Inspection on 27/07/05 for Homefield House

This inspection was carried out on 27th July 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Homefield House 18/09/07

Homefield House 19/10/06

Homefield House 22/11/05

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 Homefield House Old Coulsdon Surrey CR5 1ET Lead Inspector Michael Williams Unannounced 27th July 2005 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 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 G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Homefield House Address 57 Homefield Road, Old Coulsdon, Surrey, CR5 1ET Telephone number Fax number Email 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 steve_liddicott@croydon.gov.uk 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 G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31/1/05 Brief Description of the Service: 57 Homefield Road is owned, manager and staffed by the London Borough of Croydon. The home was registered with the CSCI to provide personal care and accommodation for up to thirty-nine older people. Double rooms have been converted into singles and the council plans to convert a large single bedroom into a lounge. Consequently, the home now has thirty-five places to accommodate service users. The manager informed the inspector that the Local Authority also propose to change the home’s stated purpose. It now intends providing social “re-ablement” care for an increasing number of service users as the number of permanet service users diminishes. The home also offers 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 at the front for parking. Homefield House G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key feature of this inspection was the range of service users that might be admitted to this home. Because the home offers preparation for returning home and respite care a number of residents have been admitted who appear to fall outside the home’s statement of purpose and the registration category. The management team in the home must resist pressures to admit service users inappropriately. For those appropriately placed the home offers a very good service. 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 G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Homefield House G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 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 standard(s) 3 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. However there have been instances when the assessment information is not as detailed as the home needs to judge whether or not admission would be within its registration conditions and several service users may not be appropriately placed in this particular home. EVIDENCE: A sample of case notes were checked, staff and relatives were interviewed; they and the service users 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. 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. Homefield House G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 Page 8 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 standard(s) 7 8 9 10 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: Samples of case files were checked and individual plans of care were seen to be in place for service users, including initial assessments, from which arise the action plans. These are designed to meet the specific needs of individual service users. In most instances service users’ care needs are being met - as indicated by the record of visits by health care professionals including District Nurses, General Practitioners and Opticians. But in some instances the home is somewhat out of its depth – some service users appear to have conditions such as dementia and in other instances clinical needs beyond the capacity of the home itself and somewhat stretching the resources of the local District Nurse service. A recommendation is made to sort out how Occupational Therapy or Physiotherapy will be provided when needed (NMS 22, adaptations, also applies). Medication is administered by staff but some service users such as those in the rehab’ and respite unit do hold and administer medication themselves and care staff monitor this for safety reasons. Homefield House G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 Page 9 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 standard(s) 12 13 14 15 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: A programme of activities is provided, Bingo on the day of inspection and was apparently a popular choice of service users. Whilst many service users regretted the loss of their independence and their own homes they nevertheless accepted that the care provided in this care home was most agreeable to them. Relatives were on site and confirm that they are welcomed into the home and visit when they wish. The home provides for a wide range of service user needs; the more dependent long-term residents and those recently discharged from hospital and at the other end of the scale are those service users ready to return home. For service users destined to return home the staff make sure they keep in touch with key people in their lives whilst their homes are prepared for return. This group of service users have every opportunity to make a wide range of choices about life in the home and about their return home. The chef was complimented for her cooking and the kitchen seems to be well managed although requirements are made about checking food stocks and a deep clean is needed (NMS 38, health & safety, applies). Homefield House G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 Page 10 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 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 one complaint was made and been dealt with by the home and there are no outstanding complaints. 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 well aware of their responsibilities to protect service users and report allegations of misdemeanours. Whilst no complaints were made during this inspection two suggestions were made to the CSCI, one about hearing aids and the other about improving door signs for partially sighted service users; both suggestions were passed on to the person in charge and recommendations are made to pursue these ideas (this also applies to NMS 22, aids). Homefield House G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 Page 11 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 standard(s) 19 22 26 Service users live in a safe, well-maintained and comfortable environment. It was clean and comfortably warm at the time of inspection. There was a shortage of specialist equipment, beds and pressure-relieving mattresses, and no clear access to specialists, such as Occupational Therapists, to advise on the use of such equipment for people whose needs change and progress rapidly. EVIDENCE: This is a purpose built home with a range of communal rooms and range 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 requirements are made to repair faulty temperature gauges in a bath and a freezer. This home cares for people who have recently been in hospital and are preparing to return home so their conditions change from considerable immobility and dependency to greater mobility and independence. Whilst the home is equipped with some aids to daily living it does not have specialist beds and mattresses; nor does it appear that the home is getting the technical support from Occupation Therapists and others in using such equipment as air-flow beds, walking aids and advice on suitable exercises. A requirement is made about these matters. Homefield House G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 Page 12 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 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 means that for those services users appropriately placed there needs can be met. 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 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. In other respects the training programme is very good and includes wide range of opportunities, including basic elements such as fire safety and manual handling (lifting) and important issues such as protecting elders from abuse. Homefield House G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 Page 13 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 34 35 37 38 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 person in charge advised the CSCI that a financial audit had been undertaken on 26th July and the auditors feedback was favourable, with only two maters to be followed up. The accounts for money held by the home, and LB Croydon, on behalf of service users was in order. Records examined include service users case files, accidents complaints, food and kitchen records and these were satisfactory. A requirement is made in respect of maintaining all areas of the kitchen thoroughly clean and checking food stocks use-by dates. Homefield House G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 Page 14 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 3 x x 1 x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x 3 3 x 3 2 Homefield House G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 Page 15 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 12(4)(b) Requirement Conduct of Home: It is required that the home only admit service users whose needs can be met as described in the Statement of Purpose. . Adaptations: the home must ensure that it has suitable aids and adpataions to met the needs of service users including suitable beds, mattreses and cushions. . Kitchens: It is required that the kitchen are thoroughly cleaned and food stocks use-by dates checked. . Registered Manager the retirement of the registered manager a replacement must be employed without unreasonable delay and an application for registration submitted to CSCI. . Timescale for action 30/9/05 2. 22 23(2)(n) 30/9/05 3. 38 16(2)(j) 30/9/05 4. 31 8 30/10/05 Homefield House G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 Page 16 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 22 Good Practice Recommendations Adaptations: It is recommended that the home is assessed by an Occupational Therapist (and other specialist agencies such as the RNIB/RNID) to ensure it can meet the needs of service users with mobility, visual, hearing and other specialist needs such equipment as hi-lo beds and pressuer relieving matresses. Homefield House G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection CSCI 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. Extracts may not be used or reproduced without the express permission of CSCI Homefield House G53-G53 S43327 homefield hse V178228 080805 stage 4.doc Version 1.40 Page 18 - 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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