Inspection on 13/09/07 for Field House Care Home

This inspection was carried out on 13th September 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Field House Care Home 01/09/09

Field House Care Home 08/09/08

Field House Care Home 28/02/07

Field House Care Home 09/05/06

Field House Care Home 09/09/05

Field House Care Home 25/04/05

Field House Care Home 25/01/05

Field House Care Home 07/07/04

Field House Care Home 26/02/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Field House Care Home 127 Foxhall Road Forest Fields Nottingham NG7 6LH Lead Inspector Rob Cooper Unannounced Inspection 13th September 2007 02:00 DS0000002249.V350020.R01.S.doc Version 5.2 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 DS0000002249.V350020.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. DS0000002249.V350020.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Field House Care Home Address 127 Foxhall Road Forest Fields Nottingham NG7 6LH 0115 960 3509 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) Mr Richard Stevenson Mrs Alison Stevenson Miss Jacqueline Long Care Home 12 Category(ies) of Learning disability (12) registration, with number of places DS0000002249.V350020.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2007 Brief Description of the Service: Field House is a care home for learning disabled adults, situated in the Forest Fields area of the city, approximately one mile north of the city centre. The home is close to a range of transport options including buses and the tram system, and there are a variety of shops close by. The property is a large semi detached house, which covers three floors, with the upper floors being accessed by means of a staircase, and a stair lift, which is operated by the staff. The residents are accommodated in both single and double bedrooms. The service focuses on developing the residents independence skills, and community living. The fees are: £1,430.13 per month. DS0000002249.V350020.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit as part of the key inspection process – so that no one at Field House knew that the inspection visit was going to take place. The visit took eleven days to complete, due to key staff members including the manager being on holiday at the start of the inspection. Two inspectors were present for the initial visit, including one specialist pharmacy inspector. The method used to carry out this key inspection visit was to send out an Annual Quality Assurance Assessment (known as an AQAA) for Field House to self assess their service. This had been returned, and provided information, which informed this inspection process. This was followed with a visit to Field House, where a method called case tracking was used; this involved identifying four residents and looking at their individual files and making a judgement about the quality of care they are receiving, and if their needs are being met. This was done by a partial tour of Field House, looking at the activities on offer, and talking to five residents, and two members of staff about the quality of the service, and their experiences of living and working at Field House. Information was provided by a number of different staff members including the registered manager. During this inspection visit(s) there were twelve residents in residence. Following the last key inspection in February 2007, a further random inspection visit was made to Field House on the 10 July 2007 to check on progress with regard to the requirements made at the key inspection. Prospective residents can obtain information about Field House direct from the care home, and this would include seeing previous inspection reports prepared by the Commission for Social Care Inspection. What the service does well: Resident’s have a plan of care, and said that they are happy living at Field House. Observations of staff working practices showed that residents were treated with respect and staff were friendly and approachable. DS0000002249.V350020.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Fourteen statutory requirements and five good practice recommendations have been made as a result of this key inspection. The requirements related to: * The Statement of purpose is inaccurate, and needs to be corrected. * The staff must consult with residents about a programme of social and leisure activities. * The medicines cupboard needs to be cleaned, and medicines no longer required returned to the pharmacy. * Medication must be checked when it is received, and any queries raised with the pharmacist. * Medication recording sheets must be complete and accurate. * The medicines fridge must be in good working order and at the correct temperature. * Residents must be encouraged to take responsibility for their own medication administration if they are able to. * Field House must have a medicines policy in place to guide staff. * A programme of redecoration must be carried out throughout the entire building. * Furniture in resident’s bedrooms must be in good repair. * All staff working at Field House must have two written references. * The manager must receive formal supervision. * All staff must receive training so that they are able to do their jobs properly. * The proprietor must undertake Regulation 26 monitoring visits at Field House. DS0000002249.V350020.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000002249.V350020.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000002249.V350020.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12&5 Quality in this outcome area is adequate; this judgement has been made using available evidence including a visit to this service. Prospective residents at Field House would not have accurate information on which to base their decision to live there. Current residents are well informed about the services Field House offers. Every resident has a contract for his or her placement at Field House. EVIDENCE: The statement of purpose and the service user guide for Field House were seen, and the statement of purpose was found to be inaccurate in that it described bedrooms as being en-suite. None of the bedrooms at Field House have en-suite facilities; this issue was raised at the last key inspection. Four resident’s files were seen; each file contained an in-house assessment carried out by Field House staff, and the assessment had been used in the care planning process. All of the resident’s placements are sponsored by Social Services, and each file contained a copy of the terms and conditions of residence and a contract, although neither a representative of Field House nor the individual resident had signed any of the contracts. DS0000002249.V350020.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9 & 10 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at Field House have an individual plan of care containing information about their needs following a needs assessment. Risk assessments to support individuals in leading an independent lifestyle are brief or not in place. EVIDENCE: Each of the four files seen as part of the case tracking process had a plan of care, and the care plans had been reviewed within the past six months, as recommended by the National Minimum Standards. Evidence was seen that residents had been consulted about the colour scheme in their bedrooms (when the redecoration takes place) and there was also evidence that care plans had been signed by residents to signify that they had been consulted. Residents meetings are held regularly, and decisions about the weekly menu are taken with input from all concerned. Discussions with five residents indicated that they thought they were involved in decision DS0000002249.V350020.R01.S.doc Version 5.2 Page 11 making in their lives, with one resident saying: “I don’t go to the centre anymore, I stay here instead, and do what I want to.” Care plans did have risk assessments in them, however these were quite brief, and did not cover activities such as residents going out of Field House independently, or any issues related to residents moving towards greater independence. Residents care plans and files were seen to be stored securely in a filing cabinet in a locked room, with access to the information restricted. Observations of staff handling files showed that they were not left unattended, and care was taken to return files to the filing cabinet when they had been used. DS0000002249.V350020.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 15 16 & 17 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at Field House are not offered a stimulating range of activities, although they are involved in the local community. Residents are offered a varied and healthy diet, and are involved in menu selection. EVIDENCE: Activities within Field House are client led often with minimal staff input. Discussions with two residents about activities showed that one resident spent most of his time watching television. Some of the residents attend local day centres, and others are using local community facilities, generally recording within care plans around activities was poor, with little information, or evidence of support for residents in pursuit of activities and leisure interests. Two residents were spoken with about community activities, and both said that they were very busy, and often “popped to the local shops.” Another resident DS0000002249.V350020.R01.S.doc Version 5.2 Page 13 entered Field House having just been shopping in the local Hyson Green area, and in the larger group, the residents talked about the Goose Fair, and how much they enjoyed going (the fair is held in the local area). Recording in care plans around community activities is also poor, and does not reflect the level of community activity that residents say they enjoy. Discussions with several residents about contact with their family indicated that most residents see members of their family on a fairly regular basis. Residents said that the staff made their relatives welcome when they came to visit, and there were no problems with times of visits. Residents said that sometimes they met their families in town, but more usually it was at Field House. Observations of staff to resident interactions were seen to be positive, with residents being treated with respect. Staff were observed knocking on resident’s bedroom doors, and were heard to speak to residents in a friendly, and professional manner. The impression was that the staff care about the residents and treat people as individuals. Residents are involved in planning the menu on a weekly basis, and this showed a reasonably balanced diet on offer. Observation of the evening meal being prepared, evidenced a tasty and appetising meal, in sufficient quantities to meet the resident’s needs. Discussions with three residents about the food, were all positive, with one resident saying: “It’s lovely, very tasty, very nice”. This view was echoed by the other two residents. DS0000002249.V350020.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 & 20 Quality in this outcome area is adequate; this judgement has been made using available evidence including a visit to this service. Residents at Field House have their health care well managed, and are supported in a positive manner by the staff. Medication is not well managed at Field House. EVIDENCE: Discussions with five residents in a group setting showed that they are happy with the support they are receiving, and the manner in which it is being offered. The resident’s files seen as part of the case tracking process all had information about the resident’s preferences in relation to their personal support. The case tracking process showed that appointments with dentists, doctors and other health professionals are recorded within the files. Discussions with three residents individually evidenced that they felt their health was well managed and supported by the staff, with the necessary appointments being made when required, and with staff support if needed or wanted. DS0000002249.V350020.R01.S.doc Version 5.2 Page 15 Records The Medication Administration Records (MARs) are handwritten by staff at the home and are incomplete. The name of the drug and strength is always recorded but the form of the medicine is not recorded and the dose in not recorded clearly enough. There are also medicines available in the home that are not recorded on the MAR. The errors and omissions on the MARs are the same each month, which suggests that the MARs are copied from previous MARs rather than from the pharmacy labels and that the person countersigning is not checking thoroughly. The MAR file contains recognisable photographs of all residents. The Care Plans contain some good information on meeting residents’ individual healthcare needs such as the procedures detailed in the plan of a diabetic resident. Each Care Plan contains a list of current medication but there is not enough information relating to how and when ‘when required’ medicines are given and residents’ preferences regarding where and when medicines are given. Administration and Audit Medicines for most residents are blister packed by the pharmacist, although one resident’s medicines are in a dossette box without pharmacy labels on it. There are medicines in stock that are no longer in use and also medicines for people who have died or left the home. One resident’s medicines have been packed incorrectly by the pharmacy which should have been noticed when they were booked in and returned to the pharmacy for correcting. There are no records of medicines being booked in when they are received from the pharmacy or of medicines destroyed or returned to the pharmacy. Used sharps are stored in a glass jar. Stock levels of some items are high which suggests that prescriptions are being ordered without checking what is in stock. There are medicines in stock that are past their expiry date. Training and Policies There is a Homely Remedies policy and a plan of action to take in the event of a medication error. Storage of medication Medicines are stored in 2 locked cupboards and the cellar. One of the cupboards is very dirty and the medicine boxes are covered with sand/grit. There is a medicines fridge, which is in need of defrosting and the thermometer does not appear to be working. DS0000002249.V350020.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at Field House are safe, and feel their views are listened to and acted upon. EVIDENCE: Field House has not received any complaints since the last key inspection in February 2007. Discussions with five residents in a group situation identified that if they were not happy about something they would talk to Jackie the manager. One resident added that he would also talk to Richard ‘the owner’ because he called in every week. The situation with regard to training in safeguarding adult’s procedures remains the same as at the last key inspection. Courses have been applied for and dates for the training are due. One member of staff has been allocated a course on the 30th October 2007, so confidence is high that further training dates will arrive shortly. This training is aimed at raising staff awareness of abuse, and the procedures in place to deal with abusive situations, and through raising the issues, offering residents greater protection against abusive practice. DS0000002249.V350020.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 26 29 & 30 Quality in this outcome area is adequate; this judgement has been made using available evidence including a visit to this service. Field House is not currently a clean, safe, homely or comfortable care home. EVIDENCE: At the last key inspection a requirement was made that a programme of redecoration should be carried out throughout the building, with a timescale for the work to be started of 31st August2007. A partial tour of Field House showed that so far no decorating work has started. Staff gave a number of reasons for this, and said that the decorators were expected very soon. Outside the ‘backyard’ remains cluttered with weeds and builders materials (bricks and planks) still being stored there many months after building work was completed. At the last key inspection a requirement was made in relation to resident’s furniture. A wardrobe and a chest of drawers in the same bedroom were found to have broken drawers. Both of these items of furniture were found to be in the same condition, having not yet been repaired or replaced. DS0000002249.V350020.R01.S.doc Version 5.2 Page 18 The stair lift, which had been broken at the random inspection visit in July, had been repaired, and residents with restricted mobility are now able to access the upper floors safely. The cleanliness of Field House is affected by the need for redecoration, which was highlighted in the last key inspection report. The chipped paintwork and damaged wallpaper covering do not lend themselves to keeping the building clean. DS0000002249.V350020.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35 & 36 Quality in this outcome area is adequate; this judgement has been made using available evidence including a visit to this service. A competent, well-trained and supervised staff team that has been professionally recruited supports residents. EVIDENCE: The Field House staffing rota showed that each shift had either two or three carers on duty, and one waking night staff through the night, with a second carer ‘sleeping in’. A problem identified at February’s key inspection with a carer’s Criminal Records Bureau check has still not been sorted, despite all of the documentation having been sent off. This means that this individual cannot work unsupervised with residents, which is hampering the staffing allocation. Four staff files were seen, and these did not all contain all of the information that would show that staff had been recruited in a safe manner – in that applicants had to fill out an application form, provide two written references and undergo a Criminal Records Bureau check. One staff file had no references, and another only one. This means that it was not possible to prove the recruitment process had worked to protect residents. DS0000002249.V350020.R01.S.doc Version 5.2 Page 20 The staff training records showed that the situation with regard to staff training was unaltered since the last key inspection in February 2007. In that not all members of staff have received training in the mandatory areas. This includes Fire, Moving & Handling and Health & Safety. There is still no annual programme of refresher training for those staff that have attended courses. Staff involved in food preparation for residents have still not all undergone certificated food hygiene training, which again is mandatory training and therefore staff are not appropriately trained to meet the needs of the residents. A review of staff records showed that staff are having regular supervision and appraisals, although the documentation relating to the formal staff supervision does not provide a reflection of the issues discussed, and does not evidence that the supervision sessions being held with staff are suitable to meet either the individual staff member’s needs, or those of Field House. No supervision records for the manager were seen, and when asked the manager said that she was not receiving regular formal supervision. DS0000002249.V350020.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 & 43 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Field House is a safe, well managed, and organised care home, however there are problems with the quality assurance systems. EVIDENCE: Jackie Long is the Registered Manager, she is suitably qualified and experienced, and has been judged by the Commission for Social Care Inspection to be a fit person to run a care home. Field House has an annual questionnaire for its residents, and copies of the latest were seen in resident’s individual files. The questionnaires were all positive about resident’s life at Field House. Resident’s meetings are arranged on a monthly basis, and the minutes relating to the last three meetings were seen, which showed that the residents were being consulted about some aspects of the running of Field House. DS0000002249.V350020.R01.S.doc Version 5.2 Page 22 Several health & safety records were seen, and found to be correct and up-todate. These included the fire safety records, the Control of Substances Hazardous to Health (COSHH) records, the fire extinguishers had been serviced within the last month, and there were no obvious health & safety issues to note. The responsible individual (proprietor) of a care home or service must carry out Regulation 26 visits; these are visits to the home to ensure that the residents are fit and well, they are being cared for appropriately, and that the building is in a good state of repair. Visiting the premises, carrying out a visual inspection and talking to residents and staff, and then writing a report are how this is achieved. In the past Field House have had requirements set for not adequately carrying out Regulation 26 visits, once again there are issues, with staff saying that the proprietor “pops in” but does not complete a report form. The manager was able to provide dates when the proprietor visited, but could not produce copies of Regulation 26 visit reports. It has been pointed out in the past that copies of the reports should remain at Field House so that they are open to inspection. DS0000002249.V350020.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 1 25 1 26 X 27 X 28 X 29 3 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 3 LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 X 3 X 3 X X 3 1 DS0000002249.V350020.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation Requirement Timescale for action 30/11/07 2. YA12 3. YA20 4. YA20 5. YA20 Regulation The statement of purpose is 4 inaccurate, and must be updated to ensure that the information within it is correct and accurate. Regulation Staff at Field House must consult 16(2)n with residents about their activities and leisure interests, record in the care plans details of the consultation, and then arrange a programme of activities based on that consultation. 13(2) Immediate Requirement - The medicines cupboard must be cleaned and all medicines that are no longer required must be returned to the pharmacy for destruction. This will ensure that medicines are not administered when they are out of date, contaminated or no longer appropriate. 13(2) Urgent Action - Medication must be checked when it is received to ensure that it is correct and any queries must be resolved with the pharmacy to ensure that all medicines are administered as prescribed. 13(2) Medication Administration DS0000002249.V350020.R01.S.doc 31/12/07 15/09/07 15/09/07 31/10/07 Page 25 Version 5.2 6. YA20 7. YA20 8. YA20 9. 10. YA24 YA26 Records must be a complete and accurate record of all medicines prescribed and administered to ensure that residents’ individual health needs are met. For any medication which is prescribed ‘when required’ there must be a protocol in place which describes how and when it should be used. 13(2) The fridge must be maintained in good working order and a temperature log must be kept to ensure that medication is stored at the correct temperature. 13(2) To promote independence and choice, residents’ ability and/or desire to look after their own medicines must be assessed and recorded along with their preferences regarding taking medicines. 13(2) The home must have a Medicines Policy, which staff understand, refer to and follow to ensure that medicines are administered as prescribed. It must include administration procedures, selfmedication, record keeping, storage, staff training, homely remedies, ordering of prescriptions, return of unwanted medicines and medication errors. Regulation A programme of redecoration 23 (2) d must be carried out throughout the entire building Regulation The Registered person must 16 (2) c ensure that residents have adequate furniture to meet their needs, and that the furniture supplied is in a good state of repair. This requirement had not been met, although the timescale still had a few days to run, so the requirement remains in place. Regulation Every member of staff working DS0000002249.V350020.R01.S.doc 17/10/07 14/11/07 14/11/07 30/11/07 30/09/07 11. YA34 20/12/07 Page 26 Version 5.2 12. YA35 at Field House, regardless of how long they have been in post must have two written references in their personal file, and available for inspection by the Commission for Social Care Inspection. Regulation The Registered person must 31/03/08 18 (1) c ensure that staff employed to work at the care home receive training appropriate to the work they are to perform. This requirement remains outstanding from the last key inspection (28th February 2007) Regulation The provider must properly 31/12/07 18 supervise the registered manager, with a written record kept as evidence of that supervision having taken place. Regulation The Registered person must 30/11/07 26 undertake monthly Regulation 26 visits, either in person or through a representative, and copies of the report must be sent to the Commission for Social Care Inspection for inspection. This requirement remains outstanding from the last key inspection (28th February 2007) 19 (1) b 13. YA36 14. YA43 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA5 YA9 Good Practice Recommendations Both a representative of Field House and the individual resident should sign Resident’s contracts. Risk assessments within resident’s files should also focus DS0000002249.V350020.R01.S.doc Version 5.2 Page 27 3. 4. YA13 YA34 5. YA36 on issues relating to independence and personal development. Care plans should record and reflect the high number of community activities that the residents are involved in. The registered person should clarify the situation with regard to the outstanding Criminal Records Bureau check for the identified individual member - it has now been five months since the application was made with no outcome. Records relating to staff supervision sessions should reflect the discussions held, as they are a management tool for the development and progress of staff. DS0000002249.V350020.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000002249.V350020.R01.S.doc Version 5.2 Page 29 - 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. 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