Inspection on 04/03/08 for Fieldhead Court Nursing Home

This inspection was carried out on 4th March 2008.

CSCI found this care home to be providing an Adequate service.

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

Fieldhead Court Nursing Home 02/03/09

Fieldhead Court Nursing Home 28/02/07

Fieldhead Court Nursing Home 27/07/06

Fieldhead Court Nursing Home 10/01/06

Fieldhead Court Nursing Home 10/11/04

Fieldhead Court Nursing Home 27/07/04

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Hawkhills

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Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Fieldhead Court Nursing Home Rectory Park Church Lane Thornhill Dewsbury West Yorkshire WF12 0JZ Lead Inspector Karen Summers Key Unannounced Inspection 4th March 2008 09:00 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 Fieldhead Court Nursing Home DS0000001082.V360232.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. Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fieldhead Court Nursing Home Address Rectory Park Church Lane Thornhill Dewsbury West Yorkshire WF12 0JZ 01924 459000 01924 459000 fhcourt@rochehealthcare.com 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) Roche Healthcare Limited Mrs Kathryn Tanner Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2007 Brief Description of the Service: Fieldhead Court is a care home providing accommodation, personal and nursing care for up to forty older persons. It is owned by Roche Health Care Ltd that is a private limited company with other registered care services in the district. The accommodation is a converted former rectory operating over two floors, which are accessed by a passenger lift, and stair lifts. There are thirty-two single rooms, of which 28 have en-suite facilities. There are four double rooms, 3 lounges and a small dining room. The accommodation is set within large grounds in a conservation area and has car-parking facilities. The provider informed the Commission for Social Care Inspection on 4th February 2008 that the fees range from £356.34 to £671.00 per week. There are additional charges for hairdressing, newspapers and magazines. Information about the home and the services provided are available from the home in the Statement of Purpose and Service User Guide. Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This report refers to an inspection, part of which included an unannounced visit to the home on the 4th March 2008, commencing at 9.00 am, and the length of the inspection was 9 hours. There were 36 people living at Fieldhead Court on the day of the visit. As part of the inspection in order to provide information to help us form judgments about the quality of the service, the manager was asked to complete an annual quality assessment document. This she did, and the document provided the Commission for Social Care Inspection (CSCI) with a lot of information about the way the home is run, and what they hope to achieve in the future. During the visit we spoke with members of staff and people who receive care to obtain their views. We also looked at a sample of care records, staff recruitment, and training records, quality assurance audits and looked around the home. To enable people who use the service to comment on the care it provides, we sent fifteen surveys to people living at the home, and thirteen of these were returned. Fifteen were sent to their next of kin and nine of these were returned. Surveys were also sent to people’s doctors and health care workers (social workers, community nurses). Two surveys were returned from people’s doctors. The feedback from those who returned surveys to the Commission were positive. We would like to thank all the people who gave feedback about this home, and would like to thank the manager and staff for their co-operation throughout the inspection process. What the service does well: People receive information about Fieldhead Court and as much as possible is done to make sure that individual needs can be met before someone goes to live there. Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 6 People said that they receive the care and support they need, staff listen and act on what they say and they receive the medical support they need. One person said that staff are very caring and know people as individuals. People living in the home are protected from abuse and they can be confident that their complaints will be listened to and acted upon. People, who use the service and their relatives, said that they knew how to make a complaint and knew who to speak with if they were not happy. 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. Fieldhead Court Nursing Home DS0000001082.V360232.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 Fieldhead Court Nursing Home DS0000001082.V360232.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): 3&5 Standard 6 – Not inspected. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed prior to them moving into the home and they are able to visit the home to establish whether or not it is the right place for them. EVIDENCE: The care records of three people who use the service were examined, and the records contained a pre-admission assessment carried out by the funding local authority. In addition to this there was evidence that the home had carried out an assessment to ensure that they can meet any identified need and the placement will be appropriate. The manager also said that people were given information about the home and where able were encouraged to visit before making a decision to move in. People stated that they receive enough information about the home before making a decision to move in. Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 - 10. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s care records are not always been kept up to date to show the level of support and care the person has received and ensuring that their needs are been met. People’s privacy and dignity are supported by caring staff, and they are treated with respect. EVIDENCE: Two people’s care records were looked at and the documentation identified the care needs, and the level of support the person requires. Risk assessments had also been completed and included the risk of falls. There were also movement and handling assessments, nutritional assessment, information about the persons health care needs, social interests and people’s likes and dislikes recorded. In relation to pressure sores, the information on one person’s records, regarding the treatment/ care to be given was not very clear and should be written more clearly to avoid mistakes being made. The manager said that people are weighed monthly, or more frequently if there are problems with Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 10 weight gain or loss. However there were gaps in the recording on one person’s care records. The staff said that this person had recently been for a stay in hospital, and also on occasions had refused to be weighed. Discussion was held about the need to record why a person had not had their weight recorded and the action taken where appropriate. Another person had been having daily routine monitoring tests for their blood sugar levels when there were no documented indications for this being needed. The manger was advised to contact the person’s doctor and discuss whether there is a need for the tests or not. The care records of people were been stored in a communal area. In accordance with the data protection Act 1998, people’s records must be kept secure within the home. The manager said that the company were planning to provide locked cabinets to keep the records in within the near future. There was evidence that people have access to advocates and information leaflets are available in the entrance to the home. One person whose first language is not English has an interpreter visit on a regular basis. The person, with the help of their interpreter, completed a survey and said that their interpreter comes to seen them on a weekly basis, and without this service they would not be able to express their needs and feelings. The person also said that the interpreter has recently translated basic words into English and that this has been helpful for that person and staff to understand what they want. There was also evidence in people’s care records that they are able to access health care services, such as the dentist, chiropodist, optician and everyone living at the home is registered with a doctor. One person commented, “Good liaison between nursing and medical staff.” Surveys received from people living at the home stated that they receive the care and support they need, staff listen and act on what they say and they receive the medical support they need. One person said, “The staff are very caring and know the residents as individuals.” Relatives also said that the staff meet the different needs of people in relation to race, age, gender, faith, ethnicity and sexual orientation. Feedback from two doctors said that they are satisfied with the overall care provided to people within the home. The medication and records of three people were inspected and found to be correct. Records were clear, and medication was stored correctly. The nursing staff carry out monthly checks on the medication to ensure that there are no discrepancies and safe practises are maintained. Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 – 15 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s cultural, religious, social and recreational needs are being met, and they are supported to maintain contact with their family and friends. A variety of meals are offered that take into account people’s likes and dislikes. EVIDENCE: At the time of the visit people were sat in different parts of the home, some people were chatting with each other, others were sat relaxing and some were joining in a quiz. People said that there were activities that they could or usually could take part in and one person said sometimes. Comments included, “I think the activities are very good.” “If I want to join in there are various activities to do.” The manager said that each time an activity is to take place it is written on a board and displayed in the lounge. Unfortunately, there were no records of what activities had taken place, and the information in peoples care records had been recorded on an ad hoc basis that is once or twice in a month. To show people’s involvement and enjoyment of activities a record should be made in each person’s individual record. Ministers from various denominations visit at different times each month, and there was evidence that people who wish are escorted to the local church. Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 12 One person who has sight impairment has taking books, and people who choose have their own newspapers delivered. The company have purchased two computers for the use of people living at the home and are to be connected to Internet in the next few weeks. Two relatives did not complete the section in the survey in relation to whether the home helped people to keep in touch, one person said that it did not apply as they visited most days, two people said, ‘always’, two said, ‘sometimes’, and another said, ‘never’. Everyone said that they were kept up to date with important issues affecting their relative/ friend, and there was also evidence to suggest this in the care records. The menus offered a variety of food, and the food preferences and diets of people were also taken into consideration. The manager said that although there are people living at the home who are from different cultures, everyone chooses to eat the ‘English’ food that is offered. However, she also said that should someone wish to have a diet specific to his or her culture then one would be provided. Everyone commented that they liked the meals at the home. One person said, “Usually the food is very good and I can always have something else if I do not like what is on the menu.” Another person said, “Sometimes there is too much for me to eat.” The person who used the interpreter said, that the food was usually good and they could always have something else if they did not like what was on the menu. Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 &18 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home are protected from abuse and they can be confident that their complaints will be listened to and acted upon. EVIDENCE: There is a complaints procedure, which is clearly communicated to people using the service, their families and professionals. People who use the service and their relatives, said that they knew how to make a complaint and knew who to speak with if they were not happy. One person said, ‘The manager of the home.’ The manager keeps a log of any complaints received and there was evidence that peoples’ concerns had been taken seriously and the appropriate action had been taken to resolve the matter wherever possible. The home has received two complaints in the last twelve months. Complements received by the home include, ‘A very big thank you for making my mums stay a happy one.’ Another person said, ‘You have been fantastic in your care for my relative and it has been truly appreciate.’ There are policies and procedures in place to reduce this risk of abuse. Records seen showed that staff commencing employment have a CRB (Criminal Records Bureau) and a POVA (Protection of Vulnerable Adults) check before starting work in the home. All staff have received safeguarding (adult Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 14 protection) training which provides information on how to protect people from abuse. Those staff spoken with during this visit spoke with confidence about how they would report poor care practice and abuse. Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 15 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 & 26 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home offers people a homely, comfortable and clean environment. EVIDENCE: As part of the inspection a tour of the home was conducted which included the communal areas, a number of people’s bedrooms, and the laundry. The planned programme of refurbishment and decoration to people’s rooms has been completed, and the carpet in the ‘blue’ lounge has also been replaced since the last inspection. The manager also said that new furniture has been ordered for the annexe and dining room, and that the dining room floor covering is also going to be replaced with a more appropriate covering in the next few weeks. The plans to renew the existing extension have not yet been approved and the areas are damaged and worn and in need of upgrading. Due to the delay in the Town Planners agreement for the work to start, the company have decided to upgrade the existing building. This has been scheduled to take place in the next few weeks. Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 16 The floor coverings outside of the staff room, and the outside rooms 31 and 32 on the second floor were stained and in need of cleaning/ or replacement. The bottom of the fire door next to the staff room and the door opposite room 15 were damaged and in need of repair/ repainting. People said that the home is fresh and clean. The atmosphere on the day of the visit was warm and friendly and people looked comfortable whilst sitting in various parts of the home. Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 17 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 – 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported by qualified, competent and experienced staff in sufficient numbers and that has had all the necessary checks before working with people so that they are kept safe. EVIDENCE: On the day of inspection there were thirty-six people in residence. The staff duty rotas were looked at and staff were spoken with. There was evidence to suggest that staffing levels and skill mix were sufficient to meet the number and needs of people living there. Everyone said in the surveys that the staff are available when you need them. One person, who does not speak English but has an interpreter, said that staff do listen and act on what you say, and that he has had some basic words translated which have been helpful for staff to understand him. Evidence was seen to suggest that care staff are encouraged to have an NVQ level 2 in care, and the manager confirmed that sixty four percent of care staff have the qualification. Staff recruitment files of three members of staff were looked at in detail and they contained the required information and employment checks. These checks are necessary to help protect people from potentially unsuitable staff. Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 18 The staff that were spoken with confirmed that they had received induction training when they came to work at the home, and training in dementia care. Fieldhead Court Nursing Home DS0000001082.V360232.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, 33, 35 & 38 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People benefit from the management approach of the home. Without records of staff supervision there is no evidence that they are supported to do their job. The home is run in the best interest of people who live there. EVIDENCE: Kathryn Tanner is the registered manager at Fieldhead Court. Ms Tanner is also a registered general nurse with a number of year’s experience of working in nursing home settings. She has NVQ level 4 qualifications in management and the Advanced Care Management City & Guilds. It was clear from speaking with staff, and people living at the home that Ms Tanner is a well like and respected manager. Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 20 For those people who wish, small amounts of personal money are held safely at the home. The financial records of three people were examined and satisfactory records were maintained. Receipts are kept of all transactions made. Staff said that they do not have regular supervision, and the training records showed only one person had received supervision since 2006. The manager said that a number of staff had recently had training to enable them to deliver supervision to staff that they were responsible for managing, and that dates for the supervision of staff would now be made. All care staff must receive regular supervision to ensure that they are supported to do their job. The manager said that meetings involving people who live at the home and their relatives/ friends take place every three months, and records of the meeting were seen. The things that are discussed at the meetings include the activities, quality of care, the quality of food and the menus, areas of concern, etc. Regular staff meetings also take place. Quality assurance surveys are sent out by the home each year and the results of those surveys are distributed to all who participated, and the manager also said that they would be displayed in the home. The home is working towards the Investors in People Award which is a standard to improve the way people work. They are also working towards The Gold Standards Framework Award, which will give the staff the necessary knowledge and skills to look after people who need end of life care. The fire training records were held on the computer and the information showed that staff had had a fire drill and a lecture in the last twelve months. Unfortunately, when recording the information, the previous dates when training had taken place had been removed. Records need to be kept of all fire drills and training that takes place to show that staff are kept up to date in how to respond in the event of a fire. Fieldhead Court Nursing Home DS0000001082.V360232.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 X X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 1 X 2 Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 14.-(2)(b) Requirement The care records of people must be kept up to date to ensure that their needs are being met. In accordance with the data protection Act 1998, people’s records must be kept securely within the care home. All care staff must receive appropriate supervision to ensure that they are supported to do their job. Timescale for action 04/03/08 2. OP7 17.-(1)(b) 04/03/08 3. OP36 18.- (2) 04/04/08 Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 23 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. 2. Refer to Standard OP12 OP19 Good Practice Recommendations To show people’s involvement and enjoyment of activities a record should be made in each person’s records. • • 3. OP38 The stained/ worn carpets should be cleaned/ replaced. The damaged doors should be repaired/ repainted. Fire drills & lectures should take place for all staff twice a year and the dates should be recorded to show that staff are kept up to date. Fieldhead Court Nursing Home DS0000001082.V360232.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region 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. 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