Inspection on 27/09/05 for Field View House

This inspection was carried out on 27th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Field View House 26/11/08

Field View House 31/03/08

Field View House 10/07/06

Field View House 12/05/05

Field View House 25/01/05

Field View House 03/08/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Field View House Sandheys The Slough Crabbs Cross Redditch Worcestershire B97 5JT Lead Inspector Deirdre Nash Unannounced Inspection 27th September 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Field View House Address Sandheys The Slough Crabbs Cross Redditch Worcestershire B97 5JT 01527 550248 01527 403787 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Arjan Bhoja Odedra Mrs Monica McGlynn Mrs Phyllis Wootton Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Manager must obtain a suitable management qualification (equivalent to NVQ 4) by 31st November 2006. 12th May 2005 Date of last inspection Brief Description of the Service: 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. Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspector called without any notice. She looked around the home and spoke to six residents and five staff including the Deputy Manager. She also looked at the care files for three residents and at other documents. What the service does well: What has improved since the last inspection? What they could do better: Written care plans need to improve and be kept up to date with the changes in peoples needs and condition and healthcare needs must be written down. More attention needs to be given to mental stimulation and providing activities and some occupation for residents day by day. Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 6 More thought needs to go into how the home is decorated, how colours are used on floors and doors and stairs so that residents with mental impairment can find their way around easily and safely. There is some guidance available in professional journals. Although there is no evidence that residents are treated other than very well, the procedures used for hiring staff still need to be tighter to fit what the law requires. The home has been told about this twice before. 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 House DS0000004234.V254523.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The home finds out what people need before they are admitted. Residents do not move into a home that cannot look after them properly. EVIDENCE: Three care files looked at contained community care assessments and community care plans. One community care plan had been very recently reviewed by Social Services. Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Service user plans are not up to date with residents changing conditions and needs and do not contain specific healthcare information, plans for addressing psychological needs or leisure needs. Residents may experience an inconsistent approach to their care. The home is in regular contact with community healthcare workers, specialists and social workers. Residents receive the same healthcare services as the rest of the community. EVIDENCE: Care plans for daily living written by the home were in each of the three files looked at. They did not accurately show what each residents care should be like. There were short on detail and some were very out of date. For example the condition of one resident has changed dramatically recently and staff find her very challenging. There was very little indication of this in her care plan. Staff are carrying in their heads the approach to looking after and managing her. Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 10 Health needs are not recorded in care plans but daily records show that people are getting treatment and medication is recorded on plans. Specialist nurses and doctors and other health care workers visit residents at the home, as they need them. Social workers come to review the care of their clients who live at the home. Leisure and psychological needs that appeared in Community Care Plans do not feature sufficiently in the daily plans written by the home for individuals. The administration of regular medication is properly recorded but there are no directions for staff on helping residents with medication that they need to take ‘on occasion’. Staff speak to residents respectfully and kindly and knock on doors before going into residents rooms but a resident care review was held in a public room this day and one resident who was in her bedroom was wearing a night dress with no front buttons left on it down to the waist. The home must mend residents clothes where necessary. All other residents were well groomed. Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 15 The home does not do enough to provide daily activities or occupation for residents. Residents psychological health may deteriorate through lack of stimulation. EVIDENCE: There was no activity going on in the home except the television. Some residents said that they had nothing to do. One said she would like to do a puzzle. The hairdresser comes once each week and there was a poster advertising the music and vocal evening in October. The home must do more to provide things for residents to do. For example, books, puzzles, newspapers could be provided in communal rooms and the mobile library may be able to call by with talking books. The cook was on holiday and a number of residents complained about the quality of lunch. Staff agreed that it was not to its usual standard. Food is not kept hot for residents who take a long time to eat. It should be to keep it appealing. Food is bought from a good quality supermarket chain. Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 0 EVIDENCE: Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 21, 26 The home has been converted from a domestic dwelling and the layout is complex. Residents with mental impairment find it confusing. EVIDENCE: Parts of the home have been redecorated since the last inspection. There are still signs of hard wear and tear in some areas. A rubber backed mat covering an inspection cover on the ground floor hallway was creating a trip hazard. The home was told to make this safe immediately. Refurbishment of this corridor is due to start in October. Toilets were short of towels and /or soap and toilet paper. A resident went from a toilet with no soap and towel into the dining room to eat lunch. Staff should replenish these and not wait until the cleaner gets to them late morning. One resident tried a number of doors before she could find the toilet or her bedroom. The dining area acts as a corridor between the front door and the Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 14 lounge and is not a comfortable space. The interior layout of the home is potentially confusing for people with mental impairment. Communal toilets must be better signed and so must bedrooms where a resident needs it to be. One resident was confusing the pattern on the tablecloth with the food on her plate. Staff understood this but no action has been taken to make mealtimes easier for her. Plain tablecloths and crockery could be provided. When redecorating parts of the home the manager should refer to advice available on some basic principles of interior design and good dementia care. Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 The home is still not being careful enough about the procedures followed to take on new staff. Residents may be at risk from people who are not suitable to work with them. EVIDENCE: There were three care staff on the shift. One cooked the meal as the cook was on leave. As the morning got progressively busier with official visitors to the home another care assistant was contacted to come in to deal with the meal and release the deputy to deal with these management duties. Flexibility in staffing is positive but cook hours should have been properly covered in the first place. The complex needs of some residents, the shape of the house and the need to provide some social stimulation for people mean that care staff should not be distracted with domestic duties. One staff file was missing the necessary personal/professional references. This worker came through a recruitment agency and the file; with the exception of a Fieldview House application form was compiled by that agency and passed on to the home. The registered manager is responsible for making sure that all the proofs and documents required by law are obtained on a prospective member of staff before he/she starts work in the home. These references must be obtained. The home has been told about this twice before. Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 37 Recording of accidents and incidents in the home is patchy. Residents may be at risk from patterns of accidents going unnoticed and therefore not prevented. EVIDENCE: The home has a registered manager who is undertaking the professional Award at level 4. One resident said that her wheelchair had caused the wound on her shin. She said that the wound had been treated by the District Nurse but there was no record of the incident in the accident book, the residents care file or her daily notes. This incident should have been recorded. A number of recent falls by another resident were written in the accident book. Records are not being made consistently across the staff group. Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 17 The passenger lift and hoist were being serviced that day. The trip hazard on the ground floor corridor has been mentioned already. The external lines of management and accountability in the organisation are not clear to the Commission. The registered person should address this and inform the Commission in writing. Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 2 2 3 2 x x 3 2 STAFFING Standard No Score 27 3 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x x x x 2 Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 19 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 OP7 Regulation 15 Requirement The registered person must ensure that individual care plans are brought up to date and accurately reflect the condition and needs of the resident. The registered person must ensure that individuals healthcare needs are recorded in their care plans The registered person must ensure that clothing belonging to residents is mended where necessary to maintain their modesty and dignity. The registered person must ensure that things are provided in the communal rooms on a daily basis for residents to do. The registered person must ensure that the food of residents who require a lot of time to eat their meals is kept hot until they have finished. The registered person must ensure that all complaints made about the home are recorded in the complaint log (compliance date from last inspection 15th July 2005, not inspected on this DS0000004234.V254523.R01.S.doc Timescale for action 15/11/05 2 OP8 15 15/11/05 3 OP10 12 15/11/05 4 OP12 12 15/11/05 5 OP15 12 15/11/05 6 OP16 22 15/11/05 Field View House Version 5.0 Page 20 7 OP38 13 8 OP26 13 9 OP19 12 10 OP29 19 11 OP36 18 13 OP37 12 occasion) The registered person must ensure that the mat in the ground floor corridor is made safe The registered person must ensure that toilets and bathrooms are kept supplied with paper, soap and towels. The registered person must ensure that the internal appearance of the home is adapted and decorated to facilitate the needs of people with mental impairment as far as is practicable and that this is planned into maintenance programmes. The registered person must ensure that references for prospective employees are followed up and kept on file at the home. The registered person must ensure that care staff have formal supervision at least six times a year and this must include all aspects of practice, philosophy of care in the home and career development needs (compliance date from last inspection 15th July 2005 not inspected) The registered person must ensure that all accidents and incidents are recorded in the home accident book and also in service users notes with the follow up action set down. 27/09/05 15/11/05 15/11/05 15/11/05 15/11/05 15/11/05 Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 21 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 OP31 Good Practice Recommendations Should the registered persons wish it to continue, they could consider formalising the arrangement whereby a family member conducts business with Commission in the absence of the registered persons. Field View House DS0000004234.V254523.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 House DS0000004234.V254523.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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