CARE HOMES FOR OLDER PEOPLE
Field House Nursing Home 8 Townsend Road Harpenden Hertfordshire AL5 4BQ Lead Inspector
Angela Dalton Unannounced Inspection 2nd February 2006 09:45 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 Nursing Home DS0000019348.V281085.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 Nursing Home DS0000019348.V281085.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Field House Nursing Home Address 8 Townsend Road Harpenden Hertfordshire AL5 4BQ 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) 01582 765966 01582 769622 alland@bupa.com BUPA Care Homes (BNH) Limited Ms Dorothy Allan Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Field House Nursing Home DS0000019348.V281085.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. This home may accommodate 37 older people who are physically infirm who require nursing care. This home may accommodate 37 older people who require convalescent nursing care. 24th August 2005 Date of last inspection Brief Description of the Service: Field House is a care home with nursing, registered to provide nursing care for older people. The home is situated in a pleasant residential area of Harpenden within walking distance of the town centre facilities and pleasant parks and gardens. It is accessible by public transport and is a short walk away from the bus stop and the train station is approximately three – quarters of a mile away. The building is an extended period house with some modern additions. The sitting and activities rooms, overlooking the garden, provide a focus for the day for most of the service users and their visitors. Meals are taken in the attractive dining room. Field House is part of Bupa Care Homes. Field House Nursing Home DS0000019348.V281085.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Two Inspectors conducted an unannounced inspection between 09.45 and 1.15pm on 1st February 2006. The purpose of the inspection was to review progress made regarding the requirements made at the previous visit. All Standards have therefore not been inspected due to the high standard of care delivered at Field House. What the service does well: What has improved since the last inspection?
Previous requirements have all been met. Amounts of stock liquid medication are now recorded. A letter is in place from the G.P. regarding Risperidone to demonstrate a risk assessment of side effects in light of Department of Health guidelines. The privacy of service users is now assured as a lock that can be opened in an emergency has been fitted to Bathroom 2. Service users felt that the standard of meat had improved since the previous inspection which coincided with a change of supplier. Lockable space is offered to all service users and where they deline a record is kept. Field House Nursing Home DS0000019348.V281085.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Field House Nursing Home DS0000019348.V281085.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Field House Nursing Home DS0000019348.V281085.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Standards not inspected on this occasion. Please see previous inspection report for comments. Field House Nursing Home DS0000019348.V281085.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 & 11 Care plans reflect individual requirements. A safe medication system is in place. EVIDENCE: Service users were well groomed and care staff were observed to spend time with service users. They took time to place items within reach and were patient and kind. Service users confirmed staff were always helpful and ‘lovely’. One service user visiting for respite care said ‘I’ve been very happy here.’ Care plans are signed by service users or their relatives. Life histories have been completed by staff or families to include a more personal dimension within the documentation. Records reflect amounts of stock medication stored. A G.P. letter regarding specific medication has been obtained. Medication was checked and found to be in good order. Each identified health need has a care plan and weights are recorded regularly. A lock has been fitted on the bathroom door since the previous inspection and privacy is now assured. Field House Nursing Home DS0000019348.V281085.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): 12,13,14 & 15 Service users social requirements are met within the home. A wholesome diet is available. EVIDENCE: The home provides an excellent selection of activities and an activities coordinator works within the home five days each week. Two members of staff are employed to ensure that activities are always available. The home has a history of providing a high standard of activities. Newspapers are provided and there is a designated room in which activities take place. Outings are organised in both small and large groups and these are successful as nursing needs can be catered for when the home hires a medically equipped coach (Jumbulance). The hairdresser was visiting during the inspection. The manager has recently started to produce a seasonal newsletter, which service users, staff and families contribute to. The quality of the meat has improved since the previous inspection. Inspectors sampled some homemade wine produced from home grown grapes (it still had some time to mature!) Field House Nursing Home DS0000019348.V281085.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): EVIDENCE: Standards were not inspected on this occasion. Please see previous inspection report for comments. Field House Nursing Home DS0000019348.V281085.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): 19,20,21,22,23,24,25 & 26 The home is well maintained, clean and odour free. The service users have access to comfortable surroundings. EVIDENCE: The home has specialist beds and necessary aids and adaptations are in place. This enables nursing needs to be fully met. An earlier requirement has been met regarding the lack of a lock on a bathroom door. The home is clean and odour free which testifies to the efforts of domestic staff. Garden furniture is available for service users who wish to sit outside in warmer weather. Field House Nursing Home DS0000019348.V281085.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): 27,28,29 & 30 Competent and skilled staff are trained to meet service users’ needs. Service users’ independence is not always maintained. EVIDENCE: Field House successfully retains the majority of staff which ensures that continuity and consistency of care is assured. Ongoing training is provided both to nursing and care staff. There had been two new staff recruited since the previous inspection. The manager is in the process of recruiting additional staff as she is aware that an area of the home has service users with increased needs. A recommendation has been made for the manager to observe moving and handling practices as some staff may be assisting service users who could be more independent with prompting. Inspectors noted that some service users were assisted rather than encouraged to be independent. Field House Nursing Home DS0000019348.V281085.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): EVIDENCE: Standards were not inspected on this occasion. Please see previous inspection report for comments. Field House Nursing Home DS0000019348.V281085.R01.S.doc Version 5.1 Page 15 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 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Field House Nursing Home DS0000019348.V281085.R01.S.doc Version 5.1 Page 16 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 Refer to Standard OP30 Good Practice Recommendations A recommendation has been made for the manager to observe moving and handling practices as some staff may be assisting service users who could be more independent with prompting. Field House Nursing Home DS0000019348.V281085.R01.S.doc Version 5.1 Page 17 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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