Inspection on 12/11/07 for Field House

This inspection was carried out on 12th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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.

Other inspections for this house

Field House 21/10/08

Field House 04/12/06

Field House 20/09/05

Field House 27/04/05

Field House 02/11/04

Field House 09/06/04

Field House 19/01/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Field House Eyebury Road Eye, Peterborough PE6 7TD Lead Inspector Elaine Boismier Key Unannounced Inspection 12th November 2007 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 House DS0000015172.V354643.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Field House Address Eyebury Road Eye, Peterborough PE6 7TD 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) 01733 222417 01733 223578 admin@fieldhousecare.co.uk Mrs Nazma Virji Mr Nazir Virji Mrs Nazma Virji Care Home 33 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (33) of places Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th December 2006 Brief Description of the Service: The home is a large former domestic property, which has been extended and adapted for its present use. It is situated in the village of Eye close to the city of Peterborough. The village is near to the city of Peterborough. The home is set in large grounds and is adjacent to the local school. Major building work has been undertaken to extend and refurbish the premises to provide up to 33 places. The current fees range from £379.44 - £471.00 per week. Additional costs include those for toiletries, hairdressing, private chiropody and newspapers. Further information about fees can be obtained from Field House. Copies of inspection reports are available at the home, on request or via our website www.csci.org.uk Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This summary includes information that we have received between the last inspection of Field House, of 4th December 2006 and up to this key inspection of 12th November 2007. We have received information provided by the local authorities with regards to concerns raised about the home and of two safeguarding alerts (previously known as protection of vulnerable adults or POVA). Before the inspection we sent out surveys to residents and relatives, carers and advocates. Of these surveys we sent out we received 6 surveys back from residents and 5 surveys back from relatives, carers or advocates. We also received, before the inspection, an Annual Quality Assurance Assessment (AQAA) form, from the home. All the above information will be referred to in this inspection report. We, The Commission for Social Care Inspection, carried out this unannounced inspection, by two Inspectors, between 10:00 and 13:50 and took just under 4 hours to complete. We spoke with people, staff, including the Manager and a visitor to the home. We carried out a tour of the premises, observed people and staff and examined documentation. Field House has been assessed to have improved from an adequate quality service to that of a good quality service. It is our expectation that the home’s internal management, rather than any reliance on our inspection and regulation, maintains this improvement. For the purpose of this report people living at Field House are referred to as “people” or “residents.” What the service does well: People that we spoke to were happy living at the home. There are meaningful activities provided and people told us that they chose what they wanted to do. People live in a clean and comfortable place that has a relaxed and friendly atmosphere. Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 6 People are cared for by a number of well-trained staff, who are patient, and have worked at the home for a long time. People are consulted about the home and are listened to. There are good procedures in place to protect people from the risk of abuse. What has improved since the last inspection? What they could do better: Although no requirements have been made on this occasion we expect the home to take action in the following areas: We expect that the home makes sure that medication is stored at temperatures according to the manufacturer’s instructions. We expect the home to consult the local pharmacist and gains advice about safe temperatures for storage of certain types of creams. We expect the home to remind staff about knocking on doors before entering. We expect the home to review the standard of food provided. It was difficult to know how the home managed the process of responding to complaints, as there was no official complaints log. We expect the home to manage this issue. We expect the home takes appropriate action to make sure that an area is made safe from harm when people visit the garden. Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 7 We expect the home to take action to ensure that there is no risk of spread of infection by introducing better methods for people and staff to dry their hands. We expect during the recruitment stage potentially new staff can make themselves understood and people can understand them, before they are considered suitable to work at the home. We expect the home to take action to ensure that copies of proof of identification of members of staff are kept on file and that the date of when the POVA check has been received is kept on file also. We expect the home takes advice to ensure staff receive more regular moving and handling training. We expect records of fire drills provides the names of all people that have attended this fire safety training. We expect the home to increase the current number of care staff with a certificate in first aid, to ensure that at any time people will be responded to, by trained staff should a first aid situation arise. All the fire doors that were open were done so by means approved by the fire safety officer, with the exception of a fire door on the first floor between the corridor and the lounge. The door was held open with the use of a wooden wedge. We expect the home to manage this issue, to protect people from the risk of spread of fire. We expect the home to remind staff, about wearing suitable foot wear, to reduce the risk of harm to residents when staff are carrying out care practices. 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 House DS0000015172.V354643.R01.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 House DS0000015172.V354643.R01.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): 2 Quality in this outcome area is good. There is a good standard of information to assist people in their decision where to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The majority of surveys from residents said that they had received enough information about the home before they moved in with the exception of one survey. A visitor told us that they had information about the home before their relative moved in The AQAA informed us that the home ensures that “pre-admission assessments completed for new admission” The AQAA told us also that copies of these “pre-assessments” are on file and we saw that this was the case when we examined two people’s care records. The inspection report was available in the administration office of the home. Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 10 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 good. People benefit from a good standard of health and personal care that could be improved upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans that we saw were of a good standard. Information provided at the pre-admission stage had been included in the care plans. Observation and discussion with people indicated that the care plans were an accurate record about the person. Care plans were reviewed each month and any changes in the care plan were summarised during the monthly review. Three of the 5 relatives’, carers’, advocates’ surveys said that the home always meets the needs of the resident. Two of the 5 relatives’, carers’, advocates’ surveys said that the home usually meets the needs of the resident. Four of the 5 relatives’, carers’, advocates’ surveys said that the home always gave Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 11 the support, as was expected, to the resident; one of the 5 relatives’, carers’, advocates’ surveys said that the home usually gave the support, as was expected, to the resident. Five of the 6 residents’ surveys said that medical support was always received when the person needed it; one of the 6 residents’ surveys said that medical support was received sometimes when the person needed it. Examination of care records indicated that people have access to arrange of healthcare professionals to include opticians, community psychiatric services, GPs, district nurses and chiropody services. When we were leaving the home, the Manager was welcoming the local dieticians into the home. We examined a person’s care records and these records indicated that the person, who was in bed, was receiving appropriate care to prevent the development of pressure sores. This care included pressure relieving aids and repositioning of the person every 2-3 hours. The person was asleep and appeared comfortable. The AQAA informed us that a loop system for the hard of hearing has been provided and pressure relieving aids, such as cushions have been purchased. An immediate requirement was made following the last inspection, for the safe storage of medication. We noted that medication was stored safe and as a result of this, this requirement has been met. Staff training records indicated that staff responsible for administering medication, have attended medication training. Medication systems were assessed on the ground floor. Medication administration records and stock levels of medication were satisfactory. Eye drops were labelled with the date of opening. Where medication is stored temperatures had not been taken. These temperatures were for both the drug fridge and room temperature. We checked the room temperature and this was 24.5 degrees centigrade. We expect that the home makes sure that medication is stored at temperatures according to the manufacturer’s instructions. Three tubes of medication were stored in the drug fridge. There was some discrepancy between the manufacture’s instructions for one type of medication. We suggested that the home consults the local pharmacist and gains advice about this. We observed staff interacting with people and spoke to people about their views of the staff. Staff interacted with people in a respectful way and people said that staff were good. We were told that sometimes staff do not always knock on doors before entering. We did not observe this during our inspection. We expect the home to remind staff about knocking on doors before entering. Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. People are provided with opportunities to live a good quality of life that could be better. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In August 2007 we were made aware of a concern made to the local authority regarding the standard of activities. Two of the 6 residents’ surveys said that suitable activities were always provided by the home; Three of the 6 residents’ surveys said that suitable activities were usually provided by the home; the remaining survey said that the person did not know anything about activities. We received comments from a relative in a survey that said, ”Patients just seem to be plonked in front of t.v.(sic) which has no sound and is often obscured by zimmer frames. No physical activities seen, just occasional singsong. No activities to stimulate clients”. In another survey, completed by a Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 13 relative, we read that the home could improve by “Offer more activities/entertainment/outings.” During our inspection we saw no walking frames obscuring the television in the upstairs lounge. The television, in the first floor lounge was not on although the television in the ground floor lounge area was on, with sound, for people to watch and listen to. We examined the record of activities and spoke to people, staff and the Manager. Evidence suggests that people are provided with meaningful activities such as cleaning, tidying tables, washing up and folding clothes. Forthcoming events were advertised and this included celebrations for the forthcoming Christmas party. Staff told us that Bonfire Night was celebrated at the home and that people are taken to the local duck pond. The Manager informed us that the home had taken some people out shopping and that this could be reintroduced based on risk assessments. Walls throughout the home were decorated with people’s works of art. Walls were also provided with sensory (“fiddle”) boards for people with dementia. We saw staff interacting with people on a 1:1 basis. People that we spoke to, including a visitor, said that the home was a good and happy place for people to live in. One of the 5 relatives’, carers’, advocates’ surveys said that the home always supported the person to live the life that they chose; 4 of the 5 relatives’, carers’, advocates’ surveys said that the home usually supported the person to live the life that they chose. People that we spoke to said that they felt that they could do what they liked. We saw people receiving their guests and the record of visitors indicated that the home operates reasonable visiting hours including up to 20:00 hours. A visitor to the home told us that they could visit the home when they liked. In August 2007 we were made aware of a concern made to the local authority regarding the standard of food. We received comments from relatives in the surveys that included, “At meal times they seem to have no choice. Portions seem small…” and “Food is a problem. It is not cut up before being served….Also need proper bibs not just a tea-towel.” During this inspection we did not observe any person, who was eating in the downstairs dining room, wearing a tea towel or any other methods of protection of their clothing against spillage of food or drink. We discussed this area of care with the Manager who informed us that no person in the home is provided with such protection of people’s clothing. She reported that this was based on a Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 14 relative’s view about such care practices, as the relative considered such care practices were for children, rather than for adults. We noted that the people eating their lunch, in the downstairs dining area were able to eat their food without any problem. Dining tables were pleasantly set out with table linen, mats and vases of flowers. The AQAA told us that changes in the menu have been made as a result of listening to people who live at the home. According to the AQAA these changes include “introducing fish and chips twice weekly, having rice pudding once weekly….” Examination of minutes of a residents’ meeting, held in July 2007, was for people to offer their views about the food. Discussion with staff and examination of the current menu indicated that fish and chips are usually offered twice each week. Examination of the record of food provided and discussion with staff indicated that although there is no alternative choice of a hot meal any person who does not eat certain foods, such as tomatoes and broccoli, alternative choices are offered. One of the 6 residents’ surveys said that the person always liked the meals; two of the 6 residents’ surveys said that the person usually liked the meals; three of the 6 residents’ surveys said that the person sometimes liked the meals. During this inspection we received a range of comments about the lunch time meal from “Good” to ”Bloody awful”. We noted that the fish and chips were not appetising to look at; the colour of the chips and colour of the batter of the fish was dark, the chips looked greasy and the fish inside the batter had a grey colour. The portions of food were of an average size although people informed us that they could have second helpings if they asked. We expect the home to review the standard of food provided. Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 15 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 & 17 Quality in this outcome area is good. People are listened to and are safe from the risk of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four of the of the five relatives’, carers’ advocates’ surveys said that the person knew how to make a complaint and the remaining survey said that the person usually knew how to make a complaint. Three of these 5 surveys said that the home always responded appropriately to the concerns that had been raised; one of these 5 surveys said that the home usually responded appropriately to the concerns that had been raised. The remaining survey said that this was not applicable as there had been no concerns raised. Four of the 6 residents’ surveys said that staff always listened and acted on what the person said to them; one of the 6 residents’ surveys said that staff sometimes listened and acted on what the person said to them; one of the 6 residents’ surveys said that staff never listened and acted on what the person said to them. Three residents’ surveys said that the person always knew who to speak to if they were unhappy; one residents’ survey said that they usually knew who to speak to if they were unhappy about something; one person wrote that that Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 16 there was no clear leadership about who to speak to. One of the surveys was not completed. Three of the 6 residents’ surveys said that the person knew how to make a complaint whereas the remaining three surveys said that the person did not know how to make a complaint. During our inspection most of the people we spoke with knew who to speak to if they were unhappy about something. The AQAA informed us that the complaints procedure is displayed in the foyer and this we saw at our inspection. Examination of the record of complaints indicated that the home had taken a listening approach and changed the delivery of care in response to the complaint. This was with regards to providing a different type of bread for a person. It was difficult to know how the home managed the process of responding to complaints, as there was no official complaints log. The AQAA told us, however “if any complaints (sic) received in the next 12 months, then this will be looked at and addressed.” The AQAA informed us that the home has received one complaint within the last 12 months. We have received no direct complaints about the home. Any concerns made we have been provided with this information by the local authority. We were notified of two safeguarding incidents that have occurred since the last inspection of the home. One allegation was not proven (with regards to poor moving and handling practices). The Manager, in line with local safeguarding procedures, made the second safeguarding alert, to protect a person from injury from another resident. Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 17 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 adequate. People live in a clean and comfortable home that could be safer. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A resident’s survey said, ”Top lounge very bare and uninviting”. We noted that following a residents’ meeting held in September 2007, walls throughout the home, to include the lounge area of the first floor, had pieces of artwork made by residents of the home. Lounge areas and bedrooms were comfortably furnished. A relative commented on in their survey that the “Garden area and facilities (could be improved upon). Need area to sit and walk about outside”. Flowerbeds were well maintained and access to the outside garden was safe Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 18 and being enjoyed by a resident. According to the Manager there are plans to improve the garden area, particularly for those people who have dementia. A requirement was made for a risk assessment to be carried out with regards to the garden fountain. A risk assessment has been carried out and this requirement has been met. We noted that in one area of the garden, near the garden sheds, there were building materials and a hand washbasin. We expect the home takes appropriate action to make sure that this area is made safe from harm when people visit the garden, rather than we make a requirement on this occasion. Four of the 6 residents’ surveys said that the home was always clean and fresh; two of the 6 residents’ surveys said that the home was usually clean and fresh. At the time of our inspection the home was clean and fresh. During the tour of the building we saw that bathrooms had hand towels for people and staff to dry their hands. We spoke with staff who confirmed that this was the case and that disposable hand drying towels are currently not provided. Such practice increases the risk of the spread of infection. We expect the home to take action to ensure that there is no such risk, rather than we make a requirement on this occasion. Staff we spoke with and examination of staff training records indicated staff attend training in infection control. Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 19 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 adequate. People receive proper care from staff who are well trained and generally well recruited although recruitment procedures must be improved upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff told us that residents receive care from a number of staff who have worked at the home for a long time. We observed that people were receiving individualised care and attention from care staff and this was carried out in an unhurried and patient manner. A relative in their survey informed us, “They are always very patient with my father…” Two of the five relatives’, carers’ advocates’ surveys said that staff always had the right skills and experience to look after people properly; three of the five relatives’, carers’ advocates’ surveys said that staff usually had the right skills and experience to look after people properly. The AQAA told us that 11 of the 15 care staff have NVQ level 2 or above i.e. just over 73 although at the inspection the Manager informed us that only one member of care staff does not have this qualification. Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 20 A resident’s survey said, ”Staff have often have poor understanding of English.” A relative in their survey said, “On the few occasions when we have spoken by telephone it has sometimes proved a little difficult to clearly understand some of the care workers.” In April and August 2007 we were informed about concerns made to the local authority. Within these concerns staff, whose first language was not English, were sometimes having difficulty in being able to understand what was being said to them and for others to be able to understand them. At our inspection when speaking with staff, who do not have English as their first language, we found on occasion that we had difficulty in understanding what these members of staff were telling us. We discussed this with the Manager as we expect that during the recruitment stage potentially new staff can make themselves understood and people can understand them, before they are considered suitable to work at the home. A requirement was made for any gaps in employment history to be explained and recorded. We examined two files of staff who had been most recently recruited and we were satisfied that this requirement had been met. We noted however that, although the majority of required information had been obtained, there was no proof of identity of the person in either of the two files that we had examined. We noted that although there was a record that a POVA check had been carried out there was no date when this was received. We were unable to assess if the home had obtained a POVA check, before the member of staff had started working at the home. We expect the home to take action to ensure that copies of proof of identification of members of staff are kept on file and that the date of when the POVA check has been received is kept on file also. We will not make a requirement on this occasion as we expect the home to manage this issue. Staff we spoke with and examination of staff training records indicated that staff have attended a range of training to include nutrition, care of people with swallowing difficulties, care of people at risk of pressure sore development and care of people with mental health needs, including dementia. Staff we spoke with, and confirmed by the Manager indicated that staff have attended training in how to care for someone with Parkinson’s disease. Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 21 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 good. People benefit from a well-managed home that could be improved upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA informed us that the Manager has completed the Registered Manager’s Award in the last 12 months and we saw proof of this in her training file. She has also attended training within the last 12 months that includes nutrition, basic food hygiene and care of people at risk of pressure sore development. The AQAA informed us that there are meetings held for service users and we saw the minutes of these meetings. The purpose of these meetings was to Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 22 gain people’s views about the home and what changes they would like to be made. The AQAA was completed in an adequate manner but it is our expectation that this will be improved with practice to become more detailed. The AQAA did however demonstrate that there is a quality assurance system in place that has identified areas that the home does well in and what areas need to be improved upon. Two people’s monies that are kept for safekeeping by the home were counted and these amounts reconciled with the record of balances. The AQAA informed us that service checks or tests have been carried out for lifts, hoists, fire detection and fire fighting equipment and we saw records that these checks have been carried out. We saw also checks had been carried out for emergency lights, portable appliance tests and temperatures for hot water that is accessed by residents. Temperatures of fridges and freezers for food storage are recorded every day and records of these were satisfactory. An environmental health report, of an inspection carried out on 30th August 2006, said that there “were no problems. Well run business”. Staff told us that they had attended training in moving and handling techniques and we saw, by examination of staff training records, that people had received this instruction during their induction period. Currently the home updates staff in moving and handling every 12-18 months intervals. We saw written advice, from the local authority to the home, about the frequency of staff training in moving and handling and this advice was that staff should receive updated training sooner than the current training practice. We expect the home takes this sound advice to ensure staff receive more regular moving and handling training. Currently fire drill records do not detail the names of people who attend these fire safety-training sessions. We expect these records to show such names and for the home to improve in this area of record keeping. According to the staff training records, and discussion with the Manager, four care staff have attended first aid training. We expect the home to increase this number of care staff to have a certificate in first aid, to ensure that at any time people will be responded to, by trained staff should a first aid situation arise. All the fire doors that were open were done so by means approved by the fire safety officer, with the exception of a fire door on the first floor between the corridor and the lounge. The door was held open with the use of a wooden wedge. We expect the home to manage this issue, to protect people from the risk of spread of fire, rather than we make a requirement on this occasion. Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 23 We saw some members of staff wearing open toed and flip-flop style of foot wear. Such footwear does not provide sufficient support when staff are caring for people, with particular regard to moving and handling techniques. We expect the home to remind staff, about wearing suitable foot wear, to reduce the risk of harm to residents when carrying out care practices. Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 2 Field House DS0000015172.V354643.R01.S.doc Version 5.2 Page 25 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 House DS0000015172.V354643.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 House DS0000015172.V354643.R01.S.doc Version 5.2 Page 27 - 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!