Inspection on 01/08/06 for Field View

This inspection was carried out on 1st August 2006.

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 View 08/11/05

Field View 22/04/05

Field View 08/12/04

Field View 03/06/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Field View Spark Lane Mapplewell Barnsley South Yorkshire S75 6BN Lead Inspector Mrs Jayne White Key Unannounced Inspection 1st August 2006 09:00 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 View DS0000018253.V303447.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 View DS0000018253.V303447.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Field View Address Spark Lane Mapplewell Barnsley South Yorkshire S75 6BN 01226 390131 01226 388322 field.view@fshc.co.uk None Chapelfield View Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Mrs Lynne Simms Care Home 40 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) Category(ies) of Old age, not falling within any other category registration, with number (40) of places Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th November 2005 Brief Description of the Service: Field View is registered as a care home providing personal care and accommodation for 40 older people. The home has provision for permanent and short stay residents. Accommodation is over two floors and a passenger lift and stairs serve these. The home is registered for 28 single and six double rooms. A range of communal areas are provided including three lounges and one dining room. A commercial type kitchen and laundry serve the home. Sufficient bathing facilities are provided. The garden areas that were well maintained were mainly lawned and have sitting areas with garden furniture. There are car-parking facilities. The home shares the site with another home also owned by the same company. Field View is located in the centre of Mapplewell Village and is within easy access to shops, local post office, pubs, clubs and places of worship. Information about the home is available in the entrance hall to the home and a service user guide is available. It was suggested to the manager the service user guide be kept near the latest CSCI inspection report in the entrance hall. The provider dataset dated 20.07.06 identified the full fee for the current scale of charges ranges from £315.00 for residents placed through Barnsley Metropolitan Borough Council and £359.00 for those placed through Wakefield Metropolitan District Council. The contribution to be paid is determined by a financial assessment undertaken by the councils. Fees for self-funding residents are £390.00. Additional charges are made for hairdressing, private chiropody and some day trips. Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over ten hours from 8:15 to 18:15. As part of the inspection process a postal questionnaire was sent to ten residents, three relatives/advocates of residents, two GPs and three health and social care professionals. Questionnaires that were returned included two by residents; two by relatives/advocates, two by health and social care professionals and one by a GP. On the day, opportunity was taken to make a partial inspection of the premises, inspect a sample of records, observe care practices and talk to residents, staff and the manager. Six of the staff on duty were spoken with about aspects of their knowledge, skills and experiences of working at the home, together with eight of the thirty two residents about their views on aspects of living at the home. Also taken into account was other information received by CSCI about the service since the last inspection. In addition the CSCI have reviewed their guidance on requirements, therefore, some requirements have been removed if they had no direct evidence of service user outcome, or reworded. The inspector wishes to thank the residents, staff and managers for their time and co-operation throughout the inspection process. What the service does well: The manager had worked at the home for a number of years and on the whole the atmosphere in the home was one of openness and respect for residents. The home had a warm and welcoming atmosphere and residents were comfortable to give their opinion of the service. The majority of residents that were spoken to said their needs were met and they were happy with the care offered to them. Residents’ and advocates general comments about the home included “visited various homes and this came out on top”, “visited several homes prior to making decision”, “sold house to come in here and I don’t regret it” and “it’s great here”. Residents were provided with access to health care services to promote and maintain their health care needs with residents’ comments including “looked after well – carers do everything – dress, toilet and bath – can’t do much for myself, “well looked after – can’t do enough – call GP when you’re not well” and “baths lovely”. Residents were on the whole treated with respect and dignity and their right to privacy upheld. Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 6 Discussions with the majority of residents’ described how they were helped to exercise choice and control over their lives and how the lifestyle within the home met their preferences, interests and needs. Their comments included “Xmas and celebrations important – Xmas dinner is as it should be. Have Xmas parties and family are invited. During the year have things going off as well – trips to local pub, sit in garden, go into town shopping – I went the other week. We always stop half way round and have a cup of tea and biscuits or lunch” and “have raffles for funds”. Residents were encouraged and assisted to maintain contact with their family, friends and the local community as they wished. On the whole residents said they received a diet that satisfied their requirements in a pleasant dining area. Their comments included “choice at all meals”, “carers come round day before and ask what you would like” and “can have what you want really”. On the whole residents spoken with were confident that any complaints they had would be listened to. One resident said “if I have anything that needs sorting, you can speak to any of staff”. Staff had a good understanding of the procedures to be followed should they suspect any abuse at the home and had, had training in the protection of vulnerable adults. The building and its environment were on the whole clean and well-maintained and the residents spoken with found the home comfortable. Comments from residents included “room ok – fans bought for all residents in hot weather”, “I’ve my own TV in my room and video so I can have family times watching videos of grandchildren who live away and rarely see so keeps me in touch”, “I have a lovely room – a lot of my own furniture, including two wardrobes”, “they tried to keep it cool when it was hot – got us all fans”. The numbers and skill mix of staff met residents’ needs and with the exception of medication staff were on the whole trained to equip them with the knowledge and skills for their roles within the home, to enable them to care for residents in a safe way. Residents’ comments about staff included “all staff good and kind – I think they like me”, “all staff kind”, “all staff good from the manager down”, “good banter with staff and residents” and “staff do a good job”. Systems were in place to safeguard residents’ financial interests. Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Make formal arrangements to listen to what residents say about the service they are provided with, on an individual basis if necessary and act upon what is said. This would ensure residents in the home received a service they were satisfied with and were not fearful of voicing their opinions because of repercussions. Comments by residents to support this included “I pay a lot of money to live here, but you can’t really please yourself what you do even in your own room”, “staff pester me to go to bed early and woken up one day at 5.00am. I prefer to stay in my own room away from residents – they start to shout and swear in the evening – sometimes come in my room, but I’ve got a key now”, “some meals can be rough”, “some staff rough”, “one member of staff said you can’t possibly want to go to toilet again” and “if you complain they can make it awkward for you”. The health, safety and welfare of residents’ were not sufficiently promoted and safeguarded, as medication practices continued to be unsafe. Having more staff trained to NVQ Level 2 in Care would enable the home to meet the minimum ratio of fifty per cent of care staff trained to NVQ Level 2 in Care or equivalent. Improvements were required with some of the records kept by the home to safeguard residents’ rights and best interests. Omissions and lack of details were noted in the home’s records for example, contracts/terms and conditions, assessments, care plans, quality assurance, recruitment and fire records. The lack of detail in care plans was demonstrated by one resident when they said “not always cared for properly and staff have been told what I need”. The quality assurance system needs to include the views of stakeholders and their opinion of the quality of the service provided. Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 8 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 View DS0000018253.V303447.R01.S.doc Version 5.2 Page 9 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 View DS0000018253.V303447.R01.S.doc Version 5.2 Page 10 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): The outcomes for standards 2 & 3 were inspected. The home did not provide an intermediate care service (standard 6). Contracts/terms and conditions for residents were not evident in residents’ files. Residents moving into the home had, had their needs assessed although the home’s own assessment lacked detail and was not fully completed. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Two residents’ files were inspected to ensure contracts/terms and conditions were in place. One resident, had not had a contract issued, the reason given that they were placed by social services and respite vouchers were being used. However, a financial breakdown on file still identified resident needed to pay a contribution. The other resident’s contract had been signed by them and their Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 11 advocate but there was no evidence terms and conditions were provided with the contract singed by the resident and their advocate. The administrator said terms and conditions were provided to the resident and held by them, a copy was not kept on file. Two residents’ files were inspected that had recently been admitted to the home. A summary of the assessment completed through care management arrangements had been received by the home for one of the residents. The home had completed their own assessment for both residents, however, some of the assessment lacked detail and there continued to be parts not completed, including, the name, address and telephone number of the residents local social services officer whose duty it is to supervise the welfare of the resident, medication details including whether or not they were to self-administer, sexuality and recreation. Comments about admissions to the home included a GP comment card that stated “residents often have significant multiple pathologies which are more akin to those in other nursing, rather than residential homes. I sometimes wonder whether the pressure to fill beds leads to the acceptance of “nursing home type” residents”. Residents’ comments included “visited various homes and this came out on top”, “visited several homes prior to making decision”, “sold house to come in here and I don’t regret it” and “pay a lot of money to live here, but you can’t really please yourself what you do even in your own room”. One resident said they didn’t come and look round, the daughters did that and chose well, “it’s great here”, another confirmed they had been assessed by social services and pays through them and his pension and that there was no problems with payment – it’s paid through direct debit from bank. Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 12 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): The outcomes for standards 7, 8, 9 & 10 were inspected. Residents’ had an individual plan of care, but omissions and lack of detail were evident. Residents were provided with access to health care services to promote and maintain their health care needs. The system used for the administration of medication has and could continue to place residents’ welfare at risk. Residents were on the whole treated with respect and dignity and their right to privacy upheld. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Six residents’ plans of care were inspected on a sample basis. The residents’ files demonstrated the plan of care was reviewed. The plans contained some Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 13 good profile information, including records of medical treatment and risk assessments for moving and handling. Omissions were noted in the plan including the care to be provided for pressure area care, even though the resident, manager and staff confirmed there was intervention by a nurse for assistance with the pressure area and specialist equipment had been obtained. Discussions were held with the manager in regard to some of the documentation recorded in care plans as it clearly labelled a resident rather than describing what the identified problem was and what action staff needed to take to deal with it. Residents were provided with access to health care services to promote and maintain their health care needs and comments included “looked after well – carers do everything – dress, toilet and bath – can’t do much for myself, “well looked after – can’t do enough – call GP when you’re not well”, “baths lovely” and “not always cared for properly and staff have been told what I need”. The last comment was demonstrated within some plans of care by information not being sufficiently comprehensive for care staff to follow a plan of care for a resident other than basic information, for example wash and dress. Questionnaires returned by residents identified staff always or usually listened and acted on what they said. Since the last inspection a notifiable incident reported a medication error had been made. A member of staff was observed during medication administration. It was noted that some of the systems in place had not improved, either since the last inspection when requirements were made or since there had been a medication error, which could result in a further error. This included medication being signed as administered prior to administering the medication and medication being left on tables for residents to take, unless the resident was unable to take the medication themselves. In addition, some medication was handled with bare hands. Discussions with the member of staff also identified errors in the recording of medication administration, the reason given, being it was signed for prior to being administered and no medication of that type had been supplied that month. The record of dates in the medication administration records also demonstrated errors. Demonstrating the home do not accept these poor practices the home’s medication policy/procedure clearly states check medicines on the label are same as those on the medication administration record, avoid touching medication, observe resident to ensure prescribed medication is taken in the way prescribed and when medication is taken by the resident the medication administration record should be signed, which clearly the member of staff was not following. The provider dataset identifies medication training has been arranged with Boots pharmacy on 14.09.06. The majority of residents spoken with said that they felt well cared for, staff treated them with respect and they were able to spend time in their room if they wished. Staff were aware of the need to treat residents with respect and to consider dignity when delivering personal care. Examples given were Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 14 knocking on residents’ doors before entering, closing toilet doors when in use, carers discreetly attending to continence needs of residents and residents being taken to their rooms when medical intervention was required. Staff were observed approaching residents in a respectful manner, respecting individual preferences and using diversion strategies when necessary. Good relationships between staff and residents were evident. Residents were able to enjoy the privacy of their own rooms if they wished. A diary used as a handover between staff with personal information about residents and MAR sheets were kept on a table in the dining room, therefore there was the possibility these could be read by other people, which did not maintain the confidentiality of residents information. Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 15 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): The outcomes for standards 12, 13, 14 & 15 were inspected. Discussions with the majority of residents’ described how they were helped to exercise choice and control over their lives and how the lifestyle within the home met their preferences, interests and needs. Residents were encouraged and assisted to maintain contact with their family, friends and the local community as they wished. On the whole residents said they received a diet that satisfied their requirements in a pleasant dining area. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The two questionnaires returned by residents identified they usually and sometimes made decisions about what to do each day and they can do what they want to do during the day, in the evening and at the weekend. Comments made by residents about their lifestyle at the home included “Xmas and celebrations important – Xmas dinner is as it should be. Have Xmas parties and family are invited. During the year have things going off as well – trips to Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 16 local pub, sit in garden, go into town shopping – I went the other week. We always stop half way round and have a cup of tea and biscuits or lunch”, “have raffles for funds” and “staff pester me to go to bed early and woken up one day at 5.00am. I prefer to stay in my own room away from residents – they start to shout and swear in the evening – sometimes come in my room, but I’ve got a key now”. Residents were observed to spend time in the lounges, whilst others chose to spend their time in the privacy of their bedroom. Discussion with residents identified they spent their time in various ways. One resident identified they went out with family – their family visited often and they visited them. They liked joining in with the game beetle and seeing to the tomatoes. They said they like to spend time in their own room watching TV and videos. Residents spoken with said there were some trips out. The provider dataset identified recreational activities at the home included board games, arts and crafts, manicures, gardening, cards, bingo, trips to local pub and shops, days out in Barnsley and tea and buns in local café. The manager said a carer was employed to provide activities for the residents and the activities record for July identified 12 occasions when activities took place including manicures, games, bingo, foot massages, crafts, visit to the local pub, exercise and baking. The provider dataset identified meal times were 8:45 breakfast, 12:30 lunch, 16:45 tea and 20:00 supper. There was a four week menu with a choice at each meal. The dining room was clean and welcoming. Comments from residents about the meals were on the whole positive and included “choice at all meals”, “carers come round day before and ask what you would like”, “can have what you want really” and “some meals can be rough”. Two residents were not happy with stews and how it was served – in a dish, not a plate. Carers were observed assisting residents to eat in an appropriate manner and holding a conversation with residents on the same table. Carers were also observed asking residents their individual choices. Some of the residents’ families also stayed on occasions for lunch. Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 17 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): The outcomes for standards 16 & 18 were inspected. On the whole residents spoken with were confident that any complaints they had would be listened to. Staff had a good understanding of the procedures to be followed should they suspect any abuse at the home and had, had training in the protection of vulnerable adults. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Details had been added to the complaints procedure to include the name, address and telephone number of the CSCI. This was displayed in the entrance hall to the home. The manager was asked to add in the timescale when complainants could expect to receive a reply from their complaint. Discussions with residents identified the majority were confident that any complaints they had would be listened to. One wasn’t happy complaining because they said “they can make it awkward for you”. Other comments included “if I have anything that needs sorting, you can speak to any of staff”. All resident questionnaires returned identified residents knew who to speak to if they weren’t happy and how to make a complaint. The GP and social and health care comments identified none had received any complaints about the home. Two relative/advocate comment cards returned identified although they had no reason to complain they didn’t know what the procedure was. The provider Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 18 dataset stated no complaints had been made and this was confirmed in the complaints record, the last complaint being 06.04.05. The manager said the homes own adult protection policy/procedure now included the contact details of the local adult protection officer. The home had the local multi agency procedures for protection of vulnerable adults. The manager said that there were no allegations of abuse. Staff spoken with could describe the action they needed to take if they suspected abuse and could define the types of abuse they would report. The home had, had three adult protection investigations, one resulting in a member of staff being referred to protection of vulnerable adults register and another where the outcome identified a need for further training for staff in adult protection and dementia. The provider dataset identified dementia training had been arranged for 31.08.06 and 07.09.06. Discussions with two staff and inspection of three different staff training records identified all but one member of staff had, had training in the protection of vulnerable adults. Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 19 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): The outcomes for standards 19 & 26 were inspected. The building and its environment were on the whole clean and well-maintained and the residents spoken with found the home comfortable. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Residents’ that were spoken with said they thought the home was comfortable and were pleased with their living environment. Their comments included “room ok – fans bought for all residents in hot weather”, “I’ve my own TV in my room and video so I can have family times watching videos of grandchildren who live away and rarely see so keeps me in touch”, “I have a lovely room – a lot of my own furniture, including two wardrobes”, “they tried to keep it cool when it was hot – got us all fans”. There were three lounges and a large dining room for residents to use. The residents had access to safe and comfortable indoor and outdoor communal facilities. The home was clean Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 20 and tidy, which promoted a comfortable and homely environment. The home was decorated in a comfortable and welcoming manner, including homely touches of pictures and ornaments. Furnishings and furniture were of a good standard. An odour that was apparent during the day was reported to the manager. Two resident questionnaires that were returned stated the home was always or usually fresh and clean. The residents’ bedrooms looked homely, as residents had been able to bring items of their own furniture and possessions with them. Laundry facilities were sited in a separate building. One resident commented “laundry’s magnificent – clean clothes and bedding every day”. Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 21 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): The outcomes for standards 27, 28, 29 & 30 were inspected. The numbers and skill mix of staff met residents’ needs. The recruitment files did not demonstrate the recruitment process was sufficiently comprehensive in order to ensure the protection of residents. Staff were trained to equip them with the knowledge and skills for their roles within the home, to enable them to care for residents in a safe way, however, improvements are required with the administration of medication and the home have yet to meet the minimum ratio of fifty per cent of care staff trained to NVQ Level 2 in Care or equivalent. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The majority of residents spoken with spoke highly of the staff team and comments included “all staff good and kind – I think they like me”, “all staff kind”, “all staff good from the manager down”, “good banter with staff and residents”, “staff do a good job”, “some staff rough” and “one member of staff said you can’t possibly want to go to toilet again”. All questionnaires returned by residents identified staff always or usually listened and acted on what they said. Good relationships between staff and residents were observed and staff were observed responding to assistance as required in a responsive manner. Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 22 The provider dataset identifies staffing is calculated on a care staff ratio of 10 residents to one member of staff therefore there are four staff on day duty and three staff on night duty. Staff that were spoken with said that on the whole staffing levels were maintained. Sufficient ancillary staff were employed to ensure standards relating to food, meals and nutrition were fully met and the home on the whole was maintained in a clean and hygienic state. Three staff files were inspected. It was not clear a comprehensive recruitment process had not been followed including demonstrating a full employment history, together with a satisfactory written explanation of any gaps in employment and that a CRB and/or a POVA first check had been obtained prior to the member of staff commencing employment. Discussions with staff, a training matrix and training and development file for each member of staff identified a training programme was in place to enable them to meet the assessed and changing needs of residents, however, the staff files inspected did not demonstrate documentary evidence of the qualifications and training they had received. The provider dataset identifies medication training has been arranged with Boots pharmacy on 14.09.06, dementia training on 31.08.06 and 07.09.06, basic food hygiene September 2006 and pressure wound care on 07.09.06. Discussions with staff and three staffs’ training records identified that they had received training in medication, moving and handling, emergency aid, protection of vulnerable adults, health and safety, fire, food hygiene, induction, control of substances hazardous to health, NVQ in Housekeeping and infection control. A third of care staff were trained to at least NVQ Level 2 in Care. The provider dataset identifies thirty five per cent of care staff hold NVQ Level 2 in Care or equivalent and three staff hold a first aid certificate. The manager is aware further staff need training in first aid. Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 23 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): The outcomes for standards 31, 33, 35 & 38 were inspected. The manager had worked at the home for a number of years and on the whole the atmosphere in the home was one of openness and respect for residents, however, the quality assurance systems need to include the views of stakeholders and their opinion of the quality of the service provided. Systems were in place to safeguard residents’ financial interests. The safety and welfare of residents’ were not sufficiently promoted and safeguarded, as the system used for the administration of medication has and could continue to place residents’ welfare at risk. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 24 EVIDENCE: Discussions with the majority of residents demonstrated the manager promoted an atmosphere of openness and respect where residents and their advocates felt their opinions mattered. Quality assurance systems formalised this process with a quality audit completed by the manager in place, regulation 26 visits by an area manager and residents meetings. The quality assurance process still did not include consultation with residents and other stakeholders of the service to ascertain their views on the quality of the service provided. The manager had completed her NVQ Level 4 in Management and Care and was awaiting her certificate. The provider dataset identified the company was responsible for dealing with three residents finances. Three residents’ monies were inspected; two kept their own monies. Monies were held together in a companies account with each resident having a record of their particular monies held in the account. Interest from the account is paid into residents’ funds. All personal allowances are paid into one account, with signatories of that account being persons employed by Four Seasons. The interest from the account was paid into residents’ funds, as the calculation of interest to be paid to each resident given the different amounts in the account would be too complex. The administrator said the residents and/or advocates were aware of this but this was not confirmed on a formal basis either through the terms and conditions or in the service user guide. Reconciliation of the account and float is completed monthly and a weekly transaction of monies spent by and deposited by each resident is kept together with receipts. There were safe facilities to store the float. Current CSCI guidance acknowledged this practice for payment of personal allowances and finances met the regulation. When the building was inspected no fire exits were blocked. Fire records confirmed weekly testing of the fire alarm system and monthly checks of the emergency lighting occurred. The filing system for the monthly checks of fire equipment was disorganised and that they were carried out could not be ascertained. Fire training and/or drills for staff were in place. Fire training for four staff was inspected; one had been present on three fire drills in the last six months, one two fire drills, the other two had, had fire training in the last six months. The provider dataset identified fire equipment checks, fire drills and training, gas servicing, water temperature checks, lift maintenance, servicing of baths, hoists and wheelchairs and disposal of soiled waste/SHARPS are in place. Notifiable incidents were being reported as required by the regulations. Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 25 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 2 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 1 Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 26 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. Standard OP2 Regulation 5 Requirement Residents admitted for respite care must receive a contract/terms and conditions of their stay. All parts of the homes assessment must be completed. Previous timescale of 30/6/05 & 31/01/06 not met. Further information must be added to care plans to meet residents’ needs including pressure area care. The medication record for the administration of medication must be completed after the medication has been administered to the resident. Previous timescale of 31/01/06 not met. Medication must not be left on tables waiting for residents to take them. Medication must not be handled with bare hands. Records of dates when medication is administered must correspond with the date identified on the medication DS0000018253.V303447.R01.S.doc Timescale for action 30/09/06 2. OP3 14 30/09/06 3. OP7 15 04/09/06 4. OP9 13 30/09/06 5. 6. 7. OP9 OP9 OP9 13 13 13 30/09/06 30/09/06 30/09/06 Field View Version 5.2 Page 27 8. 9. OP10 OP12 OP14 OP15 OP16 12 & 17 12 & 14 10. 11. OP18 OP30 OP29 12, 13 & 18 19 12. 13. OP30 OP33 19 24 14. OP38 23 & 17 administration record. The handover diary and medication administration records must be securely stored. Documented discussions must be held with every resident at the home to ascertain their views and experiences of living in the care home, including the times they are able to rise and retire, staff attitude and their satisfaction with the meals provided. Action must be taken to address any concerns raised. The records must then be submitted to the CSCI. Previous timescale of 31/03/06 not met. All staff must receive training in protection of vulnerable adults. A comprehensive recruitment process must be followed including demonstrating a full employment history, together with a satisfactory written explanation of any gaps in employment and clear evidence that a CRB and/or a POVA first check had been obtained prior to the member of staff commencing employment. Documentary evidence of any relevant qualifications and training must be maintained. The quality assurance process must include consultation with residents and other stakeholders of the service to ascertain their views on the quality of the service provided. Previous timescale of 31/03/06 not met. Monthly checks must be made of fire fighting equipment. Previous timescale of 31/01/06 not met. 30/09/06 30/11/06 30/11/06 30/09/06 30/09/06 30/11/06 30/09/06 Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 28 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 OP2 Good Practice Recommendations The resident’s file should demonstrate the terms and conditions that have been provided for the resident including a signature by the resident and/or their advocate. A minimum ratio of 50 of care staff should be trained in NVQ Level 2 in Care or equivalent. The terms and conditions and service user guide should include details of where interest from the companies account used for holding monies of residents held by the home is paid. 2. 3. OP28 OP35 Field View DS0000018253.V303447.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 View DS0000018253.V303447.R01.S.doc Version 5.2 Page 30 - 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!