Care Home: Eastfield Residential Home

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What the care home does well People have good, relevant care plans in place to enable staff to assist them in having their personal and health care needs well met. People have their care and health care needs well monitored. People benefit from a robust system of medication handling that enables them to receive their medicines safely and according to their needs, preferences and prescribed instructions. People are able to use a simple complaint procedure if they feel they have any concerns. People are well protected from abuse with good systems of monitoring, detection and referring of issues to the placing local authority safeguarding team. Systems are well used and prove to be effective. People and staff health, safety and welfare are well promoted and protected by good systems of maintenance checks and monitoring of health and safety within the home. What the care home could do better: People`s and staff records and documents held in the home could be made available at all times for viewing or referring to as necessary. People could be listened to more and have their views and wishes respected more, so they do not feel they are being dismissed some of the time. Best interest or multi-agency meetings could be held to determine people`s wishes about their lives and choices. Random inspection report Care homes for adults (18-65 years) Name: Address: Eastfield Residential Home Wawne Road Eastfield Residential Home Hull East Yorkshire HU7 5YS three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Janet Lamb Date: 1 5 0 4 2 0 1 0 Information about the care home Name of care home: Address: Eastfield Residential Home Wawne Road Eastfield Residential Home Hull East Yorkshire HU7 5YS 01482838333 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Jane Fenton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Eastfield Residential Home Limited care home 21 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Conditions of registration: 21 The maximum number of service users who can be accommodated is: 21 The registered person may provide the following category of service only: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Mental Disorder, excluding learning disability or dementia, Code MD Date of last inspection Brief description of the care home Eastfield Residential Home lies to the north of the City of Hull, near to Wawne village. The home is positioned in its own grounds just off the main road on a main bus route Care Homes for Adults (18-65 years) Page 2 of 9 Brief description of the care home leading to the nearby Bransholme shopping centre. Hull City centre is approximately eight miles away. Eastfield is a family run home and the registered provider is also the registered manager. It is registered as a care home providing accommodation and personal care to 21 people who have enduring mental health problems. An extension completed in the last three years, adding a further six single bedrooms and reducing the number of double rooms to three, creating a small communal lounge, bathroom/shower room and a drinks making area, has enhanced the environmental facilities. In the original part of the building there are three lounges, a designated smoking and a dining room, an office, kitchen, laundry, toilets and bathrooms and the majority of the bedrooms. On the first floor there is one bedroom for shared occupancy, which has an en-suite facility. Access to the first floor is by means of a staircase. New people to the home are given a service user guide explaining what service the home will provide. The weekly fees range between £829.50 and £1056.00, this information was provided by the deputy during the inspection visit. Additional charges are made for hairdressing, magazines, some toiletries and some transport. Care Homes for Adults (18-65 years) Page 3 of 9 What we found: We viewed case files for three people with their permission and all had copies of care plans which included information covered in assessments and action plans to meet them. Care plans hold information on personal care if identified as a need and if necessary and they only contain information that is pertinent to the persons assessed needs, though they do follow the same format in respect of they show dates, problems or needs, goals, actions and review dates. For one person the areas that are covered are personal hygiene, drinking alcohol, going missing, keeping self safe and socialisation and motivation, while for another they are personal care, eating well, anxiety, and needing to put on weight, and for a third and a fourth person they are issues relating to medical conditions. All care plans are very personalised. Care plans may be less specific about such as the times people get up or go to bed but they certainly state the importance of why someone should not be allowed to stay in bed all day, or should be encouraged to bed at a reasonable time and so on. Evidence recorded in diary notes shows any guidance given for such as personal care, hygiene etc., where people mainly need prompting. A recommendation was made at the last key inspection for people to have more than one rostered bath per week. Discussion with the deputy and viewing of bath records shows people now have a minimum of two planned baths per week and that people can have more if they request it. People spoken to made no adverse comments about their personal care needs not being met. Healthcare issues also appear in case files, care plans and diary notes. Three people had health conditions mentioned, while others had minor ailments noted as addressed and treated. Everyone is weighed on a weekly basis and this was observed taking place during the visit. Everyone has access to a GP, a district nurse or a community psychiatric nurse, as necessary and records are held of such as routine breast, prostate and cervical screening, of GP and hospital visits, of MIND and AA visits and so on. There are also such as bathing records and so on. There is a policy on handling medication and on self-medication. The home now uses the Lloyds Pharmacy blister pack monitored dosage system. Those staff giving out medications, seven in number, are trained in the Hull City Council medications administration course, though this could not be confirmed as training records were not available for viewing. The access to all records and information on people and staff is an issue for future consideration, so that any senior staff is able to produce the necessary information requested, in the absence of the manager. A requirement is being made to ensure this. Staff are also given instructions in their induction about medication responsibilities. There are medication administration record sheets in place, which are usually completed properly. There is a returns booklet used and signed for any unused medication that shows the persons name, a date, the drug name, and whether or not any items are from a medication fridge. One person currently takes a controlled drug and the controlled drug register shows how many are given, two staff signatures, the date and time drugs were administered and a running balance of stock. Care Homes for Adults (18-65 years) Page 4 of 9 There are some medicines that are not put into the blister pack monitored dosage system and they are kept separately in their boxes and foils in the drugs trolley. The practice of handing out medicines follows a written procedure and involves identifying the person and the drug, handing it over with water and waiting for the person to take it, and then signing of the medication administration record sheet. People spoken to say they do not self-medicate and are happy for staff to control the taking of it. Any returns are properly dealt with, listed and signed for upon collection. There is a complaint policy and procedure for staff to follow and a complaint record is maintained, though again this record could not be viewed. People spoken with say they know who to complain to and do speak to the staff regularly if they have issues. From conversations with people there seems to be a view that some staff do not always take peoples enquiries and wishes seriously as people say they sometimes feel that whatever they want to happen is often dismissed by staff. Examples of this were of wishing to occasionally have a longer period in bed in the morning, or wishing to be left alone in ones room for a time during the day. People feel they always have to conform to the routines set within the home. Another example was of one person wanting to move from the home. These wishes need to be looked at and addressed properly using a multiagency approach so people have the best opportunities for determining their own lifestyles. A recommendation is being made to ensure this happens. There is a safeguarding policy and procedure in place and the home has a copy of the local area safeguarding adults procedure. There is a record of safeguarding referrals made to the local authority, but details of these were also locked away and could not be viewed. There has been one referral to Hull City Council in last few months, relating to a staffing grievance and also to care practices. The outcome of this referral is that there is no safeguarding situation to pursue, but information has been passed to Hull City Council Care Management Teams for them to monitor care practices and to make sure care plans are being followed. The manager explains that visits to the home have been made and that care management staff and care coordinators have investigated. Evidence in diary notes and from what people say shows there are no concerns and all allegations made are not founded. There is a Health & Safety policy statement in place, there are maintenance certificates and service safety records of checks - some available, some not. In sampling a selection of maintenance checks and certificates we were unable to see gas, electrical, legionella and fire safety system certificates, as these were also unavailable, so we requested they be faxed to us as soon as possible. Evidence was seen that a well known and respected electrical company serviced the fire system in June 2008, but we needed a more up to date certificate of maintenance. A call was made to the manager on 26/04/10 to ask that these unavailable certificates be faxed to us as soon as possible. These were received a few days later and a current Landlords gas safety certificate dated 12/10/09, an extinguisher service certificated dated March 2010, an electrical installations certificate dated 11/09/08, emergency light check made in May 2009, a portable appliance test done 01/03/10 and evidence of compliance with the Water Supply (Water Fittings) Reg 1999 dated 27/01/10, were all confirmed. We saw a record of monthly fire safety checks on the system carried out in-house, and of Care Homes for Adults (18-65 years) Page 5 of 9 six weekly drills held at the same time as each staff meeting. There is a fire risk assessment document in place completed 2004 and reviewed on 16/03/10. There is no passenger lift and no lifting hoist in use so no mechanical equipment needs to be serviced. Water outlet temperature checks are carried out and recorded weekly for bathrooms. Accident records are data protection compliant and held in a confidential file. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 9 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 41 17 The registered provider must 28/05/2010 make sure all records relating to people and staff in the home are available for viewing as necessary. So people are confident the systems to protect them can be monitored and checked for efficiency at any time. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 18 The registered provider should make sure people are listened to more and have their views and preferences respected more, so they are confident their needs are met how they wish them to be. Care Homes for Adults (18-65 years) Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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