Inspection on 06/03/06 for Fieldside

This inspection was carried out on 6th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 12/06/07

Fieldside 07/07/06

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 Barbara Ryan Unannounced Inspection 6th March 2006 09:30 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 Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 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. Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 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 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) Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 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 27th June 2005 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 mental health related problems. 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 one double bedroom with spacious communal areas. There are two passenger lifts so that people can have access to all internal areas. A large attractive garden with a patio is at the back, and at the front there is parking for visitors and staff. Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection held on 6th March 2006, from 09.30 to 16.45. The inspection process included a tour of the building, discussion with the person in charge, the proprietor, one member of staff, two visiting relatives and seven residents. What the service does well: 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. Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 Page 6 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 Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 Page 7 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): 1,5,6 Service users now have updated information about the home including information about the staffing at the home. There are no intermediate care beds. Residents that come to the home do not always have a full care plan drawn up for them on admission. EVIDENCE: The home have updated their Statement of Purpose to now include information on the size of residents rooms and staff team. Books to contain life history details are on file; however, some remain empty or only very briefly filled in. The home said that they have made efforts with these but at times they find it difficult to gather this information. One resident had chosen not to do this. This had been recorded on the book and was on her file. Other books had brief entries or were empty, as the resident was not able to give information and family had not been able to help. It is suggested that the home continue to try to gather past history from residents and their families, where this is possible, and continue to record where residents have chosen not to engage in the activity. Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 Page 8 The home has a policy of offering prospective residents an opportunity to visit the home prior to moving there. One resident spoken to with a member of her family said that there was an opportunity to visit the home and to spend the day there prior to making a decision to move to the home. The home has no intermediate care provision; however they do admit residents on respite, short-term placements whilst awaiting funding or banding agreements. Residents that are admitted on the basis of one of the above have an interim care plan drawn up. However, some residents are staying at the home several months awaiting final discussions around long term plans. If a resident is admitted to the home for short periods of respite, no more than two weeks, and there is a set end date then they should have a care plan to meet their needs for the time they will be at the home. If residents are staying over two weeks they should have a full care plan completed for them on admission the home. Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 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. Residents know that their health, personal and social care needs are set out in an individual plan of care; however, service users are not always consulted about the contents of this plan. Medication is generally handled safely by the home although further work is needed to ensure a consistent approach to emollients and other self-administered medications. Residents who share rooms are provided with appropriate screening to ensure privacy. EVIDENCE: The home uses a comprehensive care planning system, these give appropriate information about residents’ needs and how to meet them. The care plans are reviewed on a monthly basis via a dependency profile score. The care plans looked at all showed evidence that this had been done. However, the scores alone did not give full information to show that the resident’s needs had been reviewed, what actions were needed and how the resident, or their family had been involved. The care plan system used has space for more extensive comments and action planning. These are only completed if there is a change identified in residents’ needs. On some of the care plans looked at, there had been no details recorded for considerable time. There was no evidence as to how residents and their families might be involved in this process. Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 Page 10 Other places in the care plan give information about the aspects of personal care given; however, some of these had not been completed fully, giving the impression that some residents had not been washed or bathed for several weeks. The person in charge was very clear that all residents are supported with personal hygiene on a daily or twice daily basis as well and at other times as needed. Residents at the home all looked well groomed and appropriately dressed. Residents and family spoken to all felt happy with the care provided and that their needs were met with regard to personal hygiene. The home has a daily record book as well as a weekly record book; not all actions around personal care are recorded, or at times only with very little details. The home needs to ensure that support with personal care and other relevant issues around progress or changes are recorded on a daily basis. Residents’ choices need to be recorded to show how they and/or their family have been involved. Care plans include a section on risk and their assessment; all the files inspected showed that they are being reviewed once a year. At present there are no residents who are on self-medication programmes. The medication and Mar charts were inspected. The Mar charts tallied medication given that day. There has been some confusion around the application of creams and where they are to be recorded. The home has had discussion with CSCI about how this should be done. If residents can manage their own medication or creams they should self medicate, this should include creams, providing they are able to be independent with this. A risk assessment should be completed to ensure that the resident is able to do this. If they need support then the application of creams should be recorded on the mar chart. If the creams are aqueous and emollients they can be recorded on a separate sheet which is kept in the resident’s room or daily notes. Old creams and out of date eye drops must be appropriately disposed of. An out of date tube of eye drops was found in one resident’s room. Eye drops are kept in the fridge in the kitchen. One room in the home is a shared room; there was appropriate screening to ensure privacy to both occupants. The residents who share have done so for a long time and are happy to share. Only one of the residents that share was available to speak to; she was with her daughter and both were very clear that they saw sharing as positive. Residents are supported to make decisions about their death and funeral arrangements. Many of the residents’ families have supported them to make these arrangements. The home has supported residents to make funeral plans when this has been needed to ensure their wishes will be met. Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 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): 12,13,14,15 Residents are supported to maintain links with family and with the community. They are able to access appropriate leisure and social activities, and make choices about their lives. The home provides a healthy and appetizing diet for residents. EVIDENCE: Residents spoken to felt that they were able to exercises choice around how they spend their day. On the day of the inspection some residents were spending the morning in their rooms, others in the communal areas. Residents have opportunities to go out on local trips with dial-a-ride, although the staff reported that often residents did not seem to wish to go on trips. Other residents arrange their own trips and shopping on a regular basis for themselves. The home has a programme of activities with people coming in to do exercise classes and illustrated talks on a regular basis. The home has parties, barbeques in the summer, and visiting entertainers every few months. Residents are supported to maintain contact with their families; visiting hours are flexible, with visitors only being expected to let the home know if they are coming late at night so staff are confident about opening the front door. The home have visits from a local priest, and are hoping to encourage more visits Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 Page 12 to the home at other times rather then just Christmas when visits from local community organisations tended to call. The home has established a link with a local secondary school and pupils from this school make regular visits to the home to chat to residents. The home say this is very popular with residents who enjoy the opportunities to speak to young people. The home provides a healthy and appetizing diet; all residents spoken to said that they were very happy with this. A menu was on display in the dining room, written in large print. If residents did not like that day’s menu they said they would be given another choice. The food was served in a very pleasant manner, in attractive surroundings on nicely laid tables. The kitchen is open plan and the layout makes it a visible and integrated part of the home. Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 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 a complaints procedure, they have policies on vulnerable adults and staff receive training on this. Residents are protected by the home’s policies and procedures. EVIDENCE: Residents and family members spoken to all felt that they had no complaints, but said that they would speak to the manager if they did have. The home has an appropriate complaints procedure in place. The home has a policy and information around protection from abuse and staff are given training on this. There have been no reported incidents around adult protection in the last 12 months. Staff have a POVA check are not allow to work with residents on their own until this has come through. Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 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): 19,20,24 26 The home provides a safe, comfortable and well maintain environment, with access to pleasant indoor and outdoor communal areas. Residents’ rooms are comfortable and are personalised. The home is clean and hygienic. EVIDENCE: The home offers a very pleasant environment in a large Victorian house, with an extension built on the back. All the bedrooms are single except for one. The communal areas include a large wood panelled sitting room, dining room and a second communal sitting room at the rear in the extension; this overlooks the garden and has large patio doors. The garden is fully wheelchair accessible. Residents’ rooms are comfortable and suitably furnished to a high standard. All the rooms seen were personalised. One resident has specific visual needs and staff are aware of the need for all items not to be moved in order for the resident to maintain their independence whilst in their room. At the last inspection there was a requirement that residents have a personal store of incontinence pads available in their room, this has been done. There was a recommendation that incontinence pads also be stored in cupboards in Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 Page 15 the toilet, out of view rather than on open shelves. The home feels that cupboards are not suitable and now all incontinence pads are stored in residents’ rooms. This has resulted in them not being available in the WC for residents and for staff needing to offer support to a resident. The home should try and identify a way of storing pads in the toilet that is appropriate to residents’ needs and staff efforts to support them without presenting an institutional appearance. This was discussed with the person in charge on the day of the inspection and various ideas suggested. Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 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): 28, 29. Residents are protected by an appropriate recruitment policy. Staff have undertaken training but have experienced problems getting the certificates from the training agency. With the staff that are awaiting certificate they have a 50 quota trained or doing NVQ level 2 or above. EVIDENCE: The files of two new staff were examined; both had two reference, proof of identity and a photograph. In one case this was the photocopy of the passport photo, but was such that it could be used to identify the person. Both had had CRB checks. The home has a policy to employ the person but ensure that they will not work unsupervised until their CRB check has come through. The staff team is relatively stable with some workers having been at the home for a number of years. At present four care staff have NVQ level 2 or above. Nine staff members had undertaken training but have not as yet received their certificate due to problems with the training organisation, which has now been taken over by another proprietor; two staff are starting training. The lack of certificates due to problems with the organisation has as yet not been resolved. With the staff who have undertaken training but are awaiting certificates the home have over 50 qualified at level 2. The home has an appropriate induction programme for staff. Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 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, 38 The home is run in the best interests of residents. The financial interests of residents are safeguarded and the home meets health and safety standards with regard to fire drills, fridge and freezer temperatures. EVIDENCE: The home has a questionnaire which residents and family are asked to complete. The home will respond to any issues raised and try to resolve them. They will also have discussion around what the home might need to look at or change to provide a better service to residents. The home also has, as part of their quality assurance, a three monthly meeting with residents; they will follow this with a questionnaire if they feel this is necessary. The home is not the appointee for any of the residents; they hold the personal allowance for five residents. The home has an appropriate procedure for safeguarding residents’ money; there are petty cash receipts and a ledger where entries are made. Money is kept in a lockable cash box in a locked Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 Page 18 cabinet. If residents’ savings increase to more than £100 the home will bank the money in a resident’s account. Residents who can manage their own money are encouraged to do so. The home is sending in regulation 37 notifications on a regular basis to the CSCI. The home complete regular fire drills once a month and test an alarm point one a week. The fridge and freezer temperature are check daily and recorded. Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 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 3 X X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 Page 20 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 all residents who come to the home without a finalised long-term plan should have a full care plan drawn up on admission. The registered manager must ensure that care plans are dated and reviewed monthly. Where additional monitoring sheets are in use such as records of bathing or bed linen changes these must be kept up to date (Timescale of 31/01/05 and 30/09/05 have both not been met) The registered manager must ensure that care plans evidence the involvement of service users or their representatives in the care planning and reviewing process. The registered manager must ensure that service users care and progress is recorded on a daily basis (time scale of 31/05/05 not met) The registered manager must ensure that all applications of creams and ointments are DS0000025619.V285633.R01.S.doc Timescale for action 01/06/06 2. OP7 15 01/06/06 3. OP7 15 01/06/06 4. OP7 12 (1) (a) 01/06/06 5. OP9 13 (2) 01/06/06 Fieldside Version 5.1 Page 21 7. OP9 13(2) recorded on the MAR chart. Although it is acceptable for applications of aqueous creams and bath emollients to be recorded elsewhere for example on a separate record kept in the service users room or in the daily notes. If residents are able to self medicate they should then manage their own medication, this would included the application of creams provide they where able to do this. (Timescale of 31/12/04 and 31/08/05 The registered manager must 01/06/06 ensure that all eye drops are stored in the fridge and that all out of date eye drops are returned to the pharmacist. 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 OP3 OP22 Good Practice Recommendations It is recommended that life history books be persevered with. If residents and or family refuse or are not able that this be recorded on the book. It is recommended that the home continue explore a suitable way of storing some pads in the WC’s in a noninstitutional way that enables residents and staff to access them, as they need to. Fieldside DS0000025619.V285633.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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. 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