Inspection on 22/07/07 for Fieldview

This inspection was carried out on 22nd July 2007.

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 no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fieldview 07/08/06

Fieldview 31/01/06

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Fieldview Pearcroft Road Stonehouse Gloucestershire GL10 2JY Lead Inspector Ms Lynne Bennett Key Unannounced Inspection 22nd July 2007 10:15 Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fieldview Address Pearcroft Road Stonehouse Gloucestershire GL10 2JY 01453 824591 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) stroudcarehomes@hotmail.com Stroud Care Homes Limited To be Appointed Care Home 7 Category(ies) of Learning disability (7), Mental disorder, registration, with number excluding learning disability or dementia (7), of places Physical disability (1) Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Learning Disability (LD)7 Physical Disability (PD) 1 Mental Disorder, excluding learning disability or dementia (MD) 7 Date of last inspection 11th January 2007 Brief Description of the Service: Fieldview is a purpose built home for 7 adults with a learning disability and/or associated mental illness. The home can also accommodate one person with a learning and physical disability. It is one of three homes owned and managed by Stroud Care Homes. Near to the village of Stonehouse it is close to local amenities and transport systems. There is comfortable communal accommodation and large gardens around the home. All bedrooms have en suites and there is an additional bath/shower room. The home has under floor central heating. Fee levels range from £1,000 to £2,700. Each person is given a copy of the Statement of Purpose and Service User Guide as they move into the home. Further copies are available in the office and the last inspection report is displayed in the hall. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. This inspection took place in July 2007 and included two visits to the home on 22nd and 24th July. The manager was present during the second visit. Most of the people living at the home were spoken to and comment cards were received from six people. Four comment cards were returned from parents and relatives. One comment card was received from a healthcare professional. Time was spent talking to people and observing the care they were receiving. Staff on duty were also spoken to about their experiences of working at the home. A selection of records were examined including selected care plans, medication and financial records, staff information, quality assurance and health and safety records. The manager completed an AQAA (Annual Quality Assurance Assessment) as part of the inspection, providing considerable information about the service and plans for further improvement. Notifications to the Commission (Regulation 37 reports) also provided additional information for this inspection What the service does well: A purpose built home provides accommodation of the highest standard with en suite facilities including a shower. An additional bathroom is provided on the first floor. A person living at the home said that they ‘really like their rooms and having their own bathroom’. A comprehensive admissions policy and procedure is in place that provides people wishing to move into the home with the opportunity to visit the home and involves other people living there. New people living at the home said that they were settling in well. Robust healthcare records are maintained confirming that people living at the home have regular access to a range of healthcare professionals and their local Community Learning Disability Team. Systems for the administration of medication are mostly good being let down on this occasion by one error. Staff are regularly assessed to ensure that they have the knowledge and skills to administer medication. Staff receive training in positive behavioural management which is accredited with the British Institute for Learning Disabilities. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 6 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. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have access to the information they need which is regularly reviewed enabling them to make a decision about whether they wish to live at the home. An assessment of their needs and wishes are taken into consideration before offering them a place. EVIDENCE: The organisation has recently changed its name from Stroud Care Homes to Stroud Care Services. The Statement of Purpose and Service User Guide will need to be amended to reflect this. Two people have recently moved into the home. There was comprehensive information about their admission process which included a front sheet giving details about their initial assessment, provision of placing authority assessments and care plans, a list of visits and when they were given a copy of the Statement of Purpose and Service User Guide. Documents were in place in their files to back up this list. In addition to this information had been provided from their former placements and other healthcare professionals involved in their care. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 9 Comments from a relative indicated that they were extremely happy with the amount of information that was made available to them and the support from the home during the admission process. One person said that ‘they gave me a lot of information about the home, which helped me to decide about moving there’. There was no evidence on these people’s files that they have received a copy of the statement of terms and conditions that are in place with the home. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are involved in decisions about their lives and play an active role in planning the care and support they receive. Risk assessments safeguard people from possible harm. Some restrictive practices that are in place may not always be in the person’s best interests. EVIDENCE: The care for three people living at the home was examined in depth. Fieldview has adopted a person centred approach to care planning that involves regular reviews with each person every six months and includes key people involved in their lives. Prior to each meeting each person discusses their likes and dislikes, strengths and needs with their key worker setting an agenda for their review. The Annual Quality Assurance Assessment indicated that the manager wants to involve people in chairing their own reviews. People living at the home and other people who attend their reviews sign the care plans. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 11 Care plans are developed which relate to their assessed needs and can be cross referenced with risk assessments which are in place to minimise any hazards identified. For instance a care plan promoting effective communication gave staff clear guidelines about the support needed for a person during times of crisis. This document cross-referenced to a risk assessment and reactive management strategy that identified triggers and ways of enabling this person to cope. Staff were observed putting this into practice. Key workers monitor and review these as and when change happens or on a monthly basis. A key worker review is produced each month. Care plans included some reference to restrictions and locked areas of the home, giving the rationale for this. The Mental Capacity Act will have an impact on these restrictions and discussions will need to be held with placing authorities. (See also Standard 35) People were observed being supported to make decisions about activities of daily living. Some people went out for a trip, another person went shopping and another person was preparing their lunch. Times for getting up are flexible, some people having a lie in and helping themselves to a drink and breakfast as they got up. Each person is asked to sign a copy of the house rules which includes restrictions about accessing communal areas between the hours of 10.30 pm and 8.00 am. One person commented that they were not happy with these constraints. Some people have access to drink making facilities in their rooms but others do not. Restrictions to the kitchen overnight used to be in place due to risks associated with a person who recently left the home. This procedure needs to be reviewed. The manager confirmed that where previously cutlery was locked in draws in the kitchen this is now accessible to people. One person’s risk assessment for using public transport did not state whether they had to be supported by staff whereas their care plans indicated that they could not leave the home unsupervised. The home has a comprehensive missing person’s folder that includes a pen picture and a current photograph. These did not appear to be in place for the new people who have moved into the home. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live at the home make choices about their lifestyle, and are supported to develop life skills. They have the opportunity to take part in social, educational and recreational activities and keep in touch with family and friends. People have a nutritional diet and their diverse needs are catered for. EVIDENCE: Each person has an activities schedule in place that has been developed with them providing a range of opportunities throughout the week. Some people attend day centres and others attend the local college. One person said they were looking forward to attending a summer school at the college. The manager stated that staff are researching work experience opportunities locally for some people. People said that they are able to earn wages from the home in return for washing the car or cleaning communal areas. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 13 The facilities in Stonehouse are a short walk from the home. A person went to the shops during one visit. They said they go to the post office, bank and local church. People confirmed that they use public transport, buses and trains as well as the home’s family size car. One person was observed going into Stroud on the bus and using tokens supplied by the local council. Some staff are able to use their own transport if people decide to go out together in a group. One person said that they were due to go swimming the afternoon of the first visit. Daily records were sampled for a two week period in July confirming a range of activities are completed. Occasionally people refuse to participate in an offered activity and this is recorded. One parent commented that “the home needs to be more creative with the social life of the clients”, and that “ too many times residents are expected to go on an outing as a group instead of individually, and if they don’t want to go this is recorded as a refusal”. Schedules indicated that group activities take place at weekends. The manager said that a group might entail three people being supported by two staff. The Annual Quality Assurance Assessment indicated that there have been problems with over booking of activities leading to some cancellation and disappointment to people. People were planning a holiday away during the first visit and two other people had just returned from their holiday. Staff also confirmed that day trips are arranged. People said they enjoy regular visits to the pub and local garden centre. One person said that they had just completed sessions in hydrotherapy and trampolining. A person had gone to visit their family during the first visit to the home. Others said that they keep in touch by phone or visits. One parent commented that there is good communication between the home and themselves. People have responsibilities within the home to clean their rooms and to help with their laundry. They also help with the shopping. People have unrestricted access to their home apart from during the night, when access to communal areas is restricted. (See Standard 7) The home has complied with the recent ‘No Smoking’ legislation and the organisation’s signs are displayed in the home. One person has their own food budget buying their own ingredients and food. Records of meals eaten are kept in a food diary. They are provided with separate storage facilities. Staff confirmed budgets are satisfactory and that they do two large shops each week supplemented by daily shopping locally. Other people are involved in the choice of meals at the weekly house meeting and help to prepare and cook meals. People were observed cutting vegetables and making snacks during the visits. During the first visit a roast lunch was being prepared and during the second visit fresh soup was made. People said that they enjoy the food. Menus confirmed a wide selection of meals being Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 14 offered with an alternative to the main meal. Where people choose an alternative to the main meal this is recorded on the rear of the menu planner. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20 and 21. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Peoples’ health and personal care is based on their individual needs and they are treated with dignity and respect. On the whole medication systems protect people from possible harm. EVIDENCE: People’s personal care needs are identified in their plans. Each person has a list of likes and dislikes, and care plans are in place for how they would like to be supported with personal care. One person was observed being helped by staff to have their hair plaited and several ladies had help to colour their hair. Staff were observed to be sensitive to the needs of people and to go with them to discuss issues in the privacy of their rooms. Concerns have been highlighted at staff meetings and in the Annual Quality Assurance Assessment about the gender mix of the staff group representing that of people living at the home. There is presently a higher proportion of female staff to male staff. During the visits people were observed interacting positively with the staff teams on duty. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 16 Robust records are kept of people’s healthcare appointments. A spreadsheet also provides an immediate overview of people’s appointments and would highlight when people are due to see the optician or dentist. Appointment records also provide an outcome of each appointment. Health action plans have been obtained and the manager confirmed will be put in place. People have access to the local Community Learning Disability Team. The Annual Quality Assurance Assessment indicated that the positive relationships with the team have been sustained. People who are part of the Care Programme Approach have access to a named social worker and regular reviews. Medication administration systems were inspected and these were mostly satisfactory. Staff complete training in the safe handling of medication. A schedule confirmed their annual assessment with the organisation. Two paracetomol had been put in a pot and labelled with the name of the person. The record indicated that this ‘as necessary’ medication had not been given to the person for some time. There was no explanation for this. The manager had addressed this with the staff member by the time of the second visit. There were no gaps on the administration record, a stock tally was being kept, and two staff had countersigned most handwritten entries. One entry was countersigned during the visit. Creams and liquids were labelled with the date of opening and external and internal medications were kept separately. A homely remedies list was in place that had been recently reviewed. A stock record is kept of ‘as necessary’ medication. Protocols are in place for this medication and when given the section of the reverse of the administration record is completed. There was evidence that people were having an annual medication review with their doctor. The AQAA indicated that some people would be assessed with a view to self-medication. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are confident in the knowledge that any concerns they may express will be listened to and acted upon. Systems are in place that safeguard people from possible harm or abuse. EVIDENCE: The home has a complaints policy and procedure that is displayed throughout the home with details about who to speak to at the home and at the Commission for Social Care Inspection. People spoken with said that they would talk to staff or the manager if they had concerns. The manager was observed to be open and accessible to people. There was evidence on the complaints file of such a complaint from a person living at the home. Details of the outcome of the complaint were recorded. Staff confirmed that they have attended training in the safeguarding of adults with Gloucestershire Adult Protection Team. A memo confirmed that further training has been booked for other staff. An alerters guide produced by the team was displayed in the office. Staff spoken to had a good understanding about abuse and their responsibilities. They confirmed that they learn about the organisation’s whistle blowing policy and procedure during induction. Staff are trained in Positive Behavioural Management by two managers qualified to do this training. This is accredited with BILD. They confirmed that they complete regular refreshers and assessments to ensure that they are Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 18 competent to supply this training. Training records confirmed that staff access this training during induction with refresher courses being provided annually. Records indicated a significant reduction in the use of physical intervention in the home. Two incidents had been reported to the Commission in the past six months. Reactive management strategies refer to physical intervention and ‘as necessary’ medication being used as a last resort. Observations of staff and discussion with them confirmed this. Some people manage their finances independently. For those who need support risk assessments are in place. Financial records were examined and found to be satisfactory. Receipts are cross-referenced with debits and credits and balance checks conducted regularly. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,29 and 30. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a home that is safe, clean and well maintained which promotes their independence and complements their lifestyle. Specialist equipment is provided to those people who need it. EVIDENCE: Fieldview offers accommodation to a high standard, with each person having a room with en suite facilities that include a shower. A bathroom is also provided on the first floor. Communal areas were clean at the time of the visits. People stated in their comment cards that they would like to personalise communal areas with pictures and photographs. The AQAA also stated that this was an area for improvement. The gardens around the home are well maintained. A maintenance person is employed for day-to-day repairs of the home. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 20 Several people complained of problems with water from their shower leaking onto the floor of their en suite. An incident record indicated that one person had slipped as a result of this. Shower curtains in showers although clean and appearing to be new were rather long. One person said that if these curtains hang inside the shower they collect excess water that deposits on the floor when opened or if they hang outside the shower the floor becomes wet. People did not appear to have shower mats outside of the cubicles. Specialist adaptations have been provided to a person after consultation with an occupational therapist and physiotherapist. People living in the home share responsibility with staff for keeping the home clean. Hazardous products are stored safely in the laundry that is kept locked. Paper towels and liquid soap are available near communal hand washbasins although the sink in the laundry did not have any supplies. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 and 36. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Peoples’ needs are met by a competent staff team, who have access to an improved training programme that aims to equip staff with knowledge about the diverse needs of people living at the home. Further improvements to recruitment and selection will safeguard people from possible harm. EVIDENCE: There have been three new appointments to the staff team and one person appointed to work on the bank team. Those spoken with confirmed that they shadow staff initially as part of their induction programme. Samples of an induction programme being worked through were available for inspection and follow the common induction standards. Although the AQAA indicated that staff need more opportunity to complete these. People confirmed that they also complete mandatory training. Records on their files verified that they had completed or were due to attend first aid, fire, basic food hygiene and moving and handling. A course in Positive Behaviour Management is also part of their induction. Having completed this people then move onto NVQ Awards in Care. New staff are given a copy of the General Social Care Council’s code of conduct. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 22 Comments received indicated that at times during weekends the staff team is put under pressure and is not up to full strength. At the time of the first visit (a Sunday) there were four staff on duty plus one person working supernumerary as part of their induction. Staff spoken with said that ratios are kept to these levels. A letter to staff from the providers indicated that there had been problems with some staff leaving before the end of their shift. They were obviously addressing this. People living at the home felt that they have sufficient staff on duty to meet their needs. The AQAA states that people living at the home are involved in recruitment and selection. Files for four people were examined. Each person completes an application form and a health questionnaire. Two forms had gaps in employment history. There was no evidence that these had been investigated. Each person had been appointed after at least two written references had been obtained and a satisfactory Criminal Records Bureau check. The reference request forms used did not determine the reason why the person left former positions in care. The manager confirmed that the wrong reference request form had been used and immediately updated records in the home to ensure that this information would be obtained. Each person has a front sheet to their file confirming that evidence of their identity had been obtained prior to appointment. A recent photograph of each staff member is held on file. Identity cards are being put in place for all staff. Access to training is improving with evidence that in the last 3 months staff have been attending training in all mandatory courses in addition to internal courses on mental health. The manager stated that he was hoping to send a person on health and safety training so that they could take on responsibility for health and safety within the home. Although information concerning the mental capacity act was available within the home managers and staff have not yet had training in this area. Information is available in the home about the needs of people and their specific conditions. The AQAA stated that ‘more specific training would be identified re service users’ needs’ over the next 12 months. There was evidence that staff are having regular access to supervision sessions and annual appraisals. Staff meetings are scheduled every two months and copies of minutes confirmed that six have been held over the last nine months. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect. Quality assurance systems are in place involving people who live at the home. Health and safety recording systems need to be monitored to ensure that the health, safety and welfare of people is promoted and protected. EVIDENCE: The manager transferred to Fieldview from another home in the group. His application to become the registered manager is being processed by the Commission. He has almost finished his Registered Manager’s Award. He confirmed that he completed a professional trainers course and is hoping to become a trainer of basic food hygiene. He supplied an Annual Quality Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 24 Assurance Assessment prior to the inspection and stated that he had developed an action plan for issues that he considered could be done better. Staff spoke highly of him and people living at the home appeared to have a positive relationship with him. A quality assurance report was produced in 2006 as a result of the quality assurance system that was in place. Monthly health and safety audits do not appear to be taking place at the moment. The manager stated that as soon as a member of staff received the appropriate training these would be resumed. People living at the home were surveyed last year for their views on the home. Unannounced visits to the home although taking place are not being recorded. Records must be kept and available for inspection. The manager confirmed that at the last visit care plans were sampled. The following issues were raised concerning health and safety issues: • Although being regularly monitored temperatures for the fridge indicated that the temperature was outside safe parameters • water temperatures in two rooms indicated that over a significant period of time they have been over 60° Centigrade. (A risk assessment indicated that staff would monitor this and the maintenance department would deal with any concerns.) • environmental and fire risk assessments need reviewing. Records confirmed regular fire equipment and alarm checks, servicing of equipment and drills/training for staff and people living at the home. Portable appliances have an annual check and annual gas servicing is carried out. The temperatures of hot food is tested and recorded. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 2 X Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? 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 YA1 Regulation 6 Requirement Timescale for action 30/09/07 2. YA5 3. YA7 4. YA20 People wishing to use the service need access to current information in the Statement of Purpose and Service User Guide that includes the correct name of the organisation providing the service they receive. 5(1)(ba) People must be provided 30/09/07 with a statement in respect of accommodation and personal care and the total cost to them. 17(1)(a) Sch 3.3(q) Any restrictions to 30/09/07 people’s freedom of movement or choice must be discussed with them and their placing authority, with reviews as changes occur to the reasons for these restrictions. Consideration must be given to the impact of the Mental Capacity Act on such restrictions. 13(2) Medication must be given 25/07/07 directly to the person for whom it is prescribed DS0000065133.V336850.R01.S.doc Version 5.2 Page 27 Fieldview 5. YA24 23(2)(b)(c) 6. YA34 19 Sch 2.6 7. YA39 26(2)(3)(4) 8. YA42 13(3) 9. YA42 13(4)(c) from the original container. This is to ensure that people receive the correct dosage of medication. People must be able to have a shower safely and without the risk of harm. This is in respect of providing adequate facilities to prevent water leaking onto the floor. Before staff are appointed a full employment history, with a written explanation of any gaps, must be in place to ensure that people are safeguarded from possible abuse. In order to assess the quality of service being provided records must be kept of any unannounced visits by representatives of the provider to the home. Where the temperature of the fridge is outside safe parameters action must be taken to ensure that people are not put at risk of infection. Action must be taken to adjust water outlets registering outside safe parameters (over 43°C) to prevent people from getting scalded. 30/09/07 30/09/07 30/09/07 31/07/07 31/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Fieldview Refer to Good Practice Recommendations DS0000065133.V336850.R01.S.doc Version 5.2 Page 28 1. 2. 3. 4. 5. Standard YA7 YA9 YA9 YA30 YA35 People should be able to have access to drink making facilities in their rooms if they so wish as long as there is not a risk to their safety. A risk assessment for a person using public transport should clearly state the level of staff support needed for this activity. Create a missing person’s information sheet with a photograph for the two new people who moved to the home. Ensure that people using the laundry have access to soap and paper hand towels to prevent the risk of infection. Staff and managers need to be aware of the implications of the Mental Capacity Act. Fieldview DS0000065133.V336850.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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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