Inspection on 22/11/05 for Homefield House

This inspection was carried out on 22nd November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Homefield House 18/09/07

Homefield House 19/10/06

Homefield House 27/07/05

Homefield House 31/01/05

Homefield House 26/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Homefield House 57 Homefield Road Old Coulsdon Surrey CR5 1ET Lead Inspector Michael Williams Unannounced Inspection 22nd November 2005 10:30 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.V267675.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. Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 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 Mrs Janet Staton Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th July 2005 Brief Description of the Service: Homefield House is owned, managed and staffed 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, or rehabilitation, for an increasing number of service users as the number of permanent service users 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. Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was focused on outstanding key standards and requirements that arose from the previous inspection in July 2005. A key feature of the earlier inspection was the range of service users that might be admitted to this home and the acting manager confirmed that the home now offers intermediate care with the support of health care team that includes Occupational Therapists, Physiotherapists and District Nurses who attend the home each day. Because the home offers preparation for returning home and respite care a number of residents were being admitted who appeared to fall outside the home’s statement of purpose and the registration category. The home now is clearer about what range of service users will be admitted in future. On this occasion the person in charge was invited to comment upon issues of equality; the home employs staff from a variety of backgrounds whilst most service users are from the indigenous population and their cultural, religious, dietary and other specific needs can be met. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 36 Social care and health care needs are assessed prior to admission, these needs are then translated into care plans and are reviewed and revised periodically. This ensures that service users will know that staff in the home will be able to meet their changing needs. The home also has in place arrangements to provide intermediate care and these service users 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. The person in charge, some staff and relatives were interviewed during the course of this and the previous inspection; they and the service users themselves advised the inspector of their experiences at the time of admission. The pre-admission assessments include general information about each service user, details of their background medical and social history and comprehensive details of specific issues such as mobility nutrition, diabetes, continence, medication and so forth. Service users, with their representatives, assist in the compilation of these case notes. Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 8 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 service users with nursing care needs that cannot be met by a visit once each day by a District Nurse. Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Care Plans are in place for each service user. This means that, so long as the placement was appropriate, the needs of service users can be met. Medication can either be administered by the care staff or they will support service users to hold and administer their own medication in order to maximise their independence. Service users are treated with respect and dignity. EVIDENCE: These standards were not revaluated on this occasion. In the previous inspection one service user appeared out of category but has since been discharged so all key standards in this section have been met this year. Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 10 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): The home provides a comfortable setting for service users to engage in social and cultural activities as they choose and in accordance with their expectations for the home. The staff assist and encourage service users to lead as fulfilled lives as they wish or their frailty allows. Service users 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 service users. EVIDENCE: Standards in this section met in the previous inspection and not reassessed on this occasion. Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 11 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 Arrangements are in place for service users 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 service users. EVIDENCE: Service users confirm that with these arrangements in place they are confident their opinions and concerns are dealt with in a professional and thoughtful manner. A record of complaints is in place and shows that no complaints have been made since the previous inspection in July 2005. No complaints arose during the course of the inspection. In contrast several complimentary comments were made by those people interviewed. The home has a 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 service users and report allegations of misdemeanours. Whilst no complaints were made during this inspection or the previous inspection two suggestions were made to the CSCI, one was about hearing aids and the other was about improving door signs for partially sighted service users. Both suggestions were passed on to the person in charge and recommendations were made to pursue these ideas and on this occasion the person in charge confirmed that these two suggestions have been followed up. Doors signs have been improved and staff are undergoing training to support service users with sight or hearing difficulties. Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 26 Service users 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 home with a wide range of communal rooms and 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 requirement is made to provide an action plan to deal with leaks and a damp area near service pipes. Some furniture was also old and worn and must be repaired or replaced, dining tables for example where the surface laminate is lifting. 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 service users. Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 13 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 Care staff and ancillary staff were present in sufficient numbers and with the skill mix to meet service users’ needs on the day of inspection. A training programme is place and this provides a comprehensive schedule of induction and ongoing training for all staff. This ensures that service users’ needs can be met in a safe and well run home. Whilst the recruitment of staff is basically sound the home could not demonstrate that all checks have been made with the potential to compromise service users’ well being. EVIDENCE: Staffing levels for existing care homes must be no less than the guidance issued by the previous regulating body and that was the case on the day of the visit (guidance is that there be, as a minimum, 13 day-care hours per resident per week - a total of 455 day care hours; the equivalent of four carers for each day time shift). The home is 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 training programme is very good and includes a wide range of opportunities, including basic elements such as fire safety and moving and handling (lifting) and important issues such as protecting elders from abuse. During the examination of staff records it was apparent that not all checks (made by the local authority’s personnel department) were confirmed in the documentation held in the home. So, for example, not all files had evidence of CRB (police) checks and there were incomplete application forms so that it was not clear if a full work history was given. A requirement is made to ensure staff files contain details listed in Schedules 2 and 4 of the Care Home Regulations as amended. Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 14 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 The registered manager has retired so a replacement is required as soon as practicable if the home is to be managed in a way that will meet service users’ 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 service users. EVIDENCE: The key standards in this section were assessed in the previous inspection and confirmed as satisfactory with the exception of the need to register (with the CSCI) a manager and this requirement is reissued on this occasion. No failures in health and safety were identified in this inspection. Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 15 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X 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 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X 3 Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 16 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 OP31 Regulation 8 Requirement Registered Manager: following the retirement of the registered manager a replacement must be employed without unreasonable delay and an application for registration submitted to CSCI. This is an outstanding requirement from 30/10/05. Environment: An action plan is to be supplied to the CSCI for the repair of leaks and damage to walls in the area of pipe-work and services on the ground floor. Environment: Furniture that is worn must be repaired or replaced including for example dining tables where the laminate is worn away. Staff: Staff files must contain all the information listed in Schedules 2 and 4 of the Care Home Regulations as amended. Timescale for action 30/03/06 2 OP19 23(2)b 28/02/06 3. OP19 23(2)b 30/05/06 4. OP29 19 28/02/06 Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 17 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Homefield House DS0000043327.V267675.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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