Inspection on 18/04/06 for Field House

This inspection was carried out on 18th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 17/11/05

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 18th April 2006 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.V289305.R01.S.doc Version 5.1 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.V289305.R01.S.doc Version 5.1 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 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.V289305.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th November 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. The care fees range from £427 to £440 per week. Field House DS0000002357.V289305.R01.S.doc Version 5.1 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. The inspection focused on the key inspection standards and checking whether requirements from previous inspections had been met. A tour of the premises was conducted, service users care records and staff records were inspected. The inspector spoke with the new acting manager who has recently taken up her role, five service users and two staff members. What the service does well: What has improved since the last inspection? What they could do better: A significant number of requirements remain outstanding from the previous inspection although it is acknowledged that a new acting manager has recently taken up overseeing the management of the home. Admission procedures are not adequate as service users care needs are not fully and clearly identified and care records do not fully document the care provided. Recruitment procedures are not fully followed and staff must receive induction upon commencing work at the home, they must be adequately supervised and attend all statutory training. Field House DS0000002357.V289305.R01.S.doc Version 5.1 Page 6 The homes health and safety procedures do not fully protect service users who may be prone to wandering. The homes provision of activities is not fully adequate to meet service users recreational needs. Fire safety precautions are not adequately managed as fire drills are not fully undertaken as per fire safety regulations. Some maintenance records could not be located during the visit although it is acknowledged that the acting manager has only recently took up their role. 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.V289305.R01.S.doc Version 5.1 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.V289305.R01.S.doc Version 5.1 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): 2, 3, 6 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Systems for assessing service users care needs are not fully adequate as individuals care needs are not clearly identified although service users are involved in devising of their individual care plans and are satisfied with the admission process. EVIDENCE: A care assessment is undertaken for each service user and some improvements have been made since the previous inspection although information within the records inspected did not clearly identify each service users care needs. Other care records did not fully all identify risks or the correct action to be taken by staff to minimise these. For example, the care records of one service user whom occasionally became agitated and aggressive did not clearly identify this or any action needed to be taken by care staff. Field House DS0000002357.V289305.R01.S.doc Version 5.1 Page 9 The service users spoken with were satisfied with the homes admission arrangements. Comments included: “I can’t remember much about it but they were all very helpful”. “The staff have always been helpful and kind and answered any questions”. “You can ask anything and they put your mind at rest, nothing is too much trouble”. Field House DS0000002357.V289305.R01.S.doc Version 5.1 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 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users feel they are treated respectfully although care records overall do not provide staff with sufficient information to meet service users care needs or fully document the care provided. EVIDENCE: Care records overall more clearly identify individuals care need although they did not adequately instruct staff how individuals assessed care needs were to be met. A risk assessment is undertaken for each service user although these do not identify all risks and the action to be taken to minimise these. Care records are all generally updated daily although they are not all reviewed each month. The care plans viewed identified service users health care needs and how these were being met. For example, one service user was receiving district nurse input and their care records detailed the care being provided by the nurses and any given instruction or advice. Field House DS0000002357.V289305.R01.S.doc Version 5.1 Page 11 The service users spoken with were satisfied with standards of care within the home and that staff treated them respectfully at all times. Comments included: “You can’t complain about the care, the staff are the best really”. “They are all easy to talk with and they respect you”. “Yes, they treat you how you would want them to”. Field House DS0000002357.V289305.R01.S.doc Version 5.1 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users can maintain and develop community links and spend their time as they prefer. The meals and activities provided by the home are enjoyed by service users but activities are not sufficient to meet resident’s recreational needs. EVIDENCE: The service users spoken with confirmed that they were no restrictions as to how they spend their time, that they enjoyed the homes provision of activities although these were not regular or sufficient. The care records inspected identified individual’s interests but not that these were being catered for. Service users’ meetings are not regularly held and residents do not feel that they are fully consulted with about their likes and dislikes or life within the home. Comments included: “It’s a nice place but a bit boring sometimes as there’s not much to do”. “We have some activities but not a lot really when you think of it”. “I enjoy what there is to do but there could be more”. Field House DS0000002357.V289305.R01.S.doc Version 5.1 Page 13 The service users said that they enjoyed the meals provided and a record of all meals provided is maintained along with meal and equipment temperature records although service users are not involved in the planning of meals and there are no formal menus. Field House DS0000002357.V289305.R01.S.doc Version 5.1 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users spoken with feel able to express any positive or negative views about the care provided and complaint guidelines are in place regarding this. Abuse and whistle blowing policies and procedures are in place and staff attend awareness training regarding this subject matter. EVIDENCE: Staff attend abuse awareness training and policies and procedures regarding complaints, whistle blowing and abuse are in place. The staff spoken with were aware of the correct action to be taken in the event of an issue of abuse being identified. Complaint policies and procedures are in place and information regarding these is provided to service users who said that they felt able to voice any opinions regarding the home and that any comments would be acted upon. Comments included: “I don’t know about this but you can talk with the staff”. “If you need to complain then you just have to say, they wont treat you bad for it”. “I can talk with them and say what I need to, they will listen”. Field House DS0000002357.V289305.R01.S.doc Version 5.1 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, 22, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean environment and are able to make their own rooms more homely by bringing with them some of their personal belongings. Some fire safety systems are not adequately maintained overall. EVIDENCE: 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. 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 fitted to regulate water temperatures throughout the home. The service users spoken with were satisfied with the physical Field House DS0000002357.V289305.R01.S.doc Version 5.1 Page 16 environment. Comments included: “They keep it all nice, the staff come round regularly and clean it all”. “It’s kept spick and span, they tidy your room too”. 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. The homes fire safety drills had not been undertaken as per fire safety regulations although the acting manager took action regarding this matter during the visit. Field House DS0000002357.V289305.R01.S.doc Version 5.1 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 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Some recruitment procedures are in place and the staff receive some induction when commencing work at the home although further alterations are needed to safeguard service users. There are sufficient numbers of staff, appropriately deployed to allow them to care for the residents. EVIDENCE: The service users spoken with were satisfied that their care needs were appropriately met and that there were sufficient numbers of staff. The staff records viewed did not evidence that appropriate recruitment checks had been undertaken for all staff prior to them commencing work at the home. For example, Criminal Record Bureau checks and two references. The staff records inspected documented that not all recently recruited staff had received induction and some of 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.V289305.R01.S.doc Version 5.1 Page 18 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, 33, 35, 36, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are satisfied overall with standards of care but their views are not fully sought regarding life within the home. The records available do not fully demonstrate that the home is adequately maintained overall. Staff are not sufficiently supervised or fully trained to enable them to provide adequate care for service users. EVIDENCE: The staff attend some statutory training, which is ongoing although training regarding moving and handling and infection control is required. Field House DS0000002357.V289305.R01.S.doc Version 5.1 Page 19 Some maintenance records could not be located during the visit. These included: electrical safety certificates, hoist and stair lift service records and legionella test. The home refrain from involvement in service users finances where possible although the records viewed were not kept separately and records did not document where service users had signed for any transaction. Also, each service users monies must be kept separate. An acting manager has recently taken up the overall management of the home although they have not yet received a full induction to oversee this role although it is understood that this is currently being arranged. Field House DS0000002357.V289305.R01.S.doc Version 5.1 Page 20 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 2 2 X X N/a 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 X X 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 2 X 2 X 2 X X 2 Field House DS0000002357.V289305.R01.S.doc Version 5.1 Page 21 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 Standard OP2 Regulation 5 Requirement Timescale for action 31/07/06 2 OP3 14(1)c 13(4)c 15(2)a 3 OP7 13(4)c 14(2) 15(1)2 4 OP12 15 and 16 (2) (n) Each service user must have a written contract or terms and conditions of residence (previous timescale 30/12/05 not met). A full needs assessment must be 31/07/06 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 (previous timescale 30/12/05 not met). A comprehensive care plan must 31/07/06 be completed for each service user, which must clearly identify each service users needs and demonstrate how these are met. Each plan must be reviewed every month and updated on a regular basis (previous timescales of 30/03/05 and 30/12/05 not met). The registered person shall 31/07/06 prepare a plan as to how the service users needs in respect of health and welfare are to be met. Therefore, it is required that care records demonstrate DS0000002357.V289305.R01.S.doc Version 5.1 Field House Page 22 5 6 OP19 OP22 23 (4) 23 (C) 7 OP29 19 8 OP30 12 (1) (a) 9 OP31 8, 9, 10 10 OP33 24 11 12 13 OP35 OP38 OP38 Schedule 4 (9) 18 (1) (c) (i) 12(1) 13(3)4 13 OP38 16(j)k 23(4)e fully how the daily living and recreational needs of service users are met. Fire safety drills must be undertaken as per the Fire Safety Officers instructions. Confirmation is required of the up to date servicing of the homes hoists and lifting equipment. 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 (previous timescale of 18/11/05 not met). 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 (previous timescale of 30/12/05 not met). Confirmation must be received regarding an application being made for home to have a registered manager. The registered person shall establish and make arrangements for reviewing and improving the quality of care provided through consulting with service users. Service users monies must be kept separate and a record maintained of any transactions. Staff must attend statutory training appropriate to the work they perform. All of the homes equipment must be adequately serviced and records of this maintained. This must include a 5-year electrical test and test regarding legionellosis. All of the homes equipment must be adequately serviced and DS0000002357.V289305.R01.S.doc 19/04/06 31/07/06 31/05/06 31/07/06 31/07/06 31/07/06 31/07/06 31/07/06 31/07/06 31/07/06 Page 23 Field House Version 5.1 records of this maintained. This must include a 5-year electrical test and test regarding legionellosis. 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.V289305.R01.S.doc Version 5.1 Page 24 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.V289305.R01.S.doc Version 5.1 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. 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!