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Inspection on 24/08/05 for Field House Nursing Home

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

This inspection was carried out on 24th August 2005.

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 home was clean and odour free. Service users receive a high standard of care. The home retains a core of staff and the home currently has no staff vacancies. Service users spoke highly of the care that they receive and the Inspectors observed positive interaction from staff. Service users were spoken to with respect and staff evidently had a thorough awareness of service users` requirements.

What has improved since the last inspection?

A requirement made at the previous inspection to ensure that overseas` staff records are kept in the home has been met. A door guard has been fitted to a servery door where a wedge was previously used.

What the care home could do better:

Not all service users have access to lockable space. This is of concern as there has been a recent episode of theft within the home. Records of liquid medication stock are not kept and a requirement has been made. Service users and staff complained the quality of meat had deteriorated over the past weeks. There has been a change of supplier following a company directive. A requirement has been made. Bathroom 2 has no lock fitted and privacy is not assured.

CARE HOMES FOR OLDER PEOPLE Field House Nursing Home 8 Townsend Road Harpenden Herts AL5 4BQ Lead Inspector Angela Dalton Unannounced 24 August 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 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 I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Field House Nursing Home Address 8 Townsend Road, Harpenden, Herts, AL5 4BQ 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) 01582 765966 01582 769622 BUPA Care Homes Limited Dorothy Allan CRH Care Home 37 Category(ies) of OP-37 registration, with number of places Field House Nursing Home I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9 December 2004 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 I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted by two Inspectors on 24th August between 10.15am and 3.15pm. The following reflects the Inspectors’ findings on the day. What the service does well: What has improved since the last inspection? What they could do better: Not all service users have access to lockable space. This is of concern as there has been a recent episode of theft within the home. Records of liquid medication stock are not kept and a requirement has been made. Service users and staff complained the quality of meat had deteriorated over the past weeks. There has been a change of supplier following a company directive. A requirement has been made. Bathroom 2 has no lock fitted and privacy is not assured. Field House Nursing Home I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 Page 6 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 I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Field House Nursing Home I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 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 standard(s) 1,2,3,4&5. Standard 6 is not applicable to Field House. Comprehensive information is available enabling service users to make an informed choice about living in a care home. EVIDENCE: The home or deputy manager conducts an assessment either prior to admission or on arrival to the home. Assessments for service users who had recently been admitted were inspected. This information forms the basis for care plans. A relative was visiting the home to decide if it was suitable for their parent to move into. They had been provided with information to take away to the prospective service user. The home does not provide intermediate care. The previous report and Statement of Purpose are available for visitors in the reception area of the home. Field House Nursing Home I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10&11 Care plans reflect individual requirements. Privacy is not assured in all bathrooms. 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’. Care plans are signed by service users or their relatives. Life histories are being completed by staff or families to include a more personal dimension within documentation. A requirement has been made to record amounts of stock medication and to obtain a G.P. letter regarding specific medication. Other than these points medication was in good order. Each identified health need has a care plan. The home manager is taking steps to ensure that weights are recorded regularly as they are being recorded less frequently of late. A requirement has been made to fit a lock on a bathroom door, as privacy cannot currently be assured. Field House Nursing Home I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 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 standard(s) 12,13,14&15 Service users social requirements are met within the home. Meat served at mealtimes has deteriorated in quality of late. EVIDENCE: The home has a history of providing a high standard of activities. The activity co-ordinator was on annual leave but a member of staff was temporarily filling this role. 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. A requirement has been made to address the quality of the meat within the home as service users and staff have noted deterioration. The home manager is pursuing a complaint made by a service user. There has been a recent change in butchers and the home is endeavouring to resolve the problem. With the exception of one staff member positive interaction was observed and overheard at lunchtime. The manager will address the exception. A recommendation has been made for service users who sit together to be served at the same time. Currently those who have a pureed meal eat first and have finished before their dining companions. The dining experience at Field House is enhanced by decorative napkins and wine or sherry at meal times. Field House are sponsoring a sign at the local bowls club to reflect their participation in the community and social needs of older people. Field House Nursing Home I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 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 standard(s) 16,17&18 A robust complaints procedure is in place. Secure storage space is not provided for all service users. EVIDENCE: The home has experienced a recent theft and dealt with it appropriately. In light of the fact that this has highlighted that not all service users have access to a lockable space a requirement has been made. Service users confirmed that any concerns are listened to and taken seriously. The complaints procedure is displayed within the home and service users and staff know how to make a complaint. Evidence is cited earlier regarding the quality of meat. Service users money is overseen by the home’s administrator. Unfortunately, a service user who chooses to manage their affairs experienced the recent theft and was not using the lockable facilities provided. The police are conducting an investigation. Field House Nursing Home I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 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 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: Some bedrooms have recently been redecorated. Additional specialist beds have recently been delivered. The majority of beds within the home are of hospital standard to enable nursing needs to be fully met. They are domestic in style to ensure that bedrooms are not overly clinical. Within an earlier standard a requirement has been made regarding the lack of a lock on a bathroom door. The home is clean and odour free which testifies the efforts of domestic staff. Garden furniture is available for service users who wish to sit outside in warmer weather. Field House Nursing Home I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29&30 Competent and skilled staff are trained to meet service users’ needs. 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 no new staff recruited since the previous inspection. One member of staff is due to go on maternity leave and a risk assessment had been conducted to ensure she was safe to continue in her role and appropriately supported. 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. Field House Nursing Home I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36,37&38 The home is run in the best interests of service users. EVIDENCE: The manager visits service users daily and is aware of any issues or concerns within the home. Service user meetings take place at intervals throughout the year. One is arranged for the near future to discuss complaints about the quality of eat and review the content of menus. Staff receive supervision and informally meet with the management team on a daily basis. Service users are at the core of Field House and the records examined reflected this, as did the ambience of the home. Field House Nursing Home I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 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 Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Field House Nursing Home I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 Page 16 NO 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 OP9 Regulation 13(2) Requirement Amounts of stock liquid medication must be recorded. A letter must be in place from the G.P. regarding Resperidone to demonstrate risk assessment of side effects in light of Department of Health guidelines. The privacy of service users must be assured by fitting a lock that can be opened in an emergency to Bathroom 2. The quality of the meat must be comparable to that previously served in the home. Lockable space must be provided to all service users. Timescale for action 30/09/05 2. OP10 12(4)(a) 31/10/05 3. 4. OP15 OP18 16(2)(i) 16(2)(1) 30/09/05 31/10/05 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 OP15 OP10 Good Practice Recommendations Service users seated together at mealtimes should be given the opportunity to eat at the same time. Field House Nursing Home I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City, Herts AL7 3BQ 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 Nursing Home I52 s19348 Field House v245094 240805 Stage 4.doc Version 1.40 Page 18 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!