Inspection on 30/06/06 for Field House, Minehead

This inspection was carried out on 30th June 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, Minehead 17/06/08

Field House, Minehead 20/02/06

Field House, Minehead 18/08/05

Field House, Minehead 08/03/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Field House The Parks Minehead Somerset TA24 8BU Lead Inspector Judith Roper Key Unannounced Inspection 30th June 2006 10:00 Field House DS0000060745.V300702.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 Field House DS0000060745.V300702.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. Field House DS0000060745.V300702.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Field House Address The Parks Minehead Somerset TA24 8BU 01643 708751 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) Miss Dawn Paxton Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Field House DS0000060745.V300702.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th February 2006 Brief Description of the Service: Field House is a large detached house situated in the Seaside town of Minehead in Somerset. The home is situated in a quiet residential area, which is only a few minutes walk from the town centre and benefits from beautiful views over the surrounding countryside. Field House is registered with the Commission for Social Care Inspection to provide personal care for up to 5 service users between the ages of 18 and 65years, who have a learning disability. The home is not registered to provide nursing care. All service users are accommodated in single bedrooms which are situated on the first and second floor. The home has large landscaped sloping gardens and access to the home is via a number of steps. Field House would therefore not be suitable for service users with mobility difficulties. The registered provider/manager is Dawn Paxton. Field House DS0000060745.V300702.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place over one day between the hours of 10.00 am – 11 45 am. Three service users currently have placements at the home. There is one vacancy at the home. The ethnicities of the service users are white/British and all residents are under 65 years of age. The inspector met all but one service user on the morning of the inspection before service users went out to their usual day-to-day commitments. One service user had gone home with their family for the weekend. As well as speaking with the two service users at the home, the inspector received two written surveys from service users. The verbal and written responses were from all three service users in total. The proprietor Miss Paxton was at the home to discuss the management of the home with the inspector. The inspector would like to thank Miss Paxton and her duty team for their time and hospitality shown to the inspector during her visit. The focus of this inspection visit was to inspect relevant key standards under the CSCI ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are - excellent, good, adequate and poor. These judgement descriptors for the seven chapter outcome groups are given in the report. Records examined during the inspection were three service user care and support plans, medication administration records and the home’s Statement of Purpose. On request the home completed a pre-inspection questionnaire. The total time spent in planning the inspection, carrying out the visit, consolidation of evidence and report writing has been 10.5 hours. What the service does well: Field House provides a comfortable and very homely environment for service users with a learning disability. All service users have their own bedroom, which they are able to personalise. The home has a good range of comfortable and well equipped communal areas and a beautiful garden. Service users living at the home are able to enjoy a ‘family’ type environment. All areas of the home are decorated and furnished to a very high standard. Field House DS0000060745.V300702.R01.S.doc Version 5.2 Page 6 Service users benefit from an ethos that is both open and inclusive. Service users are encouraged and supported to be fully involved in all aspects of life at the home. Service users are supported and encouraged to pursue their own hobbies/interests and to be involved in many activities in the local community. 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 DS0000060745.V300702.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Field House DS0000060745.V300702.R01.S.doc Version 5.2 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 the following standard(s): 2. The outcome for this assessed Standard is good. The home ensures that prospective service users have the information they need to enable them to make an informed choice about moving to the home. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide. The Statement of Purpose has been revised and updated. These documents provide information on the facilities and services offered by the home and are made available to service users, prospective service users and/or their representatives. The home’s scales of charges are between £1172 & £1300 per week. This is a guide and fees are determined upon the assessed needs of an individual. Extra charges are met by the service user for personal items/toiletries and chiropody treatment. The home provides transport for organised trips and activities at no extra charge to the service user. Service users retain any DLA money awarded to them. Field House DS0000060745.V300702.R01.S.doc Version 5.2 Page 9 There have been no new admissions since the February inspection. Standards 2 – 5 were inspected and met at that inspection. Field House DS0000060745.V300702.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9. The overall outcome for these assessed Standards is good. The home’s care planning process remains comprehensive, clear and consistent. The home ensures that service users are encouraged to take informed risks as part of their agreed plan of care. Service users are supported to participate in all aspects of life at the home. EVIDENCE: Care and support plans for the three service users were inspected. Care records contained detailed and appropriate information on the service user’s assessed needs and how these were best met. The inspector was able to see evidence that assessments from other relevant professionals had been taken into account. Feedback from associated community health care Field House DS0000060745.V300702.R01.S.doc Version 5.2 Page 11 professionals was sought at the February inspection. One response via a feedback questionnaire was received and was positive about the service. A good social history is included in care and support plans and a record of the service user’s preferences are identified. Risk assessments are in place covering appropriate factors. Service users are supported to take informed risks within their agreed plan of care. The home also maintains detailed daily records. The home ensures that service users are encouraged to be involved in the day to day running of the home. Service users confirmed this verbally and in survey responses. Given the number of service users living at Field House, formal meetings are not felt to be appropriate. Service users get together on a weekly basis to decide their menu for the following week. Many enjoy shopping for the food in the town. All service users have their own personal bank accounts. The provider/manager offers support to service users in managing small amounts of ‘pocket monies’ where appropriate or requested. Field House DS0000060745.V300702.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 17. The overall outcome for these assessed Standards is good. Service users have access to a wide range of appropriate activities and are supported to establish links with the local community. Family relationships are supported. Service users benefit from a wholesome and varied menu. EVIDENCE: Field House DS0000060745.V300702.R01.S.doc Version 5.2 Page 13 Service users are supported and encouraged to pursue their own interests and hobbies. One service user enjoys gardening tending the elegant garden and growing vegetables. Service users choose what time they get up and go to bed and the preferences of the service users are clearly recorded in the individual’s plan of care. Service users have a key to their bedroom and are made aware that the home maintains a spare key, which would only be used in the case of an emergency. The home supports service users to maintain or develop independent living skills. Each service user has a programme of activities. These include activities such as college, horse riding, shopping, walks, drama and gym. Service users maintain close family links at their preference. As part of the agreed plan of care, service users are supported to prepare their meals where appropriate and service users are involved in shopping for food. Service users have access to drinks and snacks, as they require. Fresh fruit is also available. The home has a spacious and well equipped kitchen which is accessible to service users. Service user feedback surveys were positive about the meals offered. Field House DS0000060745.V300702.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. The overall outcome for these assessed Standards is good. Service users are appropriately supported to meet their personal care and health needs. The home’s procedures for the management and administration of service users medication are generally good but staff training in the administration of medicine would benefit from being formalised by an outside competent training source. EVIDENCE: Care plans examined detailed clear information regarding how personal care needs should be met. This also took into account the preferences of the individual. Health care contacts and information relating to health care needs and visits were seen to be detailed and informative. Given the assessed needs of service users living at the home, prescribed medication is currently managed and administered by staff. Field House DS0000060745.V300702.R01.S.doc Version 5.2 Page 15 The home uses the monitored dosage system (MDS) with pre-printed Medication Administration Records (MAR). These records were inspected and were appropriately maintained. Staff training in the administration of medicines is sometimes done in-house. It is recommended that this is formalised and that staff training in the administration of medicines is by an outside competent source. Field House DS0000060745.V300702.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. The overall outcome for these assessed Standards is good. A complaints procedure is in place and the views of service users are encouraged and listened to. The home takes appropriate steps to reduce the risk of harm or abuse to service users. EVIDENCE: The home has produced a complaints procedure, which is also available in the Statement of Purpose and Service User Guide. No complaints have been received by the home and no concerns have been raised directly with the CSCI. The home takes appropriate steps to reduce the risk of harm or abuse to service users. The home has produced policies relating to adult protection and the prevention of abuse, Whistle Blowing, bullying and aggression. The home also has a copy of Somerset’s Policy on Safeguarding Vulnerable Adults. All staff have a POVA check and enhanced CRB check. Field House DS0000060745.V300702.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28, 29, 30. The overall outcome for these assessed Standards is good. Service users benefit from a very homely ‘family’ type environment, which is decorated and furnished to a high standard. Service users can choose from a good range of communal areas or can enjoy the privacy of their own bedroom. The standard of cleanliness is high and the home takes appropriate steps to reduce the risk of the spread of infection. EVIDENCE: Field House DS0000060745.V300702.R01.S.doc Version 5.2 Page 18 Field House is a large three storey detached house situated in a quiet residential area, which is not far from the centre of Minehead. The home is in an elevated position and enjoys far reaching views to the surrounding countryside. All areas of the home have been decorated and furnished to a high standard and the home promotes a ‘homely’ feel. Communal areas are located on the ground floor, with bedrooms and bathrooms located on the first and second floor, which are accessed by stairs. There is a toilet on the ground floor. The home has large landscaped gardens to the front and rear. As the gardens are sloping, they would not be accessible to those with mobility difficulties. The home is fitted with appropriate fire detection systems and fire fighting equipment. A call bell system has been installed throughout the home. All up stairs windows have been restricted to ensure the safety of service users. All service users are accommodated in single bedrooms, which are fitted with the provision of a wash hand basin. One bedroom is fitted with en-suite shower facilities. Privacy is respected and service users have a key to their rooms. Service users have access to spacious and comfortable communal areas, which are situated on the ground floor. The home has two large lounge areas, which are decorated and furnished attractively. A dining area is available in one of the lounges. One lounge has a television and the other can be utilised for those wishing to enjoy some quiet time. This lounge also has the provision of a payphone. The home is clean and fresh. Liquid soap and paper hand towels are appropriately sited throughout the home. Field House DS0000060745.V300702.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36. The overall outcome for these assessed Standards is good. Service users needs are appropriately met by the number and skills of staff on duty. Appropriate staff recruitment processes are followed but could be more robust if applicants were asked to declare cautions and reprimands as well as convictions at application stage. Service users benefit from a small and stable staff team. EVIDENCE: The home employs one non-family member of staff. There have been no changes in staffing since the last inspection. The recruitment file of the staff member was examined at the last inspection and there was evidence that appropriate recruitment procedures were followed. POVA checks and CRB details for all persons working in the home (not providers) were inspected. The staff application form would benefit from stating that posts are exempt from the 1974 Rehabilitation of Offenders Act and that applicants should declare cautions and reprimands, as well as convictions. Field House DS0000060745.V300702.R01.S.doc Version 5.2 Page 20 The provider and her partner continue to provide 24 hour cover as they live at the home. The two staff at the home, which are not the providers, are enrolled on NVQ training courses in care provision. Staff members reported feeling appropriately supervised at the home and gave testimony to the open culture of raising concerns to the providers, who were reported to be welcoming of suggestions on how to further improve the service. Staff supervision records were viewed and are appropriately maintained. Field House DS0000060745.V300702.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41, 42. The overall outcome for these assessed Standards is good. Service users benefit from an open and inclusive style of management where their views are encouraged. Records in the home are appropriately stored and maintained providing audit trails of the service provision. The home takes appropriate steps to ensure the health and safety of service users, staff and visitors. EVIDENCE: Field House DS0000060745.V300702.R01.S.doc Version 5.2 Page 22 The registered provider/manager is Dawn Paxton. Dawn has worked with service users with a learning disability since 1994. Dawn has previously been registered with the NCSC in Surrey as a manager of a care home for younger adults with a learning disability. Dawn has a City & Guilds certificate in ‘Advanced management for care’ and certificates in ‘epilepsy and the administration of rectal diazepam’ and ‘Nonphysical & physical intervention’. It was apparent to the inspector that the provider promotes an ethos that is open and inclusive. The views of service users are encouraged. This was observed during the inspection. Interactions observed during the inspection were relaxed and respectful. The home has a comprehensive range of policies and procedures, which are discussed with staff. Records seen at this inspection were up to date and stored in accordance with the Data Protection Act 1998. Health and safety records were inspected and met at the February inspection. No health and safety issues were identified by the inspector on the tour of the premises. The provider notified the CSCI appropriately via the Regulation 37 reporting process regarding a recent incident of challenging behaviour in the home. Staff first aid training is arranged for the 11th July. The inspector was informed that there have been no accidents in the home since the last inspection. The home displays an appropriate and current certificate of employers liability insurance. Field House DS0000060745.V300702.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 3 2 N/A 3 X 4 X 5 X 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 4 25 X 26 X 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 3 3 X Field House DS0000060745.V300702.R01.S.doc Version 5.2 Page 24 N/A 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. 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 YA20 YA34 Good Practice Recommendations It is recommended that staff training in the administration of medicines be by an outside competent source. It is recommended that the home’s staff application form states that posts are exempt from the 1974 Rehabilitation of Offenders Act and that applicants state any past cautions or reprimands as well as convictions. Field House DS0000060745.V300702.R01.S.doc Version 5.2 Page 25 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 DS0000060745.V300702.R01.S.doc Version 5.2 Page 26 - 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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