Inspection on 18/04/07 for Field House

This inspection was carried out on 18th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Field House 16/04/08

Field House 18/04/06

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 Key Unannounced Inspection 18th April 2007 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.V335710.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Field House DS0000002357.V335710.R01.S.doc Version 5.2 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 Karina Irene Naomi Elves 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.V335710.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care to service users whose primary needs fall within the following category: Old age, not falling into any other category (26). Dementia, under the age of 65 years (2). The maximum number of service users to be accommodated is 28. 2. Date of last inspection 18th April 2006 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.V335710.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place over five hours; it was unannounced and was carried out by one inspector. Outcomes from the previous inspection are also identified within this report. The care received by three service users was looked at in detail. This process is called “case tracking” and individual service users care records and general home records were looked at as part of this along with discussions with service users about their experience of life within the home. The inspector spoke with five service users, the registered manager and three staff members. Feedback was also received prior to the visit from seven satisfaction surveys completed by or on behalf of service users. A tour of the premises was conducted, service users care records and staff records were inspected along with policies/procedures and administrative systems. What the service does well: What has improved since the last inspection? A new registered manager is now in post and general improvements are being made with overall administrative systems. For example, service users care records and staff records. The homes electrical system is now being upgraded and a new hoist has been purchased. The homes other hoist has been serviced. The homes provision of activities is being improved as staff have been designated to oversee this role with service users. Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Field House DS0000002357.V335710.R01.S.doc Version 5.2 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.V335710.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are satisfactory procedures in place overall for the introduction of residents to the home. EVIDENCE: The service users care records viewed identified that an assessment of each service users care needs had taken place, which included an assessment of risk and how these were to be minimised. Records included a brief history of the service user and individual likes and dislikes. A care plan is devised from the assessment information and the plans seen were updated regularly although service users or their representatives (where appropriate) had not all been consulted with or involved in the devising of their individual plan. During discussions two service users said that they were satisfied with the admission process, which involved a visit to the home, and receiving written information about the service. Comments included: “I really can’t remember Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 9 much about coming here but I’ve not wanted to leave”. “It’s nice and relaxed, if you need to ask something you just ask or there is information”. “They were all very kind and couldn’t do enough for you to help”. Admission policies and procedures are in place providing guidance to staff”. The home does not provide intermediate care services. Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users care records are well maintained and the service users spoken with are treated with respect and are satisfied with the standards of care provided. Procedures for the administration of medication are appropriate. EVIDENCE: The care records viewed identified service users care needs and instructed staff as to how these were to be met. Any health care needs were separately documented and detailed how these were being met and included any given instruction or guidance from supporting health agencies. Care records were updated daily and upon any care need changes and they were reviewed each month. The service users spoken with confirmed that their care needs were met and that staff continuously respected their privacy and dignity. Comments received in satisfaction surveys completed by service users indicated that service Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 11 users/representatives were satisfied overall that they generally received the care and support they needed. Comments included: “They know how to look after you, all of them”. “I wouldn’t stand for anything but they are all lovely here”. “The staff are just what you need”. Discussions with staff members confirmed that staff were aware of service users care needs and how these were to be met. The homes medication system was well maintained and documented medicines as receipted into the building, where administered and as disposed. Medicines are securely stored and staff whom administer medication receive awareness training regarding this. Refresher training regarding this subject matter is booked. Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to choose how they spend their time and to maintain and develop community links as they prefer. The meals provided are enjoyed by service users although their views regarding meals are not fully sought. EVIDENCE: The service users spoken with were satisfied with the homes provision of activities of which some improvements have been made since the previous inspection visit. For example, three staff members are now responsible overall for organising activities, which are more regularly held. Service users comments regarding activities included: “Oh, there’s things going on regularly, quite enough really”. “I enjoy the activities, bingo, cards, games, entertainers its good to join in”. “There are a selection of things, you don’t have to join in but it’s good fun”. Comments received in satisfaction surveys completed by service users indicated that some service users/representatives views regarding activities differed and included: “Could do more, I believe staff should be designated to social activities every afternoon”. “The staff should do more than sit chatting with residents”. The manager said that further action would be taken to improve satisfaction levels further. Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 13 Service users said that they were able spend their time as they liked, that they were encouraged to maintain their independence and that their visitors were made welcome. The care staff spoken with were aware of policies and procedures promoting service users rights and choices. A four-week menu is in place and a record of all meals provided is maintained along with meal and equipment temperature records. A new cook has recently commenced working at the home who is currently making some adjustments to the provision of meals. The service users spoke positively about this although they said that their views regarding meals were not regularly sought. It is recommended that the cook regularly communicates with service users to ascertain individual’s views when planning the menu. Service users comments included: “The new cook is settling in well although we need to be listened to a bit more about what we like”. Comments received in satisfaction surveys completed by service users indicated that some service users views regarding the standards of meals differed and included: “I like the food, generally it’s very good here”. “Needs an experienced cook as food not always at its best, needs to be presented better”. “Some improvement with dinners since new cook employed, always plenty to eat but not always cooked well for elderly peoples, e.g. tough meat”. The manager agreed to address these to improve satisfaction levels. Field House DS0000002357.V335710.R01.S.doc Version 5.2 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. 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 comment or complain about the care they receive and staff are made aware of the systems in place to protect service users from abuse. EVIDENCE: Records show that there have been no complaints or safeguarding adult’s referrals since the last inspection visit. The pre inspection information received identified policies and procedures to safeguard adults, which included: comments and complaints, whistle blowing and risk assessing. Information regarding these is provided to service users. The service users spoken with said that they felt able to express their views regarding the care provided and that any comments would be appropriately acted upon. Information regarding complaints is displayed in the home. Comments included: “You can talk with them all, even the manager, it’s what makes the place”. “They are easy to talk with, about anything, you just have to say”. “I’ve no complaints but I would say if I needed to”. Comments received in satisfaction surveys completed by service users indicated that some service users were not fully aware of how to complain, which the manager said would be addressed. Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 15 The staff members spoken with were aware of the correct action to be taken in the event of an issue of abuse being suspected and confirmed that they had attended abuse awareness training of which additional refresher training has been booked. Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of cleanliness and hygiene is satisfactory and the environment is considered comfortable and homely by service users although some redecoration is now due. EVIDENCE: The home was clean and tidy throughout and the service users personal accommodation viewed had been personalised although the manager acknowledged that some general redecoration and refurbishment was due. For example, some service users personal accommodation was in need of being re decorated and the upstairs corridor carpet was worn. The service users spoken with were satisfied with the cleanliness of the home although comments received in completed satisfaction questionnaires differed. Comments included: “There has been a deterioration since my loved ones arrival”. “The home is always clean and fresh”. “I like the home, the girls Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 17 keep it all clean and neat”. “My loved one was previously offered a single room but it has not happened”. Cleaning materials were safely stored and the staff spoken with were satisfied with the awareness training and equipment provided to enable them to undertake their roles, of which policies and procedures are in place. There were no obstructions in corridors or other communal areas that could limit mobility. Fire safety systems were being tested as per fire safety regulations. For example, records of emergency lighting and fire system tests. The homes electrical system was being upgraded during the visit of which a requirement was made during the previous inspection visits. Hoisting equipment had been serviced, which was also previously identified and a new hoist had recently been purchased. Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is being staffed to meet the current needs of residents and appropriate recruitment procedures are in place although staff have not received all necessary training. EVIDENCE: During discussions service users said they were satisfied that their care needs were met by the number of staff within the home. Comments received in satisfaction surveys differed and included: “Staff not always available when you need it”. “Staff always available”. “Staff mostly available”. The staff records viewed evidenced that appropriate recruitment checks had been undertaken prior to staff commencing work at the home. The checks included criminal record bureau checks, obtaining professional references and staff completing application forms. Records detailed where all newly appointed staff had received a formal induction, which was further confirmed by the staff members spoken with who were satisfied that they received adequate training to undertake their roles. A rolling programme of nationally recognised training is in place although the staff training records viewed did not fully evidence that sufficient training regarding dementia awareness had been undertaken although the manager said that this was being arranged. Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 19 Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well maintained and managed and systems are in place to ensure that care is provided in a safe and appropriate manner. EVIDENCE: The service users and staff members spoken with were satisfied with the manager’s approach to the role, which was further confirmed in the completed satisfaction surveys seen. Comments included: “Managers very good, very caring”. “The new manager has settled well, yes, I’ve no complaints”. “The home is friendly and it’s all the staff that make it”. “You can approach the manager or any staff”. Quality satisfaction questionnaires are displayed in the home although not fully promoted and service users meetings are not regularly held. It is Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 21 recommended that satisfaction questionnaires are more regularly sent to service users and that meetings are regularly held to further afford service users and their representatives opportunities to express their views regarding life within the home. The staff records viewed evidenced that staff are now receiving some formal supervision and appraisal. Policies and procedures are in place to protect service users where the home has any involvement in their finances. Monies are kept separate and receipts and records of transactions and totals are maintained although the records of one service users finances were not fully accurate, which the manager started to address during the visit. Service users sign for any transactions, where this is possible. A risk assessment of the premises had been undertaken and the staff members spoken with were satisfied with the homes management of health and safety. Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 3 Field House DS0000002357.V335710.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP33 Regulation 24 Requirement Make arrangements for reviewing and improving the quality of care provided through consulting with service users (previous timescale of 31/07/06 not fully met). Maintain accurate records of service users money to protect service users financial position. Provide dementia awareness training for staff to enable service users to be supported appropriately. Timescale for action 31/07/07 2. 3. OP35 OP30 Schedule 4 (9) 18 (1) 31/07/07 31/07/07 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 OP19 OP15 Good Practice Recommendations Revise the decoration and refurbishment programme to provide a comfortable environment for service users. Seek service users views regarding meals regularly. Field House DS0000002357.V335710.R01.S.doc Version 5.2 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: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Field House DS0000002357.V335710.R01.S.doc Version 5.2 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!