Inspection on 12/06/07 for Fieldside

This inspection was carried out on 12th June 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fieldside 01/04/08

Fieldside 07/07/06

Fieldside 06/03/06

Fieldside 27/06/05

Fieldside 03/11/04

Fieldside 08/06/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Fieldside 9 Canadian Avenue Catford London SE6 3AU Lead Inspector Pam Cohen Unannounced Inspection 12th June 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 DS0000025619.V340830.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. DS0000025619.V340830.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fieldside Address 9 Canadian Avenue Catford London SE6 3AU 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) 0208 690 1215 0208 473 1242 Mr John R France Mrs V France Ms Gillian Amelia Hennell Care Home 33 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0), Physical disability (0), of places Sensory impairment (0) DS0000025619.V340830.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 33 persons of whom up to 33 may be elderly, up to 15 may have dementia, up to 4 may have a physical disability and be over 65 years and up to 1 may have a physical disability. to include one named person with sensory impairment one temporary resident with physical disability under the age of 65. This condition will apply until the named person leaves the home 7th July 2006 2. 3. Date of last inspection Brief Description of the Service: Fieldside is a privately owned care home registered for up to 33 older people, some with varying degrees of physical disabilities and dementia. The home also takes people for respite stays. Fieldside is situated close to the shops and public transport facilities of Catford Bridge. The main part of the building is early Victorian and a large three-storey extension was added a few years ago. The accommodation consists of 31 single and 1 double bedroom with spacious communal areas. At the time of inspection there was building work to reconfigure the double bedroom and office space. There are two lifts so that people can have access to all internal areas. A large attractive garden with a patio is at the back and is fully accessible; at the front there is parking for visitors and staff. At the time of inspection the weekly fees were £461.93 DS0000025619.V340830.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the day of 12th June. The manager was available during the inspection and the deputy manager came on duty later and joined the manager. The inspector was also able to speak to care staff, the cook and the maintenance man. She sat with residents at lunch and was able to speak to them then, and during the rest of the day. She also spoke to two visiting relatives. What the service does well: What has improved since the last inspection? What they could do better: Residents’ care plans are not sufficiently detailed in many respects, risk assessments are not being drawn up and some aspects of medication administration are not properly carried out. It is not clear that sufficient recreational activity is provided in the home for people’s varying needs. Recruitment practises should adhere to Equal Opportunities legislation. Manual handling procedures need to be followed and do procedures for the proper handling of substances hazardous to health. The home needs a quality monitoring system and an annual development plan. DS0000025619.V340830.R01.S.doc Version 5.2 Page 6 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. DS0000025619.V340830.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 DS0000025619.V340830.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): 1,3,5,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has the necessary information available and obtains up-to-date assessments for prospective residents to ensure that Fieldside is able to meet their needs. EVIDENCE: The home has a statement of purpose and service user guide; however a relative said that the family had not been given this when they came to visit the home. The manager confirmed that it is available at the home and is given to all residents but is not given out to visiting relatives. As the relatives are usually visiting on behalf of prospective residents who are not able to get there it would be good if every effort were made to ensure they had access to all necessary information. The manager obtains copies of an up-to-date multi-disciplinary assessment for all prospective residents and the proprietor goes to see them to ensure that DS0000025619.V340830.R01.S.doc Version 5.2 Page 9 the home can meet their needs. These pre-admission assessments were however, not available at the home. Prospective residents and their relatives are encouraged to visit but many people come straight from hospital and so it is usually the family who visit the home. The home does not offer intermediate care. DS0000025619.V340830.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. Residents’ health care needs are well met and they are treated with respect. However inadequate care planning means that they cannot be sure that all their care needs are being assessed or met. Some aspects of medication administration put residents at potential risk. EVIDENCE: Care plans were seen for residents who had lived in the home for some time, as well as for newer residents. One lady who had been in the home for a month did not have a care plan. Other care plans varied in quality but most still did not cover people’s needs, in areas such as personal care or mobility, in necessary detail. Also most did not set out people’s social or emotional needs. Also, although, many people in the home are now suffering from some degree of dementia this was not usually assessed, or the care needs that arose from it, detailed. From observation, and talking to residents and relatives, it would seem that the care given is of a good standard. But unless care needed is DS0000025619.V340830.R01.S.doc Version 5.2 Page 11 assessed and detailed in a care plan, it is not possible to be sure that all necessary care is being given. Proper risk assessments are not now being carried out. The manager showed that she is looking at a format for this and her intention to assess risk areas and produce plans to minimise assessed risk must be progressed. The home has good systems to meet peoples’ health care needs and works closely with a local GP and district nurses. They are able to access physiotherapists; also opticians, chiropodists and dentist visit regularly. They must also however make sure that they access professional advice about the promotion of continence and assessment of incontinence. There was evidence on file that the home now asks people if they wish to self medicate but no one does at the moment. With so many people coming for respite this is of concern and the manager should ensure that they make every effort to enable people to administer their own medication if they are able. Medication administration is not being recorded as each person takes his or her medication and this can lead to errors. When checking the charts it was found that there were instances of medication being recorded as having been given when it had not. Also one resident was recorded as not having had a medication administered over a period of 2 weeks but with no recording of why, or of any action being taken. The procedure for keeping an accurate record of the medication in the home is still not always clear. Care practices were seen to be good and residents and their relatives spoke highly of the care they receive. DS0000025619.V340830.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 adequate. This judgement has been made using available evidence including a visit to this service. Service users are enabled to follow their individual life styles, retaining choice and control over their lives. However, it is not clear that sufficient recreational activity is provided in the home. Food provision is good although a clear choice is needed on the menu. EVIDENCE: Residents are able to spend their days as they wish. One lady told the inspector that she had got up late, and she had a large print book from the small “library” that she was reading. Other residents like to spend most of their time in their room. All are offered a key to their room and have a lockable space. They are also enabled to conduct their own financial affairs if they wish and are able. Visitors are welcomed. There is a daily exercise class and many music and singing sessions. There are trips to the park in the summer although not many people choose to take advantage of this; there are also barbecues arranged. It is hard to be sure whether there are sufficient activities taking place in the home to suit the DS0000025619.V340830.R01.S.doc Version 5.2 Page 13 varied needs of the residents, including those with dementia. This is because most people’s social needs and wishes are not detailed in their care plans; there is not a programme of the activities which take place and there is no recording of people taking part in activities. Also residents who spoke to the inspector said they did not take part in any activities. However the manager said that many activities do take place and a letter from a relative thanked the home for “the activities you arranged in the care home to overcome the boredom of everyday life.” Residents have a nutritious and appetising menu. They and their relatives were positive about the food. People also said that they are treated as individuals and given what they like. A good variety of fresh produce is used. However there is no real choice for the main meal. The manager and cook said that they know what people like. However there have been about 40 admissions to the home in the past year (which includes people coming for respite stays). In these circumstances, and because people’s tastes change, there should be a choice of food for the main meal. DS0000025619.V340830.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. Residents and their relatives can be confident that their complaints will be properly dealt with. Vulnerable adults are supported by the home’s policies and procedures. EVIDENCE: The home has an up-to-date complaints policy and procedure in place. The commission has received no complaints about the home since the last inspection. The home has received one complaint which was properly recorded and investigated. There is a policy and procedures for safeguarding adults and the home has a high priority for training staff and management in this area. Since the last inspection the home properly reported a cause for concern which was appropriately investigated through the correct channels. DS0000025619.V340830.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): 19,20,21,23,24,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, well-decorated, furnished and maintained home which is safe and suitable for its purpose. EVIDENCE: The home has been adapted and extended with the needs of residents in mind. It is comfortable, homely and accessible throughout. There is ample communal space of a good standard and a conservatory leading to a pleasant garden. All residents’ rooms are now single and have a sink en-suite. They are well furnished, and most seen were well personalised. There are a good number of toilets, showers and assisted baths. Fieldside is well located for public transport and is near community facilities. It is well decorated and maintained and has been made safe throughout. There has been a fire assessment by a specialist DS0000025619.V340830.R01.S.doc Version 5.2 Page 16 firm in November 2006 and the recommendations of that inspection have been actioned. On the day of inspection the home was clean throughout and had proper hygiene systems in place. However the work done to the laundry since the last inspection has not addressed the problem for the walls which still need to be of a material that is readily cleanable. DS0000025619.V340830.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): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are cared for by well-trained staff, deployed at a suitable level. Recruitment practises should adhere to Equal Opportunities legislation. EVIDENCE: On the day of inspection there were sufficient staff on duty for the needs of the residents. The rotas showed that this staffing level is maintained at all times. However the rotas also showed that some staff are doing an afternoon shift immediately followed by a waking night shift, which is not safe practise. In the past two years there has been minimal turnover of staff with only one new carer recruited. Care must be taken in the advertising and interviewing of new staff to ensure that procedures adhere to Equal Opportunities legislation. 80 of staff have an NVQ qualification which is an extremely good percentage. Other training needs are highlighted in yearly appraisals and recording seen and conversation with staff, indicated that a good level of training is given to staff on the needs of residents. DS0000025619.V340830.R01.S.doc Version 5.2 Page 18 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): 31,32,33,35,36,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well managed home with well-supervised staff. Their opinions are not yet taken into account when monitoring quality. Their health and safety is, for the most part, well protected. EVIDENCE: The registered manager has been in charge of the home for many years and has the Registered Managers Award and NVQ4 in care. She is supported by an able deputy and three senior staff. She explained that she keeps up-to-date by reading relevant publications and attending seminars and training days. Observation during the day, as well as conversation with residents and staff showed that the home is managed in an open and supportive manner. However the views of residents, relatives and visiting professionals are not DS0000025619.V340830.R01.S.doc Version 5.2 Page 19 being sought in order to allow the manager to monitor the quality of care that the home is providing. An annual development plan is also not produced. The financial procedures for dealing with residents’ monies were checked and seen to be robust and enabling of residents’ ability to keep control over their finances as much as is possible. Staff supervision was seen to be happening on a regular basis; the manager should make sure that it is not always in a format of ticking of whether practical tasks can be done but that it gives staff and manager opportunities to look at other areas. There is good monitoring of health and safety issues. All necessary documentation about the safe running of the environment was also in order. However there is not at the moment proper attention to manual handling issues. Where residents are using mobility aids, or wheelchairs and are needing help from staff, the appropriate assessments are not being carried out. In addition the kitchen still needs a deep clean and attention needs to be paid to the recorded temperature of food probes. The cleaner’s cupboard must always be secured and the COSHH shed should be signed. DS0000025619.V340830.R01.S.doc Version 5.2 Page 20 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 3 X 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 2 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 3 2 X 3 3 X 2 DS0000025619.V340830.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES 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 Requirement The registered person must ensure that care plans provide enough detail in all areas where support is needed, and that the care plans are reviewed and the review recorded, in sufficient detail. Target date of 31/10/06 not met. The registered person must ensure that risk assessments are completed together with plans to minimise areas of assessed risk. The registered person must ensure that a care plan is drawn up for the resident identified at the inspection as not having one. The registered person must ensure that professional continence advice is sought when needed. The registered person must ensure that all medication administration is properly recorded and audited. The registered person must ensure that an accurate record is kept of amount of medication received for each service user. DS0000025619.V340830.R01.S.doc Timescale for action 30/09/07 2 OP7 13(4)(b,c) 31/08/07 3 OP7 15(1) 26/06/07 4. OP8 13(1)(b) 31/08/07 5. OP9 1392) 31/07/07 6. OP9 17(1)(a) Sch 3 (k) 31/08/07 Version 5.2 Page 22 7. OP12 16(2)(m) (n) 8. OP12 16(2)(m) (n) 9 10. OP15 OP26 12(2)(3) 13(3) 16(2)(j) 11. OP33 24(1)(a) (b)(2)(3) 12. OP38 13(4)(a) (c) 13 OP38 13(5) Target date of 31/08/06 not met. The registered person must ensure that service users interests are fully assessed and recorded on their care plans Target date of 31/10/06 not met. The registered person must ensure that there is a varied programme of activities provided, suitable for the different abilities of residents. The registered person must ensure that there is a menu offering a choice of meals. The registered person must ensure that the laundry walls are cleanable and the floor impermeable. The floor is now suitable but the requirement still stands in relation to the walls. The registered person must ensure that they implement an annual development plan and publish an annual report on the quality monitoring they undertake. Target date of 31/03/07 not met. The registered person must ensure that all health and safety issues noted in the kitchen and to do with the storage of hazardous chemicals are acted upon. Target date of 31/08/06 not met The registered person must ensure that manual handling assessments and care plans are completed where necessary. 30/09/07 30/09/07 31/08/07 31/12/07 31/12/07 31/07/07 31/07/07 DS0000025619.V340830.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 3 4 5 6 7 Refer to Standard OP1 OP3 OP8 OP12 OP27 OP29 OP36 Good Practice Recommendations It is recommended that every effort be made to supply the home’s information to visiting relatives. It is recommended that the proprietor’s pre-admission assessments are made available at the home. It is recommended that every effort be made to enable respite residents to self medicate. It is recommended that residents’ participation in activities be recorded. It is recommended that no staff should work a night shift in conjunction with another shift. It is recommended that the manager should ensure that recruitment procedures for staff are in line with Equal Opportunities legislation. It is recommended that supervision should not only cover practical tasks. DS0000025619.V340830.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection SE London Area Office River House 1 Maidstone Road Sidcup Kent DA14 5RH 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 DS0000025619.V340830.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. 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!