Inspection on 13/10/05 for Ifield Park

This inspection was carried out on 13th October 2005.

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

The inspector 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

Ifield Park 14/11/06

Ifield Park 31/05/05

Ifield Park 13/10/04

Ifield Park 25/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Ifield Park Rusper Road Ifield Crawley West Sussex RH11 0JE Lead Inspector Miss Helen Tomlinson Unannounced Inspection 13th October 2005 10.00a 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 Ifield Park DS0000014583.V251323.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. Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ifield Park Address Rusper Road Ifield Crawley West Sussex RH11 0JE 01293 594200 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) Ifield Park Housing Society Limited Mrs Janis Linda Bain Care Home 72 Category(ies) of Old age, not falling within any other category registration, with number (72) of places Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Up to 21 male and/or female service users in the Category OP requiring nursing care may be admitted/accomodated in Woodroffe Benton House. Up to 22 male and/or female service users in the category OP requiring personal care only may be admitted to Ellwood Place. Up to 29 male and/or female service users in the category OP requiring personal care only may be admitted to Penn Court. Only persons over the age of 65 years may be admitted to the home. The total number of service users to be accommodated at Ifield Park must not exceed 72. 31st May 2005 Date of last inspection Brief Description of the Service: Ifield Park is registered as a care home with nursing and is able to accommodate up to seventy-two older people, over the age of sixty-five years. Residents are accommodated in three separate buildings. These are called Woodruffe Benton, which provides nursing care, Penn Court and Ellwood Place, which provide personal care. All rooms have en-suite facilities and a variety of communal space is provided in each unit. This includes lounges, dining areas and conservatories. There is a separate building in which is located the offices and training/meeting facilities. The home is located in a quiet residential area on the outskirts of Crawley. It is situated down a private drive, away from the road. There are extensive grounds, much of which is safely accessible to residents. Car parking is available. Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The inspector arrived at the home at 10am and left at 8pm. The focus of the inspection was to monitor the requirements and recommendations made at the previous inspection, to assess the health care the residents received and to inspect against all key standards, which were not inspected at the last visit. At this inspection it was found that four of the five requirements and both of the recommendations made at the last inspection had been met. To assess the outcomes of care practices for the residents accommodated seven residents’ files were examined in detail, others were looked at for specific information. Seventeen residents, ten members of staff and four visitors were spoken with. The inspector had lunch with the residents. A tour of the premises took place and records were read. Discussions took place with the registered manager, responsible individual and the person in charge of each unit. The inspector spent time in all units of the home. What the service does well: Ifield Park is a large care home, spread over three buildings with a large number of staff employed. Despite this the managers worked well to maintain a high profile in all units and residents spoke highly of the management team, knowing they would see them frequently and be able to discuss anything with them. The individual plans of care documented for the residents contained a large amount of information about their care needs, their choices and preferences. Small things, which made a big difference to the residents’ lives, were recorded. These included not wanting to be checked by staff in the night, their feelings about care being given by males and rising and retiring times. Residents benefit from being actively consulted and included in the decisions about day-to-day life in the home, which affect them. They said they “had many opportunities to have their say” including attending meetings, informal discussions with the manager and responsible individual and being given responsibilities for gathering the views of their peers. Staff have good opportunities to complete training, which is appropriate for the work they are doing. Residents said the staff were “good at their job” and “very helpful” to them. The registered nurses had opportunities to up date their practice. Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 6 Staff talked about working very much as a team throughout all the units. There had been staff changes, with some staff moving from one unit to another, since the new responsible individual had started work. Whilst staff were still getting used to the change they said it was working well and thought it was improving things for the residents. One resident was overheard to say to a staff member “ you staff are all lovely to each other” and staff were seen to support each other, being friendly and positive when talking among themselves or with the residents. Staff were recruited in a way, which protected the vulnerable adults accommodated at the home. The management and staff were very health and safety conscious. Each unit had a health and safety representative who had completed appropriate training. All parts of the building were assessed for risks and individual risk assessments were carried out for the resident’s safety, including all activities inside and outside the home. Staff had an understanding of the need to balance this with residents being supported to take risks if they made an informed choice to do so. What has improved since the last inspection? Several residents said that things had improved with the arrival of the new responsible individual. They explained how they could talk easily with her, that she listened to them and acted upon what was said. They felt the atmosphere was open and that they were “part of what was going on.” One resident said that the “team at the top” of the registered manager and responsible individual was “working well to improve things here”. At the last inspection several residents made negative comments about the food served at the home. At this inspection, although not all residents were totally satisfied with all meals, all those spoken with said the food had improved generally and the choices were better. A more substantial supper of sandwiches or other snack is now offered at 8pm. Several residents put this improvement down to consultation with them about what they wanted. When the inspector arrived a meeting was taking place about the food. This involved a resident as a representative from each unit, the management of the home, the chef and the catering company who supply kitchen staff. A resident who attended said it was worthwhile and they liked the opportunity to discuss, at first hand, their views. A requirement at the last inspection to make sure prescribed medication was available had been met. The system had been reviewed and staff made fully aware of their individual responsibility about this. Additional charts for care assistants to complete when administering creams had been introduced. A new call bell system had been fitted in Ellwood Place. Residents said this was an improvement, but there were problems with the volume. If it was turned up so that staff could hear it in all parts of the building it was annoying to the residents. If it was turned down then staff could not hear it. A third panel had been ordered, the position of which would solve this problem. Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 7 Improvements had been made to several parts of the home, following requirements about décor and wear and tear. The carpets in Woodruffe Benton had been cleaned and were now improved, the corridor in Ellwood Place and the dining room had been decorated. The residents said this was a much needed improvement and they thought the dining room was now a nice place to eat their meals. Decoration of the corridors was underway during the inspection. The manager said the carpets would be cleaned once the decoration had been completed. The responsible individual no longer undertook the unannounced monthly visits, which are required by the Commission, when a company owns the home. These visits are now carried out by a member of the company who is not involved in the day to day running of the home, and so provide a more objective view. These visits form part of the quality assurance for the home and provide the Commission with a report, by a third party, of the residents’ satisfaction with life in the home. What they could do better: The assessments of individual resident’s health needs should be reviewed frequently to make sure the care given is adequate to meet that need. Due to this not being recorded regularly there was some conflicting information on the care plans. This could lead to a confusion of the care needed by that resident. All staff given the responsibility of completing health assessments must receive adequate training. This should include an understanding of the outcome of the assessment and the care needed as a result. All equipment used by residents must be safe. Wheelchairs must have two footplates in use and bed rails should be fitted correctly and safely with protectors in place when in use. The social life of the residents, including some information about their life before entering the home, should be included in the care plans. This should be taken into account when drawing up the social activities calendar in the home. A record of the activities which take place should be kept. This should provide an evaluation of the suitability and enjoyment of various activities. Staff should be more aware of the fire safety precautions they are responsible for in their daily work in the home. The fire exits must be kept clear, fire doors shut and combustible items correctly stored. The bedroom doors in Ellwood Place and Penn Court must be closed unless held open by a device which meets the approval of the fire service. The responsible individual confirmed to the Commission, in writing, on 17th October 2005, that the fire service had been consulted and all doors would have appropriate closures fitted. This work would be completed by 25th November 2005. A registered nurse must be on duty and in the building of Woodruffe Benton at all times. The nurse must not leave the building to attend to residents in other units, unless this leaves another registered nurse in Woodruffe Benton. Please contact the provider for advice of actions taken in response to this Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 8 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 9 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 Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 10 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): None of these standards were assessed at this inspection. Standards 3 and 4 were assessed at the last inspection and were met. EVIDENCE: Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 11 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 and 10 All residents had a plan of care documented. Assessments of health care were not always up to date or consistent with the care plan. This led to concerns about their needs being adequately met. Residents were treated with dignity and respect. Their privacy was protected. EVIDENCE: All residents had a plan of care documented. This had been drawn up from various health care assessments, including the risk of developing a pressure sore, nutritional assessments and safe moving and handling. There was a lot of detail in the plans, but some of this was not up to date and did not always meet with the health care assessments. For one resident on Woodruffe Benton the weight chart showed a loss of weight of over 9kg in 10 months. The nutritional assessment and subsequent plan of care had not been reviewed. For another the pressure area risk assessment dated 6th January 2005 showed the resident to be at high risk. This had not been reviewed. A body map chart was present for this resident which showed broken skin. This was dated November 2004 and had not been reviewed. The current situation with this resident’s pressure areas was unclear. For another resident the pressure area risk assessment recorded a very high risk whilst the moving and handling Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 12 assessment recorded a lower risk of developing pressure sores. This change could have had an effect on the resident’s care. In Ellwood Place the pressure area risk assessments were not fully completed. This affected the overall risk score allocated to the residents and, in the two care plans seen, would effect the care and equipment needed for that resident. For one resident there was particular concern as a change in behaviour and a choice to sleep in a chair could result in an increase in pressure sore development risk. This had not led to a re-assessment, a change in the plan of care or the use of additional equipment. On talking to staff they had not received adequate training to carry out these and other health assessments. It was discussed that if these were to be used on these units, then staff must receive training and recognise when to call in the district nurses. Staff on Ellwood Place said the records were completed the same on Penn Court and some shortfalls would be present. Appropriate consultation with other health professionals took place. Records showed that hospital consultants, specialist nurses and other health professionals were approached for advice when needed. Residents were assisted to attend hospital appointments. Sight, hearing and communication difficulties were recognised and appropriate assistance and equipment provided. Some residents and one visitor said they had been consulted about their plans of care. Staff said this was carried out when appropriate. A daily record of the resident’s situation was kept. It was discussed that the language in this, and the monthly review was not always appropriate. Slang words for parts of the body and records such as “not very good” to describe the residents general condition do not provide adequate or accurate information. A large number of risk assessments were carried out for the residents. These were comprehensive and covered all aspects of the resident’s life, including activities inside and out of the home. In these the resident’s ability to make an informed choice to take a risk was considered. Bed rails were in place for some residents. A risk assessment for the use of these had been completed. The bed rails for one resident were ill fitting and no protectors were in place. It was discussed that all bed rails must be checked to make sure they are fitted safely to the bed. Protectors must be in place at all times when they are in use. Two wheelchairs were seen with only one foot plate in use. All others had two in place and should have at all times. An issue of incorrect moving and handling was raised. This was carried out by a staff member from an agency. It was pleasing to note that a permanent staff member intervened to prevent possible injury to either party. This issue was brought to the attention of the registered manager. Residents said the staff treated them with respect. They said they used their preferred name, spoke politely to them and were calm and friendly in their approach. Staff were seen to talk appropriately to residents, having a laugh with them and discussing issues which showed they had an understanding of the resident’s life. Residents said the staff always closed bathroom and bedroom doors when giving help and support. That they knocked on the bedroom door before entering and waited for an answer. Those residents who Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 13 chose to spend time in their rooms and not join in so much with the life of the home said they were free to do this and were not “bothered” by the staff trying to make them be sociable. Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 14 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 and 15 A variety of activities were provided in the home. These were carried out in accordance with the wishes of the residents when consulted. There was a lack of information about the resident’s individual social life and past life before being accommodated at Ifield Park. Residents were assisted to maintain contact with friends and family. Visitors were welcomed into the home. Residents’ individual choices and preferences were explored and respected. Residents said the food and choices had improved over the past few months. EVIDENCE: A member of staff was employed as an activities co-ordinator. She had devised a programme of activities which had been drawn up following consultation with the residents. This included film afternoons, reminiscence groups, quizzes, bingo, shopping trips, arts and crafts and entertainers coming to the home. Special events such as birthdays, Easter and Christmas were catered for. A recent event which was about past trips to the seaside had taken place. This had included a visit by a donkey, which had been enjoyed by many. A minibus was available for the use of the residents. Residents spoken with said they enjoyed the activities provided. Most joined in with some things, whilst those not wishing to said they were not put under any pressure to do so. Volunteers were used in the home to assist with individual activities Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 15 and outings. A shopping trolley went to each unit on a weekly basis for residents to purchase various everyday items. It was discussed that the residents’ individual lives, before being accommodated in the home were not recorded or explored. There was a lack of information about their social history which would lead to a greater understanding of the person and their character. This was particularly important for those residents who were unable to communicate this to the staff. There was a sheet for recording the activities undertaken by each resident in their plan of care. These were not completed and for most seen the last entry was last Christmas’s pantomime. It was discussed that the system for recording this should be reviewed. Residents spoken with said they were assisted to keep in touch with relatives and friends. They said they could have visitors at any reasonable time, were assisted to go out and visit others and could see their visitors in private, or in the lounges as they wished. Community groups visited the home in accordance with the residents’ wishes. These included representatives from local churches and residents said they were assisted to attend the service should they wish. The local library brought in some books. One resident said the books were unsuitable for her and she had not been asked what kind of books the library should leave. A dog, which the residents could pet, visited the home. The choices of the residents about how to live their lives were recorded in the plans of care. These included not wishing to be disturbed at night, being cared for by a male carer, likes and dislikes of food and rising and retiring times. Staff had an understanding of the residents’ preferences and residents said the staff respected them. Residents said they could speak to the staff at any time about their lifestyle choices and did not feel restricted by the routines of the home. They could chose to join in with activities or sit in the lounge or be alone as they wished. An advocacy service was used for residents who did not have any family members or anyone else to act on their behalf. At the last inspection residents were generally unhappy about the food served in the home. Whilst some were happy with the choices of food available others were dissatisfied and felt some choices inappropriate, especially at suppertime. Since then a lot of consultation with the residents had taken place and was ongoing. Residents said the food had improved, the choices were acceptable and the quality of the meals was better. They said a late supper of sandwiches or other snack was available on request at 8pm. Whilst not all residents were totally satisfied the overall comments were favourable and pleased with the improvements, feeling listened to by the management. The meal eaten by the inspector was tasty. The dining room in Ellwood Place had been decorated providing a pleasant setting. Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 16 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): 18 Residents were protected from abuse. EVIDENCE: Staff spoken to were aware of their responsibilities to protect the vulnerable adults in their care. They had mostly received appropriate training, and attended in house workshops regarding the prevention of abuse. The correct policies and procedures were in the home and staff were aware of these and where to find them. Those staff who may be in charge of a unit had some awareness of the procedure to follow should an allegation of abuse be made to them. They were not all aware of the full procedure to take, rather would contact the manager on duty and rely on them for direction. Whilst this is the policy in the home, staff in charge should be aware of the correct procedure to follow to make sure there was no delay in protecting vulnerable people. Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 17 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): 19,22,25 and 26 Residents live in a well maintained environment. Some concerns regarding fire safety were raised. Specialist equipment was provided as required. There had been no changes to the heating system in Ellwood Place since the last inspection. Residents could not regulate the temperature in their own bedrooms. The home was clean, tidy and free from offensive odours. EVIDENCE: Since the last inspection several areas of the home had been redecorated and carpets cleaned. This had improved the overall impression of the home and it appeared well maintained. Some parts of the building are old and the problems, such as inappropriate windows and heating system, are ongoing maintenance issues. Residents said they were happy with their bedrooms and communal areas, on the whole and were pleased that maintenance work was going on. Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 18 All staff had received fire safety training, the fire alarms and other equipment was serviced and maintained and fire drills had taken place. Several issues of fire safety were raised. The bedroom doors on Penn Court and Ellwood Place did not have self-closure devices fitted. The residents and staff left them open. This issue was discussed with the responsible individual. Advice was sought from the fire service and the Commission was informed, in writing, on the 17th October that all bedroom doors, on these units, would have closure devices fitted by 25th November 2005. The bedroom doors on Woodruffe Benton had appropriate devices fitted. At lunchtime, on Woodruffe Benton, the spare dining chairs were stacked against automatic fire doors. Staff did not realise the danger in doing this. The chairs were removed to avoid this happening. Some cardboard boxes were stored in a stairwell, near a fire exit and a store cupboard door was not shut and locked, as the sign on it stated. Staff should be reminded of their responsibilities, on a day-to-day basis, for maintaining fire safety in the home. Specialist equipment to meet the needs of the residents accommodated was available. This included pressure relieving mattresses and cushions, bed rails, wheelchairs and recliner chairs, assisted baths, hoists and grab rails. Since the last inspection a new call system had been provided in Ellwood Place. This gives the residents a hand held remote call bell, which they can take to their en-suite bathroom. This system was much improved and residents said it was better than the other one when they could not reach the bells. At the time of the inspection there were some issues about the volume of the ring. This had been resolved with the introduction of an additional call box, which mean the staff could hear the bell better than currently. At the last inspection a requirement regarding the ventilation in Ellwood Place was made. At this inspection the residents become cold in the evening and wanted the heating switched on. The maintenance man had to come out to do this at the boiler. The manager said that once the heating was on the radiators could be turned on or off in the individual resident’s bedrooms. The individual radiators could not be turned up or down due to no thermostats being fitted. The responsible individual said the heating system was one of the ongoing issues on the maintenance programme. The requirement regarding the restricted openings on the windows had been addressed. Staff wore appropriate protective clothing when caring for residents. Plastic aprons and gloves were readily available. On Woodruffe Benton appropriate signage was in place to alert people to the risk of infection. Appropriate linen and clinical waste bags were used and stored correctly. Hand washbasins, pump soap and paper towels were provided. Staff spoken with were aware of their responsibilities to prevent the spread of infection. Policies and procedures were present in the home. No formal infection control training had been done. This should be provided for all staff. Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 19 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 and 29 The numbers and skill mix of staff on duty met the residents’ needs. However there were times when Woodruffe Benton did not have a registered nurse on the premises. The recruitment of staff protects the vulnerable adults in the home. EVIDENCE: The duty rota for all three units showed that adequate numbers of staff, with suitable skills and experience, were on duty at all times. The manager said that since the last inspection the use of agency staff had reduced. The home has a bank of regular casual staff who they call on to fill any gaps in the rota. Since the last inspection two full time positions had been filled. This gave an extra member of staff who could move between the units and work were they were most needed. This person would be allocated work each day, dependant on the needs of the units. When looking at the daily notes for one resident in Ellwood Place it was clear that the registered nurse, during the night, had visited this resident to give advice to the staff on duty. The nurse had completed the resident’s notes following the visit. This left Woodruffe Benton understaffed in numbers and without a registered nurse. This must not occur and all nurses must be aware that a registered nurse must be present, on Woodruffe Benton unit, at all times. The files of two staff members were examined. These contained all information needed to make sure they were fit to work with vulnerable adults. Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 20 The notes taken at interview were on file. These documented the exploration of gaps in employment which had been recorded on the application form. Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 21 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): 33,35 and 38 Residents were consulted about the day-to-day life of the home. Residents’ financial interests were safeguarded by the policies of the home. The staff and practices at the home protected the health and safety of the residents. Some issues of fire safety were raised. (see standard 19) EVIDENCE: Residents said they were consulted on the day-to-day life of the home. They felt included in decisions made about the home in general and their care in particular. They had the opportunity to attend meetings, complete questionnaires and enter into informal discussions with any staff member, including the manager. There are lots of meetings which take place in the home, to allow for consultation with the various parties to occur. These include weekly managers meetings, quarterly full staff meetings, monthly unit managers meetings, quarterly laundry staff meetings, monthly residents meetings either with or without staff and catering meetings. The manager and Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 22 responsible individual both showed a commitment to true consultation and were keen to continue improving the process in the home. Residents had been given some responsibility, where they accepted this, for consultation with other residents. Residents’ comments were that “things have improved recently and we now have our say in what goes on.” They felt sure they could talk to staff or management at any time. The manager said they did not take responsibility for any residents’ money. Whenever possible they passed this to a family member. Where this was not possible they would use the local advocacy service to assist the resident. There was a health and safety representative from each unit. They attended regular meetings and were updated as needed. Risk assessments were carried out for all parts of the care home, all activities which take place and for individual residents care and equipment. Staff received health and safety training, moving and handling training and some had first aid training. The manager was made aware that there should be a first aid trained member of staff on duty at all times. Further first aid training was booked for the near future. There were some issues of fire safety. (see standard 19 and requirement) All equipment was maintained in accordance with the manufacturers guidelines. Accident records were kept and an audit carried out which had resulted in a change of care for two residents. Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 23 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 Standard No Score 16 x 17 x 18 2 2 x x 3 x x 2 2 STAFFING Standard No Score 27 2 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 4 x 3 x x 2 Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 24 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 23(4) Requirement All fire exits must be kept clear. All fire doors must be kept closed, unless held open by a device which meets the approval of the fire service. All combustible items must be safely stored. A registered nurse must be on duty and on the premises in Woodruffe Benton at all times. Timescale for action 31/10/05 2 OP27 18(3) 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP8 OP8 OP8 OP12 Good Practice Recommendations All care assistants expected to complete health assessments should be given adequate training, including the steps to prevent deterioration. All health assessments must be reviewed frequently and the plan of care changed in accordance with this review. All equipment should be used safely. The residents’ social needs should form part of the care provided in the home. Their individual social lives and DS0000014583.V251323.R01.S.doc Version 5.0 Page 25 Ifield Park 5 6 7 OP18 OP25 OP26 history should be explored and recorded. The activities undertaken by residents should be recorded. All persons who may be in charge of a unit should be familiar with the procedures to take if an allegation of abuse takes place. Residents should be able to control the temperature in their own bedrooms. Staff should receive training in the control of infection in the care home. Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Ifield Park DS0000014583.V251323.R01.S.doc Version 5.0 Page 27 - 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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