Inspection on 23/11/05 for Fieldway Residential Home

This inspection was carried out on 23rd November 2005.

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

Fieldway Residential Home 04/09/07

Fieldway Residential Home 26/01/07

Fieldway Residential Home 02/05/06

Fieldway Residential Home 04/05/05

Fieldway Residential Home 10/01/05

Fieldway Residential Home 30/07/04

Fieldway Residential Home 04/12/03

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Inspirations

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

CARE HOMES FOR OLDER PEOPLE Fieldway Residential Home 5 Fieldway Blythe Bridge Stoke On Trent Staffordshire ST11 9HL Lead Inspector Sue Jordan Announced Inspection 23rd November 2005 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 Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 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. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fieldway Residential Home Address 5 Fieldway Blythe Bridge Stoke On Trent Staffordshire ST11 9HL 01782 393355 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) Mr Thomas Hope Mrs Mavis Hope Mrs Hazel June Malbon Care Home 18 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (18), of places Physical disability over 65 years of age (10) Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 10 PD(E) - 1 may be aged 60 on admission The Registered Manager must Gain the knowledge and receive appropriate training in the local procedures to follow in the event of an allegation of abuse, in particular the role of the Local Authority Adult Protection Team. This should be done by 1 October 2005. Commence the Registered Manager`s Award Date of last inspection 04/05/05 Brief Description of the Service: Fieldway is a residential care home for 18 older people. The registered facility is all on the ground floor with 16 single and one shared bedroom, all but one single room have en-suite facilities. There are two lounges and a smoking room/conservatory, as well as a separate dining room. Outside there is a lawn area for the use of the resident service users in good weather. The home is of modern construction and is furnished, decorated, and maintained to a high standard. There is a brick paved car park adjoining the front entrance, and the whole is situated in a quiet residential street with local services within half a mile, as is access to the bus route, with the railway station being about a mile away, close to the health centre. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced Inspection took place over seven and quarter hours with one Commission for Social Care Inspection inspector. Methodologies used were informal discussions with several of the residents, an interview with one staff member and scrutiny of records, including those pertaining to service users and staff. Feedback was given to the registered manager, Hazel Malbon and the proprietor Thomas Hope. What the service does well: What has improved since the last inspection? The Statement of Purpose and The Service Users’ guide have now been updated to include all of the required information. The care plans are now being maintained to a high standard and the information within regularly reviewed. Some minor improvements were suggested. Health care needs are monitored and all action, including appointments and visits recorded. Individual risks are being assessed, although it was identified that more are required. The home undertakes comprehensive assessments of need and in general the manager now ensures that she obtains a Community Care Assessment and care plan prior to admission. Staff recruitment procedures have improved, although more is required. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 6 The manager has settled well into her role and improvements in record keeping are particularly noted. Staff report an improvement in communication. Training opportunities have increased and a staff supervision system has been implemented. This will continue to be monitored. Although a sensitive area, the manager is gradually obtaining information for each resident regarding death and dying. The manager has documented the action taken to address concerns and complaints. 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. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 6 The manager has improved the information given to potential residents and/or their families, although contracts must be in place for all service users purchasing their own care. Pre-admission information must be obtained for all potential service users, ensuring that The Home is able to meet their needs. EVIDENCE: The Statement of Purpose and Service Users’ Guide have been amended since the last inspection. These documents now contain the required elements. The complaints procedure needs minor amendment and a requirement is made under National Minimum Standard 16. The manager is undertaking quality assurance and when complete, a collation of the results must be added to The Service Users’ Guide. The manager has developed a contract to be used between the home and selffunding residents. She is now required to put these in place. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 9 Four service user files were checked at this inspection. With regard to the correct assessment information being obtained, there is evidence that this is improved. However the manager is awaiting the Care Management assessment and care plan for a recently admitted resident. She was advised that she must obtain this information prior to admission in order that she can establish whether the home is able the person’s needs. The home undertake their own comprehensive assessments of holistic needs, which are subsequently reviewed regularly. Care planning and assessment information has improved, ensuring that the care workers know and understand how to meet the residents’ needs. Staff training opportunities have increased. The home appropriately seeks guidance and intervention from medical, health professionals. Fieldway does not provide intermediate care. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 Care planning information has vastly improved, ensuring that comprehensive information is available to the staff as to how they should meet the residents’ needs. In order that the residents are further protected the medication systems must be strengthened and improved. EVIDENCE: Major improvements have been made to care planning information. Care plans and assessments are developed at the point of admission and updated and amended accordingly. Regular reviews are undertaken of all relevant information. The deputy and senior care worker share care plan completion responsibility. Some expansion of information is required. For example, a care plan review highlighted deterioration resulting in some behavioural difficulties. This needs further explanation, including how staff are to safely manage this problem. This could be completed in the form of a risk assessment. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 11 Some documents were not dated and this was recommended. For example, additions to the medication information kept in the file. The relatives are being offered the opportunity to be involved in care planning and sign accordingly. The health sections of the care plans indicate that Medical health professional input is accessed appropriately. The residents also have the opportunity to access other services including chiropody and dental. The medication systems were checked during this visit and a number of deficiencies identified: • Gaps were found on the medication administration recording sheets pertaining to night time administration. • Stock control must be improved, including out of date medication being returned to the pharmacist. • Concerns were raised with regard to the administration and recording of medication treated as controlled. • The pharmacist labels must not be removed from medication containers. Only medication prescribed for the resident must be administered. The medication procedures must be strengthened to ensure a safe system for the residents and staff, including staff training and understanding of the procedures. It is recommended that stock control checks be made of controlled medication at the beginning of every shift and that these be recorded in the bound books. It is recommended that bottles, creams and preparations be dated on opening to assist with stock control monitoring. The home’s pharmacist delivers some of the training to staff, however it is strongly recommended that staff re-commence with the ‘Safe Handling of Medicines’ distance-learning, module based course. The manager must also monitor staff competency and address any shortfalls in supervision, appraisal and with the provision of appropriate training. It was noted that the staff member observed administering medication during this visit, did so appropriately. Positive interaction and communication was observed between the staff and the residents. The residents spoke highly of the staff on duty. The manager has started to record resident and/or family wishes with regard to death and dying. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 15 The home continues to provide a variety of activities for the residents. Residents’ choice is ascertained and recorded in their care plans and this includes food preferences and dislikes. EVIDENCE: The home continues to provide a varied activities programme. On the afternoon of this visit, some of the residents were involved in a reminiscence session. Some residents have newspapers delivered. The residents are able to choose where they sit in The Home and whether they wish to eat their meals in the dining room. One of the residents said that she was able to request a bath at any time. Alternatives are provided within the lunchtime menus and residents’ likes and dislikes are recorded in the care plans. Two of the residents like to smoke and arrangements are made for staff supervision and a separate area provided. Most of the residents have their own bedrooms and the residents are encouraged to personalise them. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 13 The home has a new cook and the residents praised the quality of the food. Choices are offered and likes and dislikes recorded. Food and hygiene training is being planned for the new cook, in January 2006. The home was advised that the new cook may require more intensive training, which includes a higher level of food hygiene training. She should also be equipped to understand how to respond to dietary needs, including diabetes and allergies etc. The residents reported having supper in their bedrooms at night. The menu is available in the hallway. New worktops and a fly screen have been supplied in the kitchen and the proprietor reported that new cupboards are to be fitted in the New Year. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Complaints are addressed and recorded appropriately, however the procedure requires expansion to allow for easier access to the Commission for Social Care Inspection, if required. Staff must be trained in the Protection of Vulnerable Adults to safeguard the residents. EVIDENCE: The complaints procedure requires minor amendment including a 28-day response timescale, the Commission for Social Care Inspection contact details and the fact that complainants are free to approach them at any time/stage. The manager records all complaints and concerns and the action taken to address them. The manager has received training from the Local Authority Adult Protection officer with regard to the local Protection of Vulnerable Adults procedures to follow. She is planning to access this training for staff. She was advised to cascade this information and guidance to staff in the interim period. The staff member interviewed during this inspection was aware of the correct procedures. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21, 22, 24, 26 Fieldway has an on-going maintenance and cleaning programme affording the residents a pleasant and safe environment. EVIDENCE: Fieldway continues to provide a comfortable, well-maintained environment and there is evidence that this is on going. A fire officer recently visited the home to deliver training and at the same time he checked the procedures in place. A magnetic door catch, attached to the fire alarm system needs to be fitted to the dining room door. The residents and staff need to move freely through this door and it is having to be wedged open. The equipment provided in the home is maintained and records kept. One of the residents uses bed guards. The use of this is risk assessed although the manager was advised to extend this to include maintenance checks and staff monitoring systems. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 16 The bedrooms are pleasantly decorated and well equipped. Some of the residents hold a key to their bedrooms and their right to this is offered at admission and recorded. The manager was advised that a risk assessment must be completed for any resident not able to have a key, which includes the justification. The Home was clean and hygienic on the day of this visit. A new domestic has been employed working four days a week. A washing machine has been purchased, which has a sluice facility. The Home uses the alginate bag system for the laundering of soiled articles. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 The residents are supported by a consistent staff team. Recruitment and training procedures are improving, although further work is required to ensure that the residents are fully protected. EVIDENCE: Staffing ratios are adequate in The Home, which includes a separate auxiliary work force. The residents are fortunate that there is a consistent staff team employed at Fieldway, many of whom have worked there for some time. There is a career structure within The Home. Four of the existing staff team have NVQ 2 or above. Some of the senior care team are undertaking NVQ 3. Staff recruitment procedures have vastly improved and in particular this is with regard to the Criminal Records Bureau and Protection of Vulnerable Adults checks. Contracts of employment and job descriptions have also been developed and included in the files. Some elements were missing from the files seen at this inspection and the manager was also advised that undated, “To whom it may concern” references are not appropriate. The manager must ensure that the required elements are available in all of the files. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 18 The manager has developed an application form and a discussion was held as to some additional required information. This includes space to record a full employment history, space to record whether a proposed referee is professional or personal, a declaration that the staff member has not committed a criminal offence, or otherwise the circumstances and space for the applicant to sign and date the document. The manager has developed a training matrix and training opportunities have improved. Various external training agencies have been contacted with regard to providing appropriate courses. The manager is trained to deliver manual handling instruction and provides this to new staff. Future training is planned and booked. This indicates an improvement, however there are still training requirements, some of which have been identified during this visit. These include medication, Protection of Vulnerable Adults and food hygiene; therefore this will be monitored at the next visit. New employees complete an induction booklet together with the manager. She was advised that the staff should also sign this record. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Management systems in the home have improved, although these need to include further development of staff supervision and quality assurance systems. EVIDENCE: The manager, Hazel Malbon was registered with the Commission for Social Care Inspection in August 2005 and has continued with her commitment to improving the standards in the home. She is presently undertaking the Registered Manager’s Award. The staff spoken to said that communication systems have improved in the home since Hazel became manager and that she is very approachable. The manager and the proprietor were very helpful and co-operative with the Commission for Social Care Inspection process. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 20 The manager has started to develop a Quality Assurance system. The questionnaires used were not dated and some of them had been completed by care staff. The manager is aware that this system needs to be further developed to include the views of family members. Once established the results should be collated and the information available in The Service Users’ Guide. The manager informally meets with relatives on a regular basis. Families are generally responsible for managing service user finances, although the Home maintains smaller amounts of personal allowance. The records are well maintained and one was checked against the amount of money held-this was correct. Staff supervision has commenced and it is in its initial stages. The concerns regarding medication administration highlighted the need for more effective staff supervision systems. This will be monitored at the next visit. Random Health and Safety records were checked and generally found to be appropriate. The Home has robust monitoring systems in place. Generic risk assessments are being reviewed. The manager was reminded that the home’s fire risk assessment should be reviewed annually. Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 2 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X 2 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 22 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 OP2 Regulation 5 (1b) Timescale for action A contract must be put into place 01/02/06 between The Home and residents purchasing their care privately. All new service users must only 01/01/06 be admitted following a full assessment. The medication systems must be 01/12/05 strengthened to protect the service users and staff. This should comply with The British Pharmaceutical Guidelines. Staff receive Protection of 01/02/06 Vulnerable Adults instruction and guidance. The dining room must be fitted 01/02/06 with an appropriate magnetic catch, appropriate to fire safety and evacuation. The use of bed guards must be 01/01/06 risk assessed, to include maintenance checks and staff monitoring systems. All staff personnel files must contain all of the required elements listed in Schedule 2 of The Care Homes Regulations. Previous Requirement. DS0000004943.V261208.R01.S.doc Requirement 2. 3 OP3 OP9 14 13 (2, 6) 4 5 OP18 OP19 13 (6) 23 (4a, b) 6 OP22 23 (2c) 7. OP29 17, 19, 2 01/01/06 Fieldway Residential Home Version 5.0 Page 23 8. OP29 18 (1ci) 9. OP33 24 10. OP36 18 (2) More evidence is required that all 01/02/06 staff have received mandatory training at the appropriate frequencies. Previous Requirement. A Quality Assurance system 01/02/06 must be further developed, which includes ascertaining the views of the service users, their friends and family and stakeholders in the community, including for example GPs, chiropodist etc. The results of the service user surveys must collated and added into the Service Users Guide. Previous Requirement The staff supervision should be 01/02/06 further developed. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 7 Refer to Standard OP7 OP7 OP9 OP9 OP9 OP30 OP38 Good Practice Recommendations It is recommended that, where appropriate, care plan information be expanded to include further explanation and guidance for staff. It is recommended that all records, including amendments be dated. It is recommended that stock control of controlled medication be undertaken at the end/beginning of every shift. This should be recorded in the bound books. It is recommended that bottles, creams and preparations be dated on opening to assist with stock control monitoring. It is recommended that staff undertake the ‘Safe Handling of Medicines’ training. It is recommended that staff also sign the induction booklet. The fire risk assessment should be reviewed at least annually. DS0000004943.V261208.R01.S.doc Version 5.0 Page 24 Fieldway Residential Home Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Fieldway Residential Home DS0000004943.V261208.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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