The kitchen and other areas in the existing building will be refurbished as part of the project. The intention is that residents whose view from their room is adversely affected by Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 20 the extension will be offered the opportunity of moving in to one of the new rooms. The current laundry is small but tidy and well equipped with suitable washing machines and a new tumble dryer. Different doors are used for the movement of dirty and clean laundry to avoid contamination. New laundry facilities are planned as part of the new extension and the manager confirmed that consideration is being given to the correct layout to help prevent cross infection. Liquid soap, disinfecting hand gel, disposable gloves and disposable aprons are in good supply throughout the house. People are helped to identify their bedrooms by naming them and using pictures to help make them stand out from other rooms. Inside their bedrooms people are encouraged to have their own belongings. This helps to make the room personal to them so they feel more at home. The sensory garden at the front of the house is an attractive feature of the accommodation and popular with people who live at the Home. The building which housed a swimming pool in the past has been renovated to create a large conservatory called The Rainbow Room. An official opening ceremony was held with a party for people and their relatives. The oldest person living there was asked to cut the ribbon to declare it open. Due to the building works there is some disruption due to noise and dust. The construction site is fenced and the manager told us that the builders are very careful and alert to safety issues for people who live at the Home. She also told us they are very good about talking to residents who take interest in the work. Residents chose the colour for the exterior wood cladding of the new building and are being consulted about the internal colour scheme. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living at Field Farm House are cared for by staff who are provided with the training they need to develop their knowledge and skills. Recruitment procedures are thorough to reduce the opportunities for unsuitable staff obtaining employment in the Home. EVIDENCE: Staff share responsibility for laundry and at weekends the care staff do any cleaning needed. The cook only works until 1pm and is not supported by a kitchen assistant. The cook told us that she leaves most of the food ready for tea before going off duty but this still means the care staff complete the preparation of the meal as well as serving it and clearing away. These arrangements for housekeeping and catering will not be suitable when the Home is larger. The registered manager recognises that more ancillary staff will be needed and roles will need to be separated. Responses we received from people who live in the Home, from staff and from relatives indicates that staffing levels are generally satisfactory at present. Some references were made to staff being busy although others told us that staffing levels are ok Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 22 ‘It has become excessively busy at present because of changing needs of certain residents.’ ‘The shifts are always covered to meet the individual needs of all the service users.’ A relative questioned if current night staffing levels (one person awake and one on call) might have had a bearing on the number of falls their relative had had at night. Last year the responsible individual highlighted night staff levels and the registered manager was instructed to keep this under review. This year, the Home has begun to review accidents in a structured way to help them in reducing the number of falls people have. This review process needs to include when accidents happen as well as where. The Home has policies and procedures for the recruitment of staff that are in line with legal requirements. We looked at two recruitment records which showed the recruitment process is carried out thoroughly with good records kept to provide a record of decisions made. The manager has begun to request a higher number of references than she is required to do. This is because some references give limited information to enable her to judge if an applicant has the qualities she is looking for and because she has recently experienced problems in obtaining a reference from an employer in spite of repeated requests. The manager has also begun to telephone all referees, not just a sample, to make sure that references are authentic. This resulted from a situation where doubt arose about the information the Home was given about an applicant. NVQ training is well established with 75 of staff having attained NVQ level 2 or above. The two care coordinators and a senior night carer are nearing completion of the Registered Managers Award (RMA). Training is also made available for housekeeping staff – the cook has achieved NVQ level 2 in catering and one cleaner has done an NVQ level 1 in domestic support. A new care assistant told us that she had already been enrolled on a four day First Aid at Work qualifying course and on an NVQ level 2 course. The manager has the RMA and is a qualified NVQ assessor and moving and handling trainer. She is working towards an MSc in Dementia Studies with Bradford University. The Responsible Individual has completed a Diploma 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 an advanced Food Hygiene qualification, and provides the in house food hygiene training to all staff. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 23 Training is also arranged in respect of various care related topics including dementia. When a person with Parkinson’s Disease moved to the Home a talk by the specialist Parkinson’s nurse was arranged. ‘I think the induction process has improved since I started here 4 ½ years ago …Field Farm is always eager to put me on training courses.’ ‘The induction covered everything I needed to know to do my job when I started. I had the support of my manager and team behind me at all times…. Regular training is provided by our care manager to meet the needs of the service users.’ One relative commented that an increasing number of non- British staff are working at the Home and felt this can make communication less easy. They also said that these staff have pleasant, caring attitudes. The service has recognised the importance of enabling overseas staff to communicate well with people living in the Home and with colleagues and visitors. They have therefore arranged for them to have English lessons at the Home for 2 hours a week. These are provided by a literacy project team based in Hereford. Staff feel supported by the management team and a system of regular supervision is being built up – ‘I have regular support from my care manager to discuss my position and I am always asked if I have any problems. If I have these are always dealt with.’ ‘As a senior member of staff I feel that I have full support of my care manager and team. The care manager is very approachable at all times which makes my job run smoothly.’ Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 24 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, 38 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The Home is managed in a way that values the people who live and work there. The management team are competent and knowledgeable and look for ways to improve and develop the quality of care they provide. People who live there are safeguarded by a responsible and well managed approach to health and safety. EVIDENCE: The Registered Manager is experienced and well qualified and is continuing to develop her knowledge and skills in the specialist area of Dementia care by undertaking a Masters Degree. Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 25 The monthly reports that one of the directors writes following her visits to the home show a sound understanding of good practice and provide evidence of a strong commitment to the Home by the company which owns it. Quality assurance in the Home is based on direct discussions with people who live there during the director’s visits, in residents meetings and during general contact. Questionnaires have not been used because the manager feels people get tired of filling them in and already have the ones from us to complete. This is an area she is giving further thought to. Staff told us that improving how they do things is something they are all expected to help towards as illustrated in this comment – ‘I feel that our organisations best points are that we are continually trying to improve our service. One of the best ways in which I feel this is carried out is by using the feedback we get from our clients by informal chats, or residents meetings etc. In this way we can make regular changes to daily routine and food menus etc ensuring that everyone has a wider choice of meals and activities…..As with any service there is always room for improvement, but if we or anyone notices an area which can be improved on then this is usually carried out. Any changes are usually monitored to ensure that everyone is happy with them and that it works effectively.’ Residents or their representatives are encouraged to deal with the safekeeping of personal money and valuables. For those residents who need help from the Home, there is a secure safe at the Home. Records are made and receipts kept whenever the Home has involvement in dealing with a person’s money. There is a rolling programme of training for staff in topics related to health and safety such as first aid, moving and handling and fire safety. The director checks health and safety compliance during her monthly visits. The Home has relevant policies and procedures and the company reviewed these in November 2007. The information we received from surveys and from speaking to people at the Home gave us an overall positive picture of this Home and the quality of the service people receive. ‘I am happy here, it is a wonderful place.’ ‘I think this is the best home in Hereford.’ ‘Friendly approachable management.’ ‘The team at Field Farm House are excellent, I’m really pleased and feel easy that Mum’s safe.’ Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 26 Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 27 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 4 X 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 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 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 4 Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 28 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.V369118.R02.S.doc Version 5.2 Page 29 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Field Farm House DS0000052987.V369118.R02.S.doc Version 5.2 Page 30 - 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. 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