Inspection on 02/07/07 for Fieldhead

This inspection was carried out on 2nd July 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fieldhead 26/07/06

Fieldhead 24/10/05

Fieldhead 05/05/05

Fieldhead 22/02/05

Fieldhead 30/09/04

Fieldhead 09/03/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Fieldhead Back Lane, Skelton Road Langthorpe Boroughbridge North Yorkshire YO51 9BZ Lead Inspector Donna Burnett Key Unannounced Inspection 2 July 2007 01:30 Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 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 Fieldhead DS0000007874.V334208.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 Adults 18-65. 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. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fieldhead Address Back Lane, Skelton Road Langthorpe Boroughbridge North Yorkshire YO51 9BZ 01423 325052 F/P01423 325052 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) info@st-annes.org.uk St Anne`s Community Services vacant post Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 5 Service Users with Learning Disability some of whom may also have a Physical Disability. 26th July 2006 Date of last inspection Brief Description of the Service: Fieldhead is a care home registered by St Annes Community Services to provide personal care and accommodation for up to five younger adults with learning disabilities, some of whom may have physical disabilities. The home is a detached, two-storey house that is situated in its own grounds that are set back from a main road in Langthorpe, which is close to Boroughbridge. Local community amenities and facilities, including shops and pubs, are within walking distance for those with good mobility. Other than that, transport would be required. Each of the five bedrooms is for single accommodation, two of which have ensuite facilities. These are situated on the ground and the first floor, the latter of which are accessed via a staircase. There are well-maintained garden areas to the rear and side of the house along with an area for parking. The standard fee charged by the home is £1212.47 per week. Toiletries, hairdressing, cigarettes, holidays and activities outside of the home are not included in the fees. This information was provided on 2 July 2007, during the inspection. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Four hours were spent preparing for the inspection and gathering information about the service, including what had been happening at the home since the last inspection. A Pre Inspection Questionnaire asking for information about the home was sent to the acting manager before the visit and information from this was used to help plan the inspection. Surveys were sent to the relatives of people living in the home as well as a selection of health and social care professionals who have involvement with the service. Their comments and feedback about the service are included in the main body of the report. All of the key standards were looked at during the inspection to try and find out what it was like to live at the home. The inspection lasted three and a half hours and was timed for mid afternoon to allow time to speak with the staff prior to people returning to the home following their usual daily activities. The acting manager was available throughout the inspection. The inspector spoke with two people living in the home and observed their interaction with staff. Time was also spent speaking with staff on duty, looking at care plans and other records. A tour of the premises was carried out to see if the previously required improvements had been carried out. What the service does well: What has improved since the last inspection? Refurbishment and improvements have been carried out to the home. This makes it a safer, more pleasant place in which to live. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 6 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. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. People who use the service experience good quality outcomes in this area. They know what to expect from the service and can be confident that their needs will be met. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: People who might be thinking about coming to live at the home are given written information about the services on offer so that they know what to expect. License agreements explain to the people who live in the home, how much they have to pay and the terms and conditions of living in the home. Although there have not been any new admissions for several years, people would be invited to spend time meeting the staff and other people living in the home. They would be invited to stay for meals and could stay overnight to see what it would be like to live in the home. People thinking of coming to live at the home would be fully assessed to make sure that the home would be able to meet their specific needs. The acting manager stated that she would not accept anyone new to the home unless she was certain that the staff had the skills to be able to provide the care required. Consideration is given to the social and emotional needs of people as well as their physical well-being. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 9 Other professionals such as occupational therapists and psychologists carry out additional assessments, when required, so that specialist needs can be clearly identified and planned for. The people who live in the home have recently been consulted with about possible future changes to the service. They have been asked to consider where they might like to live, who they might like to live with and how they would like to be supported, in order for their needs to be best met. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. People who use the service experience good quality outcomes in this area. People who live in the home are supported and encouraged to make their own decisions about how they live their lives. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: People who live in the home are provided with the care and support that they need. This is detailed in individually written care plans. The plans are reviewed as changes happen so that the information in them is always correct. The plans also explain to staff what to do in the event of harmful or hostile behaviour being displayed. A lot of importance is put on identifying and preventing difficult situations from arising in the first place. Everyone who lives in the home has a key worker who takes a special interest in them and makes sure that they have got everything that they need. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 11 The acting manager has recently attended training in the promotion of equality, diversity and rights. Both she and the staff team try hard to encourage people living in the home to make their own choices and decisions. People who live in the home are kept safe whilst being allowed to take reasonable risks. Where safety measures or restrictions are put in place, the reasons why are clearly recorded. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. People who use the service experience excellent quality outcomes in this area. They are supported to live full, meaningful lives and maintain close family relationships. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: People living in the home are supported to join in a good range of activities and to take up social and recreational opportunities outside of the home. They are encouraged to be part of the local community and enjoy going bowling, to the local cinema, pubs and cafes. A relative who returned a survey commented that ‘the home is good at providing an appropriate level of activities’. At the time of the inspection, two of the people living in the home were away on holiday. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 13 Visitors can be seen either in people’s bedrooms or in one of the three communal rooms. Family relationships are encouraged and help is given to people to visit family members who cannot get to the home themselves. Bedroom doors are lockable and privacy is respected. Staff do not go into bedrooms without consent. People who choose to smoke are supported to do so safely and with consideration for the other people living in the home. The home is not restrictive and the people who live in it have free access to all of the communal areas including the laundry, kitchen, gardens and bathrooms. People living in the home can use the kitchen facilities although meals tend to be cooked by the staff. Staff attend food hygiene training so that they know how to handle food safely. People living in the home are encouraged to help plan the menus and assist with the shopping. Food is prepared and presented taking into account dietary preferences and specific needs. Assistance is given to those people who need it and aids such as plate guards are available to people assessed as needing them. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. People who use the service experience good quality outcomes in this area. They get the health and social care support that they need. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Each person who lives in the home has a ‘Personal Profile’. This helps staff to understand individual, specific needs and to respect people’s wishes. Personal support is specific to the needs of each person and takes into account preferences and individual choice. People who live in the home have access to a variety of health and social care professionals who say that the staff at the home are good at ‘joint working’. Referrals to and visits from other professionals are clearly documented in people’s individual notes. This helps to make sure that people get all the help and support they are entitled to. People living in the home are supported to take their prescribed medication. Medication is stored securely and only administered by staff who have been trained to do so safely. Most of the medication is supplied in blister packs and Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 15 labelled for the sole use of the person prescribed for. The system is safe and there is little chance of medication errors occurring. Specialist training is also provided to allow staff to administer certain specialist medicines such as suppositories. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. People who use the service experience good quality outcomes in this area. People who live in the home are safe. Concerns are addressed and dealt with properly. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: A family member who returned a survey commented that ‘the home did not respond well to concerns in the past but has done so since the new (acting) manager took over’. Another relative said that the (acting) manager is ‘keen to address any issues’. There have not been any complaints since the last inspection but a record has been kept of all previous complaints. A concern raised by a neighbour was taken seriously and dealt with appropriately. The acting manager is very approachable and easy to talk to. People living in the home and staff members seem comfortable with her and come in and out of the office at ease. They give the impression of not being afraid to speak up if unhappy about anything. The acting manager takes the protection of people living in the home seriously. The company’s adult protection procedures have been recently updated and training is provided in this area. Staff are encouraged to be aware of and speak up about poor practice without fear of repercussion. The acting manager continually reinforces this at staff meetings and in individual one to one supervision. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 17 Records are kept of money held on behalf of the people living in the home and a random check found them to be in order. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. People who use the service experience adequate quality outcomes in this area. People live in a clean, pleasant environment. However, delays in carrying out essential maintenance and repairs could pose a risk to the health and safety of people living in the home. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The building is attractive from the outside and homely from the inside. It is suitable for the needs of the people who live in it. There is sufficient indoor and outdoor space for people to be able to have time and space alone without having to go into their bedrooms. The one person who would struggle to use stairs has a ground floor bedroom and the use of a ground floor shower room. All of the communal areas are also on the ground floor. The home is a clean and tidy place in which to live. Rooms are airy and spacious. The ground floor bathroom has been refurbished following the last Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 19 inspection when it was out of use. The bath has been replaced with a walk in shower making it safe and accessible for people with mobility problems. The washing machine has been replaced with one with a sluicing facility. This reduces the risk of spread of infection. The kitchen and living room have been redecorated to provide a more pleasant environment for the people living in the home. The kitchen units have been replaced and the floor covering improved to be less hazardous and to comply with the requirements of the Food Standards Agency. One of the gas rings on the hob is not working correctly and although the fault has been documented and reported by the acting manager on more than one occasion, the problem has not been rectified. This poses a potential risk to the health and safety of people living in the home and to the staff who use the hob on a daily basis. The provider is required to make the hob safe to use as a matter of priority. It is recommended that until necessary repairs can be carried out, the faulty gas ring is not used. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35. People who use the service experience good quality outcomes in this area. People who live in the home are safeguarded and protected by good recruitment practices. The staff team are skilled and provide a good standard of care. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: People who live in the home have the benefit of being supported by skilled, well-trained staff who are warm, welcoming and knowledgeable about the needs of the people they care for. A relative who returned a survey commented that ‘in the past some staff have not had the right skills and experience for the job and this has led to their dismissal’. Members of staff who have been found to be unsuitable to work with vulnerable people have been dismissed. The acting manager and other people who returned surveys expressed confidence in the abilities of the current staff team. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 21 Training needs are identified and relevant courses planned so that people living in the home can be cared for in the best way possible. Training records were looked at which evidenced that a lot of training has been provided since the last inspection. The home has for the past few months been without a deputy manager to provide management cover when the acting manager is not on duty. Although this does not appear to have had any negative impact on the people living in the home, consideration should be given as to whether or not the acting manager will be able to sustain the improvements to the service and support to the other staff, without anyone to deputise for her. The staff team has a good skill mix and is made up of both male and female workers. This is in consideration of the fact that the people living in the home are presently all male. The recruitment records of two newly appointed members of staff were looked at. All necessary pre employment checks had been carried out which showed that staff were being recruited properly and safely and that people living in the home were not being put at risk of being cared for by unsuitable people. New employees receive good induction training to equip them with the skills needed to do the job well. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. People who use the service experience good quality outcomes in this area. The home is well managed and the health and safety of the people who live in the home is protected. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The registered manager’s post is currently vacant. The company has not applied for the acting manager to be registered with The Commission for Social Care Inspection and her future role within the organisation is uncertain. The acting manager has been in post for two years and has completed a management qualification in care to support her in her role and further enhance her skills. Since the appointment of the acting manager, improvements have been seen in the way that the service is run. Someone who returned a survey commented that the acting manager should be ‘commended’ for her ‘effort in maintaining and developing the service’. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 23 An application should be made to The Commission for Social Care Inspection for the acting manager to become the registered manager of the home. In light of previous difficulties in the home, a stable, reliable manager would provide consistency and commitment to both the people living in the home and the staff team. Someone from the senior management team of the organisation visits the home on a monthly basis to assess the quality of the service and recommend improvements if necessary. People living in the home are encouraged to attend joint meetings with the staff team. This provides the chance to talk about things that are good about the home or improvements that they would like to see. Although it is sometimes difficult to get the views of the people who use the service, every attempt is made to consult with them wherever possible. The views of relatives and family members are sought in order to get feedback about the service. The acting manager keeps a record of comments and observations made so that shortfalls can be identified and improvement made. Health and safety checks are carried out regularly to make sure that the home is a safe place in which to live and work. People are taught about fire safety and know what to do in the event of a fire in the home. Records are kept of all accidents and incidents in the home so that patterns can be identified and steps taken to stop them happening again. Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 4 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 3 3 X 3 X X 3 X Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 25 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 YA24 Regulation 16 (2)(h) 23(2)(c) Requirement The gas hob must be made safe to use and kept in good working order. Timescale for action 02/08/07 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 YA24 Good Practice Recommendations In order to protect both the people living in the home and the staff, it is recommended that the faulty gas ring not be used until the necessary repairs have been carried out. It is recommended that an application be made to the Commission for Social Care Inspection for a nominated person to become the registered manager of the home. 2. YA37 Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Fieldhead DS0000007874.V334208.R01.S.doc Version 5.2 Page 27 - 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!