Inspection on 14/11/05 for Fieldgate Nursing Home

This inspection was carried out on 14th November 2005.

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.

Other inspections for this house

Fieldgate Nursing Home 30/10/08

Fieldgate Nursing Home 09/01/07

Fieldgate Nursing Home 08/06/05

Fieldgate Nursing Home 07/02/05

Fieldgate Nursing Home 09/09/04

Fieldgate Nursing Home 10/07/03

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Fieldgate Nursing Home 153 Portsmouth Road Horndean Hampshire PO8 9LG Lead Inspector Anita Tengnah Unannounced Inspection 14th November 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 Fieldgate Nursing Home DS0000011488.V265023.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. Fieldgate Nursing Home DS0000011488.V265023.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fieldgate Nursing Home Address 153 Portsmouth Road Horndean Hampshire PO8 9LG 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) (023) 9259 3352 Extraservices Limited Mrs Muriel Joy Emery Care Home 39 Category(ies) of Physical disability (4), Physical disability over 65 registration, with number years of age (39), Terminally ill (4), Terminally of places ill over 65 years of age (39) Fieldgate Nursing Home DS0000011488.V265023.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the PD, TI , categories and/or service users in need of general nursing care must not be admitted under the age of 50 8th June 2005 Date of last inspection Brief Description of the Service: Fieldgate nursing home is a registered care home providing nursing and personal care to 39 service users in the older person category. The home is situated in a residential area close to local amenities. The service users accommodation comprises of seven single rooms and sixteen shared rooms and there is a passenger lift that allows access to both floors. There are a variety of aids and assisted baths to meet the needs of the residents. The service also benefits from a large and well-maintained garden with access for wheelchair users. Fieldgate Nursing Home DS0000011488.V265023.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection took place over one day on the 14th of November 2005. As part of the inspection process a tour of the building was undertaken. The inspection took place over 5 hours. The inspector spoke to 9 service users, 2 relatives, 2 opticians, staff, the manager and the provider who was at the home on the day of the visit. The process included examining care records, staff records and discussions with service users, staff and visitors. Information from the completed pre inspection questionnaire was also used. What the service does well: What has improved since the last inspection? What they could do better: The manager must ensure that care plans are in place for all service users in order to inform practice and reflect how the assessed needs would be met. Fieldgate Nursing Home DS0000011488.V265023.R01.S.doc Version 5.0 Page 6 The bathroom on the ground floor must be cleared while this is awaiting refurbishment in order to be available for service users use. This area did not provide a homely environment and alternative storage facility must be found. The manager must ensure that accurate records are maintained of all training undertaken by staff to reflect that staff have the skills required to meet the needs of the service users. 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. Fieldgate Nursing Home DS0000011488.V265023.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 Fieldgate Nursing Home DS0000011488.V265023.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): 3,6 The home has a good pre admission process in place to ensure that service users needs could be met. The home does not provide intermediate care. EVIDENCE: The manager assesses all service users prior to admission to the home to ensure that their needs can be met. Service users are offered visits to the home and information was available to enable them to make an informed choice. The pre-assessments were available in all service users records examined on the day of the inspection. Care management assessments are also secured as part of the admission process. The home does not provide intermediate care. Fieldgate Nursing Home DS0000011488.V265023.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): 7,9,10 Care plans were available for service users except for a newly admitted service user. This has the potential of putting the service user at risk and not meeting the assessed needs. The medication at the home was well managed ensuring the welfare of service users is promoted. The care practices ensure that service users autonomy and choices are respected. EVIDENCE: A sample of four care plans was seen as part of the inspection process. Assessments of long- term needs were undertaken. These included manual handling, nutritional and risks assessments. A care profile sheet was available in all service users rooms inspected that gave a quick reference guide of service users needs. All night care plans were updated on a monthly basis in order to reflect any changes in service users’ needs. However the day care plans seen were not all reviewed. The manager must ensure that staff review the service users’ plans regularly to ensure that Fieldgate Nursing Home DS0000011488.V265023.R01.S.doc Version 5.0 Page 10 their changing needs are identified and care plans are updated to meet their needs. It was noted that there was no care plan in place for one service user who had been recently admitted. This has the potential of putting the service user at risk and unmet needs/ lack of continuity of care. This was discussed with the manager as this particular service user had a comprehensive pre-assessment in place that reflected some acute immediate needs. All service users are registered with GP’S and the manager reported that service users had the choice of retaining their own doctor on admission as appropriate. Service users access to NHS care is promoted and well managed. Two visiting opticians were attending the home on their second visit at the time of the inspection. A number of the service users said that they had their eyes tested and discussed the outcome. Feedback from the visiting professionals were positive and said that staff were organised and very helpful and they had received assistance as required. All the service users spoken to expressed satisfaction with the care that they are receiving. One service user said that he loves living at the home and that the “doctor was amazed at his progress” and was only given “a short time to live”. He was now looking forward to g out shopping. Comments from other service users included” It’s wonderful in here”. “Staff could not be kinder”. Service users said that they had choice regarding getting up and going to bed. Fieldgate Nursing Home DS0000011488.V265023.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 There is a variety of activities available to service users. Further development of the activity programme would ensure that service users needs are met. The visiting at the home is good and ensures that service users maintain contact with family and friends. Meals at the home were well-managed and ensured variety and choice. EVIDENCE: The manager said that the home has activity coordinators who provide activities for service users. The home has a sensory room that contains soft lighting, slides and music. The manager reported that this is used regularly and service users enjoyed this facility. The local vicar visits on a monthly basis and service users receive communion as requested. The manager reported that links are maintained with the local church group who attends the home regularly. The hairdresser attended the home and service users reported that they enjoyed this facility as having their hair done made them “feel better” Service users spoken to say that there enjoyed a bingo game that was undertaken as a group activity. Comments from the service users were that they would like more regular group activities. One service user said that the bingo game was available once a month. This was discussed with the manager and group activities will be explored further in order to meet the needs of Fieldgate Nursing Home DS0000011488.V265023.R01.S.doc Version 5.0 Page 12 service users. One service user said that she went to the library with her daughter and enjoyed reading. A visiting library would be beneficial. The manager will also be looking at access for the visiting library for service users where books, tapes and other materials would be available as requested by service users. The home has an open visiting policy, service users and relatives spoken to say that there is no restriction with visiting. The visitors’ book maintained at the home supported this. One relative said that he comes in daily and spends the day with his wife, and he always feels welcomed. Another relative came in regularly and assisted her mother at lunchtime. Lunchtime meal was observed. Meals appeared appetising, well balanced and nicely presented. Service users say that choice of meals was offered and all 6service users spoken to said that “meals were very nice” and that hot drinks and snacks were available at all times as requested. Another service user said that “food is great” and he had gained weight since admission to the home. Staff were observed to offer support with meals in a sensitive manner as required. Two service users said that they preferred to take their meals in their rooms and staff respected their choice. Fieldgate Nursing Home DS0000011488.V265023.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 satisfactory procedures in place to deal with complaints and the protection of abuse to ensure the safety of service users. However the lack of complaint recording may be detrimental to the welfare of the service users. EVIDENCE: The home has policy and procedures to inform practice and how to make a complaint. The complaint log was seen. There has been no recorded complaint since the last inspection. Staff spoken to say they deal with issues raised and did not record. This was discussed with the manager who must ensure that concerns raised are recorded in the complaint log and details of investigation and any action taken. Service users spoken to say that they would approach the manager or the nurse in charge with any issues. The home has in place adult protection procedures including the Hampshire abuse procedures. The manager reported that training in abuse was available and also forms part of induction. The manager is aware of the need to record and report all allegations of abuse to the appropriate authority. Fieldgate Nursing Home DS0000011488.V265023.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): 19,21,23,26. The home provides a homely and comfortable environment for service users to live in. The service users bedrooms were personalised and meet their needs. However one of the bathrooms was in poor state of repair and may be to the detriment of service users. EVIDENCE: A tour of the premises was undertaken as part of the inspection. The home was clean and welcoming and furnishing was in good order and suitable to the needs of service users. The manager said that there is an ongoing programme of refurbishment in place. Recent refurbishment included the ground and the first floor hallways, four toilets, the laundry room and one service user’s bedroom. Service users bedrooms were personalised and it was evident that service users are encouraged to bring in items of personal belongings on admission. Service users spoke fondly of their bedrooms and being surrounded with their belongings. Some service users had private telephone lines in their bedrooms as requested. Call bells were available in all rooms that were accessible to Fieldgate Nursing Home DS0000011488.V265023.R01.S.doc Version 5.0 Page 15 service users. Screens were provided in all shared rooms to maintain service users’ privacy. The home has equipment including hoists, grab rails and assisted baths to assist and promote the service users’ independence. One bathroom had been refurbished. However another bathroom on the ground floor was in a poor state of repair, the side panels of the bath were broken and the paint peeling. This was also used as a storage area with bedrails and door panels that may be unsafe for service users. This was discussed with the provider who agreed that this would be addressed and made safe for service users’ use. The provider discussed that as part of the refurbishment, he is planning to install a shower facility in this bathroom that would be completed in March next year. This would be beneficial to service users and give them the option of an extra facility. The home has a laundry and all service users’ laundry is undertaken internally. One relative raised an issue regarding clothing belonging to other service users that had been given to him. These consisted of four items of clothing that were unmarked. This was discussed with the manager for her to take necessary actions. Fieldgate Nursing Home DS0000011488.V265023.R01.S.doc Version 5.0 Page 16 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): 27,30 The home had adequate staff and skill mix to meet the needs of the service users. There is a training programme in place to ensure that staff have update in meeting the needs of the service users. EVIDENCE: The home has a roster for nurses and carers and a separate roster for ancillary workers. A sample of the roster was seen and copies were received as part of the pre-inspection questionnaire. The roster showed that there is one trained staff on all the shifts that take charge of the home. The manager supports the staff and deals with the management of the home. Service users spoken to say that call bells are answered promptly and “staff are good and kind”. It was evident that staff and service users have developed good relationship and service users said that they are treated with respect. The home has a training programme in place to ensure that staff update their skills and are competent in providing care. Recent training included update in HIV care, manual handling. However the training records were difficult to access and some needed updating. Discussion was undertaken with management about the development of a training matrix that will provide an up to date record of staff training and easily accessible. The manager has confirmed that this will be put in place. This will also help in identifying gaps in mandatory training such as health and safety, fire prevention, and moving and handling to ensure the safety of the service users. Fieldgate Nursing Home DS0000011488.V265023.R01.S.doc Version 5.0 Page 17 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): 33,35,37 The systems for service users’ consultation are good and their views are sought. The system for service users financial management is good ensuring that they are protected from abuse. Records are maintained safely and protect the welfare of the service users. EVIDENCE: The home has an internal audit system in place to seek the views of the service users and ensuring that the home meets the aims and objectives as illustrated in the service users’ guide. The manager said that a recent audit of the service users/ relatives’ views has been completed and issues raised will be looked into. Fieldgate Nursing Home DS0000011488.V265023.R01.S.doc Version 5.0 Page 18 The home does not manage any of the service users’ financial affairs. The manager reported that either their families/ advocates deal with this. A sample of the home financial dealing showed that invoices were raised for hairdressing, chiropody, newspapers on behalf of service users and receipts were kept. Service users are issued with terms and condition of residency and the provider confirmed that all extras that are not included in the fee would be included in the contracts. Records were maintained safely. Reports as per Regulation 37 are sent to the Commission. The insurance liability certificate was displayed and current. Fieldgate Nursing Home DS0000011488.V265023.R01.S.doc Version 5.0 Page 19 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 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X 3 X X 3 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 X X 3 X 3 X 3 X Fieldgate Nursing Home DS0000011488.V265023.R01.S.doc Version 5.0 Page 20 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 OP7 Regulation 15(1) Requirement Timescale for action 30/12/05 2. OP7 15(2) (b) (c) 3. OP21 23(2) The manager must ensure that all service users have a care plan in place to demonstrate how their care needs would be met All care plans must be reviewed 30/12/05 and updated on a monthly basis to reflect the changing needs of the service users. This must include involvement of the service users/ relatives as appropriate. The manager must ensure that 30/12/05 the bathroom on the ground floor is cleared and equipped to assure comfort and meet the needs of the service users. 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 Fieldgate Nursing Home DS0000011488.V265023.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Fieldgate Nursing Home DS0000011488.V265023.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. 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