Care Home: Fieldhouse

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What the care home does well The home carries out a very thorough assessment of people`s needs before they make a decision to admit them to the home to make sure they are able to meet their individual care needs. People are able to visit the home before they make a decision to move in. The care records are personalised and consider any risks for each person and how these may be minimised. Each person has a designated key worker who develops and reviews the care plan and their individual goals. People who use the service are consulted and fully involved with this process to ensure the home is acting in the best interests of each person. People are encouraged and supported to maintain their independence regarding personal needs and their individual finances. People are encouraged and supported to attend college courses of their choice, get out and about in the community and to spend time with their family and friends. The home provide a choice of menu each day. People who use the service are asked about the type of food they like to eat, they are encouraged to help with the preparation of meals and to get themselves drinks and snacks throughout the day. People are encouraged and assisted to maintain the cleanliness of their own rooms and to launder their own clothes. Staff respect people`s privacy by always knocking on the door and waiting to be invited in before they enter the room. The home provide assistance with personal care needed and ensure people`s healthcare needs are promoted. People who use the service are consulted and their views are listened to and acted upon. There is a thorough recruitment process for new staff to ensure suitable people are employed to work in the home. Staff receive a thorough induction programme and ongoing training to ensure they have the correct skills to carry out their role. There are enough staff employed to meet the needs of the people who use the service. The home is modern and spacious and provides good sized single rooms with en-suite bathrooms. The home is clean, safe and well maintained. The service is managed by an experienced manager who has systems in place to monitor the quality of the service in consultation with the people who use the service and other visiting health and social care professionals. What has improved since the last inspection? This is the first inspection of this service since it was registered in April 2009. What the care home could do better: More robust recording is needed when the home hold money on behalf of the people who use the service, this will ensure that all entries are checked by a second person. Improvement is needed to the way the home manages the medication for the people who use the service. More detail is needed in the care plan when people are prescribed medicines on a `as required` basis to ensure staff know when and how to give the medication. A copy of the prescription signed by the General Practitioner should be kept in the home to ensure medicines are dispensed and are given at the time and frequency prescribed. The home should record the date of opening all boxed medicines to enable them to carry out an audit of this medication. The use of `Homely Remedies` for each person should be authorised in writing by their Doctor and reviewed annually to ensure they are safe to be given and does not place them at risk of harm. Allergy boxes should be completed on the medication charts to ensure people are not exposed to anything they are allergic to which may place them at risk of harm. Key inspection report Care homes for adults (18-65 years) Name: Address: Fieldhouse Field House Rectory Lane Worcs DY130TJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Sandra Bromige     Date: 2 3 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought 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 The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Fieldhouse Field House Rectory Lane Worcs DY130TJ 01299828828 01562829001 sunnycrofthomes@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Sunnycroft Homes Limited Name of registered manager (if applicable) Mr Peter Sarll Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is : 6 The registered person may provide the following category/ies of service only: Care Home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability- (LD) Mental Disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home Fieldhouse was registered as a new service in April 2009. It is owned by Sunnycroft Homes Limited Group who also operate two other services in Kidderminster. The Director of Care and registered manager for Fieldhouse is Mr Peter Sarll. The home is on the outskirts of Stourport-on-Severn, approximately one mile from the town centre. The accommodation is a modern bungalow with a good sized garden at Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 6 6 Brief description of the care home the rear with views from the front of the building over the open countryside. There are six large single rooms all with en-suite bath and shower facilities. The rooms have a designated bedroom and lounge area which can be partitioned off if requested. Communal facilities available are a large kitchen which people are encouraged to use to prepare drinks and snacks and a lounge with a television and a conservatory/dining area. The six places may be used to accommodate people who have a learning disability or mental disorder, which may be due to an Acquired Brain Injury. The home provides written information about the service it provides in a Statement of Purpose and Service User Guide. This information is required so that people have the information they need when they are choosing a home that is going to suit them. Anyone thinking of moving to the home should receive a copy of the Service User Guide and the Statement of Purpose should be available to read at the home. People who want information about how much it costs to stay or live at Fieldhouse should ask the owners for this information. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This service was registered by the Care Quality Commission in April 2009. This is the first inspection of the service since registration. We, the commission, did this unannounced inspection over one day. One inspector spent seven hours at the home, talking to people who use the service and the staff, and looking at the records, which must be kept by the home to show that it is being run properly. The focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. We looked in detail at the care provided by the home for two people. This included observing the care they receive, discussing their care with staff, looking at care files and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. The manager of the service had previously completed an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the Care Homes for Adults (18-65 years) Page 6 of 29 service. Some of the managers comments have been included within this inspection report. We have not received any concerns or complaints about this service since it was registered. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: More robust recording is needed when the home hold money on behalf of the people Care Homes for Adults (18-65 years) Page 8 of 29 who use the service, this will ensure that all entries are checked by a second person. Improvement is needed to the way the home manages the medication for the people who use the service. More detail is needed in the care plan when people are prescribed medicines on a as required basis to ensure staff know when and how to give the medication. A copy of the prescription signed by the General Practitioner should be kept in the home to ensure medicines are dispensed and are given at the time and frequency prescribed. The home should record the date of opening all boxed medicines to enable them to carry out an audit of this medication. The use of Homely Remedies for each person should be authorised in writing by their Doctor and reviewed annually to ensure they are safe to be given and does not place them at risk of harm. Allergy boxes should be completed on the medication charts to ensure people are not exposed to anything they are allergic to which may place them at risk of harm. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering moving to Fieldhouse can be confident the home are able to meet their needs as there is a thorough assessment of their needs that they have been involved in. Evidence: The service has produced written information about the facilities they offer and who they offer a service for. This is called the Statement of Purpose and Service User Guide. It is available in the home in a normal printed format which is suitable for the people who currently use the service. The manager told us they can produce these documents in other formats as needed, for example pictorial and easy read. People who use the service told us they were given written information about the home and visited the home before they made any decision about using the service. The AQAA told us before people move into the home there is a long, thorough, referral process which includes the receipt of relevant reports from care planning approach, including social and psychiatric reports. Visit to Service User in current placement to make full assessment and complete Strengths and Needs Assessment. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: We looked at the care records of two people who use the service and we saw all of this information had been obtained by the home about these people. The information was very comprehensive and informative. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Fieldhouse can be confident they will have a plan of care that they have been involved in developing. They are able and supported to make decisions about their life because the staff promote each person rights and choices. Evidence: The AQAA completed by the manager prior to the inspection visit told us they have clearly written documentation to promote independence based upon needs and decisions of individuals and they promote independence within a risk assessment framework. We looked at the care records for two people who use the service and we found the records are personalised and each person has a support and action plan showing the changes they wish to make to their lives. Each person has a key worker, although the information for one person about their current address and allocated key worker had not been updated since moving into the home from one of the companies other services. The records show consideration of any risks for these people and how any Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: identified risk is minimised. The care records were in a suitable written format for these two people who use the service. We saw Mental Capacity Assessments had been undertaken involving specialist mental health professionals to ensure any decisions made are in the best interests of these people. The care records were regulaly reviewed by the key worker and there was written information for one person showing they had been involved in the review of their care records. We spoke to people who use the service. They told us they had made the decision to come to the home and no restrictions were placed on them. One person said I understand the service, its requirements and mine. They confirmed they had discussed and agreed their care needs with their key worker recently. One person told us they manage their finances themself. One person told us they had a meeting with the staff recently. We saw the minutes from this meeting which was attended by two staff and the people who use the service. They discussed activities, menus, holidays and complaints. We saw that people had made suggestions about things they would like to do. We spoke to a carer who told us what action had been taken by the home to look into and implement the suggestions made by the people who use the service. The home look after the money for one of the people whose care we tracked. We saw they audit these records each month. We saw receipts were obtained for any monies spent by this person or on their behalf. The manager and us checked the balance with the amount of cash in hand and found there was 20 pence less than the amount stated in the records. We saw there was only one staff signature for all transactions. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Fieldhouse can be confident they will be encouraged and supported to follow their personal interests, keep in touch with and spend time with their family and friends. People are provided with a well balanced diet and meals can be enjoyed at a time and place to suit them. Evidence: The AQAA told us people who use the service have daily and regular use of a range of local community facilities by all Service Users supported by Staff. They attempt to develop an appropriate lifestyle which promotes a quality of life despite complex and diverse needs. Promote dignity and independence, encourage individuals to utilise their own personal rooms and to personalise these. Encourage personal educational development through College classes. Individuals are able to eat in the communal room or their own room with whom they wish and when they wish. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: We saw in the care records that people who use the service were being supported to attend college courses of their choice, get out and about in the community and to spend time with their family locally and through holidays in this country and in other parts of Europe. People who use the service told us they went out and about with staff as a group and individually. The home does not have a designated vehicle, they use a taxi or private hire vehicle. We saw in the minutes of a recent meeting that people had requested to go swimming, on other trips and made a suggestion for a group holiday next year. A support worker told us since the meeting they had been swimming and a trip to Blackpool was booked for later this month as well as attending events in the local town. On the day of the inspection the three people who use the service went out with two staff after lunch. Two people returned after enjoying a short walk and one person had stayed in town with a support worker. We saw the menu provided by the home. This was a four week menu which showed a choice of meals including a vegetarian option. One person told us they had discussed the menus at a recent meeting with staff. We saw people having breakfast at various times throughout the morning depending on what time they got up. One person told us they make their own drinks and snacks and had cooked the evening meal for everybody one evening. We sat and ate lunch with two people who use the service and both staff. It was very relaxed and enjoyable and people were talking and having a joke with staff. One person had chosen to eat lunch in their room. We saw in the care records that people have a key to their room and are encouraged and supported to be involved in cleaning their rooms, doing their personal laundry and the preparation of meals and snacks. We heard staff knocking on bedroom doors before they entered. People who use the service are not able to smoke inside the home. The service user guide states the home is a non-smoking environment. We saw they all went into the garden to enjoy a cigarette. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Fieldhouse can be confident they will be supported to ensure their personal and healthcare needs are met. There are some small improvements needed to the way the home manage medication to ensure the system is more robust. Evidence: The AQAA states the home provide individual, dignified, personal care to meet the assessed needs of the Service User in an unhurried manner. The care records for the two people whose care we tracked gave detailed information about the personal care needed and how the staff at the home would support this care. Peoples hygiene needs were recorded and the home monitored their weight each month and the food they ate to ensure they received a healthy and balanced diet. We heard staff knocking on doors and encouraging people to get up and dressed in accordance with their individual care plans. One person told us staff wake him every day at the requested time and continue to do this at intervals until he gets up. This person told us they did not need any assistance with personal care. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Care records showed people were registered with a local Doctor and regular healthcare appointments for these people and the staff supported them to attend the appointments. One person told us they had recently visited the dentist and another person told us they had recently been in hospital for a follow up procedure after their accident. Specialist support is accessed privately by the service from a psychiatrist and psychologist. We saw information in the care records showing these specialist health professionals are consulted and visit the service. Care records showed each person had signed a consent form to give permission for staff to manage their medication. Care plans designated times for administration of identified medicines. We observed a support worker giving people medication at lunchtime. This was done on a individual basis and the staff observed them taking the medication. Medication in the home is generally well managed, although there were some areas which could be improved. There were no instructions in the care records when people were taking medication prescribed when necessary to ensure consistency of usage. The allergy boxes were not completed on the medication charts. There was a Homely Remedies policy in use although it was due for review in June 2008. Written consent had not been sought from the Doctor for the use of homely remedies for each person. We were unable to carry out an audit of boxed medication which was not in the dosette boxes and the date of opening was not written on the box. The staff are recording the receipt of medicines on the medication chart, but they are not recording the date it was received. We suggested a book was used to record medication sent for disposal rather than individual sheets and to ensure two staff sign all entries. Training records showed staff have received medication training. Staff told us they had received medication training from the pharmacy they use. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Fieldhouse are consulted and their views are listened to and acted upon. They are protected from any potential abuse through robust selection of staff to ensure only suitable people are employed to work in the home Evidence: The AQAA tells us the home safeguards people who use the service through their interview, selection procedures and checks carried out on staff before they are employed. We looked at two recruitment files and these showed that a thorough process had been followed including references and Criminal Record Bureau checks done to ensure suitable people are employed at the home. The service user guide contains a copy of the complaints procedure and also gives information for people how they can contact us, the local Primary Care Trust, Social Services and advocacy service. People who use the service told us they had received a copy of this guide before they moved into the home. The home has not received any complaints since they were opened. We have not received any concerns or complaints about the service since it was registered in April 2009. We saw from staff training files that staff have receive training about protecting people and staff told us they had received this training. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Fieldhouse are provided with a modern and spacious environment which is clean and well maintained to ensure their comfort and safety is maintained at all times. Evidence: The AQAA states, we provide a homely atmosphere for a small group of people who all have individual bedrooms with en-suite bathroom and private lounge. Each Service User is encouraged and assisted to personalise their own room to meet their own needs and requirements. The Home is accessible to all people being all on one level except for three steps up to two of the bedrooms. There are ample lavatories, baths and showers to meet personal needs. These are private and lockable. Each Service User having their en-suite facilities as well as the house bathroom. There are three communal areas and external garden available to all individuals. The Home is clean and well maintained, systems are in place for hygiene and the control of cross infection. The accommodation is a modern spacious detached bungalow. The entrance to the home is accessed via a ramp. There is no bell at the front door. The home has six single bedrooms with a private lounge area and en-suite bathroom. These are well furnished and have been personalised by the people who use the service. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: The communal facilities are a kitchen with a small dining area, lounge and conservatory which contains a dining table. Laundry facilities are available for people to launder their clothes or for the staff to carry out this task. The home is very clean and well maintained. People who use the service are encouraged and supported to clean their own private rooms in the home as part of their rehabilitation programme. The garden is accessed via the conservatory and is mostly laid to lawn. The front views from the home are over the open countryside. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Fieldhouse are looked after by staff who are suitable, trained, competent and in sufficient numbers to meet their needs. Evidence: The AQAA stated the home currently employ seven male and female staff. Five have completed induction training using the national standards set by Skills for Care. Two staff are still undertaking their induction programme. Four staff have NVQ II or above. On the day of the inspection there were two staff on duty in the morning this included the manager. There are currently three people using the service. In the afternoon the manager was on duty and two support workers. Staff told us these are the normal staffing levels and they have one support worker at night who sleeps in the home. The staff rotas show these to be the current staffing levels each day. The manager told us staffing levels will be reviewed depending on the numbers and needs of the people using the service. Staff spoken with told us they have achieved their NVQ II and III in care and received a robust induction programme using the national standards. Training records and discussion with staff showed they had received all of the core mandatory training and training relevant to the people who use the service. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: We looked at the recruitment of the two most recently employed staff. These showed thorough checks had been done to check the suitability of these people before they were employed by the home. We saw they are currently undertaking a detailed induction programme using the national standards set by Skills for Care. People told us the staff are very nice and one person said they are easy going. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at Fieldhouse live in a home which is well run. They are consulted about the quality of the service to ensure it is being run in the best interests of the people using the service. The environment is safe and well maintained ensuring the safety of the people who live and work at the home. Evidence: The service was registered by us in April 2009. The registered manager is also the Director of Care for the organisation which owns the home. The qualifications of the manager and all staff working in the home are listed in the service user guide. The home employs a deputy manager. The manager told us he spends at least 30 hours each week at the home. Staff told us the manager is at the home Monday to Friday and his hours are supernumerary to the staff rota. The home receives an unannounced visit by one of the Directors for the company once a month as required through regulation. The manager told us a report of the outcome of these visits are provided. The home intend to send out a questionnaire to the people using the service, social workers, and healt professionals in January 2010 to Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: seek their views about the quality of the service. The manager told us internal audits are done each month to monitor the standard of management of medication and health and safety in the home. A meeting was held recently with people who use the service to consult them about various aspects of the service such as the menus and activities. Two staff meetings have been held since the home was registered. We looked at the fire records which showed weekly and monthly fire checks had been recorded. Fire risk assessments are written for each area of the home. The manager told us they do not have any water storage tanks in the home. There are records of random water temperature checks carried out to ensure the water temperatures are not hot enough to scald the people who use the service. There is a health and safety poster on display in the office. This needs to be completed to ensure staff have the relevant information available of who to contact for health and safety. Care Homes for Adults (18-65 years) Page 25 of 29 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 29 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, Care Homes 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 20 13 13(2) 27/11/2009 To make arrangements to ensure that care plans include detailed information and instructions for staff in respect of the administration and management of medicines, including the reasons to give medicines on a when required basis and what constitutes needed.for a named person. To ensure staff know when and how to give the medication. 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 7 There should be two signatures for all receipts and expenditure of monies held on behalf of people who use the service to ensure there is a more robust system in place for managing peoples spending money. Page 27 of 29 Care Homes for Adults (18-65 years) 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 2 20 A copy of the prescription signed by the General Practitioner should be held in the home to ensure medicines have been dispensed and are given at the time and frequency prescribed by the Doctor. The home should record the date of opening of boxed medicines to enable them to carry out an audit of the medicine to ensure it is being given as prescribed by the Doctor. The use of Homely Remedies for each person living in the home should be authorised in writing by the General Practitioner and reviewed annually to ensure they are safe to be given and does not place them at risk of harm. Allergy boxes should be completed on the medicine charts to ensure people are not given medicines or items are not used which they are allergic to which may place them at risk of harm. 3 20 4 20 5 20 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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