Inspection on 21/10/08 for Field House

This inspection was carried out on 21st October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Field House 12/11/07

Field House 04/12/06

Field House 20/09/05

Field House 27/04/05

Field House 02/11/04

Field House 09/06/04

Field House 19/01/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Field House Eyebury Road Eye, Peterborough PE6 7TD     The quality rating for this care home is:   two star good 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: Elaine Boismier     Date: 2 1 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 28 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 28 Information about the care home Name of care home: Address: Field House Eyebury Road Eye, Peterborough PE6 7TD 01733222417 01733223578 admin@fieldhousecare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Nazma Virji,Mr Nazir Virji care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Field House is a registered care home to provide care and support for up to 33 places for people, mainly over 65 years of age, some of whom have dementia. The home is a large former domestic property, which has been extended and adapted for its present use. It is situated in the village of Eye close to the city of Peterborough. The village is near to the city of Peterborough. The home is set in large grounds and is adjacent to the local school. The current fees range from 387.03 pounds to 480.42 pounds per week. Additional costs include those for toiletries, hairdressing, private chiropody and newspapers. Further information about fees can be obtained from Field House. Copies of inspection reports are available at the home, on request or via our website www.csci.org.uk 0 0 Over 65 26 33 Care Homes for Older People Page 4 of 28 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: two star good 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 last inspection took place on the 12th November 2007. We carried out an Annual Service Review (ASR) on the 10th October 2008 and from the information we had received about and from the home we decided, that we would bring the next inspection forward. We,The Commission for Social Care Inspection, carried out this key unannounced Inspection, by three Inspectors, over two days. The first day, two Inspectors visited the home and on the following day a Pharmacist Inspector visited. Some of the people living at Field House are not able to say what it is like living there. Care Homes for Older People Page 5 of 28 So, on the first day, an Inspector spent some time observing and recording the experience of some of the people using the service. This activity is called short observational framework for inspection (SOFI). We also looked around the premises, spoke with some of the staff, including the Manager and the other joint registered owner, visiting health care professionals and some of the residents. We also looked at some of the records. Before the ASR we received an Annual Quality Assurance Assessment (AQAA)and 5 surveys from residents, 4 surveys from relatives and 4 surveys from the staff. After the first day of our inspection we spoke with a relative, at their request, on the telephone. For the purpose of this report people, who live at Field House, are referred to as people, person or resident/s. What the care home does well: What has improved since the last inspection? What they could do better: Care plans need to be developed to become person centred and to be reviewed each month or sooner. A care plan must also be developed for when a persons needs have changed. We expect the home to manage this issue, rather than we make a requirement on this occasion. The storage of medication must be made safer. A requirement has been made about this. Care Homes for Older People Page 7 of 28 Although activities have improved these could be better.We expect the home to manage this issue, rather than we make a requirement on this occasion. People should be offered a choice of drink and these to be offered in a more flexible way, any time of the day or night. The standard of decor and lighting, in the two areas that we have identified, need attention. All areas of the home must be safe from the risk of the spread of infection. We expect the home to manage this issue, rather than we make a requirement on this occasion. The home should ensure that all staff can communicate, clearly with the residents and visitors to the home. The staff roster and fire drill records must have the full names of any person entered on these two legal documents. We expect the home to manage this issue, rather than we make any requirements on this occasion. All the required,full and satisfactory information about staff, including a POVA 1st check, must be obtained before the person is allowed to work at the home. We expect the home to manage this issue, rather than we make a requirement on this occasion. If you want to know what action the person responsible for this care home is taking 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 8 of 28 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 9 of 28 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. There is a good standard of information, about the home,to assist people in their decision where to live. Systems are in place to ensure the home can meet the assessed needs of any person before they move in. Evidence: Both the Statement of Purpose and Service Users Guide have been reviewed since our last inspection and the information in both of these documents was of a satisfactory standard. For example, the Statement of Purpose states that as the home provides care for different ethnicities, the home does not offer pork on the menu and alcohol is not provided. All of the 5 residents surveys said that the person had received enough information about the home, to help them in their decision where to live. Care Homes for Older People Page 10 of 28 Care Homes for Older People Page 11 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive safe and proper care from kind and caring staff although there are some risks to their health and welfare. Evidence: Currently the home is reviewing the standard of care plans and the format used. The care plans,that we examined,indicated that there needs to be more information about the peoples needs and how staff are to meet such identified needs. For example, a person was assessed as having problems with their sight but there was no information as to how such a sensory impairment might affect this person. For people diagnosed with dementia it was not clear as to how this condition affected the person in their abilities (including their strengths and their difficulties) in living from day to day. For one person, who was currently on antibiotic medication, there was no short term care plan as to how staff were to assess and monitor this persons change of needs, although senior care staff were able to tell us how this was done. Whilst we acknowledge that the home is carrying out a review of the care plan Care Homes for Older People Page 12 of 28 Evidence: documentation, the monthly review of current care plans must not be affected as we saw that one persons care plan had been last reviewed in April 2008 and another persons care plan had last been reviewed in July 2008. We expect the home to manage all of these identified issues, rather than we make a requirement on this occasion. All of the 4 surveys from relatives and all of the 5 residents surveys told us that the home always/usually met the care and medical needs of the residents. One of these surveys said that the staff of the home Go that extra mile. Another of these surveys said My (relative) is happy and content and well cared for at Field House. We were told, during our telephone conversation with a relative, that they were Extremely happy with the care my (relative) gets. In one of the homes (relatives) surveys we read that the home is To carry on doing the excellent job they do and make family and friends welcome. We spoke with two visiting health care professionals who told us that they visited the home on a regular basis; the district nursing service visits the home twice a week and the chiropodist visits at least every 12 weeks. We saw that peoples personal care was of a good standard, with clean hair, clean clothes and clean finger nails. Peoples care records, and discussion with the staff, indicated that the home promptly refers any of the residents to the general practitioner, should a medical need arise. In one of the peoples care records we saw that their weight was recorded each month and, using the Malnutrition Universal Screening Tool (MUST), the home had correctly identified the level of risk of malnourishment for this person (which was low). A pharmacist inspector looked at the practices and procedures for the safe handling and use of medicines. Facilities provided for medicines storage are secure but the temperature of the area on the ground floor is of some concern since it has been recorded above the maximum recommended temperature of 25C several times over the previous month. The record of the temperature of the refrigerators used to store medicines has also been recorded outside of the recommended range without any action taken by staff to investigate the performance of the fridges or the quality of the medicines stored there.The failure to store medicines at the right temperature could result in people receive medication that is ineffective. The current cupboard used to store controlled drugs does not comply with the requirements of the relevant legislation.There have been concerns raised on previous inspections about the storage of medicines and so a requirement has been made about this.Records are made when medicines are received into the home, when they are given to residents and when they Care Homes for Older People Page 13 of 28 Evidence: are disposed of.These were of a good standard and provide an audit trail of medicines used and good evidence that residents receive the medicines prescribed for them. Only those staff who have been trained are permitted to give medication to residents and the standard of training is high although there is no record that staff have been formerly assessed as competent to undertake this task.We expect this to be managed by the home rather than make a requirement on this occasion. In our last inspection report we said that we expected the home to remind staff about knocking on doors before entering. We saw that the staff knocked on the door, before they went into any persons room. During our SOFI observation we saw the staff respond to, and interact with, the residents in a warm, genuine and caring manner, examples of which the Inspector, who was carrying out this SOFI, said,The best that I have seen, yet. Care Homes for Older People Page 14 of 28 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 have the opportunities to live a good quality of life that continues to improve. Evidence: There was a range of views, from the residents surveys, about the activities provided, from them being always suitable to being sometimes suitable for the person to take part in.The local council told us that, since our last inspection, there was a lack of therapeutic activities focused on the residents dementia. There was also a lack of individual residents activities related to their personalized care planning. (The AQAA made no actual reference, however, how improvements in this area, were going to be achieved). We saw in one persons care records, and during discussion with the Manager and the staff, that this is an area that is starting to improve. We were told that the residents key workers are starting to get more information about the person and their likes and dislikes with regards to activities. For one person the key worker had taken action in response to what the resident said to them: the person said that they liked cleaning; the key worker supported the resident in cleaning the dining room tables with a duster. On another occasion the person said that they liked to paint; the key worker supported the person who proceeded to draw and paint. Care Homes for Older People Page 15 of 28 Evidence: During our SOFI we noted that one person had a magazine and a jigsaw put in front of them although, for most of the other people there were no meaningful activities provided. Due to the lack of information in the peoples care plans it was not clear if some of these other people preferred not to have such activities during this time of the day. We noted that a television was on and some of the people, who had a care plan to say that they liked to watch television, were not able to see what was being shown, due to the position of the television and where these people were sitting. It was noted also that a number of walking frames were assembled by the side of the television and thereby blocking any chance of seeing the television even further. Records indicated that some of the people have attended trips out of the home, to include Ferry Meadows and a garden centre. The home held a garden party, in July 2008. People told us that they had a choice of when to get up and when to go to bed and we saw such choices recorded in their care plans. All of the relatives surveys said that the home supported the person to live the life they chose. One of the surveys went on to say, (My relative) retains her dignity & right to choose what she eats and drinks, what clothes she wears etc. Surveys carried out by the home and responses to our surveys, indicated that guests are welcome to the home at any time. We noted comments in one of the homes surveys, completed by a relative, that the home is Very welcoming and relaxed. In another of these surveys we read that the home is To carry on doing the excellent job they do and make family and friends welcome. In July 2008 we received information, from a community dietician, who considered that there were no significant concerns about the nutritional content of the food provided and The weight trend for most residents is also up rather than down - all of which would suggest that the nutritional requirements of most residents are being met. The dietician told us that, in June 2008, they had met with the home Manager and advice was given with regards to the current menus. During the mid morning we saw people were offered a choice of fruit. Following our inspection, in November 2007, we expected the home to review the standard of food provided. We saw the homes records of what people said about the food and during this inspection, of October 2008, we saw that the standard of food had improved. It was also noted that choices were offered, to that of the main course of chicken and vegetables, and portions were varied according to the persons preference. People we spoke with said that they generally liked their food and all of the 5 residents surveys said that the person always/usually liked their meals. Some of the people we spoke with said that they would like to be offered more hot drinks as it was considered that such choices were not available, rather it was timetabled. We noted Care Homes for Older People Page 16 of 28 Evidence: that people were offered cold and hot drinks although choices were not offered. One person was asked if they would like a drink of juice although there was no offer of different flavours for people to choose from.We also noted that when a resident asked for a cup of tea, instead of juice, a member of the staff suggested that the person had the juice instead of the cup of tea, as this would be offered to them, later on in the day. We expect the home to consider more flexibility in offering choices of hot and cold drinks during any time of the day. Care Homes for Older People Page 17 of 28 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 are listened to and there are systems in place to safeguard them from the abuse. Evidence: During the November 2007 inspection, there was no record or log of complaints and we expected the home to take action about this. During this inspection we saw that the home has introduced such a log, and this also included compliments paid to the home. Although the AQAA said that the home had received 2 complaints, within the last 12 months, the Manager explained that this was inaccurate and that no complaints had been made against the home. The AQAA should have said that, rather than the two complaints, it should have said two safeguarding enquiriesd had been made. We have recieved no complaints about the home. People we spoke with said that they knew who to speak to if they wanted to make a complaint and all of the relatives surveys and 4 of the 5 residents surveys said that the person knew how to make a complaint. All of the 4 staff surveys said that the person knew what to do if a concern, about the home,was made to them.We saw a copy of a letter, sent to relatives, inviting them to visit the home and speak, with the Manager, about any concerns or complaints they might have, before going onto the homes Bonfire Night party.The letter stated that should the date and time not be suitable the relative might wish to make arrangements, to see the Manager, at another Care Homes for Older People Page 18 of 28 Evidence: time. We received concerns about the home, in January 2008, that resulted in a safeguarding meeting, held on the 14th March 2008.The concerns were about the standards of care provided to one of the residents.The outcome of this safeguarding investigation was that some of the concerns were upheld although there was no evidence of willful neglect. In May 2008 a safeguarding meeting was held in response to allegations, made in April 2008, regarding the standards of care for another resident,including physical and psychological care and management of the persons risks to another resident. It was felt, by the members of the safeguarding team, that due to conflicting information, from different people, during the subsequent investigation by the home, the outcome of the allegations was recorded as inconclusive. The staff we spoke with told us what they would do if they witnessed an event of abuse against any of the residents. Some of the staff have attended safeguarding awareness training and the staff training records indicated safeguarding awareness is part of the induction training process. Care Homes for Older People Page 19 of 28 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. People live in a clean and comfortable home although there remains a small risk to their health. Evidence: In front of the home we saw colourful flower beds and to the rear we noted that action had been taken, in response to our findings during the inspection of November 2007, to fence off outdoor sheds and working areas. The majority of the indoor areas were well-maintained with the exception of the decor of one of the shared rooms (the wallpaper border was torn) and lights of one dark corridor not working. We expect the home to manage these issues rather than we make any requirements. We noted, at our last inspection, that hand drying facilities posed risks to the spread of infection and we expected the home to take action about this issue. All of the toilets and bathrooms, with the exception of one of the bathrooms, were provided with disposable hand towels, although in two of these areas we noted that non-disposable hand towels were available. In the majority of the toilets and bathrooms, with the exception of one, there were soap dispensers for hand washing. In the remaining area there were bars of soap and no soap dispenser. In the corner of this room we saw a floor mop that was grey looking. We expect action to be taken by the home to reduce the risk of the spread of infection, rather than we make a requirement on this Care Homes for Older People Page 20 of 28 Evidence: occasion. Some of the staff told us, and examination of their training records confirmed that, they have attended a demonstration in how to wash their hands to reduce the spread of infection. All of the 5 residents surveys said the home was always/usually clean and fresh and we found the home was clean and there were no offensive smells. Care Homes for Older People Page 21 of 28 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 can be confident that they are cared for by well trained staff although the systems of recruitment could be better, to make sure people are cared for safely. Evidence: In our last inspection we found evidence that some of the staff, who did not have English as their first language, difficult to understand what they were telling us. The information provided by the local authority, in June 2008, told us that this remained an issue at the home. During this October 2008 inspection we saw that the residents were able to understand the majority of the staff. A member of staff also assisted our inspection when we were talking to a resident, whos first spoken language was not English. However, we found that there remains an issue where the staff do not have English as their first language. The AQAA told us that within the next 12 months there is an intended action to improve this area and we were told by the Manager and joint owner, they have found difficulties in accessing resources/agencies to help with this issue. We again suggested, that during the interview process, how the candidate communicates should be considered as part of the recruitment criteria. According to the Manager there are currently no staff vacancies.All of the 5 residents surveys said that the staff were always or usually available when the person needed them and all of the 4 staff surveys said that there was a sufficient number of staff to Care Homes for Older People Page 22 of 28 Evidence: meet the individual needs of the residents. We saw the staff respond to peoples requests and needs in a prompt and timely manner, such as getting a person a yogurt from the kitchen. The staff roster was seen and this had the first names of the staff entered on this. For one person their preferred name was entered that had little bearing on the persons real name. We expect the home to take action to improve this standard of record keeping, rather than we make a requirement on this occasion. According to the AQAA the home has 14 of the 17 care staff with a National Vocational Qualification (NVQ) level 2 or equivalent, in care. Following our inspection, in November 2007, we found that there were no copies of proof of identification and no dates of when a POVA 1st was obtained. At this 2008 inspection an examination of the files of two of the most recently recruited staff was carried out and we found full and satisfactory information both of these files with the exception of a POVA 1st. Examination of the staff roster, and discussion with the Manager, confirmed the start date of this member of staffs employment. Findings indicated that this member of staff commenced working at the home on the 12th September 2008 and their POVA 1st check was issued on the 18th September, and received by the home on the 19th September 2008. The results of a criminal records bureau check (CRB) were awaited. It was clear that the home was aware that the member of staff should not have worked at the home until a POVA 1st check had been received. We have taken a reasonable view not to make a requirement on this occasion. (POVA = protection of vulnerable adults against abuse and a POVA 1st check refers to the Department of Health register of any person who has committed an act of abuse against a vulnerable person and is deemed not suitable to work, in care homes for example). The staff training records and discussion with the staff indicated that staff have attended training in how to care for a person with dementia and Parkinsons Disease and activities for people with dementia. All of the 4 staff surveys said that the person was very satisfied with their induction training, feeling that it covered everything the member of staff needed to know to do their job. These same surveys said that the member of staff had attended up to date and ongoing training to be able to meet the individual and changing needs of the residents. Care Homes for Older People Page 23 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a well-managed home. Evidence: According to the current Statement of Purpose the Registered Manager has worked at Field House for 15 years. She has an Open University certificate in Caring for the Elderly and she has the Registered Managers Award. The training records indicated that she keeps her practice up to date by attending training courses, including health and safety refresher training. We have noted that there has been an improvement in the standards of care and management in the home, since our last inspection. In one of the homes surveys we read Field House is a well managed home. The homes quality assurance systems have improved since our last inspection. The AQAA was of a better standard and reviews have been carried out to ask people about their food. The home has also introduced a monthly audit on a number of areas, such as the response time of staff to attend to peoples calls for assistance; the interaction Care Homes for Older People Page 24 of 28 Evidence: of the staff with visiting professionals and the standard of food. The letter sent to relatives, inviting them to see the Manager on the 5th November 2008, included an invite for them to discuss anything about the care provided to their relative. Three peoples monies were counted and two of these balances reconciled with the records. For the third person they had more cash available, than the records said. We expected the home to improve the training of the staff in moving and handling and first aid training. Examination of the staff training records, and discussion with some of the staff, indicated that the home has taken action to improve these two areas. We expected the home to record the names of all staff who attend any fire drills. The record of fire drills was seen and these have been carried out in May and September 2008. The fire drill record indicated that the names of the staff, who had attended this fire training session, had been entered, although their first names, only, were recorded. Full names should be entered on this legal document and we expect the home to further improve this area of record keeping, rather than we make a requirement. Due to a fire door being held open, with the use of a piece of wood, we asked for the fire alarm to be tested. We noted that, during this test, the door closed with ease,and by itself. The temperatures of hot water, in bathrooms, and fire alarm and emergency lights are tested each week, of which the last tests were recorded,as being taken, on the 16th October 2008. Service tests for hoists and lifts were in date and arrangements have been made for (overdue) safety tests on portable electrical appliance equipment. We noted, at our inspection in November 2007, that some of the staff were wearing unsupportive and unprotective footwear.During this inspection, of October 2008, we saw the staff wearing safer and more suitable footwear. Care Homes for Older People Page 25 of 28 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 26 of 28 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 1 9 13 Medicines must be stored properly in line with current legislation and in suitable environmental conditions. To ensure medicines are not accessible to unauthorized people, that their quality is not compromised and residents are protected. 28/02/2009 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 Care Homes for Older People Page 27 of 28 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. 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