Inspection on 17/11/05 for Field House

This inspection was carried out on 17th November 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 16/04/08

Field House 18/04/07

Field House 18/04/06

Field House 20/07/05

Field House 24/11/04

Field House 28/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Field House Fleet Hargate Nr Holbeach Spalding Lincs PE12 8LL Lead Inspector Mr David Bacon Unannounced Inspection 17th November 2005 08:30 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 DS0000002357.V260784.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 DS0000002357.V260784.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Field House Address Fleet Hargate Nr Holbeach Spalding Lincs PE12 8LL 01406 423257 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) Farrington Care Homes Limited Mrs Vanessa Collins Care Home 28 Category(ies) of Dementia (2), Old age, not falling within any registration, with number other category (26) of places Field House DS0000002357.V260784.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th July 2005 Brief Description of the Service: Field House is a former farmhouse built in 1935. The home has been adapted and extended to provide care and accommodation for 28 service users over 65 years, 2 of these having dementia. The home is situated in the village of Fleet Hargate, approximately 4 miles from Holbeach and its shops and facilities, and is set in approximately 2 acres of landscaped grounds and gardens. It is approached from a private driveway with parking to the front of the property. There are 20 single, and 4 shared bedrooms, which are located on the ground, first and second floors and accessed by stair lifts. The home has a lounge, separate sitting and dining room and a large heated sun lounge. Field House DS0000002357.V260784.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5 hours; it was unannounced and was carried out by one inspector. A tour of the premises was conducted, service users care records and staff records were inspected. The inspector spoke with the manager of the home, four service users and one service users representative along with a Community Nurse. What the service does well: What has improved since the last inspection? What they could do better: An assessment of each service users care needs is undertaken although this information is limited and not fully transferred into a comprehensive care plan. Care records do not clearly identify individual’s care needs or instruct staff about how to meet these or document the care being provided. Many of the homes recording systems are in need of being revised and updated. For example, staff records did not clearly detail that all checks had been undertaken prior to an individual commencing work within the home or that staff had received induction or all statutory training. Some improvements have been made regarding documenting the training undertaken by staff although it is recommended that this system is further improved. Field House DS0000002357.V260784.R01.S.doc Version 5.0 Page 6 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 DS0000002357.V260784.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 DS0000002357.V260784.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 Procedures are in place for the guidance of care staff in undertaking admissions although improvements are required with the assessing of service users care needs. Service users are satisfied with the homes admission process. EVIDENCE: The service users and representative spoken with were satisfied with the homes admission arrangements and confirmed that they had visited the home without having a prior appointment and that they were made welcome. Comments included: “I’m very happy to tell people that they were very welcoming and very helpful, we asked a lot of questions and got honest open answers, it was all done very genuinely”. “I can’t remember much about it but they would have been good else I wouldn’t have stayed”. “You see how good the staff are now, well it was just the same when we looked around the home”. A statement of purpose and service users guide have been produced and these are displayed in the home and made available to service users although service Field House DS0000002357.V260784.R01.S.doc Version 5.0 Page 9 uses are not provided with a copy of the service users guide as part of the admission process. Service users are invited to visit the home prior to admission as often as they prefer and without making an appointment to gain an understanding of life within the home. The service users records viewed did not clearly evidence that the care needs of each service user had been assessed prior to admission and the information within these records was basic and not fully sufficient to inform a detailed plan of care. A risk assessment had been completed for each service user and this information briefly identified the risks to each individual and how these were to be minimised. Service users are provided with written terms and conditions of residence contracts and signed copies are mostly maintained on the premises. Care records did not fully document where service users or their representatives had been consulted with regarding their plan. There was no written confirmation given to service users stating that the home was able to meet their care needs although the manager was not aware of this requirement. The home does not provide intermediate care services. Field House DS0000002357.V260784.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, 10, 11 Service users are treated with dignity and respect although care records do not provide staff with sufficient information overall to meet service users care needs or to document the care provided. EVIDENCE: The service users and representatives spoken with confirmed that staff respected their privacy and dignity. Comments included: “You can see for yourself, the staff are wonderful, they treat everyone absolutely properly”. “Yes, they treat you with respect, of course”. “Well I’ve been here for a good while and I wouldn’t have stayed if they didn’t treat me well, but they are lovely”. During the visit the staff were observed carrying out care tasks and they were respectful to the service users. A care plan is completed for each service user and information within these is basic and adjustments are required to more fully document each individual’s care needs and how these are met. The completed risk assessments identified any potential risks and the action required to be taken by staff to minimise these. Field House DS0000002357.V260784.R01.S.doc Version 5.0 Page 11 Care records are generally updated daily although they are not fully reviewed and updated as service users care needs change and they did not fully document where service users or their representatives had been consulted with regarding their care plan. The care plans viewed evidenced where residents were seen by health care professionals in relation to their health care needs. The community nurse spoken with expressed a high level of satisfaction regarding the standards of care provided and said that the homes staff followed any given instruction or advice. Field House DS0000002357.V260784.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): 13, 14, Service users are supported to express their views regarding life within the home, the care they receive and they can maintain and develop any community links as they prefer. The relatives and friends of service users are made welcome by staff. EVIDENCE: The service users and representative spoken with confirmed that they were no restrictions as to how residents spend their time and that staff respected their individual wishes and preferences. Comments included: “I’m not aware of any rules or things like that, you can do what you like as far as I know”. “Well you would let them know if you were going out but otherwise you just do as you like”. “They have made us all welcome from the start, but I already knew that before I came here”. “It’s more like a big family, really, they look after everyone very well, you have piece of mind and you can have a laugh with them”. Service users confirmed that they are consulted with about their likes and dislikes and they have opportunities to express their views at residents meetings and on a daily basis. Field House DS0000002357.V260784.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The service users spoken with feel able to express their views regarding the care they receive and complaint guidelines are in place regarding this. Staff are made aware of the homes whistle blowing and abuse policies and procedures. EVIDENCE: Complaint policies and procedures are in place and information regarding these is provided to service users and displayed in the home. Staff attend abuse awareness training and policies and procedures regarding complaints, whistle blowing and abuse are in place. The service users and representative spoken with said that they felt able to voice any opinions regarding the home and that any comments would be acted upon. Comments included: “I now know the staff well and if I needed to then I would speak with them and they would resolve anything, I’m sure”. “I know I find them approachable and I would complain if I needed to”. Field House DS0000002357.V260784.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 26 The home is well maintained and provides a comfortable and homely environment for residents. EVIDENCE: The service users and representatives spoken with were satisfied with the physical environment. Comments included: “It’s nice and homely clean, the staff do a tremendous job”. “It’s always clean here, you wont find anything different”. Service users can gain access to all areas of the home. There are four bathroom/toilets and four separate toilets, which are situated on each floor and nearby to lounge areas. Some action has been taken to minimise risks to service users who may be prone to wandering although further action would be required if the home aimed to care for service users having these care needs. Service users personal accommodation was viewed, which was cleanly decorated and demonstrated where service users had personalised their room. Furniture is of a domestic style and is in good order. Field House DS0000002357.V260784.R01.S.doc Version 5.0 Page 15 Environmental risk assessments are in place and all above ground floor windows have window restrictors. Door locks are fitted to service users bedrooms. Safety valves are now fitted to regulate water temperatures throughout the home. Field House DS0000002357.V260784.R01.S.doc Version 5.0 Page 16 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 Recruitment procedures are in place and the staff receive induction when commencing work at the home although minor alterations are needed regarding this. There are sufficient numbers of staff, appropriately deployed to allow them to care for the residents. EVIDENCE: The service users and representatives spoken with confirmed that the homes care staff met their individual care needs. Comments included: “It’s a very caring place and I am very happy here”. “I have no complaints about the staff they work very hard and are a great help”. “They have looked after my loved one from the word go and we are all very satisfied”. The staff records viewed did not evidence that appropriate recruitment checks had been undertaken for all staff and an immediate requirement was placed upon the home regarding this. The staff records inspected documented that newly appointed staff members had received induction although these were not fully completed or signed. At least 50 of the homes staff have attained NVQ training to level 2 and others have been identified to attend this training. Field House DS0000002357.V260784.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, Service users are supported overall to express their views regarding life within the home and the care provided and they are satisfied with the homes management. The premises are well maintained overall. EVIDENCE: A qualified and experienced manager is in charge of the home and the service users and representatives spoken with were satisfied with the overall management approach. Residents’ meetings are held and records of these are maintained. Quality satisfaction questionnaires have been devised although these have not recently been sent to service users and their representatives. Field House DS0000002357.V260784.R01.S.doc Version 5.0 Page 18 The home refrains from any involvement in service users finances and policies and procedures are in place giving guidance to staff and service users are notified of this. Field House DS0000002357.V260784.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 2 2 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 X X X Field House DS0000002357.V260784.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? 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 2 3 Standard OP1 OP2 OP3 Regulation 5 (2) 5 14(1)c 13(4)c Requirement The service users guide must be provided to each service user. Each service user must have a written contract or terms and conditions of residence. A full needs assessment must be completed for all service users who are admitted. Care assessments must detail all items included within standard 3. A comprehensive risk assessment must be completed for each service user. A full needs assessment must be completed for all service users who are admitted. Care assessments must detail all items included within standard 3. A comprehensive risk assessment must be completed for each service user. The registered person must confirm in writing to the service user that the home can meet the care needs. A comprehensive care plan must be completed for each service user, which must clearly identify each service users needs and DS0000002357.V260784.R01.S.doc Timescale for action 30/12/05 30/12/05 30/12/05 3 OP3 12(1)a 15(1)(2) 30/12/05 4 OP4 14 (1)(d) 30/12/05 5 OP7 13(4)c 14(2) 15(1)(2) 30/12/05 Field House Version 5.0 Page 21 6 7 OP11 OP29 4 19 8 OP30 12 (1) (a) 9 OP33 12 (2) (3) demonstrate how these are met. The plan for every service user must be reviewed each month and updated on a regular basis. Service users and their representatives (where appropriate) must be involved in the devising of care plans where possible (previous timescale of 30/03/05 not met). Service users wishes regarding death must be recorded. Staff recruitment procedures must be followed to ensure that a POVA and CRB check is undertaken for all staff prior to them commencing work within the home. Staff must receive an induction and ongoing training to give them the skills to promote and make proper provision for the health and welfare of service users. The registered person shall enable service users to make decisions regarding the care they receive. Therefore, it is required that service users meetings are offered and quality satisfaction questionnaires are provided. 30/12/05 18/11/05 30/12/05 30/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Field House DS0000002357.V260784.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 DS0000002357.V260784.R01.S.doc Version 5.0 Page 23 - 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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