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Inspection on 27/02/06 for Field House Care Home

Also see our care home review for Field House Care Home for more information

This inspection was carried out on 27th 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service users spoken with had a high opinion of the home and the care they received. Praise was given for all staff, including the activities organiser who had enabled some stimulating discussion on the day of this inspection. The premises are well maintained and comfortable. Care is planned appropriately to meet individual needs.

What has improved since the last inspection?

Since the inspection that took place four weeks earlier, all bedroom doors that are left open at night have been fitted with self-closing devices, which operate in the event of a fire. There is a new policy in place for recruiting staff. No one is interviewed until satisfactory references have been received.

What the care home could do better:

There had been some incidents of slight bruising caused by the use of bed rails. Careful consideration should be given about their use and service users or their representatives should give their signed consent if they are to be in place. Those in use on one bed seen required some adjustment. Clear instructions must be given to staff to ensure bed rails are used always safely. People have previously been able to give their opinions about the home at meetings and informally to staff, but there is no formal quality assurance scheme and this needs to be established to cover all areas of the service provided.

CARE HOMES FOR OLDER PEOPLE Field House Care Home 11 Main Road Radcliffe On Trent Nottingham NG12 2FD Lead Inspector Meryl Bailey Unannounced Inspection 27th February 2006 2:15pm 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 Care Home DS0000026436.V281842.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 Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Field House Care Home Address 11 Main Road Radcliffe On Trent Nottingham NG12 2FD 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) 0115 9335811 0115 Mr R C Pring Mrs P A Pring Mary Patricia Walker Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50), Terminally ill (4) of places Field House Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. within the total number of beds a maximum of 4 beds may be used for the category TI 30th January 2006 Date of last inspection Brief Description of the Service: Field House Care Home provides social and nursing care for older people. The home is located approximately five minutes walk from Radcliffe on Trent town centre. Accommodation is arranged on two floors with forty-four (44) single bedrooms and three (3) double bedrooms. There is a passenger lift and the home is accessible to wheelchair users throughout. There are six bathrooms with specialist lifting equipment in place and sufficient well-sited toilets to meet service user need. In addition there are safe enclosed gardens. Field House Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one inspector during one afternoon and just over two hours. The previous inspection took place just four weeks earlier and this inspection concentrated mainly on key areas not assessed last time. On this occasion the inspector looked around the communal areas, and saw just one bedroom in detail. The evidence was gained through speaking with service users and staff on duty. Also from observation and from examining written records. The manager and administrator were very helpful in providing information for this inspection. A more comprehensive summary was provided in the report of the previous inspection, which took place on 30th January 2006. What the service does well: What has improved since the last inspection? 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 Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 6 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 Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 7 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): None of these standards were assessed at this inspection. The recommendation made regarding Standard 1 is carried forward from the last inspection. EVIDENCE: Field House Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 8 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, 9 and 10 Care is planned; medication is well organised; and service users feel respected. Some action is needed, though to ensure appropriate risk assessments are carried out where bed rails are used. EVIDENCE: The files of 2 service users were examined. These were both well-organised and contained clear standard action plans designed to meet identified needs. One of these service users had been resident for less than one week, but there was a full care plan in place so that all staff would know the action they needed to take. The other service user was cared for in bed and, in addition to the clear plans there were charts in the bedroom to monitor the care given. There had been some incidents of slight bruising caused by the use of bed rails. It is strongly recommended that care plans contain risk assessments with respect to the use of bed rails and consents to them being in place. The rails seen required some adjustment to reduce the gap and secure the padding. Clear instructions must be given to staff to ensure bed rails are used safely when needed. There was a dedicated clinic room for the secure storage of all medicines. The temperature of this room should be monitored. It was, though, well organised Field House Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 9 with a fridge and extra security for controlled drugs. Disposal of drugs no longer required was dealt with using a “Doom Kit”. Locked trolleys were used for transporting medicines and there were separate sections within trolleys to keep each service user’s medicines separately. Records were well maintained and the manager was observed following correct procedures when administering to service users. Several service users made very positive comments about their care and said that they always felt respected by staff. Field House Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 10 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): None of these standards were fully assessed at this inspection. EVIDENCE: Field House Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 11 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): These standards were met at the inspection carried out on 31/01/06. EVIDENCE: Field House Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 12 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 Service users have a pleasant, well-maintained environment. EVIDENCE: The home was clean and tidy. Furnishings were of a good quality and homely. The garden was well maintained. In all, there were various areas in the home that gave residents choice of where to sit. Those spoken with said they were very satisfied with their rooms aswell as the communal areas. Field House Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 13 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): 28, 29 and 30 Service users are safe with trained nursing staff present in the home. Care staff are supported to attain National Vocational Qualifications, but not enough have attained the expected level. The recruitment policy in place protects service users and staff are closely supervised. EVIDENCE: There was always at least one registered nurse on the premises and usually two. 4 out of 25 care staff have attained a National Vocational Qualification at Level 2 in Care. 5 or 6 more were intending to enrol on such a course. The files of the two most recently appointed staff were examined and found to contain references. There was a new policy in place that no candidates would be interviewed until satisfactory references had been received. The manager and administrator confirmed that the provider had informed them verbally that a check of the Protection of Vulnerable Adults list had been carried out so that the two new staff could start work, but the result of the full Criminal Records Bureau check had not been received. It is recommended that evidence of all such checks be kept on staff files in order to verify they have taken place. Staff training needs were monitored and records of training completed were kept. Staff supervision was on the agenda for the next staff meeting and arrangements were being made to commence regular supervision meetings. Field House Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 14 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): 33 and 38 Service users views are not formally sought, though informal discussion takes place and their best interests are a priority. Action is taken to promote health and safety within the environment. EVIDENCE: There was no established quality monitoring system in place, but meetings had been held in the past. A discussion was held with the manager during this inspection about various ways the views of service users could be sought on all areas of the service. Service users spoken with gave their views of the service and were very positive about the care they received from staff and about the environment. Positive communication between the manager and service users was observed. There were several examples within the home of action being taken to promote health and safety. Fire extinguishers were last checked on 06/07/05 and Field House Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 15 smoke detectors were checked on 17/01/06. Records were available of regular weekly and monthly checks. The closing mechanisms had been recently fitted to the doors of those service users who choose to have doors open at night. This means that those doors would close automatically if there were a fire and this completed the fire plan for the home. Other checks were made on the water system and water temperatures were monitored. Field House Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 4 X X X X X X X STAFFING Standard No Score 27 X 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X 3 Field House Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 17 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. Standard Regulation Requirement Timescale for action 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 OP1 OP7 Good Practice Recommendations Separate the statement of purpose and the service user guide to ensure that they both meet the requirements. Care plans should contain risk assessments with respect to the use of bed rails and signed consents to them being in place. Clear instructions must be given to staff to ensure they are always used safely. Monitor the temperature of the clinic room. Further care staff should be supported to pursue a National Vocational Qualification to at least Level 2 in Care. Keep evidence of all checks through the Criminal Records Bureau on staff files in order to verify they have taken place. Establish a formal quality monitoring system. 3. 4. 5. 6. OP9 OP28 OP29 OP33 Field House Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Care Home DS0000026436.V281842.R01.S.doc Version 5.1 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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