Inspection on 25/11/08 for Field House

This inspection was carried out on 25th November 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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Heathlands

Aston Court Nursing Home

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Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Field House Sandford Avenue Church Stretton Shropshire SY6 7AA     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Pat Scott     Date: 2 5 1 1 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 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 24 Information about the care home Name of care home: Address: Field House Sandford Avenue Church Stretton Shropshire SY6 7AA 01694723787 01694723787 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Ann Dunn Type of registration: Number of places registered: Barchester Healthcare Homes Ltd care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The Registered Person may provide personal care (excluding nursing) and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Old Age not falling within any other category (category OP). The maximum number of service users who can be accommodated is: 20 Date of last inspection Brief description of the care home The home is situated in a quiet residential area within easy reach of the rural centre of Church Stretton. It has gardens at the front and rear for use by residents with a small amount of parking. The home is owned by Barchester Healthcare Ltd. The accommodation is an adapted large family house. Fees range from £600 to £700 and are reviewed on an annual basis. Information about the service is contained in the statement of purpose and service user guide. Inspection reports are available from the home. Care Homes for Older People Page 4 of 24 Over 65 20 0 Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is *THREE star excellent service. This means the people who use this service experience excellent quality outcomes. We, the commission, used a range of evidence to make judgements about this service. This includes: information from the manager in the annual quality assurance assessment (AQAA), staff records kept in the home, medication audits, survey results from people who use the service, discussion with the manager, tour of the premises, previous inspection reports, quality assurance processes, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. Care Homes for Older People Page 6 of 24 Although this service is a new service, it has been re-registered in that it is an existing service that has been taken over by a new provider. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking 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 24 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 24 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. Written records for the admission of new people to the service demonstrate that the process is personalised and that consideration has been given to all aspects of care. Evidence: Discussion with the manager established that the service maintains pre-admission and admission records. The Single Assessment paperwork is provided through the care management process. The assessment information forms the care plan based on the individuals needs. The manager keeps copies of the assessment summary and care plans of those carried out through care management arrangements. An example of the homes total care assessment seen shows that the service determines the needs of individual residents before coming to live at Field House. A service user spoken with stated that she had provided information to the manager Care Homes for Older People Page 10 of 24 Evidence: prior to coming to live at the home. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service aims to address and meet assessed need through the continued development of plans of care, so that residents are provided with person centred care. The manager understands the need to comply with safe medication systems and staff practice ensures that the homes procedures are complied with and that service users health matters are always safely addressed. The actions of staff and their approach to care ensures that service users are treated with respect and their right to privacy is upheld. Evidence: Each resident has a clear, personalised care plan. Personal, health, spiritual and cultural needs are planned for well. Residents are supported to access services to assist in improving their well being. For example, one resident with diabetic foot problems has been able to get medical support from the specialist hospital clinic, Care Homes for Older People Page 12 of 24 Evidence: chiropodist, district nurse and GP. This input has been well managed by the manager and staff to provide excellent outcomes for this particular person. Records are clear and plainly written so that people can understand their content. They have signed and printed signatures of staff completing them which assists in the audit process of the service. A staff member spoken with demonstrated her knowledge of the residents needs. She also spoke of the training she has been given to enable her to do her job well. Eight out of ten surveys returned to us stated that good medical support is always received. A respondent told us The staff are well trained and caring. Personal privacy is safeguarded and residents are treated as different personalities. Care Homes for Older People Page 13 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with social activity and can keep in contact with family and friends. Social, cultural and recreational activities meet peoples expectations through assessment, consultation and choice. Residents receive a healthy diet according to their assessed requirement and preference. Evidence: The assessment process demonstrates that social and leisure pursuits are addressed prior to admission in a personal way for the individual. Staff are taking life histories of individuals. An activity person is employed for 20 hours a week. Once living at the home social activities are provided and the service shows that these are based on resident consultation at regular meetings. Planned activity sheets are in each bedroom and displayed around the home. A survey respondent stated that a weekly programme is published and there are additional events at short notice including outings. All residents spoken with said they liked the food and it is always nicely cooked. One resident said she is very, very happy in the home and enjoyed going out. Relevant staff have had food hygiene training. Menus are displayed around the home and staff Care Homes for Older People Page 14 of 24 Evidence: assist people with their choice. Barchester have their own chefs academy as well as training staff to NVQ level. A comment in a survey reads There is a good variety and plenty of it. I have put on weight since coming here a year ago. The routines of daily life are less regimental and more focused on the individual. Staff are seen to have time to speak with residents and know them very well. The manager spends quality time in the lounge on a daily basis so that she is visible and residents know they can speak to her. Care Homes for Older People Page 15 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a complaint procedure which is accessible so that people who use the service have information of how to make complaints about the home. Training is provided so that service users are protected from abuse and have their legal rights protected. Evidence: People spoken to say that they would go to the manager or one of the staff if they had a problem. All expressed confidence that issues would be dealt with. Records show that concerns spoken about by residents had been promptly dealt with and a satisfied outcome reached. Staff spoken with understand how to deal with complaints from people and are also clear when information needs referring through safeguarding processes. The person centred approach by the manager and staff have gradually given people the confidence to air their concerns. A person commented that she had Never felt able to do this before with a previous owner. Staff, through improved training and development, are well quipped to listen to concerns and ensure they are responded to. Care Homes for Older People Page 16 of 24 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. The physical design and layout of the home has improved, through resident choice, so that they live in a safer, better-maintained and comfortable environment, which encourages independence. Evidence: The manager spoke of the refurbishment improvement plan which has been achieved and of the further work in progress. All areas seen around the home are clean and rooms personalised and decorated according to the wishes of those people occupying them. This has been welcomed by those living at the home and many favourable comments were made about the decoration. They state that the home is always spotlessly clean. The service has a five year plan to upgrade the inside and outside of the home. Care Homes for Older People Page 17 of 24 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. Staff in the home are trained and are in sufficient numbers to fill the aims of the home and meet the changing needs of residents. Evidence: Staffing rotas are in place in the office. NVQ training is provided and the minimum ratio of 50 trained staff being at level 2 has been met. Staff files kept in the home evidence the induction process provided for new starters. Initial training such as infection control, manual handling, first aid and medication are provided. After induction, candidates are assessed for suitability to move onto NVQ training. Staff turnover in the home is low so that continuity of care is provided. The residents know the staff very well and observation showed that they provide a personal but professional service. Staff spoken with feel that the training is much better and it enables them to fulfill their role to their best ability. They are complimentary about the level of support they receive from Barchester Healthcare Ltd and their manager. Staff have more responsibility within their area of work, for example, they are required to conduct risk assessments which are reviewed by the manager. Respondents to surveys stated It is Care Homes for Older People Page 18 of 24 Evidence: a very happy home and everyone is always ready to help you. I have an allocated care worker but all the staff will listen and seek help. This is a very happy and welcoming home. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home is based on openness and respect. The service has quality assurance surveys in place so that people are assured that the overall conduct of the home is taking into account their views. Peoples opinions are more central to how the home develops and reviews its practice, and the service is developing appropriate ways of making sure they get things right. So, people have confidence in the care home because it is run and managed well. Evidence: The managers practice is people focused and customer satisfaction is high on the agenda. This is evidenced by the commitment to conducting service user surveys, regular resident and family meetings that are minuted, and excellent day to day contact. Medication systems are audited as are many other aspects of the service including the dining experience, infection control, person centred care and health and Care Homes for Older People Page 20 of 24 Evidence: safety. People who use the service say that they trust the staff and feel safe in the home. One stated that the management consistently offers good care and a returned survey stated The manager is extremely enthusiastic and goes out of her way to help both residents and staff. The manager discusses bank statements with individuals to allay any anxiety about money. She is aware of the impact moving into care has on peoples finances and the burden it creates. The service has a robust system for dealing with peoples monies which is audited. The annual quality assurance assessment by the home identified where the provider suggests they could do better. The manager has an action plan to address these areas. Record keeping systems have improved. All records seen are written in a way that shows the service listens to the people who use it. What people say is heard, acted upon and reviewed and elements of the annual quality self assessment were seen to be in place. e.g. redecoration and quality assurance processes. Risk assessments for the management and safe working practices in the home are in place. Individual staff are responsible for these and the manager reviews their quality. Care Homes for Older People Page 21 of 24 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 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - 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!