Inspection on 28/02/06 for Field House

This inspection was carried out on 28th February 2006.

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

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

Other inspections for this house

Field House 17/02/09

Field House 20/02/07

Field House 12/10/05

Field House 18/02/05

Field House 27/08/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Field House Cannards Grave Road Shepton Mallet Somerset BA4 4LU Lead Inspector Justine Button Unannounced Inspection 28th February 2006 09:30 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 DS0000016014.V285126.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Field House Address Cannards Grave Road Shepton Mallet Somerset BA4 4LU 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) 01749 342006 01749 345146 linda.tungate@somersetcare.co.uk Somerset Care Limited Mrs Linda Christine Tungate Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th October 2005 Brief Description of the Service: Field House provides residential care for up to 39 service users within the older people category of registration. Day care is also provided for which a designated member of staff is employed. Field House is part of Somerset Care Limited. The registered manager is Mrs Linda Tungate. Field House is set well back from the road with a long drive and circular front garden. There are parking areas to the front and side of the house. Large, attractive gardens and patio areas surround the home. These are accessible to service users from a number of ground floor rooms. The home consists of a listed building with later ground floor extensions. Service users’ accommodation is on four floors serviced by a passenger lift. There steps to a small minority of rooms. These would not be accessible to people with mobility problems. Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector conducted this announced inspection over the course of one day. The inspector was able to speak with a large number of the residents as well as staff on duty. The manager Mrs Tungate was not available on the day of inspection. The inspectors would like to thank the residents and staff for their time and hospitality shown to the inspector during their visit. The inspector’s aim on this inspection visit was to seek views on the quality of the service from as many service users as possible and to speak to staff. Records examined were care plans, staff recruitment files, duty rota’s, and health and safety records. A tour of the building was carried out on this visit. What the service does well: What has improved since the last inspection? One requirement relating to staff recruitment was made at the last inspection. This issue has been resolved an recruitment practises are now in line with good practise. Field House DS0000016014.V285126.R01.S.doc Version 5.1 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. Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 & 5. People who intend to move into the home have adequate information in order for them to make an informed decision about moving to Field House. A member of the senior staff team conducts assessments prior to admission. The opportunity to visit the service prior to admission is available and people moving into the service are aware that the home can meet their individual needs. EVIDENCE: The home displays its statement of purpose and service user guide on the hallway. These documents contain all necessary information about the services the home is able to provide including a copy of the last inspection report. This document states, “The aim of the home is to provide high quality care”. Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 9 One person who recently moved to the home stated that her family had been able to visit prior to her moving in. Staff had answered any questions that had been raised. The information given had lessened her concerns about moving into the care environment. The staff stated that a visit to all people is made prior to moving into the home to ensure that the service can meet their needs. This service provides personal care only so is not suitable for those people who have complex or multiple nursing needs. Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. People who live at the service have their health and personal care needs met. People who live at the service are treated with dignity and respect. Care plans are in place but some need to be developed. EVIDENCE: All people who live at the service have a care and support plan. Five of the care plans were viewed on the day of inspection. The plans need to be developed in order to give clear guidance to the staff on the specific needs of the people living at the service. Ambiguous statements such as “encourage fluids” need to be avoided. The plan should state how much fluid should be encouraged. Discussions with staff however showed that they had a clear knowledge of individual’s needs and requirements. The use of assessment tools e.g. for moving and handling or nutrition was spasmodic. In two of the plans viewed a need had been identified following an assessment. No care plan was in place to address these needs. Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 11 All the plans had been reviewed on a regular basis. There was no evidence however which demonstrated that service users and/or their representatives had been involved in this process. The plans demonstrated that the district nurse visits the service regularly to treat medical conditions that are outside of the skills of the staff group. GP’s from the local practise visit the service as and when required. People who live at the service also have access to chiropody, dental services and opticians. Staff were observed talking to people in a respectful manner and knocking on bedroom doors. People who live at the service stated that staff treated them in a dignified manner and that all treatments and personal care is conducted in privacy. Medication was seen to be handled in safe manner by the staff member responsible for it’s administration on the day of the inspection. The pharmacist had visited the service the day prior to the inspection. The pharmacist had left four recommendations. These were • Homely remedies need to be kept separate from prescribed medication. • The date of opening for medication needs to be recorded. • A list of staff signatures needs to be developed. • No gaps on the Medication Administration Record should be seen. A reason for any omissions should be recorded. Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. There are a wide range of social and leisure activities available. Family and friends are able to visit at any time. People who live at the service are able to maintain control of their lives and choices are offered. The food provided is of a good quality. EVIDENCE: There were a range of activities that had taken place or that had been arranged. Records are also kept about who attended sessions and if they enjoyed the activity. Activities included coffee mornings, visit from the donkey sanctuary, flexercise, bingo and reminiscence. A visit to a local garden centre had been organised for the week following the inspection. Regular church services are also held. People spoken to confirmed that there was a range of activities on offer. A pancake tossing competition had been arranged for the day of the inspection. People were seen watching a DVD in the lounge and others playing cards the morning of the inspection. Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 13 People stated that visitors were always made welcome and were free to visit at any reasonable time. People can receive visitors in the communal areas or in the privacy of their rooms. The main meal of the day is served at lunchtime. On the day of inspection the meal was chicken pie or home made pizza. Vegetables and potatoes were served at the table by staff. Following the main meal a wide choice of puddings were served. The menu is displayed on a daily basis and people who live at the service stated that if they did not like what was on offer staff were more than willing to provide an alternative. All but one person stated that the food was of a good standard and that they enjoyed the food provided. People can chose to eat their meals in the dining room or in their bedrooms. A range of drinks was available. The kitchen was seen on the day of inspection and found to be clean and tidy and in a good state of repair. Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17. There is a clear complaints procedure and people who live at the service are confident that their complaints would be listened to. The recruitment and training procedures carried out ensure that people are protected from the risk of harm or abuse. EVIDENCE: There is a clear complaints procedure, which is on display in the main hallway. People spoken to confirmed that they would be happy to raise any concerns with the management team. No complaints have been received since the last inspection. There is a policy with regard to the prevention of abuse. This area is also covered in the induction of new staff. People who live at the service are protected to the fullest extent, as the recruitment procedures are now robust. Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26. Field House is homely and quiet, creating a relaxing atmosphere. Bedrooms are personalised creating a private space for residents. The home is domestically clean. The service is on the whole well maintained. One area relating to infection control was identified. EVIDENCE: A tour of the building was conducted on the day of inspection. The home is located close to the town centre set back from a busy road and surrounded by large attractive gardens that are accessible from the house. Local facilities are within walking distance for physically fit and traffic aware service users. Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 16 Inside there are spacious and comfortable communal rooms. All floors are accessible by a passenger lift. Private accommodation varies in size and facilities. Some rooms are very large and some have en-suite facilities. They are all personalised and homely and all have washing facilities. There are a number of spacious and attractive communal rooms including sitting and dining areas. There is a grand entrance hall with a spiral staircase that is most attractive. WCs and bathrooms are adapted to meet recognised needs. There is a mobile hoist. The majority of bedrooms seen were lovely, fully personalised and comfortably equipped. People spoken to during the inspection stated that they were happy with their rooms. The laundry was viewed during the inspection. This area is in need of refurbishment. There is no dedicated staff member to complete the laundry. For a home of this size this is quite a large task so the employment of dedicated laundry staff should be considered. One area relating to infection control for one individual was identified on the day of the inspection. This was discussed with staff who agreed to review this area. The hot water to the wash hand basins in some areas was in excess of 50 degrees centigrade. Water delivered at this temperature increases the risk of scalding. This needs to be reviewed. Hot water signs should be in place if the water temperatures to these areas cannot be reduced. Risk assessments should be conducted to identify individuals who may be at risk. Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. The service provides staff who are suitably trained and in adequate numbers. The recruitment practises protect the people who live at the service. EVIDENCE: Testimony from the people living at the home and staff confirmed that there are adequate numbers of staff on duty at all times. People living at the service stated that they did not have to wait long if they required assistance or support. Staff training records were viewed. These showed that staff had received all mandatory training. In addition training in catheter and bowel care, diabetes and medication have been provided. A number of staff have completed an NVQ qualification. Staff spoken to during the inspection stated that they felt adequately trained in order to fulfil their role. The recruitment files of the most recent staff members were inspected these demonstrated that the homes recruitment procedures were in line with good practise guidelines and included CRB and POVA checks. Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33 & 38. This home generally has good occupancy rates. Service users speak well of the care and service they receive. Records are well managed and are stored securely. The home is well managed. EVIDENCE: Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 19 Mrs Tungate is an experienced and qualified manager. Mrs Tungate has completed an NVQ 4. All feedback from service users, staff was that there is an open management approach in the home. There are regular staff meetings and further impromptu meetings when necessary to discuss issues of concern. There are also regular meetings with service users and relatives. There is a calm and professional approach to management in the home, helping to give a sense of security and comfort for service users and staff. Staff stated that they received regular supervision and appraisals. The fire safety log, accident book, wheelchair, lift and hoist servicing records were viewed. These were in line with good practise. A health and safety and electrical audit had been conducted in October and December 2005. It was not confirmed if the recommendations made had been implemented. The Environmental Health officer had visited the service on the 25/08/05. This visit was satisfactory. Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X X 3 Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP26 OP7 Regulation 12 (1) (a) 15 (1) Requirement It is required that the infection control issue for one identified individual is addressed. It is required that the service user plans are reviewed to ensure that they all adequately reflect the current needs of the people who live at the service. The plans should be developed and reviewed regularly with the individual or representative. Timescale for action 15/04/06 30/04/06 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 Refer to Standard OP26 Good Practice Recommendations It is recommended that the hot water to the wash hand basins is reviewed and reduced if necessary. If a reduction in the temperature hot water warning signs should be in place and a risk assessment completed. It is recommended that remedial action be taken to DS0000016014.V285126.R01.S.doc Version 5.1 Page 22 2 OP9 Field House address the shortfalls identified by the pharmacist. 3 .4 OP38 OP26 It is recommended that the areas identified in the health and safety and electrical audit are implemented. It is recommended that the provision of the laundry be reviewed. Consideration should be given to the employment of dedicated laundry staff. The management should ensure that the malodours are investigated and all necessary action is taken to prevent them. .5 OP7 It is recommended that the service user plans are reviewed to ensure that they all adequately reflect the current needs of the people who live at the service. The plans should be developed and reviewed regularly with the individual or representative. It is recommended that the management team ensure that they have adequate identified equipment in place prior to people moving into the home. It is recommended that the last inspection report is included in the statement of purpose. 6 OP4 7. OP1 Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Field House DS0000016014.V285126.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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