Inspection on 12/09/05 for Field House Rest Home

This inspection was carried out on 12th 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 Rest Home 06/08/08

Field House Rest Home 30/07/07

Field House Rest Home 17/01/07

Field House Rest Home 16/06/06

Field House Rest Home 28/06/05

Field House Rest Home 17/05/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Field House Rest Home Off Western Road Hagley Clent, Near Stourbridge West Midlands DY9 0HL Lead Inspector Jane Morgan Announced Inspection 12th September 2005 09:30 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 Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 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 Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Field House Rest Home Address Off Western Road Hagley Clent, Near Stourbridge West Midlands DY9 0HL 01562 885211 * 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) Mr Ernest Michael Lane Mrs Jermaine Kathleen Emily Lane Mr Kevin Beeson Care Home 54 Category(ies) of Dementia - over 65 years of age (54), Old age, registration, with number not falling within any other category (54), of places Physical disability over 65 years of age (54) Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may also accommodate two named persons aged between 62 - 65 years. 28 June 2005 Date of last inspection Brief Description of the Service: Field House is a care home providing personal care and accommodation for up to fifty-four older people who may have physical disabilities and/or illnesses of the dementia type. It is owned by Mr and Mrs Lane. There is no registered manager at present. The former deputy is the proposed manager. Field House is a Georgian style building standing in ten acres of ground. The setting is rural with village facilities nearby. The home was first registered in 1983 and consists of the original building added to with extensions. The home is divided into three areas known as the main house, the coach house and the cottage. These are connected by a covered corridor. Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Following two inspections in June and July 2005 the CSCI met with the providers to express their strong concerns about the failure to meet the Care Homes Regulations and to discuss possible enforcement action. The providers assured the CSCI of their commitment to raise standards in the home. This inspection was announced, with five days notice being given. It was carried out by three inspectors with additional input from the pharmacist inspector. The inspection lasted one day. What the service does well: What has improved since the last inspection? What they could do better: The providers have indicated their willingness to invest in the home. There is evidence that this had begun. The improvement of the environment is an ongoing process with areas remaining to be addressed. Service user plans need to accurately reflect residents’ needs. The home must be able to undertake a full medication audit of all medicines stored in the home at any one time. Staff recruitment practices are poor. The programming and maintenance of staff training has not been established. A relative expressed concern about staffing levels and these will be checked on an unannounced visit. The formal supervision of staff and a system for quality assurance are not in place. Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 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 Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 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 Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 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): 1, 3, 5. The information provided needs amendment and updating. Appropriate needs assessment is taking place. Visits before admission are facilitated. EVIDENCE: The home has a statement of purpose that needs to be updated. Staffing details and the complaints policy also needs to be included. The service users’ guide needs the inclusion of an amended complaints’ procedure and information about the deposit required by the home to secure a room, returned following assessment if the room is not taken. Assessments of need are being undertaken before admission. Prospective residents and/or their relatives are able to look around the home before a decision to move in is made. Residents moved in on a trial basis. Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 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. Service user plans are improving but further checks on accuracy are required. The evidence in residents’ files was that health care needs were being addressed, but issues were raised about the consistency of some practice. The systems for medicine management have improved since the last inspection. Clear comprehensive arrangements have been installed to ensure service users medication needs are met. The staff are keen to improve their systems further, which was commended. EVIDENCE: Three service user plans were inspected. These have been improved. The plans covered some areas of care adequately, but there was evidence that some areas of need were not covered in sufficient detail. The proposed manager was able to discuss the specific assistance required by residents but this needs to be fully included in the service user plans. There are records of monthly review. Service user files contain tissue viability assessments, a record of monthly weights and moving and handling risk assessments. The personal hygiene of Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 10 service users is being maintained. The home has a supply of continence aids. A relative commented that at times the resident was very wet, and expressed concern that her continence was not always managed properly. She was worried that this was resulting in tissue breakdown. The provider stated that continence assessments were being carried out and that different aids might be needed. Residents have access to health services. All medication is now stored in a dedicated, locked medication room. All medication seen was stored in a neat and efficient manner. A dedicated refrigerator is in use and regular temperature checks are recorded. An inhouse quality audit system is in place to ensure that any errors are dealt with efficiently and openly. Records seen at the inspection were up to date and accurate. There is no date of opening recorded onto all medication containers and a full medication audit could not be undertaken. Standard 10 was not fully inspected but it was noted that service user files contain statements on whether bedroom keys are required by residents. The communication boards on the walls in communal areas containing confidential information on residents have been removed. It remains unclear whether all toilets and bathrooms were fitted with appropriate, working locks. These need to be checked. Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 11 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): 13, 14. Residents maintain contact with family and representatives. They are able to make choices within the routines of the home. EVIDENCE: Standard 12 was not fully inspected. It was noted that there had been a trip out at the end of August. There were a number of visitors at the home. A relative spoken to stated that visitors are free to visit. Staff were described as friendly and helpful. Residents also said that visitors are welcome and that they could see them in private. Residents are able to bring personal possessions with them. The large size of many of the rooms at the home means that items of furniture can be easily accommodated. The home has little involvement in residents’ financial affairs, preferring residents or relatives to manage this. Residents have choices within the routines of the home, for example, where they eat their meals and where they spend their day. It was noted that on the day of the inspection there was a choice of food at lunchtime. On previous inspections this has not been the case. Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 12 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): 16, 18 Improvements to the complaints procedure and recording are necessary. Amendments to adult protection policies and procedures are required. EVIDENCE: The complaints procedure needs to be amended to make clear that complainants can approach the CSCI at any stage without exhausting internal mechanisms first. Any copies of the procedure displayed on notice boards and in the service users’ guide need to include this change. There is a complaints’ record. This shows that the home has received one complaint recently. This was about missing laundry. The action taken has not been recorded. The home has an abuse policy and a protection of vulnerable adults policy. The latter includes reporting allegations to the CSCI. The abuse policy and procedure stipulates an internal investigation without recourse to external agencies. The proposed manager had attended an adult protection course in June 2005. The home does not have a copy of the local authority policy and procedures. Staff have not received adult protection training. There is a whistle-blowing policy that includes details of the CSCI and local ombudsman. It states that internal mechanisms must be exhausted first. The Public Interest Disclosure Act allows recourse to bodies such as the CSCI before this stage is reached. Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 13 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, 21,22,24,25,26. The environment of the home was considerably improved in cleanliness and general presentation since the last inspection. A number of issues are being addressed. Once fully addressed the environment will meet the standards. EVIDENCE: The home is in a pleasant rural setting with lovely views from bedrooms on first and second floors. The grounds are accessible to residents. The provider provided a programme of projected refurbishment for the period of time between September 2005 and February 2006. This includes repairs to a section of flat roof, replacement of guttering, external painting of the whole home, the relocation and improvement of the laundry room in the main house, refurbishment of one of the assisted bathrooms, and the replacement of curtains in a number of bedrooms. The home has more than the required number of bathrooms and toilets. The cleanliness of these facilities had greatly improved since the last inspection and, on the day of the inspection, was of an acceptable standard. The provider was clear that staff have been instructed to stop soaking commode pots in Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 14 baths. The adequacy of the sluicing facilities had been discussed with the providers before the inspection and it had been stated that additional facilities would be provided. The home has passenger lifts. These were last inspected in March 2005. The bath hoist had been serviced in September 2005. The service of the mobile hoists had taken place in April 2005. The home has a call system. The majority of the bedrooms were inspected. The cleanliness had greatly improved since the last inspection. The providers stated that mattresses are being replaced where necessary and plastic covers provided. In one of the rooms there was an odour from the mattress. Bedrooms are carpeted and almost all of the carpets seen were clean. The provider stated that a stained bathroom carpet is due to be placed. Some residents have a lockable storage facility. Others do not. The provider indicated that these can be provided on request. Rooms are centrally heated. Progress has been made in guarding radiators. The remaining covers are due to be fitted shortly. The use of portable heaters was discussed with the provider. She stated that residents wanted additional heaters. The risk assessment of the heaters for individual residents needs to be carried out and clearly recorded. A sample of hot water temperatures was tested. They were close to 43 degrees centigrade, no more than two degrees above. In one room there was no hot water to the basin or bath. Liquid soap and paper towels were available in some bathrooms but not all. The development of a new laundry will address the lack of hand-washing facilities in the laundry in the main house, until then staff need instruction about infection control. The rusty patches on commodes are being dealt with. The home has a contract for the disposal of clinical waste. The kitchen in the main house has been improved with new wall cupboards and a fridge. The providers have decided against the purchase of a dishwasher for the main kitchen, preferring that the kitchen assistant wash up. Food is appropriately stored. Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 15 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): 29, 30. The recruitment procedure needs improvement to ensure the safety of residents. A clear training programme needs to be developed. EVIDENCE: Standard 27 was not fully assessed on this occasion as the home had been given notice of the inspection in the previous week. The rotas were looked at. These indicate ten care staff on duty on the early shift, six on the late shift and three waking night staff, plus a sleeping-in member of staff. Standard 28 was not fully inspected but national vocational qualification (NVQ) training for staff is not established. The records for the three most recently recruited staff were inspected. These staff had been recruited by the previous proposed manager. There were unexplained gaps in employment history. For two members of staff there was only one reference on file. There was no proof of identity and one CRB check was not available. One member of staff had left her previous employment due to disciplinary action being taken. There was no evidence that the home had followed up this issue. The home has an induction process but the records inspected indicated that this was not consistently followed. The process needs to be checked against the Skills for Care (formerly TOPSS) induction standards to ensure that all areas were covered within six weeks of employment. Of the mandatory areas, fire training is most up to date. A training programme for other mandatory training needs to be put into place. Other appropriate training also needs to be Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 16 planned in line with the registration categories, for example, looking after people with dementia illnesses. Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 17 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): 31, 33 The home has experienced recent inconsistency in management. There is no quality assurance system and no formal supervision of staff to the required standard. The management of health and safety has improved with areas remaining to be addressed. EVIDENCE: The registered manager left in 2004. A new manager was appointed and started work in January 2005. She left in May 2005. The deputy manager has been appointed to the post and is completing her application for registration. The proposed manager has acknowledged her lack of experience in relation to the records required by the Care Homes Regulations, but it was of concern on the day of the inspection that she had not looked at the regulations and standards. The regulation requiring a monthly report on the conduct of the home had been discussed with the providers. Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 18 A quality assurance system is being planned and is due to be implemented shortly. The home is holding money for a small number of residents. This is appropriately recorded. Two rings are also awaiting collection by a resident’s representative. These have not been recorded. There is no evidence that staff received formal, one-to-one supervision at least six times a year. The “environment” section of the report contains information about health and safety in the home. In addition, accidents to residents and staff are being recorded. The accident book recently introduced by the Health and Safety Executive (HSE) is not in use and there is no formal audit of accidents. Fire records are up-to-date. No fire doors were wedged open, appropriate devices were in use. All wheelchairs have footplates attached and staff were seen to be using them. All substances hazardous to health (COSHH) are stored safely. A gas safety record dated 10.9.05 was seen. Portable appliance testing (PAT) had been carried out at the beginning of the year, records were not available in the home. The provider stated that a member of staff is to be sent on training on PAT testing. A Legionella risk assessment and a fixed electrical installation certificate were not available for inspection. The providers agreed to forward them to the CSCI. The responsibility for the flushing through of seldom-used taps has been allocated to a member of staff. Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 19 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 2 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 2 x 2 2 x 2 2 2 STAFFING Standard No Score 27 x 28 x 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 2 x 2 1 x 2 Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes 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. 2. Standard OP11 OP11 Regulation 4 5 Requirement The statement of purpose must contain all the information listed in schedule 1. The service users’ guide must be updated and must contain information about the deposit to reserve a room. Changing needs must be fully recorded in service user plans. Timescale: from the date of the inspection. Unless it is impractical, residents or their representatives must be involved in drawing up their care plans. (Previous timescale of 31/7/05 not met). Timescale: from the date of the inspection. The continence of residents must be properly managed. Timescale: from the date of the inspection. The locks on all toilet and bathroom doors must be checked to ensure that they are in working order. The complaints policy must be amended to include that complaints can be taken to the CSCI at any stage. DS0000018505.V249436.R01.S.doc Timescale for action 31/12/05 31/12/05 3. OP77 15 12/09/05 4. OP77 15 12/09/05 5. OP88 12 12/09/05 6. OP1010 12 31/12/05 7. OP1616 22 31/12/05 Field House Rest Home Version 5.0 Page 21 8. OP1616 22 9. OP1818 13(5) 10. 11. OP1818 OP1818 13(5) 13(5) 12. OP1919 23(2) 13. OP2424 13(3) 14. 15. OP2525 OP2525 13(4) 13(4) 16. OP2525 13(4) 17. 18. OP2626 OP2626 23(2)(k) 13(3) The complaints log must include details of the investigation undertaken and any action taken. Timescale: There must be one adult protection policy and procedure drawn up in line with the local authority’s procedures. (Previous timescale of 31/8/05 not met). All staff must be provided with training in adult protection. (Previous timescale of 30/9/05) The whistle-blowing procedure must be altered to comply with the Public Interest Disclosure Act. The refurbishment of the areas of the home must be completed in the timescale identified in the programme. (Previous timescales of 31/3/05 and 30/9/05 were set by the CSCI). The condition of mattresses must be regularly checked and where stains are evident they must be replaced. Timescale: from the date of the inspection and ongoing. The programme to guard all radiators posing a risk to residents must be completed. All portable heaters must be risk assessed. (Previous timescale of 30/9/05 has not expired). Timescale: from the date of the inspection. There must be a constant supply of hot water to all bedrooms. Timescale: from the date of the inspection. The plan to provide additional sluicing facilities must be implemented. Liquid soap and paper towels must be available in all bathrooms. Timescale: from the date of the inspection. DS0000018505.V249436.R01.S.doc 12/09/05 31/10/05 31/12/05 31/12/05 28/02/06 12/09/05 31/10/05 12/09/05 12/09/05 31/12/05 12/09/05 Field House Rest Home Version 5.0 Page 22 19. OP2727 18 20. OP2828 18(1)(c) 21. OP2929 19, schedule 2 22. OP3030 12,18 23. OP3030 18 24. OP3131 26 25. OP3333 24 26. OP3535 16(2)(l) There must be suitably qualified, competent and experienced persons working at the home in such numbers as are appropriate for the health and welfare of residents. (Not fully checked on this inspection). Timescale : from the date of the inspection. A plan must be put in place, and implemented, to ensure that 50 of care staff achieve NVQ level 2 qualifications. Substantial progress on this must be evident by the timescale set. For the protection of residents, the recruitment process must meet the requirements of the regulations. All the information listed in schedule 2 must be available on every staff file. Timescale: from the date of the inspection. All members of staff must receive induction training to Skills for Care (formerly TOPSS) specification within six weeks of appointment. (Previous timescale of 31/8/05 not met) Timescale: to start from the date of the inspection. All staff must receive a minimum of three days training per year, including training appropriate for the registration categories, and have individual training and development profiles. (Previous timescale of 31/8/05 not met). A monthly report on the visits to the home by the provider must be supplied to the registration authority. (Previous timescale of 31/8/05 not met). A quality assurance system must be introduced in accordance with the requirements of regulation 24 and standard 33. (Previous timescale of 31/8/05 not met). Valuables held on behalf of DS0000018505.V249436.R01.S.doc 12/09/05 31/01/06 12/09/05 12/09/05 31/12/05 31/10/05 31/12/05 12/09/05 Page 23 Field House Rest Home Version 5.0 27. OP3636 18 residents must be recorded. Timescale: from the date of the inspection. Care staff must receive formal supervision at least six times a year. (Previous timescale of 31/8/05 not met). All staff to have had one recorded supervision session by the date shown. 30/11/05 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. 2. 3. 4. 5. Refer to Standard OP99 OP1414 OP2222 OP2525 OP3838 Good Practice Recommendations It is strongly recommended that the dates of opening of all medication containers are recorded for audit purposes. Information should be made available to residents about advocacy services. Handrails should be provided along corridors. Strip lighting in some areas of the home should be reviewed and replaced with more domestic style lighting. The HSE accident book should be used to record accidents and an audit of accidents should be regularly carried out. Field House Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Rest Home DS0000018505.V249436.R01.S.doc Version 5.0 Page 25 - 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. 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