Inspection on 06/08/08 for Field House Rest Home

This inspection was carried out on 6th August 2008.

CSCI found this care home to be providing an Adequate service.

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 Rest Home 30/07/07

Field House Rest Home 17/01/07

Field House Rest Home 16/06/06

Field House Rest Home 12/09/05

Field House Rest Home 28/06/05

Field House Rest Home 17/05/04

Similar services:

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 13/03/2009.

CARE HOMES FOR OLDER PEOPLE Field House Rest Home Off Western Road Hagley Clent, Near Stourbridge West Midlands DY9 0HL Lead Inspector Denise Reynolds Unannounced Inspection 6th August 2008 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.V369579.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 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.V369579.R01.S.doc Version 5.2 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 01562 700417 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 Manager post vacant 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.V369579.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may also accommodate two named persons aged between 62 - 65 years. 30th July 2007 Date of last inspection Brief Description of the Service: Field House is owned by Mr and Mrs Lane and is a care home registered to provide care and accommodation for up to fifty-four older people who may have physical disabilities and/or illnesses of the dementia type. Field House is a Georgian style building in ten acres of grounds. The setting is rural with village facilities nearby. The Home was first registered in 1983 and is divided into three areas known as the main house, the coach house and the cottage. The main house has large rooms, high ceilings and a large wide staircase while the coach house and cottage are smaller and more domestic in style. People who live at the Home all have their own bedroom unless they are couples or friends who wish to share a room. The Home has large lawns at the front of the building and as well as a pleasant courtyard garden at the back. There are plenty of parking spaces for visitors’ cars. Information regarding fees for the Home should be requested direct from the acting manager or from the owners. We did not check the arrangements for making copies of our inspection reports available at the Home; again, this information can be obtained direct from the service. Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was a full inspection of Field House to look at how the Home is performing in respect of the core national minimum standards (the report says which these standards are) and the quality of the service that the people who live there experience. We call this type of inspection a key inspection. We, the Commission, made one visit to the Home for this inspection; this was carried out by two inspectors who arrived unannounced. The Home completed an Annual Quality Assurance Assessment earlier in the summer and we used information provided in this to help us plan our inspection. We also took into account information in surveys that were returned to us by seven people who live in the Home (some of these were filled in for them by relatives), two health professionals and one staff member. During the inspection we spoke to people who live in the Home and to the relatives of two people. One of our inspectors spent a total of four hours sitting with people in two of the three sitting rooms to see how people pass their time and how much contact they have with staff. We also spoke with Tanya Bradley the acting manager (we have referred to her by name or as ‘the manager’ in the report) and some staff. We inspected parts of the premises and looked at various records such as care records and staff files. What the service does well: Field House is set in very attractive grounds and is a friendly and welcoming Home. Visitors are made welcome and thought goes into helping people keep in contact with family life. People are able to bring their own belongings into their bedrooms to help make them feel it is theirs. They are also able to bring pets with them when they move in. This gives pleasure to the owners and to other people living there. Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 6 Good information is given to staff when someone new arrives so that they understand the help and support the person needs to help them settle in. Most staff speak to people politely and are gentle and discreet when helping them. The food at the Home is planned with people’s enjoyment and nutrition in mind. The catering staff are well informed about their role in keeping people healthy. The information we received in our surveys and when we spoke to people was generally positive and gave a picture of a hard working staff team who want to do their best for the people who live in the Home. The comments people made included – ‘The Home always tells us if Mum has had a visit from her doctor and what has been said’ ‘The Home itself is beautifully clean and fresh every time I have visited.’ ‘The manager works very hard to ensure the residents have the best care. The food appears very good and residents are always dressed in the day and up out of bed. The rooms are very comfortable and ‘homely’.’ What has improved since the last inspection? What they could do better: Work on improving the written plans describing people’s care needs to continue to make sure the plans give clear information and guidance to staff and reflect each person’s needs and wishes. Having observed a person having an uneaten meal removed from them and a person taken to the toilet with the door open we believe that some staff may Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 7 need to be reminded of how important it is to always have people’s privacy, dignity and rights at the heart of everything they do. Decisions about areas of care where people may be at risk of harm, such as the use or not of bedrails, need to be regularly reviewed and monitored, particularly when there is a change in the person’s needs. If the Home is going to continue to accommodate people with dementia type illnesses they need to find out more about recognised best practice in this area of care, including care practice, communication, training and how the environment can be used to help people. Staffing arrangements need to be reviewed to ensure that staff are always deployed effectively and in sufficient numbers so that people in the Home have the individual care and attention they need. 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. The summary of this inspection report can be made available in other formats on request. Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 8 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.V369579.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Before being offered a place, people have their care needs carefully checked to make sure the Home can provide the right level of support and staff know what care the person needs when they arrive. EVIDENCE: When people are thinking of moving to Field House the manager visits them to find out about the care they need. People and their relatives are encouraged to come and look around before deciding whether to move in. We looked at the information the manager had gathered about three people who had moved in recently; this was detailed and informative. The manager Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 10 needs to amend the form because at the moment it doesn’t give her enough space for all the information she includes and this makes it hard to read. When a person arrives the manager writes a detailed explanation in the daily records to give staff information about why the person has needed to move in to a care home. The examples we saw showed that staff had used this information to help them to be supportive and understanding of how the people felt when they first arrived. The records showed that these people had all had their individual needs considered and that staff had worked hard to help them settle in. The information gathered when the manager does the assessment is used to create a written plan for the person’s care which includes information about the things they need staff to help them with. We have said more about these plans in the next section of the report. The manager is planning to introduce a feedback form for people and their relatives to find out how they thought their move to the Home went and what they think the Home could have done better. This will be a positive step which should help the Home improve the experience of people who move in to the Home in the future. Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at Field House have their health and personal care needs attended to by well-motivated staff who work closely with local healthcare professionals. People will benefit from further improvements planned by the Home in the way care is planned and provided. EVIDENCE: Field Farm House does not have a key worker system but uses a daily allocation system to ensure that staff are clear about their responsibilities during each shift and are accountable for shortfalls in standards of care. The written care plans improved last year and are still being developed. The plans need to describe the care a person needs in more detail rather than the generalised statements used in some of them at the moment. More needs to Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 12 be done to involve people and their relatives in discussions about what needs to be in their care plans. In some cases this will need to involve consideration in relation to the Mental Capacity Act to help staff judge how able a person is to make their own decisions about different aspects of their care. Two senior staff have recently been delegated the responsibility for improving the written care records and when we met them during the inspection they were keen to get on with this work. The daily records and the information about visits by health professionals indicated that staff are good at noticing and following up concerns about health. Information we received from health professionals who visit the Home confirm that the manager works closely with them and is very proactive in seeking medical attention for people staff are concerned about, for example ‘We are regularly asked to review the care of our patients at Field House and our advice is always acted upon.’ These professionals also told us that they are able to see people in private and that staff are hardworking and caring. During the inspection we met a specialist nurse advisor for older people who told us about the effective work the Home is doing to ensure that people have their nutritional needs attended to. This was reflected in the care records and in discussion with the cook who was aware of people who need care with their diet due to low weight or other specific health reasons. Most of the survey forms we received showed people are happy with care at the Home, with five out of seven forms confirming that people always get the care they need and two feeling this is usually the case. All seven surveys said that people always get the medical attention they need. One relative wrote ‘The Home always tells us if Mum has had a visit from her doctor and what has been said’ All but one survey told us that staff always listen and act on what people say, but in one the comment was made that staff communication could sometimes be better. The health professionals who gave us information also raised occasional lapses in communication as an area for improvement but added that Tanya Bradley always follows up problems they tell her about. We found one example of a bedrail assessment which did not fully reflect the person’s needs, the reasons for bedrails being used, and changes in circumstances. This led to the rails continuing to be used when there were reasons why this needed to have been reconsidered sooner. This highlighted the importance of keeping information under review and up to date. Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 13 While we were at the Home we saw some situations where people did not get the level of care we would expect, for example a person’s meal was removed even though they had not eaten it. We also noted that at times staff were not available to spend time with residents or to assist them promptly when they asked for help. Some of the comments by health professionals also indicted that staff though very caring and hardworking, are sometimes overstretched and not able to deal with the needs of every resident. During the inspection we saw that staff were thoughtful and discreet when assisting people to go to the toilet, taking care to ask them quietly to protect their privacy and dignity. We also saw that staff who were helping people to move were gentle and good at explaining to people what they were doing. People we saw during the inspection looked well dressed and had tidy hair, clean clothes etc. We saw one example of care where a person’s privacy and dignity were not respected and the way they were moved may not have been safe. A member of staff took someone to use the toilet and left the door open. This seemed to be because the person had to be transferred from a wheelchair and held, leaving the member of staff unable to move the wheelchair out of the way or close the door. This is poor practice and Tanya Bradley told us she would look into why this had happened. Medication is securely stored in two main locations in the home. Locked medicine trolleys are used to store medication; these are secured to a wall when not in use. Locked refrigerators are used for medication requiring cold storage. Temperature records were available to show that medication is stored at the correct temperature. Medication records provided evidence of generally good stock control and correct administration but we found three examples of medication where the balance of tablets did not match the records. In two cases this was due to lack of clarity about the when a new box had been taken from stock and when it had been opened. This was discussed with the senior carer responsible for medication; the problem could be easily remedied by clarifying the procedure for dating new boxes. We also suggested highlighting the first dose from a new pack on the MAR chart. The third example was investigated by the manager who informed us that the error was due to the person being giving one tablet instead of two on two days. This was an error made by two staff. She was confident that this was an isolated incident. We had already ascertained that the condition the medication was for had responded well even with the reduced amount being administered. Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The importance of nutritious enjoyable food is recognised and people at the Home receive a balanced diet. Improvements to the current range of activities are planned so that people have more choice of ways to spend their time. Visitors are made welcome and people are helped to keep in touch with the people who matter to them. EVIDENCE: A member of staff has recently been delegated the role of improving the range of activities for people who live at the Home. She has only recently begun this role so we were not able to look at progress during this inspection. Field House has a policy of allowing people to bring their pets with them to the Home and as a result there are three dogs at the Home. Staff support the owners with taking the dogs out for walks. We saw information in one Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 15 person’s records which showed that staff had worked to help the person gain confidence that they would help them look after the dog and that it would be safe at the Home. Several people commented in surveys that the policy is welcomed and viewed as a positive aspect of life at Field House. During the morning a person arrived to do a music and movement session with people in the main sitting room which they seemed to enjoy. When this ended, staff asked people whether they would like more music on and asked for requests. People said they would like Sinatra and Nat King Cole and this was what staff then played. This was a positive thing to see but later in the day, in The Cottage sitting room there was a long period when the television was tuned to children’s’ programmes and mostly being ignored by residents. We also noted periods during the day when people were left to their own devices for periods of time. The menus showed a varied and nutritious diet. We spoke to one of the cooks who was aware of the dietary needs of people who live in the Home and who needs special attention with nutrition. We were told that supplies of food are good and that whenever possible food is homemade. There are regular deliveries of fresh meat and produce. We saw an example of staff getting someone a fresh meal because they didn’t like something on the plate they were given. A visitor told us that Tanya Bradley is arranging for staff to support his relative and another elderly guest so they can attend a family wedding and that the Home was not going to charge them for this. He was very appreciative of this. This was an excellent example of the Home helping people to continue to be involved in family life. Because there are a high proportion of people living in the Home who have a dementia illness, attention needs to be given to developing enjoyable and meaningful ways for them to spend their time. Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People feel safe at the Home and they or their relatives know they can make a complaint if they are unhappy about something. Staff receive training to give them the knowledge they need to deal with any concern about abuse or neglect correctly. EVIDENCE: There is complaints procedure available and this has been improved and updated since our last inspection. Everyone who returned surveys said they know who to complain to if there is something they are not happy with. There is a complaints log with clear forms to record when a complaint is made. The records showed that no complaints had been made direct to the Home since our last inspection. We have had no complaints made to us since then either. During 2007 Tanya Bradley and most staff attended training about safeguarding so they will know how to recognise, understand and take action when abuse or neglect is suspected. The manager has a system to help her Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 17 monitor staff attendance at this training so she can make sure people have updates when these are due. Worcestershire Council adult protection posters are displayed in the building as well as information about the statutory protection (the ‘Whistleblowing’ legislation) offered to staff who raise concerns in good faith. We were made aware in a survey received after we did our inspection of a situation which should have been reported to us and to Worcestershire Council as a safeguarding alert. This involved unexplained bruising which the Home correctly sought medical attention for. We have since discussed with the manager the reasons why she did not make a safeguarding alert. We explained why we believe an alert should have been made to increase her understanding of the process and the protection it offers to people who use services. We also wanted to emphasise the benefits of working in partnership with other agencies when problematic situations occur. Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at Field House have a comfortable and clean accommodation which is well maintained and provides a homely environment in lovely surroundings. People with dementia would be assisted by using décor and signs in a way that helps them find their way around. EVIDENCE: The owners of Field House are continuing to make improvements to the décor at the Home and have recently upgraded the premises following an inspection by Hereford and Worcester Fire and Rescue Service. Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 19 All parts of the building we saw during the inspection were very clean and no concerns about infection control or hygiene were found. A new laundry is nearly ready to be brought into use. This will improve the facilities for the care of people’s clothing and be a more convenient and efficient environment for staff to work in. People are encouraged to bring their own belongings with them for their bedrooms many of which are very large and enable people to have living room furniture as well as a bedroom suite. The majority of bedrooms have ensuite facilities. The rural location means that most rooms have lovely views of the gardens and surrounding countryside. At the moment the Home does not have a strategy for helping people with dementia illnesses to find their way around the building. If the Home plans to continue to provide a service for people with dementia illnesses, this is something they need to develop with reference to available best practice guidelines. Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at Field House are protected by recruitment procedures which minimise the chances of unsuitable people being employed. Training arrangements have improved so that staff can develop their knowledge and skills in important aspects of safety and care. Staffing arrangements may not always ensure that people have the individual attention they need. EVIDENCE: We checked the recruitment records for three staff and found that the required procedures had been followed to check the suitability of the people involved to work in a care setting. This helps to ensure that people who are unsuitable to work with older people are not able to gain employment in the Home. In the surveys we received from people who live in the Home only one person said staff were always available when needed, the rest said they are usually available. The healthcare professionals we heard from also told us that on occasions they feel that staffing levels are not sufficient. During the inspection there were parts of the day when people did not have much contact with staff, Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 21 for example, in the afternoon in The Cottage, there was no staff contact in the sitting room from 14:05pm until 14:35pm. We also noted that in the main house at lunchtime there were two staff to help seven people who needed help with eating their meal. During the meal another person was asking for staff but because they were helping people to eat they could not respond. We saw that staff worked with people in a generally friendly and caring way and noted that most of them smiled at residents and were gentle when helping them. We have described some of the good care we saw in the health and personal care section of our report. The health professionals who gave us information were complimentary about the hard work and motivation of the staff and one relative wrote – ‘The Home has been very good with Mum from the first day she arrived there.’ We saw a small number of incidents when less care was taken, for example when the person’s meal tray was removed and when a staff member effectively ‘told someone off’ for not drinking their tea. We also spoke to a staff member whose lack of understanding about how dementia affects people was all the more concerning because she had recently attended training about dementia. One of the surveys re received included the comment – ‘Some of the staff are very good but others seem to have not interest in their job at all.’ The evidence suggests that most staff are good at their jobs but that some may have less commitment to their work; this is an area that the manager will need to monitor to ensure the standards she clearly expects of staff are maintained. The amount of training provided for staff has increased significantly in the last two years and the manager has set up improved systems for monitoring and planning staff training. This is an area where she recognises that more work needs to be done and plans to build on progress during the next 12 months. Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the service are experiencing an improved service because the Home is being managed more effectively and is planning further improvements. EVIDENCE: Tanya Bradley started work as manager of the Home in January 2007 and has implemented a range of changes that have improved the quality of the service over the last 18 months. Ms Bradley is still registered as manager in respect of The Coach House, the other service owned by Mr and Mrs Lane. This means Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 23 that she is not deployed full time at either service. To date Ms Bradley has not applied to us to be registered in respect of Field House but has undertaken to do so by 6th October 2008. A structured quality assurance system is not in place at Field House but Ms Bradley and the owners of the Home have made a number of improvements in since Ms Bradley became involved in the direct management of the service. In the AQAA Ms Bradley has identified several areas for improvement, including being more organised about obtaining the views of people to help her continue to improve the service the Home provides. A small number of people have their personal spending money looked after by the Home. There are good records kept which show how much is spent on their behalf and when we checked the balances of two people’s money against the records both were correct. We advised the manager to number the receipts kept and to reference these to the records to help provide a clear audit trail. The maintenance records we sampled showed that regular servicing and repairs are arranged so that essential equipment is kept in good working order. The training staff are having includes health and safety related topics such as food hygiene, moving and handling, fire safety and first aid. The manager confirmed that all the issues detailed in a Fire Officer’s report in 2007 had been rectified. The AQAA we were sent this year was not as comprehensive as last years. We explained the benefits of providing good evidence, including examples of good practice and specific improvements as a way of demonstrating what has been achieved in the Home. Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 24 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 25 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. 1 Standard OP7 Regulation 13(4)(c) Requirement Bedrail assessments must be reviewed to make sure they contain clear information about how and why decisions to use them have been made and they must be updated when circumstances change. Tanya Bradley wrote to us on 22nd August to confirm that this requirement had been met. Timescale for action 21/08/08 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 OP7 Good Practice Recommendations The information in the written plans describing people’s care needs to be detailed enough to guide staff in the care that each person needs. If a service for people with dementia type illnesses is going to be provided at Field House in the future you should investigate sources of information and guidance DS0000018505.V369579.R01.S.doc Version 5.2 Page 26 2. OP4 Field House Rest Home 3. 4. OP10 OP27 about recognised best practice in this area of care to enable you to develop the service. Some work may be needed with some staff to remind them of the importance of maintaining the privacy and dignity of people who live in the Home. Staffing arrangements need to be reviewed to ensure that staff are always deployed effectively and in sufficient numbers so that people in the Home have the individual care and attention they need. Field House Rest Home DS0000018505.V369579.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V369579.R01.S.doc Version 5.2 Page 28 - 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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