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Inspection on 18/09/07 for Homefield House

Also see our care home review for Homefield House for more information

This inspection was carried out on 18th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

The home now has a qualified and experienced manager in post. The menu and meals have improved we are told and the private catering company is working with the staff to ensure it provides suitable and adequate meals.

What the care home could do better:

The home has itself identified a number of areas for improvement or development and this pro-active approach is commendable. In particular the manager wants to develop social and recreational activities for residents so they can choose from a wider range. As a service in transition the manager is also reviewing the registration of resident categories with his senior managers. Because the London Borough Croydon is replacing old care homes with new ones this has affected staffing arrangements in all their care homes; it has meant that in some instances agency staff are being used for prolonged periods in the expectation that Croydon`s own staff can be redeployed into the various care homes as the old homes are closed and the new ones opened. This is not to the liking of residents who feel that permanent staff provide a better level of care than short term agency staff who may not know their individual needs and preferences quite so well. Residents have said, "There are too many agency staff (working in Homefield House)" or "Most of the permanent staff are extremely caring to me". In respect of staffing; some of their police checks [CRB] are now more than 3 years old and whilst there is no specific timescale for renewal a 3-yearly renewal is regarded as good practice. During our visit to Homefield House we checked a number of staff files and could not find written evidence of regular staff supervision but the manager did report that all staff do receive regular supervision so this needs to be clearer in the files. In respect of residents` personal allowances; it was noted that residents were routinely contributing to a weekly session of bingo. Whilst residents with capacity are free to spend their money as they wish, any arrangements for payments such as bingo or a lottery, or the care of house pets for example , must not become so routine as to be expected of residents.*

CARE HOMES FOR OLDER PEOPLE Homefield House 57 Homefield Road Old Coulsdon Surrey CR5 1ET Lead Inspector Michael Williams Key Unannounced Inspection 18th September 2007 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 Homefield House DS0000043327.V350647.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. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Homefield House Address 57 Homefield Road Old Coulsdon Surrey CR5 1ET 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) 01737 551880 01737 551681 London Borough of Croydon Post Vacant Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th October 2006 Brief Description of the Service: Homefield House is owned and managed by the London Borough of Croydon. A number of large bedrooms have been converted into single rooms or lounge space so the home now has thirty-five places. The Local Authority is also changing the homes stated purpose; currently in transition it now offers intermediate care and social ‘re-ablement’ care, that is rehabilitation, for an increasing number of residents as the number of permanent residents diminishes. The home also continues to provide respite care. The home is a purpose built detached property situated in a quiet residential area of Old Coulsdon. There are currently separate lounge and dinning areas on each floor of the home and it has a well-equipped kitchen on the ground floor. Sufficient numbers of bathroom and toilet facilities are conveniently located throughout the home. Laundry and sluicing facilities are also available on each floor. The home has a large garden and there is limited space for parking. Fees in 2007 are £467. Extra is charged only for personal requisites and items residents wish to buy. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was conducted in Late September 2007 and included the distribution of questionnaires to relevant parties including residents, their relatives, care managers, health care professionals and all staff in the home. From this the Commission received at total of 11 replies including six from residents, five from families and one person telephoned the Commission to tell us how pleased she was with Homefield House. All were very positive about the Home and the quality of care provided by permanent staff. The site visit was from late morning until tea-time and most residents had an opportunity to talk to the inspector; several relatives were visiting on this day and they most helpfully commented on the procedures for admitting new or respite residents. Comments were also received from visiting professionals including a Community Nurse. Representatives from the staff team were also interviewed. Not all the staff in Homefield House are now employed by the London Borough of Croydon; catering and housekeeping is now managed by a private company. The Home’s manager therefore loses direct day to day management of kitchen and cleaning staff. The Commission will need confirmation that National Minimum Standards can be met and Statutory Requirements complied with. What the service does well: What has improved since the last inspection? The home now has a qualified and experienced manager in post. The menu and meals have improved we are told and the private catering company is working with the staff to ensure it provides suitable and adequate meals. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 6 What they could do better: The home has itself identified a number of areas for improvement or development and this pro-active approach is commendable. In particular the manager wants to develop social and recreational activities for residents so they can choose from a wider range. As a service in transition the manager is also reviewing the registration of resident categories with his senior managers. Because the London Borough Croydon is replacing old care homes with new ones this has affected staffing arrangements in all their care homes; it has meant that in some instances agency staff are being used for prolonged periods in the expectation that Croydon’s own staff can be redeployed into the various care homes as the old homes are closed and the new ones opened. This is not to the liking of residents who feel that permanent staff provide a better level of care than short term agency staff who may not know their individual needs and preferences quite so well. Residents have said, “There are too many agency staff (working in Homefield House)” or “Most of the permanent staff are extremely caring to me”. In respect of staffing; some of their police checks [CRB] are now more than 3 years old and whilst there is no specific timescale for renewal a 3-yearly renewal is regarded as good practice. During our visit to Homefield House we checked a number of staff files and could not find written evidence of regular staff supervision but the manager did report that all staff do receive regular supervision so this needs to be clearer in the files. In respect of residents’ personal allowances; it was noted that residents were routinely contributing to a weekly session of bingo. Whilst residents with capacity are free to spend their money as they wish, any arrangements for payments such as bingo or a lottery, or the care of house pets for example , must not become so routine as to be expected of residents. * 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. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 3: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social care and health care needs are assessed prior to admission, this ensures that residents will know that staff in the home will be able to meet their changing needs. The home also has in place arrangements to provide rehabilitation support and these residents can also be assured that their needs will be assessed prior to admission to ensure their placement in this particular home is appropriate. EVIDENCE: A sample of case notes was checked. As well as talking to many of the residents we also spoke to the new manager, some staff and a few relatives were interviewed during the course of this and the previous inspections; the residents told us about their experiences at the time of their admission to the home, which is often a transfer from hospital rather than their own home. The pre-admission assessments include general information about each resident, details of their background medical and social history and comprehensive details of specific issues such as mobility nutrition, diabetes, Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 9 continence, medication and diversity needs or choices. Residents, with their representatives, assist in the compilation of these case notes. The home’s management team has taken the initiative and arranged meetings with senior care managers to discuss the issue of pre-admission information and referrals. These meetings are very important to ensure the home’s role and limitations are clearly known to all relevant agencies and inappropriate placements can be avoided and the person in charge is now confident that only appropriate referrals are being made since some clarity was brought to the admission criteria. In particular the home does not admit residents with nursing care needs that cannot be met by a visit once each day by a District Nurse. Areas of strength include the preparation for admission and information provided and as no matters requiring improvement arise this section, about choice on admission, is assessed as good. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 7, 8, 9, 10: Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Care Plans are in place for each resident. This means that, so long as the placements are appropriate, the needs of residents can be met. Medication can either be administered by the care staff or they will support residents to hold and administer their own medication in order to maximise their independence. Residents are treated with respect and dignity. EVIDENCE: A sample of residents case files were read; residents and relatives were interviewed; staff and visiting professionals, a Community (District) Nurse and a Physiotherapist, offered their opinions and the manager also explained how they aim to met the social and health care needs of all residents. The administration in this home is very good and the case files were in good order despite the range of services on offer – some residents are long stay others admitted for respite and others for rehabilitation support before returning home - so the case files need to be well managed and they are. Pre-admission information is in place and this helps direct the in-house assessments and care planning. A range of documents are required to be Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 11 maintained for each resident including items such a photograph, basic personal data, health and social care needs, professional and family involvement and so forth. Care plans and reviews are in pace for each residents and the daily notes indicate that staff are providing suitable care and support for each resident. During the inspection it was noted that the home’s staff make prompt and direct contact with health care professionals such as a Nurse or Doctor if the need arises as it did on the day of inspection. The visiting Nurse and Physiotherapist and an ambulance driver all attested to the professional manner in which this home is being run. No errors were identified in the procedures for recording, storing, administering and returning medication. In most instances staff assist residents with their medication but for those residents intending to return home the care staff can support residents in looking after their own medication in their rooms. Areas of strength include the well managed documentation to support care practices and the residents’ views that they are well cared for and as there are no matters requiring improvement in this section, about health and social care, it is assessed as good. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 12 to 15: Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable setting for residents to engage in social and cultural activities as they choose and in accordance with their expectations for the home including any ‘diversity’ issues. The staff assist and encourage residents to lead as fulfilled lives as they wish or their frailty allows. Residents are encouraged and given every opportunity to maintain contact with family and friends and the community. A full and wholesome diet is available for all residents. EVIDENCE: The most important aspect of this section is that the residents said they were very happy in Homefield House, they want to stay and they don’t want any changes made. This reflects the quiet, tranquil atmosphere evident during this visit. There is ample space for residents to sit where and with whom they please. Staff were with them throughout the day and often engaging them in some activity or conversation. It was also pleasing to hear residents in the ground-floor lounge supporting each other and chatting about their news and views – clearly a group of residents who are getting on well together. It is expected that a care home will support residents to maintain links with their family, friends and the wider community and this appears to be the case. Visitors are welcomed, residents still go out to visit their family and friends Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 13 when they wish and representatives from the community come in regularly including church members and entertainers. Several visitors were on site to confirm that they may visit freely and are welcomed by staff. The manager advised the inspector that all residents use English as their language of choice although one or two are not English by birth. Other aspects of diversity were discussed such as the accommodation of residents who may have sensory or mobility problems – the home seeks to meet such needs whenever possible. Matters of sexual diversity were also discussed, given the age of the client group many would reflect on how different things were when young but in Homefield they will be treated with tolerance and forbearance whatever their lifestyle or sexual orientation. Areas of strength are the residents’ universal opinion that this is an ideal setting in which to be cared for and as no matters requiring improvement arise in this section, about daily life, it is assessed as good. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 16 and 18: Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place for residents and their representatives to either complain or compliment the service. Effective procedures are in place to deal with complaints. Arrangements are also in place to protect the vulnerable residents. EVIDENCE: Questionnaires were sent out to residents, cares and families, professionals and to professional visions as well as staff in the home. Their comments are outlined in the summary to the report and indicate that residents are confidents that their voice is listened to and their concerns noted and acte upon. Records were checked and residents interviewed. Residents and their visitors confirmed that with present arrangements in place, to complain or make representations, they are confident their opinions and concerns are dealt with in a professional and thoughtful manner. A record of complaints is in place. No complaints arose during the course of the inspection. In contrast several complimentary comments were made by those people interviewed. Whilst no complaints were made during this inspection or the previous inspection two suggestions were made to the CSCI, one was about improving the entrance hall and the other was about improving television reception especially in residents’ bedrooms where reception is poor at the moment. Both suggestions were passed on to the home and the person in charge confirmed that these two suggestions are already being followed up and improvements made. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 15 The home has an up to date copy of the local authority’s procedures for dealing with allegations of abuse but no such issues have arisen since the previous inspection. Staff were aware of their responsibilities to protect residents and deal promptly and efficiently with any allegations or suspicions of misdemeanour but not al staff recalled the importance of referring such matters to the local authority care management team before making anything other than brief enquiries to clarify the allegation. A requirement is made to ensure the guidance is readily available to, and followed, by all staff particularly those staff who may be in charge of the unit as part of their duties. Areas of strength are positive approach to managing complaints and concerns and the positive feedback from residents but there is one matter requiring improvement. The procedures for referring allegations of abuse to the local authority care management team; refresher training is already booked and the Commission is confident this training and guidance will be acted upon if the need arises. So this section, about complaints and protection, is assessed as good. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 19 and 26: Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, well-maintained and comfortable environment. It was clean and comfortably warm at the time of inspection. EVIDENCE: This is a purpose built care home with a wide range of communal rooms and a variety of bedrooms of different sizes (although none of the bedrooms have ensuite toilets). The home is maintained safely and no hazards were identified in the general environment but a recommendation is made to replace furniture that is old and worn and should be repaired or replaced for example armchair covers are very worn. This home cares for people who have recently been in hospital and are preparing to return home so their conditions vary from considerable immobility and dependency to greater mobility and independence. The home has in place a range of facilities to support this including various aids and adaptations such as a domestic scale kitchen on the first floor for retraining domestic skills and aids in the toilets and bathrooms to ensure the safety of residents. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 17 The bedroom doors are being replaced but the locks are not suitable, they are neither safe nor provide adequate privacy. One bathroom has a lock that is not working properly. A requirement is made to fit suitable door furniture to all bedroom and bathroom doors. Areas of strength are homeliness of what is very large care home and matters recommended for improvement include the need to replace some furniture. Despite the few shortcomings this is generally a safe and well maintained building so this section, about the environment, is assessed as good at this time. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 27 to 30: Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Care staff and ancillary staff were present in sufficient numbers and with the skill mix to meet residents’ needs on the day of inspection. However there is undue reliance upon temporary, agency staff and not permanent staff as the residents say they prefer. A sound recruitment, training and supervision programme is place. This ensures that residents’ needs can be met in a safe and well run home. EVIDENCE: The home is currently not equipped for, and staff are not trained for, specialist forms of care such as dementia care and nursing care because these fall outside its registration category. The home is however considering a review of registration so as to extend registration to include dementia care. An application to vary its registration will be required before such changes in care can be undertaken by the home. The training programme is very good and includes a wide range of opportunities, including basic elements such as fire safety and ‘moving and handling’ (residents) and important issues such as protecting elders from abuse. Arrangements for staff supervision are in place the manager said, but this was not always clear in the staff files, and regular staff meetings are being held. Staff are given training in matters of safety such as handling chemicals, fire safety and maintaining a safe environment. Housekeeping staff, those that do the cooking and cleaning, are employed by a private company contracted to provide these services to the home; the person Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 19 in charge does not therefore have full control of the staff team nor some aspects of the running of the home such the cleaning of the kitchen; preparation of menus and kitchen records; training and supervision of housekeeping staff and so on. This is a matter the Commission will keep under review. It is noted that in the feedback to the Commission residents very much appreciate the care provided by staff but they are concerned about the many temporary staff they see. The Commission was advised there are typically 50 agency staff on duty as there was on the day of inspection. Again it was noted during the visit in September 2007 that this home still regularly relies upon agency care staff. Whilst some are long term agency staff and therefore familiar with residents’ needs the residents tell us that this is not always the case – residents infer this by telling us that “the permanent staff are very good”, and asked if staff are always available they report that, “Usually, except when agency staff (are on duty), then it can be difficult”. Areas of strength are the very caring manner in which staff go about their duties and the substantial support and training provided by the LB Croydon for staff in the home but matters requiring improvement include the need for sufficient numbers of permanent staff to be employed – nevertheless the overall staffing arrangements in this home are safe and sound indicating that this section, about staffing, can be assessed as good. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37 and 38: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager has retired and after some delay a replacement is now in place to ensure that the home is managed in a way that will meet residents’ needs. It was clear that the staff team, including the senior staff are managing the home with the intentions of providing for the best interests of the residents. Record keeping is proficient and the home appeared to be safely managed. EVIDENCE: The retired manager and it was many months before she was replaced but now a new and experienced manager is in post. The Commission is aware that this is delay was due in part to the reorganisation of Croydon’s care homes under the ‘New for Old’ programme - which means managers are transferring from home to home in the transition period. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 21 In respect of the general management of the care home the introduction of private company to manage the catering and cleaning of the home, and the staff who will undertake the work, is no longer under the direct managerial control of the Registered Manager. The providers (LB Croydon) must ensure that this will not inhibit the manager from complying with National Minimum Stands and Care Home Regulations. It is the opinion of residents and visitors that this home is being run in the best interests of those services users. The home is being safely run, according to residents’ statements, by a dedicated and caring staff team. The arrangements for handling residents’ money, when handed into the office, have been checked on a number of occasions by the Commission and appear satisfactory. The home’s accounts and cash held in the home are periodically audited independently in addition to the Commission’s checks. During this inspection the manager asked for advice about residents contributing their personal allowance towards certain activities, bingo for example. Whilst clarifying those residents who have the capacity may choose to contribute it remains the case that the home is expected to provide occupation, recreation and education within the overall fee structure. Such voluntary contributions must not become an expectation as if part of the fee and the home must continue to provide an adequate level of activities whether or not residents choose to pay for ‘special’ events. A sample of records were checked including residents’ case files, staff files, menus, accident records, complaints records, visitors’ log, staff duty rosters, medication charts and so forth. Record keeping and general administration in the home is well managed, indeed residents note that, “staff are overloaded with office work”. The result is however that record keeping, such as the care plans which are an important part of their work, is well maintained. One area that does need to be clearer is the record of supervision, staff must receive one-to-one supervision at least six times each year and this level of support was not clear in all cases when we checked staff files. In respect of the health and safety of residents the home is well managed and no hazards were identified during this visit. Areas of strength are the high esteem in which residents hold the home and this indicates good day to day management of the home. Matters requiring improvement include the recommendations to monitor residents’ extra payments; ensure staff supervision is noted in their files; reduce use of agency staff whenever possible. This section, about administration and management, is assessed as good. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 22 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 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 3 X 3 3 3 3 Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 23 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 OP19 Regulation 16(2)c Requirement Timescale for action 30/03/08 1 OP19 16(2)c Furniture and fittings: The home must ensure bedroom doors have suitable and safe door locks for the privacy and comfort of residents Furniture and fittings: the home 30/12/07 must ensure furniture is mainaited in good condition for the comfort and dignity of residents 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 OP19 Good Practice Recommendations Environment: Furniture that is worn should be repaired or replaced including for example armchairs where covers are worn through. Staffing: It is recommend that sufficient permanent staff be employed to ensure continuity of care for residents. Staff checks: It is recommended that staff police checks [CRB] are updated at three-yearly intervals. 2 3 OP27 OP29 Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 24 4 OP36 Staff supervision: It is recommended that the staff files make clear when staff have received one-to-one supervision meetings, which should be no less than six times each year. Homefield House DS0000043327.V350647.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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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