Inspection on 15/06/05 for The Field House

This inspection was carried out on 15th June 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Field House 02/06/08

The Field House 17/05/07

The Field House 09/05/06

The Field House 18/01/06

The Field House 13/01/05

The Field House 23/07/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Field House 110 Harborne Park Road Harborne Birmingham B17 0BS Lead Inspector Kulwant Ghuman Unannounced 15 June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Field House Address 110 Harborne Park Road, Harborne, Birmingham B17 0BS 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) 0121 426 3157 Park Houses Care Ltd Ruth Bosworth Care Home 21 Category(ies) of Old Age (21) registration, with number of places The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to accommodate 21 OP 2. That locks are fitted to the bedroom doors within three months of registration 3. That an assisted shower facility is provided on the first floor within six months of registration 4. That an assisted shower facility is provided on the second floor within 12 months of registration 5 . That a minimum of 2 care staff are on duty at all times with additional ancillary & support staff as necessary to meet the needs of the service users 6. That the manager completes the Registered Managers Award or equivalent by April 2005 Date of last inspection 13th January 2005 Brief Description of the Service: The Field house is a privately owned residential home for 21 older adults. The home is a Georgian house built in 1760 and retains some of its original features and appearance. Care facilities are provided on three floors and all areas can be serviced via a passenger lift. All rooms are for single occupancy and fourteen of these rooms have en-suite facilities. There is a split level lounge, two dining rooms, kitchen and laundry facilities on the ground floor. The home has pleasant gardens and a swimming pool in the grounds. The home has a separate hairdressing salon. The home is within a short walking distance of Harborne High Street and is on a main bus route. The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over part of a day during June 2005. This was the first of the two statutory visits for the year 2005/2006. At the time of the inspection there were 19 residents in the home, 1 in hospital and there was one vacancy. As part of the inspection the communal areas of the home were inspected, 3 bedrooms were seen, 3 residents and 2 staff files were sampled and 5 residents were spoken with. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4,5 There was information available for prospective residents about the facilities and services in the home enabling an informed decision about admission to be made. Assessments were being carried out and a good admission process had been introduced to ensure staff knew the needs of the residents and that the home was able to meet these needs. EVIDENCE: The files of 2 recent admissions to the home were sampled. There had been a thorough introduction into the home via a visit to the home, overnight stay and admission to the home on a four-week trial basis. There were contracts of residence on the files and residents spoken to confirmed that they had been given a copy of their contract. Residents were assessed by either a social worker or by staff at the home prior to their admission to the home to ensure that the home could meet their needs. The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 8 The statement of purpose and service user guide were not examined during this visit, however, the manager stated that the changes requested at the last inspection had been made. The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 The care planning system in the home was good ensuring staff knew the individual needs of the residents and how there were to be met. All residents needed to have risk assessments in place to ensure their safety and the staff needed to ensure that risk assessments and care plans were updated to reflect the current needs of the residents. Health care needs were being identified and followed up and the systems for administration of medication were good ensuring resident’s medication needs were being met. EVIDENCE: A very comprehensive assessment was carried out by the home covering all areas of daily living. A care plan was formulated from this information and instructions were provided for staff on how these needs were to be met. The manager needed to ensure that there were sufficient details to enable staff to be clear on how assistance was to be given and what tasks the residents could undertake themselves to encourage independence. Where a resident’s independence had been reduced but the overall objective was to promote independence the plan needed to be updated more frequently. Plans were reviewed on a monthly basis. Any changes in residents’ needs needed to be The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 10 reflected in the care plans straight away. have a risk assessment in place. One of the resident’s files did not There was good documented evidence of how residents’ medical needs were being met. There was evidence of visits from the GP, district nurses and of attendance at hospital appointments. Medication procedures were good and no requirements were made at this inspection. There was nothing seen during this inspection that indicated that the dignity and privacy of residents was not being safeguarded. The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 11 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 Residents were afforded a lifestyle that met their needs, maintained contact with family and friends and provided choices and nutritious food at mealtimes. EVIDENCE: Residents spoken with stated that they had flexible routines. Preferred going to bed and getting up times were recorded but flexible according to the residents’ wishes. One resident stated sometimes he got up straight after having a cup of tea but sometimes he would go back to bed. There were organised activities in the home and these were reflected in the daily records. Some residents were independent and were able to go out using either public transport or a motorised scooter. One resident was observed to set the tables for lunch. Visitors to the home stated that they were very happy with the care provided to their relative and they were able to visit when ever they wanted. They had had a previous bad experience at a home and wanted to ensure that good practice was also highlighted. They commented on the good quality of the meals provided in the home. The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 12 There was a four weekly rolling menu and each Wednesday a different resident chose a meal of their choice. On the day of the inspection it was pizza and chips, in the future rabbit had been chosen and previously there had been ox tail. There were alternatives available at all meal times. At the time of the inspectors arrival one resident was having egg and toast and another toast and tea. Special dietary needs including gluten free, diabetic and additional calorie were being provided for. A resident stated that there was fresh fruit available in the lounge at all times even though this sometimes caused problems when a resident with confusion would say that they belonged to her. The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 13 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 Residents appeared able to raise issues within the home but were not sure of where they could refer a complaint to if they did not want to raise it in house. There were procedures in place to ensure that staff were aware of their responsibilities in respect of adult protection. EVIDENCE: There had been no complaints lodged with the CSCI since the last inspection and the inspector was informed that no complaints had been made to the home directly. Two of the residents spoken with confirmed that they would have no hesitation raising issues with the manager or care staff however, they did not know who they could turn to if they did not wish to raise the issues in the home. This issue needed to be discussed with residents at a residents’ meeting. There were adult protection procedures in place and the home had been providing some training regarding adult protection including their roles and responsibilities and the adult protection procedures. The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 14 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) 19,20,21,22,23,24,25,26 The standard of the environment within this home was very good providing residents with an attractive, safe, comfortable and homely place to live. EVIDENCE: The home was generally well maintained although the wallpaper in some passageways was lifting and needed some attention. There was ample communal space for the residents and the furnishings were of a good quality. There were adequate numbers of communal toilets in the home and there were some bedrooms with an en-suite facility. Walk in shower facilities had been provided on the first and second floors of the home. The décor of these facilities was to a very high standard. The manager needed to ensure that the emergency call system was accessible from all facilities in the shower rooms. On the ground floor there was an assisted bathroom. The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 15 There were adaptations made in the home including some handrails, raised toilet seats, passenger lift and emergency call system. There were several level changes in the home including in the lounge and the passageways, which meant that the residents needed to have sufficient mobility to be able to manage the steps. The manager had made arrangements for an assessment to be carried out in the home to determine whether any further adaptations could be made to assist the residents. The home had assessed the radiators and felt that some were not a risk to the residents and had therefore these had not been covered. Not all bedrooms were inspected on this occasion. The three bedrooms sampled appeared to meet the residents’ needs. Bedroom audits had been carried out with all residents to determine what was or not needed by the resident. The home was generally very clean and there were no offensive odours noted. However in one shower room there were no paper towels. During inspection of the kitchen area it was noted that infection control procedures needed to be improved including: fridge and freezer temperatures recorded every day, bacon needed to be dated on freezing, opened packets of dried foods, for example, semolina needed to be transferred to a lidded container and staff needed to be discouraged from leaving the home through the kitchen wearing their outdoor clothes. The torn flooring by the freezer needed to be replaced The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 Staffing levels and competencies were such that the needs of the residents could be safely met. The recruitment procedures needed to ensure that CRB checks were received prior to the employment of staff so that only suitable individuals were employed at the home. EVIDENCE: Staffing levels were found to meet the requirements of the resident group with a minimum of two care staff and one manager on daytime shifts. There were two waking night staff. In addition there were two cooks on duty between 8am and 6pm and a housekeeper on duty between 9am and 3.30pm. The manager stated that she undertook the occasional care shift to enable her to understand any difficulties staff may be experiencing. Staff were receiving a number of training sessions including adult protection, moving and handling, infection control, medication, continence and a mobility and activities workshop. The majority of staff had either completed or were doing their NVQ 2 in care. Four staff were to be enrolled to undertake NVQ training. Staff had not received the induction training within 6 weeks of commencing employment. Examination of the staff files indicated that the CRB form was sent off after the member of staff had been employed at the home. There was no evidence that a POVA first check had been undertaken. The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 17 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) 31,32,33,36,37,38 The manager ensured the smooth running of the home in a competent manner. The health and safety of the residents and staff was very well managed. EVIDENCE: The home was managed and run by a manager who worked hard to ensure that the needs of the residents were paramount and that documentation required for inspection was in place and easily accessed. As stated earlier the residents appeared to have no hesitation in raising any issues with the manager and the visitors stated they were happy with the way in which the home was run. There were quality monitoring system in place however, it was noted that these were not always completed. The manager had instigated a system The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 18 whereby an unannounced assessment was carried out at the end of a shift to ensure that standards of work were as required. Supervision of staff was well managed. Health and safety was well managed in the home with only the report of the Environmental Health Officers report not available for inspection. The inspector was told that this document had been used for discussion during a supervision session with a member of staff and had not been returned to its place. The manager must ensure that the requirements of the environmental health officer are met within the timescales set down. Other issues of health and safety were in respect of infection control. The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 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 x 15 3 COMPLAINTS AND PROTECTION 2 3 2 2 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 3 3 3 x x 3 3 2 The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(1) Requirement The manager must ensure that more details are included in the care plans. Care plans must be updated as soon as a change has been identified. There must be a risk assessment on all residents files. Different avenues for the raising of complaints by residents or their representatives should be made known in the home. The toilet facililities on the first floor must be made accessible for all residents. (Previous timescale had not lapsed.) The registered person must access an assessment of the property to get advice on ways in which further adaptations could assist the residents. (Previous timescale of 1.11.04 not met.) The emergency call system must be accessible from both the shower and toilet facilities in shower rooms. Fridge and freezer temperatures to be recorded on a daily basis. Timescale for action 1.8.05 15(2)(b) 2. 3. OP7 OP16 13(4)(c) 12(1)(a) 1.8.05 1.8.05 1.9.05 4. OP21 23(2)(n) 1.10.05 5. OP22 23(2)(n) 1.9.05 6. OP22 13(6) 14.8.05 7. OP26 13(3) 15.7.05 The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 21 Paper towels to be available in all communal toilet facilities. Meats must be dated on freezing. Opened food packets must be transferred to lidded containers. Staff must not use the kitchen as an exit route. CRB clearance must be received before staff are employed. Staff must receive induction training within 6 works of commencing employment. Quality monitoring systems must be completed to enable the home to continue to monitor the serivce provided. The manager must ensure that the requirements of the environmental health officer are met within the timescales set down. The torn flooring by the freezer must be replaced. 15.7.05 15.7.05 15.7.05 15.7.05 1.8.05 1.9.05 1.9.05 8. 9. 10. OP29 OP30 OP33 19 Sch 2 (7)(a) 18(1)(c) (i) 24(1)(a) 11. OP38 13(3) 1.9.05 12. OP38 13(4)(c) 1.9.05 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 Good Practice Recommendations The Field House E54_S59651_TheFieldHouse_V233631_150605 UI stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor , Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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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