Inspection on 14/11/06 for Summerfield

This inspection was carried out on 14th November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Summerfield 16/03/09

Summerfield 21/11/05

Summerfield 03/05/05

Summerfield 09/08/04

Summerfield 20/04/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Summerfield 4 Kidmore Road Caversham Heights Reading Berkshire RG4 7LU Lead Inspector Jill Chapman Unannounced Inspection 14th November 2006 09:45 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 Summerfield DS0000011115.V318134.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. Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Summerfield Address 4 Kidmore Road Caversham Heights Reading Berkshire RG4 7LU 0118 947 2164 0118 947 4972 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) Mr Colin Robbins Mrs Tracy Jane Clark Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st November 2005 Brief Description of the Service: Summerfield is situated in a pleasant residential area on the outskirts of Reading. The home is Victorian in design and is similar to other residential properties within the area. Although on a main road the house is set back from the road by a drive, which provides parking for several cars. The home is on a bus route into Reading and located within easy reach of local shops. There is a pleasantly furnished lounge on the ground floor and a dining room adjacent to the homes kitchen. To the rear of the property are well maintained an attractive gardens. The rear garden has gravel covered patio area. The fees for the home range from £475-525 per week. Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 9.45 am and was in the service for 7 hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. A tour of the building was carried out and records relating to service users care, staff systems and health and safety were sampled. The inspector spoke with some of the service users, a relative, some staff on duty, the manager and proprietor. What the service does well: The home makes sure it can meet service users need before they agree that they can come to live in the home. Care plans show staff how to meet service users needs. The home is meeting the different needs of the elderly service users and knows how to meet the needs of service users from another culture. Staff help service users to access health care and they are trained to help service users take their medication. Service users benefit from a stimulating lifestyle, they have a choice of activities and visits from relatives and friends. They can make choices in their daily routines. Service users enjoy varied and nourishing meals and special dietary or cultural needs can be met. Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 6 Service users and their relatives know how to make a complaint and staff know how to deal with complaints. Staff are trained to know how to protect service users from potential abuse. Service users live in a home that is homely, well cared for, well maintained, clean and hygenic. Service users are supported by enough staff to meet their current needs. They are given training to meet service users needs. Checks are carried out before new staff are apointed to make sure they are suitable to work with vulnerable service users. The home is well managed by a competent and qualified manager. Service users and staff feel supported by the manager and proprietor. The views of service users and their families are taken into account in developing the service. There are good systems for making sure service users health and safety is maintained. What has improved since the last inspection? What they could do better: Individual risk assessments could have more information to show staff the actual risks to the individual service user. A stock control system for medication that is only needed sometimes would help make sure this is given correctly. Advice from the Fire Safety Officer is needed on the use of a stair gate and cleaning materials should be kept locked away to make sure service users are safe. Some staff training is outstanding or needs updating to make sure that staff are well trained and are able to meet service users needs. Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 8 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 Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 ( Standard 6 does not apply to this home.) Quality in this outcome area is good. The home makes sure it can meet service users need before they agree that they can come to live in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files of 3 new service users were sampled and show that they had been fully assessed before admission. Service users said that they had received information about the home and had visited before deciding to live there. Some respite care is offered if there is a vacant bedroom and files sampled showed that these service users are also fully assessed before coming to stay in the home. Standard 6 does not apply because the home does not offer intermediate care. Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. Care plans show staff how to meet service users needs. The home is meeting the different needs of the elderly service users and knows how to meet the needs of service users from another culture. Individual risk assessments could have more information to show staff the actual risks to the individual service user. Staff help service users to access health care and they are trained to help service users take their medication. Service users know that their privacy and dignity is respected. This judgement has been made using available evidence including a visit to this service. Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 11 EVIDENCE: Care plans seen were up to date and gave staff clear guidance on how to meet service users needs. They are reviewed monthly. Staff record care information at the end of each shift and some of these records were detailed and reflected the care identified on the care plans. Others do not always reflect the good care practice that is being carried out. There are individual risk assessments in place but these need more detail to show staff the actual risks. Care plans show that that service users have differing needs associated with old age. There is evidence that the home knows how to meet the social, dietry and conversation needs of service users from another culture. Service users healthcare needs are written in care plans and health appointments are recorded. There are monitoring records kept for special health needs such as weight and nutrition. It was seen that staff monitor service users health and call the doctor when needed. Staff told those coming on duty of any current health problems for service users. It was seen that staff encouraged service users recovering from illness to get mobile again and to come down for meals. A relative praised the good care a service user received during a long illness. A service user said that staff have looked after her well after a stroke. The doctor visited during the inspection to see service users that staff were concerned about. A previous requirement for staff to sign the medication record and to record any reasons for non-administration, has been met. There is a suitable system for the safe storage of medication and staff are given training before they can give this to service users. It is recommended that a stock control system for PRN medication (Medication that is only needed sometimes) is developed. Service users and a relative said that staff protect service users privacy and dignity. This is covered in staff induction and they work with an experienced carer in the beginning who models good care practice. Medical staff see service users in their own room for privacy. Service users open their own mail and staff assist if needed. Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. Service users benefit from a stimulating lifestyle, with a choice of activities and visits from relatives and friends. Service users can make choices in their daily routines Service users enjoy varied and nourishing meals and special dietary or cultural needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a weekly activities timetable and an activity record is kept. Activities include a trolley shop, keep fit, word games, quizzes, manicures, birthday parties and teas, sherry,and recently bonfire and halloween party. Afternoon staff said they have time to spend with service users. Some service users do not like to join in activities and choice is respected. The home helps service users meet their religious needs, a monthly church service is held in the home and others go out to churches of a different denonimation. Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 13 Service users and a relative said that visitors are welcome in the home. Relatives and friends are invited to special events eg Christmas party. Service user said they can make choices in their daily routines, what to wear, when to get up and bedtimes. All service users spoken with were complimentary about the food. One said ‘there are three cooks here and they are all good’. They said they are offered a choice if they do not like what is on the menu. It was seen that staff encourage service users if they are not feeling like eating and offer suitable alternatives to try and tempt them. Staff assist service users if needed. A lunchtime meal was a sociable occasion, food was appetising, well cooked and served hot. The cooks have had training in food hygiene but some need updating. Foodstocks were plentiful, with fresh meat, vegetables and fruit. The menu is varied and special diets or cultural needs can be catered for. Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 &18. Quality in this outcome area is good. Service users and their relatives know how to make a complaint and staff know how to deal with complaints. Staff are trained to know how to protect service users from potential abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has been no information received by the Commission about any complaints made to the home by service users or their relatives. Two complaints were made to the home, one about another service user and one about a service users medication. It was seen that these complaints were dealt with appropriately within the recommended timescale and the outcomes are recorded. Service users said they know about the complaints procedure and who to talk to if they have a problem. In speaking with the manager and staff it was found that staff have received training on how to protect service users from potential abuse. This is included in induction and National Vocational Quality training. The manager said she is booking a trainer to come to the home to give more training. Summerfield DS0000011115.V318134.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Service users benefit from accommodation that is homely, well cared for, well maintained, clean and hygenic. Advice from the Fire Safety Officer is needed on the use of a stair gate and cleaning materials should be kept locked away to make sure service users are safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises showed that the home is well cared for, clean and homely. A cleaner is employed and a relative said that the home always smells fresh. The proprietor said that there is a rolling programme of replacement or refurbishment. There are new communal carpets and replacement non slip flooring in bathrooms and toilets. Bedrooms are redecorated for new service users moving in. Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 16 Bedrooms seen were well furnished and homely, service users can bring in personal possessions and an inventory is kept. The home is generally well decorated and maintained. The Proprietor, who is a quailified builder carries out some maintenance and gets other tradesmen in if the work is beyond his skills. It was noted that some woodwork in the dining room is chipped and a kitchen worktop is worn. The lounge does not have room to seat all 15 service users. At present this is not a problem because two double bedrooms are let as singles and some service users prefer to stay in their rooms during the day. The registered person needs to take this into account if planning any future alterations to the home. It was found that a stair guard is used to prevent a service users falling if they get up at night. The registered person needs to consult the Local Authority Fire Officer to see if this meets fire safety requirements. There is a good size garden, that a service user says she uses in all weather. There is a large deck area and a gazebo is used for shade in the summer . There is a laundry room with washing and drying equipment. There is no sluice facility but this is not needed at present. It is recommended that when the washing machine needs replacement or service users needs change this is replaced with one that has a disinfection/sluice facility to further improve steps to minimise cross infection. There are suitable arrangements for the prevention of infection, staff are trained in infection control and there is a clinical waste contract. Potentially hazardous cleaning materials are currently kept in open shelving outside the back door. These should be kept safely in a locked cupboard as these could present a risk to service users and visitors to the home. Summerfield DS0000011115.V318134.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is adequate. Service users are supported by enough staff to meet their current needs. Checks are carried out before new staff are apointed to make sure they are suitable to work with vulnerable service users. Staff are given training to meet service users needs but some is outstanding or needs updating. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rotas show that there are two care staff on daytime shifts plus the manager from 8am to 3pm Monday to Friday. A cook is on duty each day and a cleaner is employed. There is one waking night staff with the manager and senior carer on call to assist in an emergency. There are low care needs, and staffing levels meet curent needs. Service users and a relative were positive about the support received from staff. Staff were seen to respond quickly and to communicate well with service users. There is minimal use of agency staff. Staff spoken with were positive about working in the home, said there was good morale and good communication. Staff said that the cultural mix in the staff team is positive. A staff handover was observed where the next shift are Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 18 updated on the service users needs and there is a communication book for messages between staff. The home has a programme of NVQ (National Vocational Qualification) training in place. One staff has NVQ 3, three staff are taking this and two are due to start NVQ 2. The manager is an NVQ assessor. The home has a recruitment procedure which includes carrying out checks and references to make sure that only suitable staff are employed. Staff spoken with confirmed that the procedure had been carried out and recruitment files showed evidence of this. Staff are given contracts of employment. A requirement that all staff have manadatory training in health and safety, fire safety, manual handling , food hygiene and emergency treatments has not yet been fully met. Some training has been carried out and some is booked. Other training needs to be booked. This requirement will be raised again. Staff receive a comprehensive induction which meets National Training Organisation standards. Staff are also given training relating to the needs of elderly service users. eg Nutrition and Healthy Eating. Dementia and Palliative Care training is planned for 2007. Summerfield DS0000011115.V318134.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The home is well managed by a competent and qualified manager. Service users and staff feel supported by the manager and proprietor. The views of service users and their families are taken into account in developing the service. There are good systems for making sure service users health and safety is maintained. This judgement has been made using available evidence including a visit to this service. Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 20 EVIDENCE: The proprietor Mr Robbins is actively involved in the home, he carries out some of the routine maintenace and safety checks. Mr Robbins undertakes training to keep up to date with systems such as Fire Safety and Environmental Health issues. The manager Mrs Clark is experienced in the care of the elderly and has National Vocational Qualification Level 4 and is a qualified NVQ assessor. There is evidence that she keeps up to date with practice and is currenyly taking Healthy Eating and Infection Control Courses. There was good feedback about the management aproach in the home. Mr Robbins is regularily in the home and it was clear that he is popular with service users and staff. Management was said to be more efficient and professional since Mrs Clark has been in the home. It was said that she is respected by service users and staff and has a very nice way of sorting out problems. There is an annual system for seeking feedback from service users and their families. Residents meeting are held every three months. Service users have a review one month after coming to the home and are reviewed if their needs change. There is a system for looking after service users personal money. This was sampled and found to be accurate with receipts kept. Staff receive one to one supervision from the manager to support them in developing their care practice. Health and safety systems in the home are generally good. There is written and verbal evidence of regular maintenance checks, servicing of equipment and health and safety checks. Accident records are kept. Summerfield DS0000011115.V318134.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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP30 Regulation 18 Requirement All staff to receive mandatory training in health and safety, fire safety, manual handling, food hygiene, and emergency treatments. Outstanding timescale 01/04/06 The registered person should Consult the Local Authority Fire Officer to see if the use of a stairguard meets fire safety requirements. The registered persons should make sure that the COSHH materials are kept in a locked cupboard. Timescale for action 14/02/07 2 OP19 23(4)a 14/12/06 3 OP38 13(4)c 14/12/06 Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 23 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 OP7 Good Practice Recommendations Individual risk assessments could have more information to show staff the specific risk to the individual service user. It is recommended that a stock control system for PRN medication (Medication that is only needed sometimes) is developed. The lounge does not have space to seat all of the service users. The registered person needs to take this into account if planning any future alterations to the home. It is recommended that when the washing machine needs replacement or service users needs change this is replaced with one that has a disinfection/sluice facility. 2 OP9 3 OP19 4 OP26 Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Summerfield DS0000011115.V318134.R01.S.doc Version 5.2 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!