Inspection on 09/09/05 for Field House Care Home

This inspection was carried out on 9th September 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Field House Care Home 01/09/09

Field House Care Home 08/09/08

Field House Care Home 13/09/07

Field House Care Home 28/02/07

Field House Care Home 09/05/06

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

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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 Friday, 9 September 2005 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 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 Stationary 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 C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Field House Care Home Address 127 Foxhall Road Forest Fields Nottingham NG7 6LF 0115 9693509 Telephone number Fax number Email 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 R Stevenson Vacant Care Home 12 Category(ies) of Learning Disability - 12 registration, with number of places Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 12 places for learning disabled adults - not falling into any other catagory. Date of last inspection 25/04/05 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 accomodated in both single and double bedrooms on the upper floors. The property has recently been extended to provide extra communal living space, and work on this is expected to be completed shortly. The service focuses on developing the residents independence skills, and community living. Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The resident’s at Field House say they are very happy, and like living there. The staff team are very resident focussed, however the home’s record keeping and documentation is not in line with National Minimum Standards. Activities organised within the home are inconsistent. There is little staff training at Field House, and this leaves residents potentially at risk. The building has undergone some extension and refurbishment, but this has not yet been completed, and there are other areas of the home also in need of attention. There is no formal staff supervision currently taking place as required in the National Minimum Standards. What the service does well: What has improved since the last inspection? What they could do better: Few of the requirements or recommendations set at the last inspection have been achieved. These include: Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 6 Revising and updating the Statement of Purpose Revising and updating the Service User Guide Developing a consistent format for care plans and identifying action to meet the resident’s needs Regular reviewing of Care Plans Developing a programme of activities for people not attending day care Risk assessing after falls and accidents to minimise the likelihood of further falls or accidents Introducing a procedure linked to whistle blowing and Nottinghamshire’s area procedure on abuse Risk assessing radiators and covering radiators where necessary Provide sluicing facilities Introduce formal supervision for all staff Carry out repairs to the ceiling of the bedroom and bathroom on the top floor Use pictorial representation within the Service user Guide Ensuring NVQ level II training includes units relating to learning disability Providing information regarding advocacy services to the residents and their families There have been no regulation 26 visits by the Responsible Individual, the purpose of which is to monitor and provide support for the staff. 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 C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 2 Prospective residents would not have the information they need to make an informed choice about living at Field House. Assessments of resident’s needs are inconsistent, and lacking in detail. The individual aspirations of the residents are well documented. EVIDENCE: The home’s Statement of Purpose and Service User Guide were seen, and both were out of date, being dated June 2003. Neither contained all of the information required under the National Minimum Standards. Three residents files were seen, and assessments were not consistent, in that basic information held in one file was missing from the others. It was not possible from reading the information available to establish a full and accurate picture of an individual’s needs. One resident has a ‘Person Centred Planning’ file and this was very good. It contained photos of things that the person liked doing, and things they would like to do, and it was clear that the individual had been involved in producing the file, and had, had a lot of input into choosing what actually went into the file. Staff said that they were planning to introduce a similar file for every resident. Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 7 8 & 10 The care-planning format is not clear, or consistent across all files, and it is unclear from the care plans what action is required to meet individual’s specific needs. Field House has regular resident’s meetings, and resident’s feel they have control over some decisions in their lives. Resident’s feel involved and consulted with in many aspects of the running of the home. Resident’s thought that their care plans were secure. EVIDENCE: Three resident’s files were seen, and the format of the files, and the way that information was presented meant it was not possible to ascertain how resident’s needs were being met. Five service users were spoken with at some length. The residents were able to talk about meetings they have, and being consulted over issues such as food shopping and the décor of the home. A number of residents said they had chosen the colours in their bedrooms. It was evident that the residents thought that many of the decisions taken in the home, were the responsibility of the staff, and that they were quite passive in letting the staff take those decisions. None of the residents, even when asked said that they were unhappy with this arrangement. Field House does not have an office, and when records and documentation was requested the manager had to retrieve the documents from various locations around the Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 10 house including the cellar. This situation seemed less than ideal. Residents said they thought their records were “safe” and that “nobody could see them that shouldn’t.” Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 14 15 & 17 The resident’s at Field House have some meaningful and purposeful activities, but these are not well documented. Family contact is encouraged at the home, and residents do have contact with their families both inside and outside the home. The food on offer at the home is to the resident’s liking. EVIDENCE: Talking with the residents, they were able to give contrasting and varied accounts of the activities they are involved in both at the home, and outside. A resident told me about travelling on the tram with his travel card, and showed me things that he had bought in town that morning. He had travelled independently, and said he was free to come and go as he pleased. However another resident when asked about his activities said “I don’t go out much.” The residents also talked about their hopes and wishes, and there was some marked difference in their expectations, from one person who saw Field House as a step on the way to living independently, to another who thought they would be living at Field House for the rest of their lives. The resident’s files that were seen did not have accurate or complete records around activities that residents undertake, and this included all forms of social activity - day Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 12 care, leisure, and family contact. The residents talked about a number of activities and outings, but these could not be evidenced in the care plans. The residents were all sitting in the lounge with the inspector and no staff member was present, there was much joking and banter between the residents and they seemed to genuinely be happy living at the home, and in their residential group. The lounge was equipped with a widescreen television, a video player and a Sky digibox. The residents all said they liked the food, and they were observed requesting a variety of different options for lunch, which the staff then prepared. The menus are prepared a week in advance – on a Sunday evening, with the residents heavily involved in this process. Records of menus, and resident’s suggestions were kept and seen by the inspector. The kitchen is currently being refitted, as part of the extension work at the rear of the property. Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 20 The resident’s physical and emotional health needs are being met, although recording of such is inconsistent. The home operates a safe medication system. EVIDENCE: All of the residents, when asked said that they were happy that the staff would help them, if they were unwell, and that they would get the doctor if they needed one. Healthcare records in files were in line with Regulatory requirements, and it was possible to case track an individuals health needs, although the records carried the minimum of detail. Risk Assessments were still not being reviewed after residents had had accidents or falls. The staff members administer medication to residents on their behalf. The storage and administration records were seen, and found to be complete and clear, the procedure was also explained, although not observed, and this was well managed. Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Residents feel safe living at Field House. The Registered person could do much more to protect the residents from potential abuse, neglect and self-harm, as staff are not trained in the protection of vulnerable adults or other abuse issues. EVIDENCE: The residents were unanimous in saying that they felt safe at Field House, and that they liked the staff. Two members of staff when asked were able to talk about and describe what action they would take if they saw an incident of abuse, or suspected abuse, however staff training on abuse and the protection of vulnerable adults has not taken place. The Service User Guide does not contain a copy of the complaints procedure, or details of the Commission for Social Care Inspection contact details. Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 26 27 28 & 30 Parts of Field House are homely, comfortable and safe, however other areas are not. Most of the resident’s bedrooms promote their independence, whilst three bedrooms are shared and do not. Toilet facilities provide for privacy but are in need of improvement with regard to the physical environment. Shared space within the home, is adequate, although the dining room is dark and oppressive. In most areas the home appeared clean and hygienic. Sluicing facilities are still not available at the home. EVIDENCE: The front lounge at Field House is large, comfortable and clean. The dining room however is dark due to the closeness of the building next door, the external fire escape and bushes in the garden taking away much of the natural light. The dining room did not smell fresh, and this was associated with the downstairs toilet, which is close by, and was in regular use. There is a lack of storage space in the home, which means that the dining room is also where many items such as games and art materials are stored. The new lounge at the rear of the property is large and has great potential, although it has greatly reduced the size of the garden, which is now mostly concreted over. The Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 16 building work does mean that some areas of the house were untidy and dusty. The home has no office, which means records are stored in the cellar, and there is no designated staff area in which to carry out the management tasks of the home, the inspection of records therefore took place in the dining room, which is by definition a resident area. There are three shared bedrooms, which could potentially hinder the independence of those particular residents, although all bedrooms were well personalized, and when asked residents said they liked their bedrooms, including those residents who are sharing a bedroom. The radiator identified at the last inspection to be risk assessed and covered if deemed necessary, has not been either risk assessed or covered. The toilet on the second floor – the ‘orange’ toilet had broken tiles, and damage to the floor and ceiling. The home employs a cleaner 24 hours a week, and there are cleaning schedules in place to direct the cleaner’s work. Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 34 & 36 The Field House staff team is not currently receiving specific training, which would improve the way in which they meet the needs of the residents. The home’s recruitment policies and procedures do protect the residents. Formal staff supervision is not currently taking place at Field House. EVIDENCE: The staff were unable to produce any staff training records for inspection. Two members of staff spoken with said that they had received very little staff training, and none regarding adult abuse issues. Two staff files were seen and these both contained two references, and evidence of a Criminal Records Bureau check. The staff spoken with said that formal staff supervision is due to start shortly, but currently no member of staff is receiving any formal support or supervision as required in Care Home Regulations. Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 & 43 The health safety and welfare of the residents are protected and promoted at Field House. The residents do not benefit from competent and accountable service management. EVIDENCE: A range of records relating to Health & Safety were seen, and were all found to be in order. Records of Regulation 26 visits were not available at the home, and there was no evidence of the provider monitoring the service, as required by Care Home Regulation 26. Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 3 x x x Standard No 22 23 ENVIRONMENT Score 3 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 3 x 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 2 2 2 x 3 Standard No 11 12 13 14 15 16 17 x 2 x 2 3 x 3 Standard No 31 32 33 34 35 36 Score x 1 x 3 x 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Field House Care Home Score x 2 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 1 C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 20 YES Are there any outstanding requirements from the last inspection? 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 YA 1 Regulation Requirement Timescale for action 30th November 2005 2. YA 1 3. YA 6 4. YA 12 Regulation The Registered person must 4&6 revise the Statement of purpose to ensure that all information specified in Schedule 1 of the Care Homes Regulations is included and up to date. (This Requirement is outstanding from the Inspection of 25/04/05) Regulation The Registered person must 5&6 revise the Service User Guide to ensure that all relevant information specified in Regulation 5 is included, and issue a copy to each resident. (This Requirement is outstanding from the Inspection of 25/04/05) Regulation The Registered person must 14 develop a format for care plans, so that the action required to meet each need is clear and also ensure that all plans are kept under review - Monthly for those aged over 65. (This Requirement is outstanding from the Inspection of 25/04/05) Regulation The Registered person must 16 consult with residents regarding day time activities that they undertake, and ensure that the consulatation and activities are recorded in Care Plans. C03 C53 S2249 Field House V247895 090905 Stage 4.doc 30th November 2005 Immediate 15th November 2005 30th November 2005 Field House Care Home Version 1.40 Page 21 5. YA 19 Regulation 13 6. YA 23 Regulation 13 (6) 7. YA 26 Regulation 23 8. YA 27 Regulation 23 9. YA 32 Regulation 18 (1) c 10. YA 36 Regulation 18 (2) 11. YA 43 Regulation 26 (This Requirement is outstanding from the Inspection of 25/04/05) The Registered person must ensure that risk assessments are reviewed following falls and accidents, to ensure all possible action is taken to avoid recurrences. (This Requirement is outstanding from the inspection of 25/04/05) The Registered person must ensure that an appropriate procedure is designed specifically for staff in the home, linked to the existing Whistle Blowing policy and to the Nottinghamshire Area Procedure. Ensure staff are trained in Adult Protection Procedures. (This Requirement is outstanding from the Inspection of 25/04/05) The Registered person must ensure that radiators are risk assessed and covered where a risk is identified. (This Requirement is outstanding from the Inspection of 25/04/05) The Registered person must ensure that repairs are carried out to damaged tiles in the toilet and bathroom areas, and the damaged ceiling and flooring in these areas is also made good. The Registered person must ensure that persons employed to work at the care home receive training appropriate to the work they perform. The Registered person must ensure that staff receive supervision to carry out their jobs. (This Requirement is outstanding from the Inspection of 25/04/05) The Responsible Individual must ensure that monthly Regulation 26 visits to the home take place, and that a copy of the visit Immediate 15th November 2005 30th November 2005 Immediate 15th November 2005 30th November 2005 28th February 2006 30th November 2005 30th November 2005 Page 22 Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 report is sent to the Commission after every visit. 12. 13. 14. 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. 3. 4. 5. 6. 7. 8. 9. Refer to Standard YA 1 YA 2 YA 3 YA 7 YA 9 YA 14 YA 28 YA 30 YA 36 Good Practice Recommendations Use pictorial representations within the Service User guide and add comments from Service Users. Develop an assessment format to use for any new admission (where no community assessment is carried out) as well as for reassessment purposes. Ensure NVQ level II includes units relating to learning disability. Provide residents and their families with clear information about independent advocacy services. When recording risk assessments specify the action staff must take to reduce or diminish the risk for each risk identifed. Consult with residents regarding their interests and hobbies. The Registered person should ensure that the natural light in the dining room is increased by triming the bushes outside the window The Registered person should provide sluicing facilities within the home. The Registered person should ensure that staff receive formal supervision a minimum of six times a year. Field House Care Home C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 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 C03 C53 S2249 Field House V247895 090905 Stage 4.doc Version 1.40 Page 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. 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