Inspection on 07/07/06 for Fieldside

This inspection was carried out on 7th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Fieldside 01/04/08

Fieldside 12/06/07

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 7th July 2006 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 Fieldside DS0000025619.V300574.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. Fieldside DS0000025619.V300574.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 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.V300574.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 6th March 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. 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. 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 is fully accessible; at the front there is parking for visitors and staff. Fieldside DS0000025619.V300574.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on 7th July. The manager was on annual leave and so the officer in charge assisted with the inspection; the proprietor was also available. The inspector saw the buildings and was invited into a service user’s room. She was able to speak to service users and staff and briefly with one relative. The weekly fee for rooms in the home is £436-70 pence and there are no additional charges. On the day of inspection there were no vacancies. 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.V300574.R01.S.doc Version 5.2 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.V300574.R01.S.doc Version 5.2 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): 2,3,4,5,6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service A good admission procedure means that both service users and the home can be confident that the decision to move into the home is the right one, and that the home can meet the prospective service user’s needs. EVIDENCE: When a referral is received by the home, prospective service users and their relatives are encouraged to visit the home before they take a decision to move in. They are able to spend the day and have a meal there. During that visit the manager or one of her senior staff will assess their care needs, to decide if the home is able to meet them. If a visit is not possible the staff member will go out to make an assessment. Service user files showed that full multidisciplinary assessments are also obtained and that there is a contract signed by both parties. Information gathered throughout the inspection showed that the home is able to meet their service users’ needs. The assistant manager said that on the rare occasions that they feel they would not be able to meet someone’s needs they will write to the referrer explaining their reasons. Fieldside DS0000025619.V300574.R01.S.doc Version 5.2 Page 8 The home does not offer intermediate care. Fieldside DS0000025619.V300574.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8.9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Service users’ health care needs are well met, and service users are treated with respect. They cannot be sure that their care needs are recorded in enough detail or that their ability to remain independent in medication administration is assessed. EVIDENCE: Full care plans were seen for service users who had been at the home some time, as well as newer admissions. Good assessments of individual risk areas, and the action needed to make them as safe as possible were included. Although all necessary areas are covered, the care plan format which the home uses is one which makes it difficult to record the necessary detail. Key worker recording as well as daily notes and tick list provide evidence of care given. There was evidence that the home is involving service users in drawing up the care plans. The deputy manager also explained that when reviewing the care plan they sit with the service user and go through the care plan in detail. However documentation on reviews was not sufficient. Fieldside DS0000025619.V300574.R01.S.doc Version 5.2 Page 10 There are good systems to meet service users’ health care needs. The GP visits weekly and reviews service users’ health and medication six monthly or yearly. The home is able to access physiotherapy services and has good relations with District Nurses. Optician and chiropodist visit 3 monthly and the dentist comes as required. Staff record weights, and blood pressure and furnish the GP with these on a monthly basis so she is able to monitor them. This is excellent practise for a care home. There is a policy for self-medication. However at the moment there is no-one in the home who looks after their own medication needs and this area is not something that is assessed to find out if service users wish, and are able, to be independent with their medication. When the officer in charge described the process they follow if a service user in respite self-medicates, the procedure did not follow the home’s policy, as no risk assessment is made, or monitoring undertaken. Medication administration charts were well filled in on a daily basis. However the recording of the amount of medication received was not properly done. This means that actual administration cannot be checked. Staff were seen to be relating well to service users. Service users spoken to said that they were treated with respect and one spoke warmly of the staff “they look after you well…you can ask for anything and if they can do it they will… I admire them.” A card from the relatives of a service user who recently died, thanked staff saying “each and every one of you treated her with such love, dignity and respect”. Fieldside DS0000025619.V300574.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Service users can choose appropriate lifestyles for themselves and take part in activities if they wish. There is good provision of activities outside the home. Food provision is also good. EVIDENCE: Service users were spending the day as they wished, in their own rooms, in a choice of communal rooms, with visitors or going out. A service user who was in her room said that she knows that there are activities available if she wants to join in. Service users and a relative confirmed that they are able to receive visitors when they wish, and all rooms seen had two comfortable chairs and were well personalised. If able, service users are able to conduct their own financial affairs and all are offered a key to their room and have a lockable space within the room. A member of staff was conducting the daily exercise session and old time music and singing. There is an activity programme, some of it provided by people from outside the home. There are also twice monthly trips. To ensure that the activity programme meets the wishes of service users, their interests should be fully assessed and recorded on their care plans. Fieldside DS0000025619.V300574.R01.S.doc Version 5.2 Page 12 Service users have a healthy and appetising diet. The day’s menu was displayed on a board and service users are asked in the morning if they want another choice. A service user confirmed that she always get what she wants. Service users’ dislikes, and health needs are recorded in the kitchen. All service users who were asked said they enjoyed their food and one said it was excellent. Fieldside DS0000025619.V300574.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 inspected at least once during a 12 month period. 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 Service users and their relatives can be confident that their complaints will be properly dealt with. Service users are protected by the homes policies and procedures. EVIDENCE: The home has a complaints policy and procedure in place. A complaint which had been made earlier in the year had been properly investigated, responded to and recorded. There is a policy and information on the home’s vulnerable adults policy. Staff are given training on this and the manager and deputy manager will shortly be up-dating their training. Fieldside DS0000025619.V300574.R01.S.doc Version 5.2 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): 19,20,21,23,24,26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service Service users live in a comfortable, well decorated, furnished and maintained home which is safe and is suitable for its purpose. EVIDENCE: The home has been adapted and extended with the needs of service users in mind. It is comfortable, homely and accessible throughout. It is well located for trains and bus and is near community facilities. It is well decorated and maintained and was safe throughout. There had been an inspection by the fire brigade in 2005 and all their requirements had been put in place. There is ample communal space of a high standard and a conservatory leading to a pleasant garden. All service users’ rooms, but one, are single with a sink ensuite. They are well furnished and personalised. There are an appropriate number of showers and assisted baths. On the day of inspection the home was clean throughout. There is some work that needs to be done to the laundry floor and walls. Fieldside DS0000025619.V300574.R01.S.doc Version 5.2 Page 15 Fieldside DS0000025619.V300574.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Service users are cared for by well-trained staff, deployed at a suitable level. EVIDENCE: On the day of inspection there were sufficient staff on duty and rotas showed that this staffing level is kept at all times. The home does not use agency staff but is able to cover any shifts needed from amongst the permanent staff group. The turnover of staff is small, there had been no new staff recruited since the last inspection and so recruitment practise could not be checked. However at the last inspection it was seen to be good. Nearly 100 of care staff have the NVQ qualification. Other training needs are highlighted in yearly appraisals and necessary training undertaken. Any new procedure involving medical equipment should not be undertaken without a training session from the District Nurses. Fieldside DS0000025619.V300574.R01.S.doc Version 5.2 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): 31,33,36,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Service users benefit from a well managed home and well supervised staff. Their feedback concerning quality needs to be brought together and analysed and an annual development plan needs to put in place. EVIDENCE: The manager was not at the home on the day of inspection. However the evidence seen during the inspection showed that she is well able to manage the home, is assisted by an able deputy and supported by the proprietor. At the moment the home is monitoring quality by a monthly inspection from the proprietor plus questionnaires to service users and relatives and feedback at residents and relatives meeting. This evidence needs to be collected into an annual report and furnished to the Commission. The home also needs to produce an annual development plan. Fieldside DS0000025619.V300574.R01.S.doc Version 5.2 Page 18 There is a good system of supervision and annual appraisal in place, and all meetings are documented and signed by both parties. As well as formal supervision there was evidence of good “on the job” supervision. Most health and safety systems are in place and well monitored, with some exceptions. In the kitchen the food temperature probe was not always being used where needed and the ovens were not being cleaned according to the schedule drawn up. The COSHH cupboard did not have the required sign on it and was not locked. Also the cleaner’s cupboard did not seem to be lockable, but it is in a place where service users go, and it contains chemicals and therefore, must be locked. Fieldside DS0000025619.V300574.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 3 3 X 3 3 X 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 X 2 X X 3 X 2 Fieldside DS0000025619.V300574.R01.S.doc Version 5.2 Page 20 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 15 Timescale for action The registered person must 31/10/06 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. The registered person must 31/10/06 ensure that all service users are assessed to find out if they wish, and are able, to administer their own medication. The registered person must 31/08/06 ensure that an accurate record is kept of amount of medication received for each service user. The registered person must 31/10/06 ensure that service users interests are fully assessed and recorded on their care plans The registered person must 31/12/06 ensure that the laundry walls are cleanable and the floor impermeable. The registered person must 31/03/07 ensure that they implement an annual development plan and publish an annual report on the quality monitoring they DS0000025619.V300574.R01.S.doc Version 5.2 Page 21 Requirement 2. OP9 12 (2)(3) 3 OP9 17(1)(a) Sch 3 (k) 16(2)(m) (n) 13(3) 16(2)(j) 24(1)(a) (b)(2)(3) 4 OP12 5 OP26 6 OP33 Fieldside 7 OP38 13(4)(a) (c) undertake. The registered person must 31/08/06 ensure that all health and safety issues noted in the kitchen and to do with the storage of hazardous chemicals are acted upon. 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 OP3 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 toilet doors on the ground floor which open outwards are risk assessed. It is recommended that if a new service user moves into a room with a balcony there is a risk assessment to ensure it is a safe environment for them. It is recommended that District Nurses should be involved in training if a service user needs help with colostomy care. It is recommended that the kitchen should have a yearly “deep clean.” It is recommended that the home consider safer replacements for bleach. 2 3 4 5 6 OP19 OP19 OP30 OP38 OP38 Fieldside DS0000025619.V300574.R01.S.doc Version 5.2 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. Extracts may not be used or reproduced without the express permission of CSCI Fieldside DS0000025619.V300574.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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