Inspection on 03/10/06 for Homefield House Nursing Home

This inspection was carried out on 3rd October 2006.

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 Nursing Home 05/10/05

Homefield House Nursing Home 28/04/05

Homefield House Nursing Home 01/12/04

Homefield House Nursing Home 14/07/04

Homefield House Nursing Home 10/10/03

Homefield House Nursing Home 22/07/03

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

CARE HOMES FOR OLDER PEOPLE Homefield House Nursing Home Homefield Way Basingstoke Hampshire RG24 9HX Lead Inspector Tracey Box Unannounced Inspection 3rd October 2006 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 Nursing Home DS0000012132.V310190.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 Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Homefield House Nursing Home Address Homefield Way Basingstoke Hampshire RG24 9HX 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) 01256 333433 homefield-house@shaw-homes.co.uk Shaw healthcare Limited Teresa Anne Mary Packer Care Home 24 Category(ies) of Dementia (24), Mental disorder, excluding registration, with number learning disability or dementia (24) of places Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th August 2006 Brief Description of the Service: Homefield House is a registered care home providing nursing and personal care for 24 service users in the older person category. The home is situated on the outskirts of Basingstoke and has no amenities close by. Accommodation is all provided on ground level and divided into 4 units. The home has 2- shared rooms and 20 single rooms. There are a variety of aids to assist with the mobility of service users. The home has adequate communal space and enclosed gardens that are safe and accessible to service users. The service is owned by Shaw Healthcare and has a contracting arrangement with the local NHS trust. Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The people living at Homefield prefer to be referred to as residents, therefore the rest of this report will reflect this The opportunity was taken to look around the home, view records, procedures and talk with the manager, staff and a General Practitioner. The inspector also had the opportunity to observe the interaction between residents and staff and attend a fire practice. The staff on duty during this visit felt they were very supported to do their job. The manager confirmed the fees for the home are £800.00 per week. 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 Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 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 Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 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): 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home have a comprehensive pre admission assessment form which enables each resident to be fully assessed to ensure the service users needs can be fully met by the home. The home provides short term respite care to residents. EVIDENCE: The manager completes the pre admission assessments of prospective residents and for people who want respite care. The manager confirmed she is appropriately qualified to complete these assessments. The manager said the assessment forms are easy to follow and very comprehensive. The inspector looked at the most recent pre admission assessment record of a resident who was staying at the home for respite care. The manager confirmed all prospective new residents are referred to the home by local GP’s, the inspector spoke with a GP as part of this inspection, the GP confirmed the home do thorough pre admission assessments to ensure they are able to meet the individuals needs prior to them being admitted. The home provides respite care to a number of residents on a regular basis. Care plans Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 Page 8 showed that residents needs are assessed on each admission to ensure that any changes are identified and action plan put in place. The GP confirmed this. The pre admission assessment includes a moving and handling assessment. Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 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): 7,8,9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans reflect the individual’s health, personal & social needs, which ensure resident’s personal needs, are met. Residents are protected from the homes medication policies & procedures. Residents feel they are treated with dignity and respect & that they are given information to enable choice. EVIDENCE: Members of staff had a good knowledge of resident’s healthcare needs. Staff said the care plans provide them with the information they need to support the individual in their own home. Care plans were detailed and assessments included mental health profiles, nutritional assessments, the residents history, experiences, people important to the individual and things the resident likes/ doesn’t like and things that made the resident happy or upset. All care plans seen were reviewed on a monthly basis, the manager confirmed this is the case for all care plans. There was some evidence that family/ advocates are involved in the formulation of care plans as residents are unable to participate in this process Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 Page 10 due to their mental health state. The care plan for one resident who was on respite care showed that the their needs had been re-assessed. Comprehensive risk assessments were available in particular with regards to falls, manual- handling and pressure sore risks, dietary need, aggressive behaviour and individuals who require bed rails which included the risk of suffocation (these risk assessments had the residents relative’s permission.) These were also reviewed at regular intervals to reflect any changes in the needs of the residents. Staff confirmed there is always a trained nurse on duty, day and night. The trained nurse administers medication which was stored securely and MAR (medication administration record) sheets seen were up to date (and had photographs of residents attached). Trained nurses check the medication when it arrives to the home from the pharmacist, records of this was seen on the MAR sheet. Records of the disposal of medication were seen. Controlled drugs were securely stored, the nurse said two staff administer and countersign controlled drugs. Staff said they receive regular monitoring by the manager, as well as training in administration of medication. Staff induction records showed that privacy and dignity and the provision of personal care are covered during the induction process, and the response from residents indicated that the carers treat them with dignity and respect and that they are trustworthy. One resident told the inspector that staff respected their choice and privacy at all times. The inspector witnessed staff talking to residents in a respectful manner. Staff said they are aware of the importance of dignity and respect, one staff said, “ I treat people as I wish to be treated”. The manager confirmed that policies and procedures are reviewed and available for staff to access regarding resident’s health and personal care, and that residents access healthcare professionals when required. Records of doctor, chiropodist and physiotherapist visits were part of individual’s care plans. The home has a weekly surgery whereby a Doctor from the trust as part of their contract sees residents and records of these visits and any changes in treatment are maintained. Staff said that they have good relationships with the multidisciplinary team and are supported by them. Residents were appropriately dressed and appeared well cared for. It was evident from practices observed that staff and residents had good relationships. Screens were available in all shared rooms seen. Staff was observed to knock prior to entering service users’ rooms although all the service users were in the lounge. Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 Page 11 Homefield House Nursing Home DS0000012132.V310190.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents social, cultural and religious needs are met and they are able to participate in a programme of suitable activities, receive visitors as they wish and are offered a choice of nourishing well-presented meals served in a relaxed atmosphere. EVIDENCE: Staff were observed talking to residents and offering them choices and asking what they would like to do, from go for a short walk, listen to music or sit in the lounge with other residents. It was apparent residents are able to exercise choice over their daily living activities and participate in a variety of things, staff were seen spending time talking to residents. Records of individual residents attending activities are recorded in their files, this is one way the staff can see if residents are enjoying them or not. Photographs were displayed on the walls of activities that the home have arranged, which included a bar-b-q, boat trip and a visiting farm, (which included live animals!) The manager confirmed that policies and procedures are in place to ensure residents are supported to lead active lives as they prefer, care plans reflected this. Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 Page 13 The registered manager said that there were no residents from an ethnic minority at present but that if a resident had cultural or religious interests every effort would be made to accommodate them. The home has an open visiting policy. This was evidenced by records of visitors to the home and confirmed by the GP, who confirmed they visit at different times of the day and are always welcomed. The manager said the home hold a meeting for staff once every six weeks, the inspector read minutes from the previous two meetings, and issues raised are dealt with, generally relatives appeared very pleased with how their relative is cared for. The inspectors observed residents eating lunch in the dining room, the atmosphere was relaxed, residents were offered choices of main meal and desserts. Cold drinks, tea and coffee with biscuits were available throughout the day and staff are able to access the kitchen at night to provide hot drinks and snacks for residents who wish them. The cook said she uses fresh produce and is aware of individual’s dietary needs and preferences. The fridges and freezers were well stocked with produce, all foods were covered and dated. Homefield House Nursing Home DS0000012132.V310190.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The procedures for managing complaints and adult protection are satisfactory and ensure that residents are protected. EVIDENCE: Records of the home receiving one verbal concern recently had been logged appropriately and included all relevant details to show concern received had been dealt with appropriately. One staff said ‘I am aware that reporting any concerns or complaints is important to improve things, I know that I should speak with the manager, or the owner if it is about the manager. I have received training in Adult Protection issues.’ The home have included the corporate Hampshire County Council and adult protection procedure, which includes a whistle blowing policy. The manager confirmed that policies and procedures are reviewed and available for staff to access regarding complaints and protection, and that staff receive training in Adult protection, training records were available to support this. Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 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): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment provides residents with a warm and comfortable home. There is a good infection control procedure at the home to safeguard the welfare of residents. EVIDENCE: The home was warm and welcoming, all parts of the home seen ware well maintained and tastefully decorated. There was ample communal space, the home has three lounges and three dining rooms. Residents live in comfortable bedrooms. It was evident that residents are encouraged to bring in items of personal belongings. The home has an internal laundry that was well maintained. Infection control procedures were in place. Staff were observed to follow these guidance, equipment such as gloves and aprons were available and staff were using them whilst cleaning. The inspector saw certificates showing staff had received infection control training, the manager said senior staff have taken responsibility of providing infection control training to all staff. Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 Page 16 Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are appropriately trained, there is sufficient skill mix within the team to meet the residents needs. The recruitment procedure for the home ensures the vulnerable people living in the home are protected. EVIDENCE: The home has sufficient staff numbers and skill mix to meet the residents needs, staff said there is always a trained nurse on duty during the day and night. The home has a duty rota which reflects this. Staff confirmed there are enough staff on duty to meet individual’s and group needs. Staff said that moral between the staff team is very high, and they really enjoy their work. It was evident from practices and interactions observed that staff had developed good relationship between themselves and residents. The inspector examined copies of three staff recruitment records. These were all found to be in order. There was evidence that written references had been obtained, application forms had been completed and evidence of personal identification was available. Appropriate checks had been undertaken with the Criminal Records Bureau and the Protection of Vulnerable Adults register. New employment contacts had been supplied by the company to all staff. Staff confirmed they are working towards their induction and foundation standards in line with skills for care guidelines. Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 Page 18 The managers explained at present 85 of the home’s workforce have achieved an NVQ (National Vocational Qualification) level 2 or 3. Two staff are NVQ assessors and one is an internal verifier. The inspector sampled records of the fire drill log, which shows un announced fire drills occur regularly, during the inspection the fire alarm was activated by a senior member of staff. All staff responded appropriately to this un announced fire evacuation drill. Records of fire alarm and equipment tests were satisfactory. The manager explained staff have received adequate training, and four staff said they had received appropriate training to enable them to carry out their role correctly, certificates were available to show that staff have attended mandatory training in health & safety, moving & handling, first aid, fire safety and infection control, as well as specialist training in challenging behaviour, wound care, nutrition, effective communication, dementia and record keeping. Evidence of the cook receiving recent food hygiene was available. Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is managed well and run with their best interests in mind. The home’s procedure for dealing with the majority of residents’ finances is good, however the procedure needs reviewing in order to safeguard residents interests. The procedures and practices for the health and safety of residents and staff are good. EVIDENCE: The manager is registered with the CSCI as manager. The home has an internal audit system in place that seeks the views of residents, relatives and other healthcare professionals on a regular basis. Records of feedback from residents seen demonstrate that there is a high degree of satisfaction regarding the care provided. Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 Page 20 The manager conducts audits of catering, care plans, medication, infection control and the environment within the home once every four months. The provider undertakes monthly reviews of the environment, residents and staff views are sought and reports of these are available to the Commission, either when an inspector visits or they would be sent to the Commission if requested. The reporting of incidents under Regulation 37 is made to the Commission. The manager confirmed the home do not deal with any financial affairs of the residents. Staff said they feel very supported by the manager and said they receive regular structured, formal supervision, records of these were seen. On the day of the inspection the majority of staff attended a staff meeting, the staff appeared happy and interacted positively together giving the impression of a close staff team. The home has a policy, procedures and information on health and safety. A sample of policies and procedures was seen and it showed that these are reviewed regularly. All COSHH materials are maintained safely. There is an ongoing system in place that ensures that all appliances are serviced. The employer’s insurance liability certificate was displayed and current. The home had comprehensive risk assessments in place to cover the staff team, the environment in and surrounding the home and residents and staff safety. Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 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 X X 3 X X 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Homefield House Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action 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 Nursing Home DS0000012132.V310190.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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