Inspection on 03/05/05 for Summerfield

This inspection was carried out on 3rd May 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

Summerfield 16/03/09

Summerfield 14/11/06

Summerfield 21/11/05

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 Debbie Willcox Unannounced 3 May 2005 @ 09:15 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Summerfield Address 4 Kidmore Road Caversham Heights Reading Berkshire RG4 7LU 0118 947 2164 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr C J Robbins Vacant Care Home 15 Category(ies) of Older Person (OP) registration, with number of places SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 09/08/04 Brief Description of the Service: Summefield 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 prarking 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 and attractive gardens. The rear garden has a gravel covered patio area. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on a weekday by one inspector lasting for approximately 6.5 hours. A tour of the home was carried out during which time some bedrooms and communal areas were seen. The majority of time during this inspection was spent talking with people resident within the home, relatives as well as time spent with the acting manager, proprietor and staff. A variety of records were seen relating to care planning and health and safety as well as time spent observing care practice. What the service does well: What has improved since the last inspection? Staff have been issued with new more comprehensive contracts and with staff handbooks, which have helped to clarify job roles and responsibilities. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 6 The Proprietor informed the inspector that requirements made by the Fire Authority have now been implemented and met. Lockable space and door keys have been provided in all rooms. There has been an improvement in the standard of Care planning documentation and recording as seen by the inspector on the day of the 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. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,4,5, Prospective service users have the information they need to make an informed choice about the home. Not everyone is provided with trial visits. Reasons for not doing so need to be documented. Service users are provided with a review before placement is confirmed. EVIDENCE: People recently admitted to the home were spoken with and files viewed. There was evidence of pre-admission assessment conducted by the home as well as the placing local authority. The homes statement of purpose and service user guide was viewed. There was evidence of these documents being made available to people moving into the home All service users spoken to said they did not have a trial visit to the home prior to moving in. The manager and proprietor said that some of those spoken to had indeed had a trial visit however this was not evidenced in documentation. Two service users had come to the home straight from hospital and a trial visit was not possible. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 9 A review is conducted at the end of 4-6 weeks trial where placement is confirmed if appropriate. The homes assessment form covers criteria within standard 3 of the national Minimum Standards. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10, Further work is needed to ensure that care plans fully reflect the care, health and social needs of individuals. Risk assessments are not always relevant to individuals and could pose a potential risk to service users if not updated. There is a need for systems to be put in place to regularly monitor staff competency in the administration and recording of medication. Failure to do so could leave service users vulnerable and at risk. EVIDENCE: Each individual service user has a care plan in place. The format for recording care needs has improved since the last inspection. However the manager recognises that there is room for further improvement to ensure that plans reflect the needs of the individual rather than compiled corporately. An attempt has been made to implement risk assessments, which is commendable. Further work is needed however to ensure that what is written relates to the individual rather than written as a corporate document relating to all. Service users weights are regularly monitored and recorded. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 11 The storage of medication, recording and the homes medication policy was viewed. Medication is administered by using the Boots monitored dosage system. There were several gaps identified on the MARR sheets used to record when medication is administered. The home does not currently have a record of when medication is returned to the pharmacy to aid in the audit of medication in and out of the home. Medication when brought into the home is recorded on the MARR sheets. The providing pharmacy regularly audits the homes medication storage, administration and recording. Staff have attending medication training however the home does not operate a system for regular competency assessment of staff. Care practice observed on the day of this inspection evidenced that staff treated service users with respect and privacy upheld when attending to personal care needs. Interactions were seen to be warm and empathic. All service users spoken to said that staff treat them well, with kindness and respect. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 The home provides meals, which are attractively presented and nutritionally balanced. Menus do not detail any alternative choice and service users are not involved in the compiling of menus, as they would like to be. This does not promote choice and independence for people living within the home. Relatives and visitors are welcomed into the home and the home endeavours to provide regular planned activities inside the home. However greater consideration needs to be given to enable people greater access to the outside community. EVIDENCE: The manager compiles a weekly list of activities taking place within the home. Service users said they found this to be very helpful especially being able to see the week at a glance. Time was spent with service users during the midday meal. All service users spoken to commented on the good quality of meals provided. The midday meal was seen to be presented in an attractive manner. However all service users spoken to on the day of the inspection did not know what was for lunch. Service users said they were not invited to be involved in the planning of menus and would like to be consulted. There is a set menu for the midday meal with no choice offered. However there was evidence from SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 13 discussions with staff and service users that if service users say they do not like something an alternative is provided. Two service users spoken to say that if they do not like something they just leave their meal without asking for an alternative. The home has a menu board downstairs informing people on a daily basis what is to be provided for the midday meal. Service users said they would like to have a weekly menu that they could view so that know in advance what is for lunch and tea. Two relatives spoken with evidenced that visitors are welcomed to the home and opportunities have been given for their involvement with activities and with giving feedback to the home regarding care received. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 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 standard(s) 16,18 The home documents complaints and takes seriously concerns and records actions taken and outcomes. The acting manager and staff have been trained in responding to abuse of vulnerable adults. EVIDENCE: The homes complaints record book was viewed. Two complaints about one staff member by other staff were inappropriately recorded within this record book and the manager was advised of this during the inspection. There was evidence that the home does take complaints from service users seriously and the outcome of complaints was recorded. The acting manager has attended training via the local authority in ‘responding to abuse of vulnerable adults’. The acting manager has cascaded this training to staff along with staff watching a video on how to recognise abuse. The home has a ‘whistle blowing’ policy which staff have received copies of. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 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 standard(s) 19,20,23,24,25,26 Summerfield is a pleasant comfortable and homely environment. However the lack of seating available within the communal lounge does prevent equal access to all people living within the home. EVIDENCE: The home has a large attractive garden, which has recently benefited from the provision of decking which has replaced gravel previously difficult for people using a walking frame or wheelchair to access. Service users said how much easier it is to get out into the garden. Two fully mobile service users said how much they enjoy a daily walk around the grounds. The proprietor informed the inspector that further paving would shortly be provided to further enhance enjoyment of the garden for people living within the home. The home is registered for 15 service users. The homes only communal lounge has 10 armchairs. This is clearly insufficient as two people living within SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 16 the home complained that they are not always able to sit in the communal lounge, as they would like to do so. It was observed that some people have difficulty getting in and out of the lounge with walking frames as sometimes tables and other peoples frames block the doorway preventing access. The lounge carpet is in need of replacement as it has become threadbare in places. The home does not have any shared rooms. Service users are encouraged to bring in their own possessions if space allows. The home was found to be clean and hygienic throughout. Several service users said how much they appreciate living within such a clean, homely environment. An assisted hoist is provided to the middle floor bathroom but not to the top floor. A walk in shower is provided on the ground floor. There is an outstanding requirement for action to be taken in response to an assessment of the premises by an occupational therapist to be provided to the CSCI. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Not assessed at this inspection. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,38 This home is run in the best interests of those that live here. EVIDENCE: Time was spent during this inspection with the acting manager. The registered manager has been on maternity leave and the home has recently been notified that she will not be returning to Summerfield. Service users and relatives spoken with were complimentary regarding the conduct and approachability of both the proprietor and acting manager. Service users said that they are consulted about changes to the home and their opinions sought. It was evident from talking with staff that supervision support is provided regularly. There was evident of staff meetings being provided but not always very well attended by staff. There was evidence of some mandatory training being provided for staff. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 19 Regular meetings are held and monthly questionnaires distributed enabling service users to air their views. Staff each time a bath is run for a service user they test the water. Thermostatic water valves are fitted to hot water outlets used by service users but are not being serviced as is required. There is no call bell in the lounge and service users were seen to ask the help of other service users when needing assistance. The home received a visit from the Berkshire Fire Officer in September 2004. A number of requirements were made during this visit. The proprietor informed the inspector that all requirements had been met and the home is waiting for the Fire Officer return visit. The home had an inspection visit from the Environmental Health Department in January 2005. Four legal requirements were made following this visit. * A Hazard analysis system to be implemented within the home. * Fly screens to be provided over the kitchen windows and door from the kitchen. * Refrigeration – Ensure that foods are arranged to prevent risk of contamination and covered. * Vegetables not to be left outside but to be stored within the building to prevent risk of access by pests. * Dried products to be stored in secure containers to prevent spillage and contamination. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 2 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 3 2 x x 3 3 3 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 Standard No 16 17 18 Score 3 x 3 3 3 3 x x x x 2 SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 9 9 Regulation 13(2) 13(2) Requirement A record to be maintained of all medication returned to the pharmacy or destroyed. Staff to sign MARR sheets at the point of administration of medication or detail reasons for non -administration of medication as guided by instructions on marr sheet. A menu to be produced for all meals provided throughout the day and made available to service users written or in other formats appropriate to suit their capacities. service Users to be consulted in the planning of menus. The Registered Person having regard to the number and needs of service users ensures that the physical design and layout of the lounge provides adequate sitting and recereational space. The communal lounge carpet to be replaced. An action plan to be sent to the CSCI detailing a response as to how the home will meet the requirements highlighted within the occupational therapists assessment of the premises. Timescale for action Immediate and ongoing Immediate and ongoing 3. 15 Schedule 4 (13) 01/07/05 4. 5. 15 20 16 23 01/07/05 01/07/05 6. 7. 20 22 23 23 01/07/05 01/07/05 SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 22 8. 9. 10. 38 38 38 13, 23 13,23 13, ORIGINAL TIMESCALE WAS 30/07/04 Thermostatic water valves to be serviced 6 monthly as required. Requirements made following Environmental Health Officer visit to be implemented. The registered person to provide appropriate nurse call communication in the communal lounge according to the assessed needs of this service user group. 01/07/05 01/07/05 01/07/05 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. Refer to Standard 9 Good Practice Recommendations Photos of service users to be provided on drug administration MARR sheets. SUMMERFIELD H51-H01 11115 Summerfield V217108 030505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale Reading RG7 4SA 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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