Inspection on 12/10/05 for Field House

This inspection was carried out on 12th October 2005.

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 17/02/09

Field House 20/02/07

Field House 28/02/06

Field House 18/02/05

Field House 27/08/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Field House Cannards Grave Road Shepton Mallet Somerset BA4 4LU Lead Inspector Justine Button Unannounced Inspection 12th October 2005 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 House DS0000016014.V254229.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 House DS0000016014.V254229.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Field House Address Cannards Grave Road Shepton Mallet Somerset BA4 4LU 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) 01749 342006 01749 345146 linda.tungate@somersetcare.co.uk Somerset Care Limited Mrs Linda Christine Tungate Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th February 2005 Brief Description of the Service: Field House provides residential care for up to 39 service users within the “older people” category of registration. Day care is also provided for which a designated member of staff is employed. Field House is part of Somerset Care Limited. The registered manager is Mrs Linda Tungate. Field House is set well back from the road with a long drive and circular front garden. There are parking areas to the front and side of the house. Large, attractive gardens and patio areas surround the home. These are accessible to service users from a number of ground floor rooms. The home consists of a listed building with later ground floor extensions. Service users’ accommodation is on four floors serviced by a passenger lift. Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector conducted this unannounced inspection over the course of one day. The inspector was able to speak with a large number of the residents as well as staff on duty. The manager, Mrs Tungate, was available on the day of inspection. The inspector would like to thank the residents and staff for their time and hospitality shown to the inspector during their visit. This is the first inspection using the new CSCI reporting format, which focuses on outcome statements for National Minimum Standards. The inspector’s aim on this inspection visit was to seek views on the quality of the service from as many service users as possible and to speak to staff. Records examined were care plans, staff training, staff recruitment files, duty rotas, and some health and safety records. Other records will be examined at subsequent inspection visits. A tour of the building was carried out on this visit. What the service does well: What has improved since the last inspection? What they could do better: A small number of recommendations were made at the last inspection. A number of these still remain. Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 6 Although improvements have been seen in the plans of care staff need to ensure that they are written in a manner that demonstrates the individual needs of the people living at the home. The management team need to ensure that people who are considering moving to the home have the necessary information and equipment prior to moving into the home. This will ensure that their care needs can be met and that the individual can make an informed choice about moving to the service. The management need to ensure that staff recruitment is robust and that all necessary checks are completed prior to the staff member commencing employment. There was some malodour in some areas on the day of inspection. Staff need to ensure that good practise guidelines with regard to infection control are adhered to. The recommendations made in the last report with regard to the laundry remain. Although a number of areas for improvements have been identified these issues on the whole were not wide spread and can be easily rectified hence only one requirement has been made with the rest being recommendations. 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 House DS0000016014.V254229.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 House DS0000016014.V254229.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, 3, 4 & 6. The service provides information to both new and existing service users. This information needs to contain the last inspection report. All people who move into the service have an assessment prior to moving in. Staff need to ensure that the assessments demonstrate the equipment needs of the person and that these are obtained prior to the person moving in thus ensuring the service can meet the needs of the individual. Intermediate care is provided in what is called “step down beds”. The service provides two such beds and one respite bed. EVIDENCE: The Statement of Purpose can be found in the entrance hallway. This contained all necessary information but did not include the most recent inspection report. This is recommended. The report on display dated from August 2004. People who had recently moved in to the service stated that their family were able to visit prior to moving in. Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 9 The care records for one person who had recently moved into the service were viewed. These showed that the management team had completed an assessment prior to the person moving in. This was in addition to assessments by other members of the multidisciplinary team. As the service provides personal care only the level of specialist equipment is not as high as one would expect to see in a service that provides nursing care. The community nursing service provides equipment such as adjustable beds and air mattresses. The assessments prior to admission had identified that the person who had been admitted required both of these items. On the day of admission, although the person had moved in, the equipment was yet to be provided. The management team need to ensure that they can meet people’s needs and equipment is obtained prior to admission. Field House DS0000016014.V254229.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. All people who live at the service have a plan of care. The plans need to be reviewed to ensure that they adequately reflect the individual needs of the person. All the health needs of people living at the service are met but the comments in “choice of home” need to be considered. Medication is stored and handled in a safe manner. The dignity and respect of people who live at the service is maintained. EVIDENCE: Samples of the care plans were viewed on the day of inspection. In two of the plans not all the necessary assessments had been completed (e.g. nutritional assessments) the staff team need to ensure that all the necessary assessments are completed for all people who live at the service. Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 11 The plans of care were very basic and included ambiguous comments such as “encourage fluids”. If the assessments identify an issue then the plans need to reflect an individual and specific approach. A number of people spoken to during the course of the inspection were not aware of their plans. This is advised to ensure that staff deliver care in a way that people would like. The home conducts written risk assessments to protect individual abilities and needs of service users. As the home provides personal care only the community nurses visit the service regularly to complete any nursing tasks. The service user plans confirmed that health professionals visited the home on a regular basis including GP, podiatry and optical care. People spoken to during the inspection confirmed this. The home conducts an internal audit system with regard to medication. The last one was conducted on the 28/08/05. This was viewed and was satisfactory. Staff were observed administering the drugs at lunchtime on the day of inspection. This was conducted in a safe manner. A number of staff have received training in this area. People spoken to stated that staff were very kind and that they always “knocked on your door before coming in”. During the inspection, the inspector observed staff interacting with service users in a professional, kindly and respectful manner. Staff are friendly, but professional in their approach. Field House DS0000016014.V254229.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. There are a wide range of social and leisure activities available. Family and friends are able to visit at any time. People who live at the service are able to maintain control of their lives and choices are offered. The food provided is of a good quality. Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 13 EVIDENCE: People who live at the service commented that there was always lots going on and that they enjoyed the activities on offer. The numerous notices about the home advertising forthcoming events confirmed this. In addition to this there were photographs and displays from recent social occasions. Social events advertised included West Country Day, film show, Italian theme day, a visit by the donkeys from the sanctuary and a sing-a-long. Home staff give their time to help with trips and outings. There is a dedicated activities organiser, employed for 15 hours per week, who arranges trips and in house entertainment. The activities organiser also spends time for one-to-one and small group sessions. Links with the community are strong. Visitors are made very welcome and can visit at any time to suit the service user. This was confirmed by people who live at the service who stated that there was “always lots going on.” There are regular residents’ meetings, the last one on the 6th June 2005, in which people can influence life at the home. Minutes at these meetings are kept. Lunch was observed on the day of inspection. People questioned stated that the food was of a good standard. The meal consisted of hotpot or bacon and mushroom risotto. Potatoes and a choice of vegetables were served. Jacket potatoes or salad are also available on a daily basis. The food was nicely served with individual dishes of vegetables served at each table. A selection of hot and cold puddings and desserts was then served from a sweet trolley. The tables were nicely laid with linen tablecloths and napkins. The menu is advertised on a daily basis on the dining tables. Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 14 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 & 18. There is a satisfactory complaints procedure and complaints are dealt with in accordance with this procedure. There are satisfactory policies with regard to the prevention of abuse. It could not be confirmed if people are living at the home are protected from abuse to the fullest extent. EVIDENCE: The complaints procedure is satisfactory. One complaint has been received since the last inspection. The details of this complaint were viewed on the day of inspection. This complaint had been dealt with in line with the complaints procedure. A number of the people at the service who were questioned during the inspection however did not know whom they would speak to if they were unhappy with any aspect of the care they received. It is recommended therefore that the complaints procedure is made available in an accessible format to all the people living at the service. As previously stated however there are regular meeting in which residents are involved. There is a policy with regard to the prevention of abuse. This area is also covered in the induction of new staff. People who live at the service are not protected to the fullest extent, as the recruitment procedures are not robust. This is discussed later in the report. Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26. The home is suitable for its stated purpose. There are adequate communal areas. Some specialist equipment is available however the previous comments made need to be considered. There were some malodours apparent around the home. Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 16 EVIDENCE: A tour of the building was conducted on the day of inspection. The home is located close to the town centre set back from a busy road and surrounded by large attractive gardens that are accessible from the house. Local facilities are within walking distance for physically fit and traffic aware service users. Inside there are spacious and comfortable communal rooms. All floors are accessible by a passenger lift. Private accommodation varies in size and facilities. Some rooms are very large and some have en-suite facilities. They are all personalised and homely and all have washing facilities. There are a number of spacious and attractive communal rooms including sitting and dining areas. There is a grand entrance hall with a spiral staircase that is most attractive. WCs and bathrooms are adapted to meet recognised needs. There is a mobile hoist. The majority of bedrooms seen were lovely, fully personalised and comfortably equipped. People spoken to during the inspection stated that they were happy with their rooms. During the inspection a number of areas although apparently clean had strong malodours. The management team need to ensure that these are addressed as a matter of urgency. Staff were observed washing their hands in appropriate manner. The laundry was viewed during the inspection. This area is in need of refurbishment. There is no dedicated staff member to complete the laundry. For a home of this size this is quite a large task so the employment of dedicated laundry staff should be considered. Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 17 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, 29 & 30. The service provides staff who are suitably trained and in adequate numbers. The recruitment practises do not protect the people who live at the service. EVIDENCE: The staffing rotas were viewed on the day of inspection. The rotas demonstrated that there are adequate staff on duty. People spoken to during the inspection stated that there were enough staff on duty and that they did not have to wait if they required assistance. Staff training records were viewed. These showed that the majority of staff had received all mandatory training. It could not be confirmed if staff have received first aid training such that a staff member with this qualification is available on all shifts. In addition to mandatory training the records showed that a range of other training has been undertaken including training in diabetic, continence and dementia. Sixteen staff have achieved an NVQ qualification with a number of other staff working towards this award. Staff spoken to during the inspection stated that they felt that they received adequate training in order to fulfil their role. Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 18 The staff files of the last three most recent employers were viewed. These demonstrated that all required checks were completed. The checks however were not necessarily received prior to the employee commencing work. This is required. This would ensure that the people who live at the service are protected to the fullest extent. Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 19 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, 36 & 38. This home generally has good occupancy rates. Service users speak well of the care and service they receive. Records are well managed and are stored securely. The home is well managed. EVIDENCE: Mrs Tungate is an experienced and qualified manager. Mrs Tungate has completed an NVQ 4. All feedback from service users, staff was that there is an open management approach in the home. The manager and her deputy were observed to demonstrate a clear sense of leadership by their interactions with staff. There are regular staff meetings and further impromptu meetings when necessary to discuss issues of concern. There is a calm and professional approach to management in the home, helping to give a sense of security and comfort for service users and staff. Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 20 Staff stated that they received regular supervision and appraisals. The fire safety log, accident book, wheelchair, lift and hoist servicing records were viewed. These were in line with good practise. Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 21 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 2 X 3 2 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 2 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 X 3 Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? No. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation Schedule two 19 Requirement It is required that all staff receive all necessary checks including POVA, CRB and two written references (one from the last employer) prior to commencing employment. Timescale for action 01/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP27 OP26 Good Practice Recommendations It is recommended that the provision of first aid training is reviewed to ensure that one staff member on each shift has this qualification. It is recommended that the provision of the laundry be reviewed. Consideration should be given to the employment of dedicated laundry staff. The management should ensure that the malodours are investigated and all necessary action is taken to prevent them. It is recommended that the complaints procedure is made available in an accessible format to all the people living at the service. DS0000016014.V254229.R01.S.doc Version 5.0 Page 23 3 OP16 Field House 4 OP7 5 6 OP4 OP1 It is recommended that the service user plans are reviewed to ensure that they all adequately reflect the current needs of the people who live at the service. The plans should be developed and reviewed regularly with the indivdual or representative. It is recommended that the management team ensure that they have adequate identified equipment in place prior to people moving into the home. It is recommended that the last inspection report is included in the statement of purpose. Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Field House DS0000016014.V254229.R01.S.doc Version 5.0 Page 25 - 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. 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