Inspection on 26/11/08 for Field View House

This inspection was carried out on 26th November 2008.

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

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 House 31/03/08

Field View House 10/07/06

Field View House 27/09/05

Field View House 12/05/05

Field View House 25/01/05

Field View House 03/08/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Field View House Sandheys The Slough Crabbs Cross Redditch Worcestershire B97 5JT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Deborah Shelton     Date: 2 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Field View House The Slough Sandheys Crabbs Cross Redditch Worcestershire B97 5JT 01214721044 01527403787 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Arjan Bhoja Odedra,Mrs Monica McGlynn care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The Registered Manager must obtain a suitable management qualification (equivalent to NVQ 4) by 31st November 2006. Date of last inspection Brief description of the care home Field View House is registered for 20 older people requiring personal care. The home does not provide nursing care other than input available via the local community nursing teams. The home is set back off the main road between Studley and Redditch in a semi rural setting. Community facilities are available in both Studley and Redditch although the home is not on a bus route. The Home, which was formerly a domestic dwelling, has been refurbished and extended. Bedrooms occupy both the ground and first floor, most of which have en-suite facilities. A shaft lift provides users access to all parts of the home. The home has one large lounge and a separate dining room. Car parking is available at the front of the home. At the time of this inspection the fees Care Homes for Older People Page 4 of 32 Over 65 20 0 Brief description of the care home ranged from #380.00 for a shared room to #450 for a single room with ensuite. Additional charges are made for chiropody, hairdressing, personal items and toiletries. Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The following are the findings of an unannounced inspection visit which took place on Wednesday 26 November 2008. The acting Home manager was on duty along with a head senior, senior and two care staff. A cook and a domestic were on duty along with the maintenance person. Seventeen people were living at Field View House at the time of the visit. Three people were case tracked, this involves finding out about the individuals experience of living in the Care Home by meeting with them, talking to them and their families (where possible) about their experiences. Looking at their care files, looking at their living environment and having discussions with the staff that provide care for them. Staff training records are reviewed to ensure that training is provided to enable staff to meet Care Homes for Older People Page 6 of 32 residents needs. The inspection process consisted of a discussion with the acting manager, staff and residents. Records examined during the inspection included complaints, care, staff recruitment, training, social activity records, staff duty rotas, health, safety and medication records. Notifications of incidents at the Home received by us and any other information received was examined. The inspection process enabled the inspector to see residents in their usual surroundings and see the interaction between staff and residents. The inspector was introduced to some people who live at Field View House and more in depth conversations were held with six people. Further information to identify the outcomes for residents was also gained through observation of residents and staff and discussions with visitors. What the care home does well: What has improved since the last inspection? What they could do better: A suitable controlled drugs cabinet and register must be available at the Home to store controlled drugs. The register must be completed when these drugs are received on the premises and administered to residents. All staff must undertake mandatory training and updates for this training on a regular basis. Training records held at the Home did not demonstrate that all staff have undertaken moving and handling training. Care Homes for Older People Page 8 of 32 Although monthly audits take place of residents spending money, staff had not identified that an amount of money had not been paid out of a residents account. Staff should be more vigilant when auditing records. All health and safety checks must be kept up to date. Emergency lighting and fire alarm tests were not up to date on the day of inspection. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Pre-admission practices ensure that residents are assessed as being suitable to live at Field View House and that staff have the information to be able to meet their identified needs. Residents are provided with sufficient information before admission to enable them to make an informed choice about moving into the Home. Evidence: The service users guide was available to each person living at Field View House. Copies of up to date information was held in the guide including results of the last satisfaction survey with details of any action taken to address issues raised. The Guide was easy to read and understand and provided residents with information about life at the Home and facilities and services available to them. Contracts of residency were seen in care files. One contract seen had not been signed or dated and the fees section had not been completed. Care Homes for Older People Page 11 of 32 Evidence: The care file of the most recently admitted resident was requested to review the pre admission assessment processes at the Home. A copy of the needs assessment completed by Worcestershire County Council was available in this file which recorded the main areas of need. The Home also completed a pre-admission assessment, the acting manager or senior care undertake these assessments. Standardised documentation is used to find out as much information about the person before agreement is reached to move in to the Home. Standard statements are recorded regarding areas of need and staff circle the appropriate level of need and write additional comments which give further information about the person i.e. hearing - good, appetite - good large portions of food, reacts to sugar, itchy skin. Areas covered during the pre-admission assessment include continence, mobility, personal care, oral health, sight etc. The pre-admission assessment also questions whether the person wishes to be as self caring as possible, do you wish to take full responsibility in any area, what do you value in daily life. Information recorded in the Homes pre-admission assessment was in accordance with that recorded in the information received from Worcestershire County Council. Evidence was seen that the manager of Field View House writes to potential residents to confirm that they are able to move into the Home on a months trial. The letter states that during the month care and support needs are assessed, discussed and agreed and then a care plan is developed. From discussion with the manager it was noted that anyone who is interested in moving into Field View House can come and have a look around and stay for a meal or stay for the day if they wish. If the Home has a room available potential residents are able to stay overnight before they make any decision about moving in. Two of the three files seen contained evidence that pre-admission assessments take place by staff at the Home before agreement is reached to move in. The third resident has been living at Field View House for nearly twenty years. A discussion was held with the resident who was most recently admitted to the Home. This person confirmed that he is happy at Field View House and feels that the staff look after him very well. Care Homes for Older People Page 12 of 32 Care Homes for Older People Page 13 of 32 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recording of residents health, personal and social care needs are good and give staff detailed guidance to enable them to meet the care needs of those that live at Field View House. Residents are treated with respect and their rights to privacy and dignity are maintained. Evidence: Three residents were case tracked at this inspection. This involved speaking to the residents and to the staff that care for them. Looking at their living environment and reviewing paperwork associated with life at Field View House. Care files were reviewed to evidence whether the personal and health care needs of individuals is identified, recorded and sufficient action detailed to enable staff to meet these needs. The acting manager confirmed that a lot of work has been undertaken on care files since the last inspection. All have been or are in the process of being re-formatted. Care Homes for Older People Page 14 of 32 Evidence: Key workers are going through care plans and discussing needs with the residents and asking them to sign to confirm that they are in agreement to care prescribed. Staff have also started to complete a reminiscence of my life with residents. This is a good opportunity for staff to sit with residents and build a relationship. Information is obtained regarding school, qualifications, history and places of work, married life, relationships, siblings, childrens, hobbies, memories, fulfilment, dreams ambitions, holidays, pets, significant events amongst other things. Detailed pre-admission assessment documentation was available in two of the three files seen. This demonstrates that peoples needs have been reviewed and recorded. Staff therefore have information to be able to care for people as soon as they move into the Home. The person who did not have a pre-admission assessment has been living at the Home for nearly twenty years. The acting manager could not confirm whether the assessment had been undertaken at the time. Standardised documentation is used for care plans. Contact details are available for district nurse, dentist, optician, social worker, GP and next of kin. Care files are broken down into sections which makes the file easy to read and understand. Risk assessments were available regarding falls, nutrition and the risk of developing a pressure area. Personal risk assessments were available regarding bathing, toileting, dressing and washing up. Risk assessments that identify that someone is at high risk were reviewed on a monthly basis. The personal risk assessments are also reviewed monthly. Details of equipment needed to provide care is recorded. Preferred routines i.e. times for rising and retiring, preferences regarding male or female carers to provide person care are recorded. Preferred time to have a bath and any special needs are also recorded. For example the need for a bright area to sit as the person has failing eyesight. A monthly log is kept of falls to monitor and identify if any pattern can be identified and action taken to reduce the falls. Residents spoken to were aware that they had a special carer who looked after them and all said that they were very helpful and friendly. Very detailed care plans were in place for all needs identified i.e. personal care and physical well being, diet and weight, sight hearing and communication, oral and foot care, medication, continence, mental state and cognition amongst other things. Care Care Homes for Older People Page 15 of 32 Evidence: plans recorded in detail the level of need, whether the resident requires assistance, number of staff required to provide assistance, timings and personal preference. Care plans were appropriate to the needs identified during the pre-admission assessment. Care plans had been reviewed on a monthly basis. There was documentary evidence to demonstrate that care plans are updated following review. Documentary evidence of visits from district nurse, GP etc are recorded in care plans. The reasons for and outcomes of the visits are also recorded. Residents confirmed that the doctor, dentist and optician are called straight away when you need them. Weight records show that two of the residents whose care files were seen had gained weight and one had maintained their weight. Body maps are available in files and are reviewed on a monthly basis. Bath monitoring sheets are available in care files which records daily washes and the number of baths taken. These record that bathing has taken place in accordance with care plan requirements. Daily records are completed by care staff on duty and are made three times per day. These recorded sufficient information to demonstrate that staff are meeting peoples needs. Any change in health or wellbeing is recorded. One care plan showed that the residents health had deteriorated and the person is now restricted to spending most of the day in bed. Staff record on contact sheets when they have been in to see this resident during the day. Staff are recording details of food offered and eaten, turn charts record two hourly turns and the positions moved to. There is sufficient evidence to demonstrate that although this resident is in the bedroom all day staff spend time chatting and providing appropriate care. Medication receipt, disposal, storage and administration practices were looked at. The medication for the three people being case tracked were reviewed. The Home do not have an appropriate controlled drugs cabinet at present, the Pharmacy are providing a new cabinet shortly. There are no controlled drugs in use at the moment. A new controlled drugs register is being purchased. Key custody practices were discussed and found to be satisfactory. A medication fridge is available, fridge temperatures are recorded on a daily basis. A maximum, minimum thermometer is in place. The temperature of the medication room Care Homes for Older People Page 16 of 32 Evidence: is also recorded on a daily basis to ensure that medication is stored at the required temperature. Medication is stored in a dedicated medication trolley, fridge and cupboard. Staff were seen administering medication during the morning of the inspection. The staff member locked the trolley at all times when it was left unattended. Staff wear tabards when administering medication which say in large yellow letters do not disturb medication being administered. Copies of the original prescriptions are taken and these are checked against medication administration records and medications received into the Home. A monthly audit of medication takes place to ensure that records are correct and up to date. The medication and medication administration records for the three residents case tracked were reviewed. Two of the records seen showed that medications available balanced with records held. Codes were used for refusal of medication. The records for one resident did not balance. This person had recently had a short hospital stay. Medication was collected to be taken to hospital. Staff made a record of all medications taken which was checked by two members of staff and double signed. However when auditing these records it was noted that there was a discrepancy of two tablets which could not be accounted for. Medication policies were not reviewed at this inspection. None of the residents self administer their medication currently. There is a list of sample signatures for all of those staff who administer medication. Care Homes for Older People Page 17 of 32 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are able to undertake regular social and leisure activities and maintain contact with family and friends as they wish. Residents were happy that they still had some control over their lives and the choices that they make which improves their sense of wellbeing Evidence: A review of the activities that take place was undertaken. Activities such as bingo, hairdresser, card making, manicure, quiz and various games are recorded in the activity log as taking place on a regular basis. The activity log records details of the activity that has taken place and information is recorded next to the residents name stating whether they have joined in or have declined the activity. Activities provided by external entertainers also take place, for example external entertainers provided an old time sing-a-long and exercise, guitar and vocalist and Irish singing and music amongst other things. During the morning of the inspection residents were seen playing hoop la. The member of staff organising the activity encouraged all present in the lounge to join in. This Care Homes for Older People Page 18 of 32 Evidence: person appeared to have a good relationship with residents and spent time sitting and chatting to individuals. Residents were given mini chocolate bars as prizes. Pictures of residents enjoying activities are available. Most of the residents spoken to confirmed that they enjoy the activities that take place. I really enjoy drawing and they sort all of the stuff I need out for me, the activities are OK, but there is not really enough to do, not enough to keep your mind going, I like to play bingo but I am not really interested in any other activities, things go on but I leave early because I have usually had enough, I am not interested in activities. An activities audit is undertaken on a regular basis. This is used to identify whether sufficient activities take place and whether residents have enjoyed the activities or not. The activities audit for August - September 2008 was seen and demonstrated that regular activities take place at Field View House. Residents spoken to confirmed that visitors are made welcome at the Home. They said that they are able to see their visitors in the lounge or in their room if they prefer. One visitor confirmed that staff are always friendly and welcoming and make you feel at ease in the Home. Residents were seen being encouraged to remain independent throughout the inspection. Care plans ask residents upon admission to the Home if they wish to be as self caring as possible and do they wish to take full responsibility in any area. Care plans also record areas where residents require assistance from staff to complete a task, prompts from staff or are fully independent. Likes and dislikes and personal preferences are also recorded. Residents were seen being given a choice of the main lunch time meal and were seen in the dining room eating their evening meal. There was a choice of sandwiches or beans on toast. Residents were sitting and chatting amongst each other and the atmosphere was relaxed and friendly. Satisfaction surveys and minutes of residents meetings seen showed that some issues had been raised regarding the quality of food. Residents spoken to on the day of inspection made the following comments- food is usually OK, they gave me brown stuff in my sandwiches today which I didnt like, the food is good, there is plenty of it, its all good, the food is sometimes good, sometimes not so good, I had my lunch for my tea but it was cold so I only managed a few mouth fulls, you used to get supper but you dont any more, I am not sure that if you didnt like something you could have something else. Care Homes for Older People Page 19 of 32 Care Homes for Older People Page 20 of 32 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are confident that their concerns will be listened to and acted upon. Systems are in place to protect residents from the risk of abuse, increasing their feeling of safety and their quality of life in the home. Evidence: We have not received any complaints since the last inspection. The Homes complaint log was reviewed and it was noted that they have received two complaints. Evidence was available to demonstrate that each of these complaints had been investigated and satisfactory action taken to address issues raised. Residents are given a copy of the complaint procedure in the Service User Guide. The policy is also on display throughout the Home. Residents spoken to were aware of how to make a complaint and said that they would speak to a member of staff if they had any problems. Some of the comments made by residents regarding complaints are as follows- Becky is the person I deal with all of the time, she sorts out anything for me, she is good. I have no complaints, no worries, everything is OK, they would help if I needed it. I have no worries, Becky is great she sorts things out. I have no concerns, staff would sort it out if there were any. Care Homes for Older People Page 21 of 32 Evidence: One adult protection issue has been raised since the last inspection of the Home. Adult protection training has been provided by Warwickshire Social Services, the Homes adult protection policies have been reviewed and the contents agreed by the Safeguarding lead at Warwickshire Social Services. A copy of Warwickshire adult protection policy was available for staff to review. The adult protection policy is on display throughout the Home. Adult protection was discussed with staff. Both staff spoken to were aware of the correct procedure to follow if they witnessed or suspected that abuse had taken place. Care Homes for Older People Page 22 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment within this Home is generally well maintained providing an attractive, hygienic and homely place to live. Evidence: A tour of the premises was undertaken. This included looking at the bedrooms of those people being case tracked, communal areas such as lounges, dining rooms, bathrooms and the laundry. All areas were clean and hygienic and no unpleasant odours were noted. The lounge was bright and airy, large patio doors let in a lot of natural light and give a lovely view of the garden. Residents are seated around the edge of the lounge. Occasional tables and foot stools were available for use as required. The lounge was well decorated with pictures and ornaments which gave a homely feel. The dining room was clean and had seating for all residents. This room was also well decorated and furniture was in a good state of repair. Bedrooms seen had been personalised with pictures and ornaments and had a homely, welcoming feel. Call bells were available in those rooms seen and were located next to beds for ease of use by residents when in bed. Each room has a lockable facility for Care Homes for Older People Page 23 of 32 Evidence: storage of personal items and bedroom doors can be locked if required. Divan beds were in use in some bedrooms, hospital type beds were also available as needed. Bathrooms were clean and equipment was in good working order. The Home are considering changing the shower room into a wet room, this was identified at the last inspection and is still ongoing. It was noted at the last inspection that vinyl flooring in one of the corridors had bubbled and raised. This flooring has been replaced and is now satisfactory. The methods used for cleaning commodes has not changed since the last inspection. The contents of commodes are emptied down the toilet, then taken to the shower room and cleaned with disinfectant spray and returned to their bedroom. The Home were advised to contact an infection control specialist to ensure that this method of cleaning commodes is the best available for the Home. Warwickshire Health Protection Agency have been contacted and provided copies of their infection control in care homes policies. These record the methods that should be used to clean and sterilise commodes. The manager confirmed that these methods are being used. A sanitising machine is rented and is used every three to four weeks in each room in the home. This machine is used to kill infection and can be used more frequently if required. The laundry was reviewed. All equipment in the laundry was in good working order. There is one washing machine and one tumble dryer, the washing machine has a sluice cycle for cleaning soiled laundry. Red bags are used to transport soiled laundry and to wash. This reduces the amount of times staff need to handle soiled items and therefore reduces the risk of cross infection. At the time of inspection there was no backlog of items waiting to be laundered. Care Homes for Older People Page 24 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The employment of staff is carried out in accordance with the homes policies and procedures ensuring that residents are supported and protected. Evidence: The number of staff on duty on the day of inspection was in accordance with duty rotas. A senior and two care staff work between the hours of 8am - 3pm and 3pm 10pm, two waking night staff work between 10pm - 8am. In addition to care staff the acting manager works five days per week, catering staff work seven days per week between the hours of 8am - 1.30pm, cleaning staff work five days per week between the hours of 9am - 1pm. The owner provides maintenance cover seven days per week. Senior care staff also work in the office undertaking management duties, however the hours were not routinely recorded on the duty rota. Duty rotas did not routinely record the hours of the acting manager. It is therefore difficult to identify whether sufficient management hours are provided. Care staff undertake cleaning duties at the weekends when domestic staff are not available. The number of staff available on the day of inspection appeared to be sufficient to meet the needs of those that live at Field View House. Staff were able to spend time sitting and chatting with residents. A member of staff also spent a part of the morning playing games with those residents seated in the lounge. Staff were attentive to Care Homes for Older People Page 25 of 32 Evidence: residents and provided assistance in a timely manner. Two staff were spoken to at length during the inspection. Both confirmed that they undertake regular training and felt that they have all of the training available to be able to care for residents. They spoke about training recently undertaken which included moving and handling, food hygiene, fire and health and safety. Staff said that they work well as a team and enjoy their job. All residents spoken to were complimentary about staff saying that they were fantastic, the staff are kind and friendly, staff are all good, kind and friendly, staff are really nice, especially some of them. Lines of accountability were discussed and it was noted that the acting manager receives support from the regional manager who visits the Home regularly. The Homes Co-ordinator works along side the manager. Head senior care complete some administration duties each day and senior care are on duty each day. Twenty care staff are employed including the acting manager, all staff are enrolled on or have undertaken a National Vocational Qualification (NVQ) in care. Two staff have the NVQ 3 qualification, eight have NVQ 2 and eleven staff are undertaking the training. Providing national vocational training goes some way to ensuring that the staff have the skills and abilities to meet the needs of the people that live in the Home. Three staff files were reviewed to evidence whether appropriate recruitment practices take place. Each file contained two written references as required. However, one reference which had been completed on the Homes standardised documentation did not record the full details of the people completing the information. One reference had been completed by Carol and the other by Matt, neither reference said how they know the staff member or who the person was completing the reference i.e. job title. Criminal records bureau checks are undertaken for staff. Medical questionnaires are completed before employment to identify any ongoing medical problems. Training records demonstrated that some staff require updates in mandatory training. The Home has a training at a glance file which records details of courses booked such as Infection control, dementia, POVA, Infection Control, First Aid, and safe handling of medication. Care Homes for Older People Page 26 of 32 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Homes manager has an in depth knowledge of the needs of those under her care. Systems in place ensure that the quality of the service provided meets the needs and expectations of the people who live at the Home. Health and safety issues have been addressed to ensure that residents live in a safe environment. Evidence: Management arrangements at the Home have not changed since the last inspection. The acting manager is currently undertaking the Registered Managers Award training programme. The acting manager receives support from the regional manager who visits the Home on a regular basis. On call arrangements were discussed and it was noted that either the acting manager, home co-ordinator or head senior care provide on call support to staff. Care Homes for Older People Page 27 of 32 Evidence: Management systems and practices appear to be efficient. Residents and staff spoken to confirmed that management are approachable and helpful. Quality assurance was discussed and it was noted that appropriate methods are used to identify whether the quality of the service provided meets the needs and expectations of those that live at Field View House. Residents meetings were held in February, March, July and October 2008. Minutes were available to demonstrate that these meetings were held and the topics discussed. The minutes of the October 2008 meeting noted that issues were raised regarding the meals. Records demonstrated that the acting manager had taken appropriate action to address the issues raised. Issues identified during satisfaction surveys are put on the agenda for the next residents meeting and discussions are held to find out what the exact problems are. Residents meeting discussion topics include meals, activities, toiletries, staffing. Residents satisfaction surveys are undertaken every six months. Surveys are sent to visitors, GP, hairdresser, chiropodist every twelve months. A pie chart is used to represent the findings of the surveys in an easy to read and understand format. The survey undertaken in September 2008 asked questions regarding quality of care, efficiency of management, food and activities. Results seen were positive. The acting manager confirmed that a survey is to be sent to family/friends/visitors next month. All policies and procedures are reviewed on an annual basis and were last reviewed in March 2008. Quality assurance processes undertaken at the Home include a review of the Homes compliance to nine of the thirty eight national minimum standards. Satisfaction with activities was reviewed in January 2008. The Homes activity coordinator completes a monthly review of activities undertaken to identify whether some activities are more popular than others. Staff meetings are held on a regular basis. Staff are able to include items for discussion on the agenda and then air their views at the meetings. Meetings are routinely planned but are also held to discuss any changes or issues that arise. Staff confirmed that they are able to speak freely at staff meetings. Care Homes for Older People Page 28 of 32 Evidence: Residents spending money records were reviewed to evidence whether records balanced with funds held and whether receipts for expenditure were available. A spending money log is available for all residents as applicable. Two staff sign records regarding any income or expenditure. Receipts are kept for all items such as toiletries, clothing, chiropody, hairdresser. The records for the three residents case tracked were reviewed and it was noted that there was a receipt for a small amount however, the funds had not been taken from the residents spending money account. Therefore the resident had extra money in their account. All other records seen balanced with monies available. Spending money records are audited on a monthly basis. Health and safety records were reviewed to evidence whether the health and safety of staff and residents is maintained. Fire records show that a risk assessment is available for each resident at the Home. Staff are asked about their knowledge of the action to take for individual residents in case of fire. Staff undertake a fire safety talk and discussions regarding their knowledge of fire safety issues. Other records checked showed that equipment is maintained as appropriate. Hoists and lifts service records were available and up to date. Emergency lighting is checked on a monthly basis. Records had been completed until 22 October 2008. Fire extinguishers had been checked during 2008 and records were available to show that fire alarms are tested on a weekly basis up until 5 November 2008. The Home continue to ensure that health and safety issues are addressed. Care Homes for Older People Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 30 13 The Registered Manager must ensure that all staff receive regular updates regarding mandatory training. This is to ensure that people in the home are protected from the risk of harm. 03/06/2008 Care Homes for Older People Page 30 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 Contracts of residency should be fully completed, signed and dated to show that the resident is in agreement with the terms of occupancy at the Home. The hours that the manager works should be recorded on the duty rota. Employment references should contain information about the person completing the reference i.e. full name, occupation and how they know the employment candidate. Emergency lighting and fire alarms should be tested in accordance with agreed timescales and records kept to demonstrate that these checks have been completed and equipment is in good working order or details of the action taken to repair should be recorded. 2 3 27 29 4 38 Care Homes for Older People Page 31 of 32 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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