Inspection on 17/02/09 for Field House

This inspection was carried out on 17th February 2009.

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 House 20/02/07

Field House 28/02/06

Field House 12/10/05

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Field House Cannards Grave Road Shepton Mallet Somerset BA4 4LU     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Poole     Date: 1 7 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Field House Cannards Grave Road Shepton Mallet Somerset BA4 4LU 01749342006 01749345146 linda.tungate@somersetcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Somerset Care Limited care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Field House provides residential care for up to 39 people 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. The home 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 people from a number of ground floor rooms. The home consists of a listed building with later ground floor extensions. Accommodation is on four floors serviced by a passenger lift. There are steps to a small number of rooms. These would not be accessible to people with mobility Care Homes for Older People Page 4 of 27 Over 65 39 0 Brief description of the care home problems. Fees at the home currently (17-02-09) range from 390. to 555. pounds per week. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for people living at the home and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. This inspection was carried out over a one day period by one inspector. During this time We, The Commission, were able to talk with people living and working at the home, observe care practices, tour the building and view records. The registered manager, deputy and area manager were available throughout the Care Homes for Older People Page 6 of 27 inspection. We were given unrestricted access to all areas of the home and all records requested were made available. The following is a brief summary of the inspection findings and should be read in conjunction with the whole of the report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 27 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People wishing to move into Field House receive adequate information to assist them to make a decision about moving in. Senior staff assess all people wishing to move in to ensure that the home is able to meet their needs and expectations. Evidence: Anyone wishing to move to Field House receives a colour brochure and service user guide which gives information about the home. The service user guide sets out what is included in the fee and where additional charges may be incurred. This helps people to decide if the home is the right place for them. People living at the home said that they received adequate information about Field House to assist them to make a decision about moving in. Senior staff see and assess all people wishing to move in to ensure that they will be Care Homes for Older People Page 11 of 27 Evidence: able to meet their needs and expectations. The manager stated that, due to the nature of the building, they assess each person according to the room that is available at the time as well as their health and social care needs. The terms and conditions of residency state that the first 12 weeks of a persons stay is an assessment period. This gives both new residents and the home time to ensure that people have made the right choice. During this assessment period the notice period to terminate residency is 1 week. After this time 4 weeks notice is required. In addition to full residential care the home offers respite care and day care, this gives people a chance to get to know the home before making a decision about moving in. Two people spoken with during the inspection said that they had attended the home for day care before moving in, and one person said that they had stayed for two weeks. The home has two step up, step down beds which provide short stay intermediate care for people coming out of hospital or people who would otherwise have been admitted to a hospital ward. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home operates a very person centred approach to care and this is demonstrated in care plans and staffs working practices. Everyone living at the home is treated with dignity and their privacy is respected. Evidence: Since the last inspection the home has moved to a computerised care planning system. Assurances were given that all areas of the care plan can be printed for people who wish to view their personal plan in a more traditional format. 5 care plans were sampled and all were extremely comprehensive. Care plans are written in a very person centred way to ensure that staff working at the home are able to support people in their chosen manner. The care plans gave details about peoples interests and lifestyle choices as well as their physical needs. Staff spoken with during the inspection reinforced this person centred approach and were able to demonstrate a good knowledge of the people living at the home and their particular needs and preferences. Care Homes for Older People Page 13 of 27 Evidence: Assessments are carried out in respect of physical healthcare and include nutrition, skin care and moving and handling. These assessments are regularly reviewed but in one instance the assessment had not been altered to match the care plan and reflect the persons changing need. However staff working with the person were aware of the changes and were able to support the person appropriately. All staff said that there was good communication in the home and that they were always made aware of changes in need or preference. Staff stated that they reviewed the care plans regularly with each person. People living at the home said that they had access to healthcare professionals according to their individual need. People said that they were always able to see visiting professionals in private. Running records demonstrate that personal health is monitored and records of all appointments are recorded in the care plan. The home is realistic about the level of support they are able to provide and seek appropriate assessments from outside professionals when appropriate. Evidence of this was seen in one care plan. Currently no one living at the home self medicates, all medication is administered by senior staff who have received specific training in this area. There is adequate storage for all medicines including storage for medicines that require refrigeration and for controlled drugs. Medication Administration Records were seen. All medication is signed for when it arrives at the home and when it is administered or refused. This gives a clear audit trail. A controlled drugs register is in place and stocks held were checked and found to correctly correlate with records held. The home carries out a monthly medication audit to monitor the practices in the home. Without exception everyone asked felt that they were treated with respect. During the inspection it was observed that staff spoke politely to people living at the home and always knocked on bedroom doors before entering. Some people have telephones in their rooms and there is a pay phone in a quiet area to enable people to make calls in private. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home continue to be in control of their day-to-day lives and decide how they spend their time. The standard of meals in the home is good. Evidence: There is a very friendly and relaxed atmosphere at Field House. People living there felt that they continued to be in control of their day to day lives and were able to choose how they spent their time. Although some people felt that they had to get up at a certain time in order to have breakfast in the dining room, all staff were very clear that this was not the case, and that people could choose when they got up. This was discussed with the manager who agreed to re-iterate at the next residents meeting that people could have breakfast at anytime and that trays could be taken to rooms if people wished to have breakfast in bed. During the inspection it was observed that some people were served breakfast during the morning. Everyone said they could go to bed when they liked. One person said that they liked to go to bed early and read. They praised the night staff saying They always came and offer me drinks and snacks another person said Im still in control of what I do, I Care Homes for Older People Page 15 of 27 Evidence: decide. There are various organised activities and trips that people are able to join in with if they choose to. People said that they are able to spend time alone or socialising with other people. There is a three monthly newsletter that informs people about forthcoming events, so that they can plan their time. Around the home there are photos of celebrations and activities that the home has organised. People were happy with the activities arranged and said that there was always things going on. It was observed that staff spent time interacting with people throughout the day. Many people said that they continued to enjoy trips out with family and friends and that their visitors were always made welcome. People said that they were able to see visitors in communal areas or in the privacy of their rooms. Everyone said that all visitors were provided with refreshments when they visited and that they were invited to all organised social functions. The home has a small shop where people can purchase basic provisions and people living at the home said that the staff were always happy to assist them to make purchases from shops in the local town. A hairdresser visits the home on a regular basis and there is a monthly church service. Care plans seen gave details of peoples religion. Representatives of all religions are welcomed into the home to ensure that people are able to continue to practice their faith. The company, Somerset Care Ltd, has devised a corporate menu that provides a varied and nutritionally balanced diet. Food is discussed at residents meetings and the menu has been adapted to ensure that it is in line with the preferences of people living at the home. Everyone asked was complimentary about the food. People said Food is very good with a nice variety, Food is lovely, always two choices but if you dont want either ask for something different and Food is extremely good and there is always a choice. There are two dining rooms to give people a choice of where they eat their meals. Lunch was relaxed and unhurried. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel able to raise concerns and are confident that they will be listened to. Appropriate systems are in place to minimise the risks of abuse to people living at the home. Evidence: The home has policies and procedures in respect of recognising and reporting abuse, making a complaint and whistle blowing. All staff spoken with during the inspection were aware of the whistle blowing policy and the ability to take serious concerns outside the home. Staff receive information about recognising abuse during their induction period and induction records seen demonstrated this had been covered. People living at the home said that they would be comfortable to approach a member of staff or the manager if they had any worries or concerns. Everyone felt that they would be listened to and any issues addressed. One person said If I think something is wrong, I tell them and they alter it. Another person said If I am bothered about anything I can go to the office at anytime and they always listen. 2 complaints have been made since the last inspection. Records show that both were fully investigated to the satisfaction of all parties within agreed timescales. Care Homes for Older People Page 17 of 27 Evidence: There is a robust recruitment procedure in place that includes checking all staff against the Protection Of Vulnerable Adults (POVA) register before they begin work in the home. It was observed during the inspection that people living at the home had unrestricted access to all communal areas and their personal rooms. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Field House provides a comfortable, safe environment for the people who live there. Standards of cleanliness are good. Evidence: Field House is an impressive grade 2 listed building which has been adapted and extended over the years. It is located close to the town centre of Shepton Mallet where all local amenities such as shops, library and cafes can be found. All areas of the home are fitted with a fire detection and call bell system. The home is well maintained and there is ongoing refurbishment to ensure a good standard of accommodation. Since the last inspection some communal toilets have been completed refurbished and other areas have been redecorated and new flooring fitted. One bathroom was being refurbished at the time of this inspection. There are four lounge areas, three within the older part of the home and one in the more recent extension. This gives people a choice of communal areas. Outside the home there are extensive grounds with seating for people to use in good weather. Many people spoken with during the inspection stated that they enjoyed spending time in the garden during the summer months. Care Homes for Older People Page 19 of 27 Evidence: A sample of bedrooms was viewed. Rooms vary in size but all seen very pleasantly furnished and appeared comfortable. People are able to bring their own personal items with them and this creates a homely individual feel. Everyone asked was very happy with their personal room. Various aids and adaptations have been fitted throughout the home to assist people to maintain independence. These include hand-rails, assisted bathing facilities and a passenger lift. The main laundry for the home is situated outside the building. The laundry has adequate facilities for the size and nature of the home. All areas seen were clean and fresh. One person living at the home gave particular praise to the domestic staff at the home. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are supported by a well motivated and competent staff team. There are good opportunities for ongoing training to ensure that all staff have the skills to care for people at the home. Evidence: The home employs 27 permanent care staff, 21 (78 ) have a National Vocational Qualification in care at level 2 or above. In addition to this 12 ancillary workers, such as cooks and care support workers, are employed. People living and working at the home felt that there were usually adequate numbers of staff on duty. One person said I get plenty of attention. People said that call bells were always answered promptly and it was observed that no one appeared rushed. Throughout the day there was interaction between staff and people living at the home. To minimise the risks of abuse to people living at the home there is a robust recruitment procedure. 4 recruitment files seen showed that no staff begin work in the home until written references have been received and appropriate checks have been carried out. Care Homes for Older People Page 21 of 27 Evidence: All new staff undertake a thorough induction programme and records of this were seen in recruitment files. Staff said that there were excellent opportunities for ongoing training. Staff spoken to were extremely enthusiastic about their jobs and demonstrated an obvious commitment to providing a high standard of care that was personal to the individual. People living at the home were very complimentary about the staff who supported them. Comments included staff are very nice, staff are very good and nothing is ever too much trouble and staff are superb. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager gives clear leadership to the home ensuring that high standards are maintained. Appropriate steps have been taken to ensure the health and safety of people living and working at the home. Quality assurance systems, that include seeking peoples views, are in place to promote ongoing improvements. Evidence: The registered manager of the home is Linda Tungate. She has completed the Registered Managers Award (NVQ Level 4) and has many years experience of working in care. She gives a clear sense of leadership and direction to the home. Everyone asked described the management as very open and approachable. People living and working at the home felt that they could approach the manager at anytime. Care Homes for Older People Page 23 of 27 Evidence: Prior to the inspection the manager completed an Annual Quality Assurance Assessment (AQAA) This was completed to a high standard and gave clear information about the home and their achievements over the past 12 months. The manager is supported by a very competent deputy and a team of senior care staff. There is a clear staffing structure in the home that ensures that there is always a senior member of staff on duty to supervise and support less experienced members of staff. There are various quality assurance systems in place which include regular audits, meetings with people living, working and visiting the home and annual quality assurance questionnaires. Returned questionnaires are analysed and action taken to address any issues raised. The most recent returned questionnaires demonstrated a high level of satisfaction with the service. The home does not act as a power of attorney or financial appointee for anyone but do have a facility to hold small amounts of money for safe keeping. Records are maintained of all monies held and all transactions made. A sample of records was checked and these records correlated with money held at the time of the inspection. The home is maintained to a good standard to ensure that all areas are safe. Records kept show that equipment, such as fire detection and lifting equipment, is regularly tested and serviced by outside contractors. Staff receive regular training in health and safety matters to ensure that their practices are kept up to date and reflect current best practice. Certificates of registration and insurance are displayed in the home. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 14 The manager should ensure that everyone is aware that they are able to have breakfast at anytime. Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 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!