Care Home: Field View

Similar services:

• Snydale Care Home
• Abbey The
• Hawkhills
• Larchfield Manor
• Beeches The - North Yorkshire County Council
• Carentan House
• Ravensworth Lodge

What the care home does well They had manager who had worked at the home for ten years, who had a good knowledge of the needs of people and was committed to providing a good quality service. She received good support from the company. There was a warm and welcoming atmosphere and people were comfortable to give their opinion of the service. The majority of people I spoke with said their needs were met and they were happy with the care offered to them. People said they had sufficient information made available to them to assist them in choosing the home. On the whole, people told me they were treated with respect and dignity and their right to privacy upheld. When I spoke to people they described how on the whole, they were helped to exercise choice and control over their lives and how the lifestyle within the home met their preferences, interests and needs. People were encouraged and assisted to maintain contact with their family, friends and the local community as they wished. There was a pleasant dining area and all the people I spoke to were satisfied with the choice and quality of food offered commenting, `it`s good`, `it`s substantial` and `there`s a good variety`. One person said, "What I like is the way that it is served". On the whole, when I spoke to people they didn`t have any `complaints` or `grumbles` and were confident that any complaints they had would be listened to. Staff had a good understanding of the procedures to be followed should they suspect any abuse. Generally, the building and its environment were clean and well maintained and when I spoke to people they found the home comfortable and to their satisfaction. In general staff were trained, skilled and in sufficient numbers to support people and maintain the smooth running of the service. Their comments included, "they come and look after you straight away, generally", "they`re caring", "they`re marvellous", "they`re approachable", "they`re kind" and "it`s service with a capital S". Systems were in place to safeguard peoples` financial interests. What has improved since the last inspection? Medication was not left on tables waiting for people to take them, which meant the risk of people taking the wrong medication had been reduced. Medication was not being handled with bare hands, which was more hygienic and reduced the risk of this affecting the effectiveness of the medication. The dates on the medication administration record corresponded to the actual date the medication was administered. This made it clear when this was and reduced the risk of errors. The change of use of the staff room to an office for staff, enabled the handover diary and medication administration records to be securely stored.The recruitment process included the application form requesting a full employment history and a Criminal Record Bureau (CRB) or a Protection of Vulnerable Adults (POVA) first check had been obtained prior to staff commencing employment. On the whole, there was documentary evidence of relevant qualifications and training that staff had attended on their training and development file. To ensure there were carers who are competent and adequately trained the minimum ratio of 50% of care staff being trained to NVQ Level 2 in Care or equivalent had been achieved. The quality assurance process had been significantly improved. It now included consultation with people and other stakeholders of the service to find out what their views were on the quality of the service provided. This meant the company were able to take action to improve peoples` lives as a result of these consultations. What the care home could do better: For the person`s file to demonstrate terms and conditions have been given to them, including a signature by the person or their advocate to confirm they agree with them. Thoroughly complete the assessment documentation to be clear that the service is able to meet peoples` needs. Make sure that the plan of care is always followed so that peoples` health and personal care needs are met. In addition, that information recorded in the plan of care is monitored so that the health care needs of people are maintained. Get the member of staff to sign the medication record for the administration of medication after the medication has been administered to the person. This will mean the record does not need amending if the person refuses their medication. To help people swallow their medication, offer them a glass of water when they are given their medication. Get staff to sign the controlled drugs register to verify the receipt of that medication. Audit training records to make sure all staff have received training or are on the training programme for the safeguarding of adults. This ensures people using the service can be assured staff would report any abuse that was reported or that they were aware of, in order to safeguard people. CARE HOMES FOR OLDER PEOPLE Field View Spark Lane Mapplewell Barnsley South Yorkshire S75 6BN Lead Inspector Mrs Jayne White Key Unannounced Inspection 5th December 2007 09:00 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 Field View DS0000018253.V337372.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. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Field View Address Spark Lane Mapplewell Barnsley South Yorkshire S75 6BN 01226 390131 01226 388322 field.view@fshc.co.uk None Chapelfield View Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Mrs Lynne Simms Care Home 40 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) Category(ies) of Old age, not falling within any other category registration, with number (40) of places Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st August 2006 Brief Description of the Service: Field View is registered as a care home providing personal care and accommodation for 40 older people. There are 28 single and six double rooms. The home has provision for permanent and short stay people. Accommodation is over two floors. There is a passenger lift and stairs to access bedrooms on the first floor. There are car-parking facilities. The garden areas are well maintained. They are mainly lawned with garden furniture. There is a range of communal areas including three lounges and a dining room. A commercial type kitchen and laundry serve the home. Sufficient bathing facilities are provided. The home shares the site with another home, also owned by the same company. Field View is located in the centre of Mapplewell Village and is within easy access to shops, the local post office, pubs, clubs and places of worship. Information about the home, including the service user guide is available in the entrance hall. This includes the most current Commission for Social Care Inspection (CSCI) report about the service. The manager said the fees ranged from £341.50 to £415.00. Additional charges are made for hairdressing and private chiropody. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. I visited the home on 5th December 2007 between 9:00 am and 5:00 pm without giving them any notice. Before the visit I took into consideration other information I had received. This included: • An Annual Quality Assurance Assessment (AQAA). An AQAA is a document completed by providers. It gives them the opportunity to tell the CSCI how well they think they are meeting the needs of people using their service. Information contained in notifications from the home about any deaths, illnesses and other events, which affect the health and well-being of people living there. Surveys that were sent to a range of people, asking them about the home. Three came back from people that lived there, four from relatives of people that lived there and two from health care professionals. • • During the visit I spoke with people that lived there, staff, the manager, the area manager, looked round parts of the building and read some records. I would like to thank the people, staff and the area and home manager for their time and co-operation throughout the inspection process. CSCI have reviewed their guidance on requirements, therefore, some requirements have been removed if they would have no direct affect on the outcome of the service provided for people. What the service does well: They had manager who had worked at the home for ten years, who had a good knowledge of the needs of people and was committed to providing a good quality service. She received good support from the company. There was a warm and welcoming atmosphere and people were comfortable to give their opinion of the service. The majority of people I spoke with said their needs were met and they were happy with the care offered to them. People said they had sufficient information made available to them to assist them in choosing the home. On the whole, people told me they were treated with respect and dignity and their right to privacy upheld. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 6 When I spoke to people they described how on the whole, they were helped to exercise choice and control over their lives and how the lifestyle within the home met their preferences, interests and needs. People were encouraged and assisted to maintain contact with their family, friends and the local community as they wished. There was a pleasant dining area and all the people I spoke to were satisfied with the choice and quality of food offered commenting, ‘it’s good’, ‘it’s substantial’ and ‘there’s a good variety’. One person said, “What I like is the way that it is served”. On the whole, when I spoke to people they didn’t have any ‘complaints’ or ‘grumbles’ and were confident that any complaints they had would be listened to. Staff had a good understanding of the procedures to be followed should they suspect any abuse. Generally, the building and its environment were clean and well maintained and when I spoke to people they found the home comfortable and to their satisfaction. In general staff were trained, skilled and in sufficient numbers to support people and maintain the smooth running of the service. Their comments included, “they come and look after you straight away, generally”, “they’re caring”, “they’re marvellous”, “they’re approachable”, “they’re kind” and “it’s service with a capital S”. Systems were in place to safeguard peoples’ financial interests. What has improved since the last inspection? Medication was not left on tables waiting for people to take them, which meant the risk of people taking the wrong medication had been reduced. Medication was not being handled with bare hands, which was more hygienic and reduced the risk of this affecting the effectiveness of the medication. The dates on the medication administration record corresponded to the actual date the medication was administered. This made it clear when this was and reduced the risk of errors. The change of use of the staff room to an office for staff, enabled the handover diary and medication administration records to be securely stored. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 7 The recruitment process included the application form requesting a full employment history and a Criminal Record Bureau (CRB) or a Protection of Vulnerable Adults (POVA) first check had been obtained prior to staff commencing employment. On the whole, there was documentary evidence of relevant qualifications and training that staff had attended on their training and development file. To ensure there were carers who are competent and adequately trained the minimum ratio of 50 of care staff being trained to NVQ Level 2 in Care or equivalent had been achieved. The quality assurance process had been significantly improved. It now included consultation with people and other stakeholders of the service to find out what their views were on the quality of the service provided. This meant the company were able to take action to improve peoples’ lives as a result of these consultations. What they could do better: For the person’s file to demonstrate terms and conditions have been given to them, including a signature by the person or their advocate to confirm they agree with them. Thoroughly complete the assessment documentation to be clear that the service is able to meet peoples’ needs. Make sure that the plan of care is always followed so that peoples’ health and personal care needs are met. In addition, that information recorded in the plan of care is monitored so that the health care needs of people are maintained. Get the member of staff to sign the medication record for the administration of medication after the medication has been administered to the person. This will mean the record does not need amending if the person refuses their medication. To help people swallow their medication, offer them a glass of water when they are given their medication. Get staff to sign the controlled drugs register to verify the receipt of that medication. Audit training records to make sure all staff have received training or are on the training programme for the safeguarding of adults. This ensures people using the service can be assured staff would report any abuse that was reported or that they were aware of, in order to safeguard people. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 8 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. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The outcomes for standards 2 and 3 were inspected. The home did not provide an intermediate care service. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People had information available to assist them in choosing the home. The assessment documentation needed completing fully to be clear that the service was able to meet peoples’ needs. EVIDENCE: Surveys received indicated people received enough information about the home before making a decision to move there. One comment from the survey was “we had two weeks to find a care home for our relative because they were in hospital. I have to say we chose well. My relative is very happy here”. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 11 When I spoke to some people they couldn’t remember looking round the home themselves, but said their family would have looked round. Some knew their family had looked round and they all said ‘they had chosen well’. The AQAA stated people received a contract, which informed the person or their advocate about the service they will receive. I looked at four files for verification that the person had received a contract. For two people who had lived there for some time a contract was in place. For the most recent admission, there wasn’t a contract. For a person on respite care the details in the contract had been completed, but neither party had signed it. To ensure that race, gender identity, disability, sexual orientation, age, religion and belief are promoted and incorporated into what the service does the AQAA stated: • A comprehensive pre-admission assessment is completed • A more comprehensive assessment has been introduced • A full assessment is undertaken prior to admission following Four Seasons Health Care policies and the National Minimum Standards Guidelines so that the service only accepts residents whose needs can be fully met. I looked at two peoples’ files for the assessment that was undertaken. One contained an assessment that gave detailed information. However, the outcome of the assessment was that the person needed nursing care. I spoke with the area and home manager who said the home could meet the person’s needs. I discussed with them that further information should be available to verify this and consideration given to the scoring in the assessment procedure. In the other file, there were gaps in the assessment in regard to the person’s mental health and well-being, including their capacity. Information received since the person’s admission were instructions about decision making for the person at the request of the family. This again was discussed with the area and home manager, in particular, the consideration of the Mental Capacity Act 2005. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 12 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): The outcomes for 7, 8, 9 and 10 were inspected. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. On the whole, the health and personal care that people received was based on their individual needs. The principles of respect, dignity and privacy were put into practice. EVIDENCE: Surveys returned by people identified they always or usually received the care and medical support they needed. The surveys from relatives identified they also felt the care needs of their relatives were always or usually met. In addition, surveys from health professionals said the service always or usually seeks advice and acts upon it to manage and improve individuals’ Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 13 health care needs. Also, that the health care needs of people are usually met by the care service. When I spoke to people they described how they had access to health care services to promote and maintain their health care needs, for example, going to the GP’s to monitor their dosage of medication and going to hospital as a result of their deteriorating conditions. The majority of people said that they felt well cared for, staff treated them with respect and they were able to spend time in their room if they wished. I looked at four care plans. The plans contained some good information, including records of medical treatment and risk assessments for mobility and falls, nutritional screening and pressure areas. One of the plans included a record in respect of further medical treatment that was required. There was no further entries to identify this had taken place, which indicated the person’s health care may not be being monitored. In another record, the plan told me the person had to be weighed monthly, but records told me the person had not been weighed for 5 months. When I spoke to the area and home manager they said it was company policy to weigh people at least monthly. People or their representatives had been involved in their plan of care, where this was possible. This gave them the opportunity to discuss with the staff how their care needs could be met. When I spoke with staff they were aware of the need to treat people with respect and to consider dignity when delivering personal care. Examples given were knocking on peoples’ doors before entering, closing toilet doors when in use and putting the ‘care in progress’ signs on bedroom doors when delivering personal care. I saw staff approaching people in a respectful manner and respecting individual preferences. There were good relationships between people and staff. People were able to enjoy the privacy of their own rooms if they wished. On the whole, people were well dressed. They were clean, as was their hair and nails. This confirmed staff were maintaining respect and dignity for them. The AQAA stated: • All senior staff have attended medication training delivered by Boots the Chemist • Annual assessments of competence are performed regarding the administration of medication • Medication audits are undertaken monthly Senior care staff administered medication. I saw the administration of medication. The medication was placed in individual medication pots, but the Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 14 medication administration record was signed as administered prior to giving the medication to people. This is not good practice as the person could refuse their medication and then the record would be incorrect. The company’s policy/procedure confirmed the medication administration record should be signed after the medication has been given to the person. People were not given a glass of water when they were given their medication. To help people swallow their medication it is good practice that a glass of water is offered. I looked at the recording and storage of medication on a sample basis. On the whole, medication received was clearly recorded on the person’s medication administration record and medication administered had been signed for. However, for controlled medication, staff had not signed the controlled drugs register to confirm receipt of the medication. Medicines were securely stored. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 15 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): The outcomes for standards 12, 13, 14 and 15 were inspected. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. On the whole, people were assisted to make choices and decisions about their life style and the social and recreational activities available met people’s expectations. EVIDENCE: The AQAA stated the service: • Supports residents to choose their preferred lifestyle and social activities • To keep in touch with family and friends and support residents to visit their family in the community • Welcome families for meals • Provide social, cultural and recreational activities to meet residents needs both within the home and the local community • Improved social care plans • Provide lots of community based activities • Have themed activities, for example valentines day, Easter • Have open visiting • Hold individualised parties Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 16 As a result of listening to people the AQAA stated: • Calendars are displayed for orientation purposes • Training sessions have been conducted around person centred care for activity co-ordinators • Regional group sessions have been held to improve activities • A varied programme of activities has been introduced Improvements planned for the next 12 months include creating a family/visitor room and monthly newsletter. The surveys returned by people contained a mixed response about their daily life and social activities. They said they sometimes made decisions about what to do each day and there is always or usually activities arranged by the home that they can take part in. One person commented, “within the confines of the home I can watch sport in my room etc or sit in the garden etc”. When I spoke to people the majority told me that because they were getting older they weren’t interested in having a lot to do. They said they were happy doing what they did. They described this as sitting and chatting to people who sat by them, people watching, watching TV and going out sometimes. They said they had been out the day before for their Christmas dinner. There was a lot of chatter about this and all that went clearly enjoyed it. One person commented, “we went out for Christmas dinner, but it’s just as good here”. They said they could get up and go to bed as they wished and do what they wanted, within reason. During the visit I saw people that were able, spending the day as they wished, following their preferred routines. I saw people spending time in the lounges, whilst others chose to spend their time in the privacy of their bedroom. The day and date was displayed in large print in the dining room so that people were kept informed of this where their memory may be diminishing. The major activity on the visit was putting up the Christmas decorations. People were encouraged to choose colour schemes and take part in putting up the Christmas tree and arranging the Christmas tree corner. People were admiring this as I left and it would be a welcoming feature for people visiting the home. The manager said a carer was employed to provide activities for people, but they are currently advertising for a new activity co-ordinator. When I spoke to people they said their family and friends could visit “at any time”. Surveys returned by relatives stated the service always or usually helped their relative to keep in touch with them. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 17 The AQAA stated: • The service provides a healthy, varied diet according to the residents assessed requirements and choice • Dining area has been redecorated Improvements planned for the next 12 months include the chef undertaking Level 2 in Food Hygiene. As a result of listening to people AQAA stated: • Menus have been reviewed Surveys from people indicated they always or usually enjoyed the meals at the home. One said, “I enjoy my meals very much”. When I spoke to people they were all satisfied with the choice and quality of food offered commenting, ‘it’s good’, ‘it’s substantial’ and ‘there’s a good variety’. One person said, “what I like is the way that it is served”. The dining room was clean and bright making a welcoming environment for people to eat their meals. I saw the breakfast and lunchtime meal being served. People were given sufficient time to eat and it was an enjoyable experience for people. There was a lot of conversation between people and staff. Staff were courteous and respectful to people when they served their meals, asking them what they would like to eat and if they would like some more. I saw carers assisting people who needed help to eat in an appropriate manner. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 18 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): The outcomes for standards 16 and 18 were inspected. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service were able to express their concerns and had access to a complaints procedure. They were protected from abuse and had their rights protected. EVIDENCE: The AQAA stated the company’s complaints procedure is followed to minimise the risk of abuse and protect residents’ legal rights. The response from the survey identified people always knew who to talk to should they be unhappy about any aspect of their care. It also confirmed people knew how to make a complaint. All but one survey from relatives confirmed they also knew how to make a complaint. They said the service always or usually took appropriate action if they had raised any concerns about the care of their relative. Surveys from health professionals also stated the service usually took appropriate action if they had raised any concerns about a person’s care. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 19 When I spoke to people the majority said that they had ‘no complaints’ or ‘grumbles’. One person did raise some concerns and asked me to report these to the manager, which I did. They were satisfied that the manager would speak with them to resolve their concerns. The complaints procedure was displayed in the foyer and clearly described the procedure for people should they have any concerns. This included who would deal their concern and how soon they could expect a response. A record was maintained of complaints that had been made. No complaints had been made, since the last visit. The AQAA stated there is yearly protection of vulnerable adults training for all current staff and there is a company whistle blowing line. When I spoke with the area and home manager they were aware of the reviewed adult safeguarding policy and procedure for South Yorkshire. When I spoke with staff they had a good understanding of the types of abuse that may occur and were clear of the action they would take to protect people. They said they received annual training on the safeguarding of adults. When I looked at staff training records there was a programme in place to train all staff in safeguarding adults, although each individual record did not confirm this had taken place. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 20 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): The outcomes for 19 and 26 were inspected. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The building and its environment were on the whole clean and well maintained and when I spoke with people they said they found the home comfortable and to their satisfaction. EVIDENCE: The AQAA stated: • Equipment is maintained so that it is safe to use at all times • Regular health and safety meetings are held • The service ensures the home is comfortable and encourages independence • The service employ their own maintenance man to manage the day to day maintenance of the home Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 21 • • There is the support of an estates team with larger maintenance issues The service has their own individualised budget and access to a capital expenditure budget for replacement of larger or expensive items or repairs Improvements have included: • Some bedrooms have been decorated • Some beds have been replaced • A new carpet shampooer has been purchased • A safe garden area for residents to sit The AQAA states further improvements as a result of listening to people include: • A refurbishment programme to replace carpets and chairs in communal areas and replace corridor carpets • Create raised flower beds for the residents to enjoy gardening outdoors • Continue with rolling programme of redecoration of residents bedrooms When I spoke with people they told me they thought the home was comfortable and were pleased with their living environment. They said they had a comfortable bedroom and were able to bring items of their own furniture and possessions with them. There were three lounges and a dining room. They presented a pleasant and homely environment for people to live. People had access to safe indoor and outdoor communal facilities. The home was clean and tidy, which promoted a comfortable and homely environment. The home was decorated in a cosy and welcoming manner, including, homely touches of pictures and ornaments. Furnishings and furniture were of a good standard. I reported to the manager a mild odour that was apparent when I first went into the home in the morning. I looked in several bedrooms, which were tidy, appropriately furnished and had been personalised by the person who lived in that room. Surveys returned by people stated the home was always or usually fresh and clean. One commented, “very clean”. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 22 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): The outcomes for standards 27, 28, 29 and 30 were inspected. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Generally staff were trained, skilled and in sufficient numbers to support people and maintain the smooth running of the service. EVIDENCE: All surveys returned by people stated staff always treated them well and acted on what they said. They also stated there were always or usually staff available when they were needed. The majority of people that I spoke with spoke highly of the staff team and their comments included, “they come and look after you straight away, generally”, “they’re caring”, “they’re marvellous”, “they’re approachable”, “they’re kind” and “it’s service with a capital S”. When I spoke with staff they said that on the whole staffing levels were sufficient and included four staff on shift during the day and three at night. Ancillary staff were employed to ensure standards relating to food, meals and nutrition were met and the home on the whole was maintained in a clean and hygienic state. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 23 I saw good relationships between people and staff and staff responding to people who needed assistance without them having to wait an unreasonable amount of time. The AQAA stated: • A new Four Seasons Health Care 12 week induction for all staff has been introduced • The community nurses have provided infection control and wound care training • Paid induction supernumerary days have been increased to three • The service ensures mandatory training is carried out • There is NVQ training • There is good retention of staff which aids the continuity of care • They have a good recruitment policy and ensure all appropriate checks and references are gained • Staff meetings are held at least every six weeks for care staff • Seventeen staff are trained in infection control Improvements have included: • All staff given Four Seasons Health Care handbook • Five staff currently on NVQ Level 2/3 programme, 1 staff member has completed this • Implemented a new personnel and training manual I looked at three staff files. A recruitment process had been followed including the completion of an application form requesting a full employment history, a Criminal Records Bureau check or a Protection of Vulnerable Adults first check being obtained prior to the member of staff commencing employment and obtaining references. When I looked at the training and development files for staff the training included fire safety, moving and handling, health and safety, protection of vulnerable adults, food hygiene and how to assess a waterlow score for pressure areas. Certificates were in place to verify the training that they had attended. When I spoke with staff they said their training had included care planning, medication, the protection of vulnerable adults, infection control, first aid, food hygiene, health and safety, moving and handling, malnutrition and fire safety. The manager said the service had now achieved the 50 minimum ratio of care staff trained to NVQ Level 2 in Care or equivalent. She also said there was always a member of staff trained in first aid on each shift. Surveys received from relatives stated they felt staff always or usually had right skills and experience to look after people properly. One commented, “they show affection and seem to care beyond the role of a care home”. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 24 The surveys from health professionals also supported this stating they felt the care staff usually had the right skills and experience to support individuals’ social and health care needs. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 25 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): The outcomes for standards 31, 33, 35 and 38 were inspected. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The manager was qualified and competent. She received support from the company and this was demonstrated in the management and administration of the home and effective quality assurance systems. EVIDENCE: The manager has worked at the home for ten years giving her good experience in the caring profession. The AQAA stated as a result she is known and respected in the local community. The AQAA also confirmed she had obtained her Registered Managers Award. She had a good knowledge of the needs of people and was committed to providing a good quality service. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 26 Discussions with people demonstrated the manager promoted an atmosphere of openness and respect where people and their representatives felt their opinions mattered. The AQAA stated to ensure the views of people are promoted and incorporated into the running of the service: • Resident and relative meetings were held • Annual customer survey results are completed • Regulation 26 reports (these are visits to the service by a regional manager) are completed • Quality audit results are completed • There is a remedial action plan • The manager has an open door policy • They use complaints investigation outcomes • Completed customer feedback leaflets are used • The service liaises with purchasing authorities • The service have introduced a new resident survey Quality assurance systems were in place with a system of quality audits, regulation 26 visits and resident’s meetings. The quality assurance process included consultation with people and other stakeholders of the service to ascertain their views on the quality of the service provided. The AQAA stated people were encouraged to look after their own finances. When I spoke to them they said their money was either looked after by the home or their family. Monies held by the home on behalf of people were held together in a companies account, with each person having a record of their particular monies held in the account. It was identified at the last visit the interest from the account is paid into residents’ funds. Discussions with the area manager identified the company were in the process of changing this so that peoples’ monies held by the home would be paid into one national account. She said a system was being implemented to calculate the interest due to each individual person who had money in the account. Reconciliation of the current accounting system and float is completed monthly and a weekly transaction of monies spent and deposited by each person is kept, together with receipts. There were safe facilities to store the float. The AQAA stated a health and safety policy was in place and maintenance and servicing certificates were in place for: • Five year electrical testing • Portable appliance testing • Gas • Passenger Lift • Certification of hoists • Waste transfer • Chlorination Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 27 • • • • • Site maintenance Fire risk assessment Fire inspection Environmental health Fire equipment When I looked round the building fire exits had been kept clear, which should make it easy for people and staff to leave the building should there be a fire. When I spoke with staff they said they had sufficient equipment to move people safely. I saw them doing this. They said there were adequate gloves and aprons available to control the spread of infection. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 28 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 2 2 X X N/A 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 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 X 3 X 3 X X 3 Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 OP8 OP30 Regulation 12 (3) & 17 (3) (a) Requirement Staff must follow the plan of care, for example, the weighing of people, so that peoples’ health care needs are met and monitored. Likewise, they must monitor when further health care intervention has been identified and make sure action is taken to meet this, so that peoples’ health care needs are met. Timescale for action 05/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP2 OP3 Good Practice Recommendations The person’s file should demonstrate terms and conditions have been given to people, including a signature by the person or their advocate to confirm they agree with them. All parts of the homes assessment must be completed to verify and make clear the service are able to meet peoples’ needs. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 30 3. OP9 4. 5. 6. OP9 OP9 OP18 The medication record for the administration of medication should be completed after the medication has been administered to the person. This is so that if the person refuses their medication, the record is not incorrect and in need of amendment. To help people swallow their medication a glass of water should be offered. Staff should sign the controlled drugs register to verify the receipt of that medication. Training records should be audited to make sure all staff have received training or are on the training programme for the safeguarding of adults. This ensures people using the service can be assured staff would report any abuse that was reported or that they were aware of, in order to safeguard people. Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 Field View DS0000018253.V337372.R01.S.doc Version 5.2 Page 32 - 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!