CARE HOMES FOR OLDER PEOPLE
Field View Residential Care Home Thompson Park Thompson Road Sunderland SR5 2SH Lead Inspector
Mr Clifford Renwick Unannounced Inspection 26th September & 12/17/18th October 2005 10:00 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 Residential Care Home DS0000015748.V250686.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 Residential Care Home DS0000015748.V250686.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Field View Residential Care Home Address Thompson Park Thompson Road Sunderland SR5 2SH 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) 0191 549 7272 0191 549 7373 PAMELA.BEALE@TISCALI.CO.UK Memory Lane Care Homes Limited Care Home 40 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (4), Old age, not falling within any other category (40), Physical disability over 65 years of age (6) Field View Residential Care Home DS0000015748.V250686.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 12th January 2005 Brief Description of the Service: Field View provides care to older people over the age of 65 years, twelve of whom may have dementia or mental health needs and six people who may have a physical disability. It provides personal care only and any health care needs are dealt with by the Community Nursing Services. The house is purpose built in construction and occupies a site on which previously stood a nursing home and is therefore well known in the area. All areas of the house offer disabled access and a passenger lift offers access to the first floor accommodation and facilities. The home is detached and stands in its own grounds with well-established trees and is approached by its own walled entrance, which leads to a private car park. Though it is located in the heart of the Southwick community it has a feeling of seclusion due to its location and large expanse of external space. There is a large garden to the rear of the home that can be used by service users and their visitors. There is access to a bus service, which offers easy access into the city centre where a range of services and shops can be accessed. Close by there is a range of shops within both the Seaburn and Southwick areas and there is easy access to the metro station at Seaburn. Field View Residential Care Home DS0000015748.V250686.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 15 hours over 2 full days and 2 half days and was carried out as part of the statutory twice-yearly inspection process. All communal areas of the premises were viewed as well as a number of bedrooms on both floors. Records of care were examined as well as records that related to health and safety and new staff employed in the home. Discussion took place with the staff on duty on the morning shift and also with the staff on the changeover of shift in the afternoon. Discussion also took place with 8 service users and also relatives who were visiting at the time of the inspection. Time was also spent observing staff practices. It was established during the inspection that the people who live in this home prefer to be referred to as “residents” therefore this term of reference is used throughout this report. The judgements made are based upon the evidence available at the time of the inspection. What the service does well:
Discussions with staff and residents confirmed that the summer garden fete had been a success and residents had enjoyed being involved in the making of goods to sell on the day. Residents and their families confirmed in discussion that they were very satisfied with the services offered in the home. Two service users were able to offer a comparison against other homes that they had stayed in and said that this was the best. Positive comments were offered about the staff and the residents confirmed that there was a “good bunch of girls working in the home.” One family stated that the staff and the manager had been very supportive during their relative’s recent illness and during her latter stages when she passed away in the home. The family stated that the support had continued and arrangements had been made to have a service in the home on the day of the funeral and for this they were most appreciative. The manager and staff have worked hard to ensure that staffing levels have been maintained in order that resident’s care needs have been met during the recent staff shortages. Field View Residential Care Home DS0000015748.V250686.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: 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 Residential Care Home DS0000015748.V250686.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 Residential Care Home DS0000015748.V250686.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, 4 The admissions process ensures that prospective residents needs are assessed prior to care being offered. This helps to ensure that they are offered the right type of care at the home and this is confirmed in writing to the prospective resident. However assessment information for the last person admitted was incomplete and consequently it could not be determined how this persons needs would be met in the home. EVIDENCE: Examination of the two most recently admitted persons to the home confirmed that assessments had been fully completed for one person and confirmation had been made in writing that on the basis of the assessment their needs could be met in the home. However for the other person the assessment provided by the social worker was incomplete. In respect of this the home carried out their own assessment but had not confirmed in writing that their needs could be met. Observations made of care practices and also discussion with both of these residents confirmed that their needs are being met and they were both pleased that they had chosen this home to move into having recently experienced short breaks in another home which they described as being not as good as this one.
Field View Residential Care Home DS0000015748.V250686.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 Residents care plans are in place, but do not fully reflect their observed needs. This can limit the guidance available to staff regarding care practice and consistency. EVIDENCE: Case tracking of four residents was carried out and this involved examining care files, care plans and assessments. The care plans do include sufficient information to demonstrate the specific actions being carried out by staff as to how they will meet resident’s needs. Assessment information and documentation that is in place was incomplete for a person most recently admitted therefore it could not be determined from the written records how staff were addressing this persons needs. Observations confirmed that the staff are carrying out some positive work with this person and it this level of work that needs to be shown in the care plan. Discussion held with the manager confirmed that she was aware of the need to develop the care plans and work had commenced in this area. Part of these developments have led to the introduction of updated moving and handling
Field View Residential Care Home DS0000015748.V250686.R01.S.doc Version 5.0 Page 10 assessments, risk assessments and night check charts for those residents identified as being at risk during the night. The manager is also going to contact the dietician to seek advice about diet and nutrition fore those service users who have needs in this area. A recent moving and handling assessment which has been introduced for one resident was examined and seen to be a positive development in that it offers clear guidance to staff and also reflects the residents preferred choice of how they wish to be supported. Records available in resident’s files confirmed that all health needs are being met by use of NHS services. Discussion was held with the manager about record keeping charts used by staff, which could be seen to be impersonal as they were on display in the office. This type of record keeping needs to be developed and any record of personal care needs to be addressed as part of the written care plan. Field View Residential Care Home DS0000015748.V250686.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, 13, 15 The residents are able to follow their daily lifestyles which satisfies their social and religious needs, however, there are limited opportunities for social activities and very little for the residents to do in the home. This restricts the resident’s ability to lead stimulating and fulfilling lifestyles. Residents are offered a varied menu with wholesome food, which promotes their health and wellbeing. EVIDENCE: Discussion with the residents confirmed that there was little happening in the way of activities within the home other than television or listening to music. Those residents who are able confirmed that they continue to follow their own routines and this has involved going over the road to the local pub or to the library at Seaburn. In discussion held with the manager she confirmed that an activities coordinator has been appointed to work 17 hours per week and would be commencing duties in one weeks time. It was stated that this would immediately lead to improvements within the home. Good contact is maintained with residents and their families and there are no restrictions on
Field View Residential Care Home DS0000015748.V250686.R01.S.doc Version 5.0 Page 12 visiting the home. The manager was in the process of organising with relatives the funeral service for a resident who had recently died and it was arranged that after the service the wake would be held in the home for relatives and any residents who may wish to attend. Discussions held with relatives who were visiting at the time of the inspection confirmed that they were satisfied with the services in the home but were keen to see more activities being made available especially the quiz sessions and the bingo, which used to be very popular. Lunch was taken with the residents and discussions over the meal confirmed that the residents enjoyed the food that was provided. In addition to the 2 main courses there was an alternative choice and residents were observed to choose their preference from the menu. In discussion with the manager it was confirmed that the meals are being reviewed in order to reflect the residents preferences and from discussion held with them in a meeting in which the cooks also attended. The manager has obtained specialist food moulds in order to ensure food that has to be blended looks appealing and different meats and vegetables are to be introduced to the menus as well “smoothies” (soft blended fruit drinks). This is a positive approach by the manager who is actively involving residents in the changes. Some discussion was held with the manager about some staff practices during the mealtime and advice was offered about how these could be developed. Field View Residential Care Home DS0000015748.V250686.R01.S.doc Version 5.0 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The home has a satisfactory complaints system. Complaints are handled appropriately and the outcomes used to improve the service. Local adult protection procedures have been implemented and instigated to help contribute to the protection of residents from abuse. EVIDENCE: A complaints procedure is in place and discussions held with residents and families confirmed that they had no complaints. They went on to say that if they had any concerns they would raise them with the staff knowing that they would be addressed to their satisfaction. Families of residents were positive about the service stating that you could discuss anything with the “girls” and they would try their best to sort things out. At recent residents meeting a number of matters had been raised and this resulted in some changes in the home with new towel being provided for everyone and fresh fruit bowls being provided in lounges on a daily basis. Staff are familiar with the policies and procedures that deal with the protection of vulnerable adults. Field View Residential Care Home DS0000015748.V250686.R01.S.doc Version 5.0 Page 14 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, 26 The home is generally clean and warm offering residents a homely environment in which to live. However, there were a number of issues, which need to be addressed otherwise they could compromise the health and safety of the residents. EVIDENCE: The upstairs kitchenette in the dining room is now showing signs of wear and there are some issues relating to hygiene control around the sink and food serving areas. A number of the carpets were stained and consequently the manager had arranged for contract cleaners to clean the carpets. It was noted on the inspection visit that the house keeping staff worked extremely hard to maintain a good standard but it was evident that the staff shortages had clearly had an impact on the overall cleanliness of the house. Some of this was also attributed to staff practices and which were discussed with the manager. The lighting in the administration office is poor and not conducive to a good working environment for staff.
Field View Residential Care Home DS0000015748.V250686.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 Staffing levels are sufficient to effectively meet the needs of service users living in the home however this has only been possible by staff working extra hours to cover the vacant posts until new staff can be employed. The procedures for the recruitment of staff are not robust and do not provide the safeguards to offer protection to people living in the home. EVIDENCE: Examination of staffing rotas confirmed that agreed staffing levels were being maintained however there has been a high turnover of staff since the last inspection and this resulted in a number of vacant posts being covered by the existing staff. Consequently staff have been working extra days and long hours in order to maintain safe staffing levels. Discussion held with the manager confirmed that new staff had been interviewed and were ready to commence work subject to satisfactory police checks that for some reason had been delayed by the agency responsible for processing them. In order to assist the manager discussion took place with both the agency responsible for dealing with the police checks and also the criminal records bureau in order to speed up the process. Following the inspection the manager was in a position to start new staff. A number of new staff had been employed since the last inspection and examination of their personnel files confirmed that there were shortfalls in the information required by regulation and this was discussed with the manager. The application forms have been developed but there were two kinds in use and one had omitted the necessary health declaration that staff must sign this too was discussed with the manager. The storage facilities currently in use for storing confidential staff files is unsuitable and does not ensure that aspects of confidentiality are maintained.
Field View Residential Care Home DS0000015748.V250686.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, 32, 33 The manager ensures that all staff have guidance and support so that service users needs can be most effectively met. Views of the residents are sought in order that they can contribute to the development of the service. EVIDENCE: The manager is new in post and has taken over the day-to-day responsibility from the owner who has now relocated to another part of the country. The manager is in the process of submitting an application for registration to be the registered manager. Since commencing work in the home the manager has been active in developing residents meetings in order to seek their views on the services being offered. So far there have been two meetings both of which have resulted in the manager acting on resident’s views and introducing new things in the home. The manager is keen to develop things further and work
Field View Residential Care Home DS0000015748.V250686.R01.S.doc Version 5.0 Page 17 has already commenced on reviewing the meals in the home. In addition to this the manager is looking at how staff can be supported in their roles and has introduced additional tools for communication. Risk assessments have been developed and an improved record keeping system has been put into place for dealing with accidents. It has not been easy for the manager with the current staffing shortages to maintain a good standard of care but she has and this is attributed to the hard work of both the manager and the staff team. In addition to this the manager has also had to deal with some difficult staffing issues and observations made have confirmed that she has dealt with these satisfactorily and this is to be commended. Field View Residential Care Home DS0000015748.V250686.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 2 2 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X X X Field View Residential Care Home DS0000015748.V250686.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14 (1) Requirement No resident must be admitted to the home unless a comprehensive assessment of needs has been completed. The individual assessment document and new care plan format must be developed as discussed during the inspection. A planned programme of stimulating and meaningful activities must be introduced for the residents. The physical standards within the home must be improved with decoration being carried out to those areas identified during the inspection. All documentation as required by regulation in respect of staff recruitment must be obtained before staff can commence work in the home. The manager must submit an application for registration to the commission. A secure lockable facility must be provided for the storage of confidential staff records with access only being available to
DS0000015748.V250686.R01.S.doc Timescale for action 18/10/05 2 OP7 14 (1), 15 31/03/06 3 OP12 16 (2), (m) 23 (2), (d) 31/12/05 4 OP19 31/12/05 5 OP29 Schedule 2 18/10/05 6 7 OP31 OP37 9 (1) 23 30/11/05 30/11/05 Field View Residential Care Home Version 5.0 Page 20 the manager. 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 OP15 Good Practice Recommendations Consideration should be given to reviewing the mealtime practices as discussed during the inspection. Field View Residential Care Home DS0000015748.V250686.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Residential Care Home DS0000015748.V250686.R01.S.doc Version 5.0 Page 22 - 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!
