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Inspection on 30/11/07 for Field View Residential Care Home

Also see our care home review for Field View Residential Care Home for more information

This inspection was carried out on 30th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a pleasant and welcoming atmosphere. The home has well landscaped grounds and service users can use a flagged patio area. Service users are well groomed and wear suitable clothes. The service users are able to maintain contact with the surrounding community, relatives and friends. Service users said that they are happy in the home, and are well treated by the staff. Comments such as, "the staff are very nice" and "the staff are very helpfull" were typical of those made to the inspector. The home gets an assessment of a new resident`s needs from that person`s social worker, before that person is admitted. This should mean that the home can meet all of those needs.The person and their family are encouraged to visit the home, before a final decision is made. Relatives said that they are also happy with the care being given, and said they had confidence in the staff. They are able to attend meetings with the manager and staff.

What has improved since the last inspection?

There are more social activities for service users and a wider variety of things for them to do. Medication storage has been made more secure.

What the care home could do better:

The home was dark in some areas and light levels should be improved. Care plans need further improvement to ensure service users get consistent care and that staff maintain their accountability. The home could provide further social activities and an activities co-ordinator would help this process. Staff need to demonstrate a greater awareness of safety issues such as reporting damaged equipment, low light levels and hot surfaces. Staff should ensure medication is kept safe and trolleys are not left unattended.

CARE HOMES FOR OLDER PEOPLE Field View Residential Care Home Thompson Park Thompson Road Sunderland SR5 2SH Lead Inspector Mr Tom Moody Key Unannounced Inspection 30th November 2007 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.V350669.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 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 Julie12-@tiscali.co.uk ORpam.beale1@tesco.net Memory Lane Care Homes Limited Julie Anne Howe 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.V350669.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user is below pensionable age with the registration category PD 26th September 2006 Date of last inspection 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 and occupies a site on which previously stood a nursing home and is 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; this 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. Information about the home is available in its ‘Statement of Purpose’; in the form of a brochure (‘Fieldview Residential Home’) available in the entrance to the home; and in information posted on the home’s notice board in the entrance lobby. These last two need to be updated. The weekly fees charged are from £381 to £405. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day in November 2007. The site visit took five and a half hours in total, and was carried out as part of the normal statutory inspection process. Information was collected about the service both before and during the site visit. The manager was on duty at the time of the visit and feedback was given to her on the day of the site visit and included any issues that needed to be addressed rapidly. All communal areas of the premises were viewed, as well as a number of bedrooms on both floors. A process called ‘case tracking’ was used to check the quality of the care received by specific service users and this included looking at residents’ care records. A sample of other records such as health and safety were also looked at. Discussion took place with the staff on duty, with service users and with relatives who were visiting at the time of the inspection. Time was also spent observing staff practices. What the service does well: The home has a pleasant and welcoming atmosphere. The home has well landscaped grounds and service users can use a flagged patio area. Service users are well groomed and wear suitable clothes. The service users are able to maintain contact with the surrounding community, relatives and friends. Service users said that they are happy in the home, and are well treated by the staff. Comments such as, “the staff are very nice” and “the staff are very helpfull” were typical of those made to the inspector. The home gets an assessment of a new resident’s needs from that person’s social worker, before that person is admitted. This should mean that the home can meet all of those needs. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 6 The person and their family are encouraged to visit the home, before a final decision is made. Relatives said that they are also happy with the care being given, and said they had confidence in the staff. They are able to attend meetings with the manager and staff. 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. The summary of this inspection report can be made available in other formats on request. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 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.V350669.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): MNS 1, 3, 4, 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The assessments of needs still lack detail in some areas and therefore it cannot be fully substantiated that all needs are effectively met. Service users and their relative receive a range of information and are able to visit the home, in order to make an informed decision about using the service. EVIDENCE: The provider’s self-assessment says that all new service users are assessed by the home and the social services department. It also states that prospective residents can visit, sample the meals or stay overnight if they wish. The manager spoke of relatives visiting before placing service user’s in the home, although the physical condition of some service users may prevent them visiting in person. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 9 The provider’s self-assessment acknowledges that care plans could be more detailed but says the care plans are better ordered. The service user’s care plans do contain an assessment of need from social services and care planning is based on this. Some of these assessments lack detail e.g. noting that service users like “music” but not specifying what kind. There is little evidence of the home making it’s own assessment independent of this and this is an area for improvement. Current information about the service is displayed on a notice board along with the minutes of residents meetings. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Medication storage has improved but some aspects of the administration need further improvement to ensure the safety of service users and the accountability of staff. Service users have access to health care but weakness in the care planning process should be address to fully demonstrate that service users needs are being met. EVIDENCE: Medication records were accurately kept although there were no photographs attached to the charts. This would be a useful check to confirm the right medication was given to the right person. Medicine storage is appropriate and secure. A staff member giving out medicines left the medication trolley unattended in a corridor for a short time. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 11 This may pose a potential hazard and the trolley could have been taken in to the room to remain in sight of the staff member. Service users have access to health services, including doctors, dentists and opticians. Service user’s comments confirm this. One person said, “ If we need to go to the doctors the staff come with us”. Assessments are based on the local authority placement assessment. This contained good information about cultural preferences and end of life observance but lacked detail in some respects. The home does not carry out it’s own independent assessment. Not all entries were dated and signed. There were also instances when new care plans had been started rather than reviewing the existing ones. This resulted in unnecessary duplication. Staff showed respect for service users in almost all aspects of care, supporting them appropriately during meals, knocking on bedroom doors before entering and when helping with their mobility. Relatives comments indicated they were happy with the care provided by the home. One relative said, of the staff, “I have every confidence in them, they are a good bunch”. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s staff promote social activities for the service users, who they can keep in contact with their families, friends and the local community. Service users are assisted to exercise choice and control over their lives and they enjoy good quality traditional meal. These aspects of care ensure that they can continue to enjoy elements of their preferred lifestyle. EVIDENCE: The service users self-assessment indicates the home has regular meetings with relatives, suggestions are acted upon and the minutes are available. It also states that visits to church or other contacts are arranged. The selfassessment also stated visiting can take place at any time and community links, to churches and schools, are encouraged. The self-assessment also states service users are encouraged to be independent. The home states that activities are available as well as social events and parties. They also say menus are changed in line with service user’s wishes. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 13 The home has not appointed an activities co-ordinator but there are photographs of service users enjoying social events. Service users confirm that they go out of the home and visit local amenities. The manager stated that the home staff helped service users with small-scale activities such as games and crafts. The materials for these were at hand in the home. There were also parcels being prepared for Christmas celebrations. The notice board has information about a local advocacy service. Service users rooms are spacious, individually furnished and pleasantly decorated. Bedrooms contain personal articles such as photographs and ornaments, and had suitable locks fitted. There is a dedicated hairdressing room where service users can have their hair styled. Service users confirm that they, “enjoy the food.” The menu has a variety of dishes. The food served was appetising and consisted of traditional dishes. One service users said “the Sago pudding was lovely.” Service users who needed assistance were supported by staff during the mealtime Service users where given their medication during their lunch and this detracted from the dining experience and the retiming of this was discussed with staff and manager. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users and most relatives are comfortable about raising issues with staff and the manager. They are sure that issues will be dealt with appropriately by the manager. Furthermore, staff have had training and have a good awareness of protection issues. The local authoritys strategy, the managers approach and the company’s policy combine to protect service users from abuse. EVIDENCE: There were few recorded complaints but the level of recording was good. This included the action taken to deal with the complaint and the outcomes. Care plans indicated the involvement of specialist staff in any incidence of challenging behaviour. The manager stated that minor complaints were dealt with at the time of the contact and this resolved things quickly. Staff training records show that staff receive training in the local adult protection process and staff spoke of this training. They have a good awareness of adult protection issues. Relatives and service users said they would be happy to raise issues with the staff. one relative said, “I have every confidence in the staff.” One service user said, “if we had problems they would help us.” Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 15 The manager spoke of having an open door policy and she was seen to greet visitors entering the home. Regular meetings take place and the manager said this was another route by which potential problems could be resolved at an early stage. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well maintained and cleaned. It provides a comfortable environment with appropriate aids and adaptations to meet service users needs, but maintenance and safety issues should be addressed to keep service users safe. EVIDENCE: The home is free from odour and it is pleasantly warm and well ventilated. At least two radiators in the home had become loose from their fixings. One of the heaters in the lounge was switched on and it felt hot to the touch. This did not present a low surface temperature and some form of guards should be in place to ensure service users are not at risk of burns. These problems were brought to the managers attention at once. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 17 Some areas of the home have low light levels. This may be due to the use of low wattage bulbs and badly designed shades. The dining area is well decorated and furnished. There is a menu board displaying the choices available for the current day. Bedrooms are suitably furnished and decorated and the bedrooms contain personal items and photographs. Handrails are available throughout the building to assist service user mobility. The home has suitable grab rails and lifting equipment fitted in toilets and bathrooms. Fire precautions are observed by staff and the home has been recently inspected by the fire service and the environmental health department. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number of staff on duty was sufficient to meet service users care needs. Furthermore the homes recruitment policy and practice safeguards service users. EVIDENCE: There were sufficient staff on the day of the site visit. Support was available for service users and care was delivered in an unhurried manner. The call system was answered promptly. Staff records that were seen indicated staff were able to access a variety of “in house “ training, as well as induction and mandatory training although it is necessary that staff develop a greater awareness of health and safety issues. Recruitment processes are thorough and all necessary checks are recorded including identity and the criminal records bureau. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,36,37,38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is experienced and the home is generally well managed. Some aspects of health and safety, quality assurance and care planning remain as weaknessess that should be addressed to ensure the occupants of the home remain safe and well cared for EVIDENCE: The manager co-operates with the registration authority and responds to advice and suggestions. She spoke of supervision taking place in the home and records are available to confirm this. The manager has a good relationship with visitors, staff and service users. The home holds meetings for residents and relatives, and minutes are kept. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 20 Service users and relatives are involved in some aspects of decision making, such as choosing decorations for bedrooms and menu choice. The manager acknowledges the home still has some progress to make in care planning. There were some aspects of a quality assurance system but this covered only a narrow area around menu and meals. It was suggested that this be expanded to cover a wider area. It was also suggested that photographs on medication charts would help to positively identify people receiving medication. Although most aspects of health and safety were addressed, low light levels, high temperature radiators and loose fixings had not been identified. Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 21 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 3 x 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 2 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 2 2 Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? 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 OP4 OP3 Regulation 14(1)(c) 14(2)(a)( b) Requirement Timescale for action 30/01/08 2. OP7 3. OP9 4 OP19 OP25 5 OP25 6 OP38 The home must ensure the service users needs are accurately assessed and reviewed to ensure they can continue to meet their needs 15 (1)(2) The home must ensure all (b) service users have an up to date and accurate care plan that meets all of their needs. 13(2) The home must ensure medication records and administration keep service users safe. 13(4)(a)(c Radiators must be secured to the ) wall and must be of a design 23(2)(b) that prevents service users coming into contact with hot surfaces. 13 (4) (a) Light levels must be maintained (c) to National minimum standards 23(2)(p) (150 Lux) in areas of the home used by service users. 12 (1)(a) The manager must ensure the 13(4)(a)( health and safety of service users are promoted and protected. 30/01/08 30/01/08 30/01/08 30/01/08 30/01/08 Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 23 7 OP37 15 (1)(2) (b) 13(2) The manager must ensure all documentation relating to service users well health and being is accurate and up to date. 30/01/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Field View Residential Care Home DS0000015748.V350669.R01.S.doc Version 5.2 Page 25 - 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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