Care Home: Fieldhouse Care Home Limited

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What the care home does well Staff and residents had formed good relationships that were based on mutual respect and trust. Residents spoken to praised the way staff were meeting their personal and health care needs and confirmed that the home was managed well. Systems were in place to ensure that residents were afforded protection from harm and residents were confident that their concerns were being listened to and addressed in a timely manner. Staff had access to training to ensure that they had the knowledge and skills to meet residents needs and care was taken to recruit the right staff to work with older people. The atmosphere in the home was relaxed and a homely and a safe living environment had been provided for residents. The provider took care to ensure that the decor was kept in good condition and that furniture and fittings were replaced as necessary. The home was found to be clean and hygienic. Priority was given to listening to residents and their relatives and suggestions for improvements had been taken on board. What has improved since the last inspection? The home prides itself on the partnership it develops with relatives and families of residents and other organisations. The managers look at issues and comments positively and this reflects in how the home is managed and how residents feel safe and wish to continue living at Fieldhouse. We were told that the home continually looks at the service provided at Fieldhouse in liaison with staff,residents and their relatives and friends to see how they can further develop the service provided. What the care home could do better: There are two requirements and some recommendations which are identified on this inspection. Key inspection report Care homes for older people Name: Address: Fieldhouse Care Home Limited Spinners Green Off Whitworth Road Rochdale OL12 6EJ     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: Kath Oldham     Date: 1 6 0 3 2 0 1 0 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 Older People Page 2 of 28 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 Older People 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Fieldhouse Care Home Limited Spinners Green Off Whitworth Road Rochdale OL12 6EJ 01706632555 01706356734 stewart-s@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Fieldhouse Care Home Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 46 Date of last inspection Brief description of the care home Fieldhouse is a purpose built home located on a residential estate on the outskirts of Rochdale. Accommodation is provided on two floors in 38 single and four double bedrooms. Five of the single rooms have an en-suite facility. Level access is available to the home and a passenger lift ensures access is provided to both floors. The home accommodates male and female service users aged 65 years and over who require residential care. Situated in its own grounds, it has the benefit of small gardens to the side and rear with ample parking available at the side and front of the home. There is Care Homes for Older People Page 4 of 28 Over 65 46 0 Brief description of the care home easy access to the motorway network and public transport. Weekly fees are from £397.26 to £407.26. Additional charges are made for private chiropody, newspapers/magazines, personal toiletries and hairdressing. The provider makes information about the service available in the form of a Service User Guide and Statement of Purpose, which are given to new residents and are displayed in the home. A copy of the inspection report is displayed in the entrance hall so the residents and visitors to the home may read it. Care Homes for Older People Page 5 of 28 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This visit was unannounced, which means that the owner/manager, staff and residents were not told that we would be visiting, and took place on 16th March 2010 commencing at 8.00am. The area manager and senior staff were available on the visit and provided us with information and records and support,in addition to the support from staff on duty during our visit and residents. The inspection of Fieldhouse included a look at all available information received by the Care Quality Commission (CQC) about the service since the last inspection which was held in April 2007. Every year the owner,person in charge or manager is asked to provide us with written information about the quality of the service they provide.Some weeks before our visit the acting manager at that time was asked to fill in a questionnaire,called an Annual Quality Assurance Assessment (AQAA), telling us what they thought they did well, what they need to do better and what they have improved upon. This helps us to determine if the management of the home see the service they provide the same way that we do. Care Homes for Older People Page 6 of 28 We considered the responses and information the acting manager at Fieldhouse provided and have referred to this in the report. Fieldhouse care home was inspected against key standards that cover the support provided, daily routines and lifestyle, choices, complaints, comfort, how staff are employed and trained, and how the service is managed. Comment cards were sent prior to the inspection for distribution to people staying and working at Fieldhouse the views expressed in returned comment cards and those given directly to the inspector are included in this report. We got our information at the visit by observing care practices, talking with people staying at Fieldhouse talking with the area manager and staff.A tour of Fieldhouse was also undertaken and a sample of care, employment and health and safety records seen. The main focus of the inspection was to understand how Fieldhouse was meeting the needs of residents and how well the staff were themselves supported to make sure that they had the skills, training and supervision needed to meet the needs of residents. The care service provided to four residents was looked at in detail to help form an opinion of the quality of the care provided.We call this case tracking.This is a way of inspecting that helps us to look at services from the point of view of the people who receive a service. We track residents care to see whether the service meets their individual needs. The term preferred by people consulted during the visit was residents. This term is, therefore, used throughout the report when referring to people living at Fieldhouse. A brief explanation of the inspection process was provided to senior staff at the beginning of the visit and time was spent with the area manager and senior manager on conclusion of the visit to provide verbal feedback. We have not received any complaints or safeguarding matters about this service. References to we or us in this report represents the Care Quality Commission(CQC). Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 Older People Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. The assessment process ensures that people referred to the home are consulted about their needs and this enables them to take a decision on whether the home will be the right place for them to live. Evidence: There was a statement of purpose and service user guide which was given to residents. This was also available in the reception area and in the corridor in the home so residents or their relatives can have a look at it when they choose.The manager will need to change the address of the Commission to reflect recent changes and include the qualifications of the staff team. We were told in the AQAA completed by the Acting Manager before our visit, The initial enquiry that is given to us comes from a social worker or relative. Occasionally the referral or enquiry may come from the actual service user. The person enquiring is given all the information that is required for them to make an informed choice as to Care Homes for Older People Page 10 of 28 Evidence: where they wish to live and they are advised by the home to look at other homes to ensure that they make the correct decision. Once this decision has been made then the homes policies and procedure will come into force and a pre assessment will take place with the service user and their advocate. The pre-assessment will help to see if the home can meet the service users needs and people involved in this will be in agreement. The files for four people living in the home contained care manager assessments of need and in house preadmission assessments. Residents and relatives spoken to confirmed that they had been consulted throughout the assessment process. The home do not offer an intermediate care service. Care Homes for Older People Page 11 of 28 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. Omissions in the recording in care plans and medication records could lead to residents not getting the care and medication they need. Evidence: Before we undertook the visit to the home we were told in the paperwork completed by the acting manager,Once the service user has made the decision to come and live at Fieldhouse and the initial pre-assessment has been completed the home will comprise a full care plan with the service user and their advocate(if required).This care plan will incorporate all with regard to health care. This care plan is geared to the individual and will be discussed in the privacy of the service users room. Evidence of this procedure being completed can be seen at the end of the care plan with the signature of all parties being present. A member of staff told us that the home, provides good care for service users of all backgrounds.Another member of staff in response to our question what does the service do well told us, interact well with service users and their relatives. Everyone knows each other on a first name basis.A further staff member said, the home is Care Homes for Older People Page 12 of 28 Evidence: good at ensuring residents have their independence and dignity.We were also told by staff that the home is good at, meeting the needs of the service users at all timesand, provides all care for service users. A resident said, cares, always helpful. and would like to see,more activities if possible.Another resident told us, takes care of us.A further resident said, that the home does, most things generally.Additional comments we received included, home fantastic. nothing could be improved upon. Its smashing. The care records belonging to four people living in the home were examined. The care plans had been developed from information supplied by the local authority and in house assessments of need. Some of the care plans did not record that all the care needs had been reviewed. This may mean that the care they need is not written down and can lead to residents not receiving the care and support they need when they need it. In addition some residents care plans indicated that they needed to be weighed weekly. Some of these residents were not being weighed as regularly as this. This could compromise there health and safety. For one resident who needs weighing with hoist scales was not recorded as having been weighed since 9th February 2010. Staff had written in the records that the scales were not available to weigh the resident. We were told when we gave verbal feedback at the end of the inspection that these scales are shared between two homes and they are brought to the home weekly to weigh residents who need this type of equipment. Some residents who needed weighing weekly were weighed say every ten days. The care plans need to reflect the needs of residents and these needs must be provided when they are assessed as being needed to keep residents safe and well. Relatives spoken to or who completed comment cards said they were very satisfied with the care provided by Fieldhouse.We were told,The staff are very kind and are marvelous with X. The home is absolutely the right place for X to live. Throughout the inspection staff were observed to interact well with residents and to provide support in a dignified and private way. Residents spoken to confirmed that they were satisfied with the care they received and that staff always treated them with respect. Service users are able to manage their medication themselves if they are able. This is explained to the service user at the initial assessment and again when they commence their stay at Fieldhouse. If the manager feels service users may be suitable for this to happen then a risk assessment is carried out which will check if they are able to do this themselves.All staff who are responsible for the administration of medication are Care Homes for Older People Page 13 of 28 Evidence: trained and have recently been refreshed in the medication policies. We looked at one resident who administered part of there medication. There was a risk assessment in place but this had not been completed. To keep residents safe a risk assessment needs to be put in place. When we gave verbal feedback at the end of the inspection senior staff thought that all the risk assessments were completed and said they would look into this and arrange for this to be done. We looked at a sample of medication administration records which are used by trained staff to record when medication is administered to residents as prescribed by their doctor. There were occasions when from looking at these records we couldnt tell if residents had received there medication when they should. This was because staff had not always signed to say residents had received there tablets or medicines or detailed a symbol to say why the medication hadnt been given. It is important that residnets receive there medication when they are prescribed to keep them well. Omissions in recording doesnt evidence that the medication policies and procedures have been followed or if residents have had the medication that they need when they should have it. Staff were recorded as having had training in medication. Apart from two staff who received this training in 2009, others had not had training since 2004 for two staff and 2007 for another staff member. In addition to updates or refreshers in medication training best practice would be to include that periodically staff competence to administer and follow medication procedures is assessed. This would ensure that practices and policies are being maintained, residents are kept safe and staff are clear about there roles and responsibilities in relation to medication administration. Detail provided in the AQAA told us.staff are trained and supervised in the areas of privacy and dignity. They are putting this into practice at every moment of their shift and therefore they are constantly monitored in how they deal with this issue. The service user is asked, at pre assessment, if they have any preference to either male or female staff with regard to personal care and this is documented on their assessment sheet and in the care plan. This will ensure that the service user dignity is maintained. Care Homes for Older People Page 14 of 28 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. Residents receive the support they need to live their chosen lifestyle. Evidence: Fieldhouse feels it is extremely important that service users continue to live their lives to the best of their ability and fulfill their wishes and choices taking into account any risk that they might face, but remembering that they have a right to take risks, if they have the capacity to make these choices. The home delivers assistance with the choices service users make and offers a range of activities through the homes activity coordinator.The coordinator,we were told liaises with the service users for ideas for activities that they would like to participate in both in house and outside.A member of staff told us the home could improve byhaving more days out for residents.A resident commented that they would like to see, more entertainment.Another resident said, provide games and entertainment which is very good. The home has a visiting vicar/priest who attends the home to deliver religious services on a regular basis and some service users do attend church in the community. Care Homes for Older People Page 15 of 28 Evidence: During the inspection residents were observed to receive visitors at different times of the day.The inspector spoke to some visitors.They said they were always made welcome in the home and that staff always contacted them if there were any concerns with their relatives care. Involving relatives in the day to day lives of people living in the home is an example of good practice. A resident told us,when we asked what does the home do well, everything well apart from meals.Another resident said, only grumble is sometimes the meals.A further resident said, food a little disappointing.We had the opportunity to have meals with residents on the inspection. The main meal is served at lunchtime when the choice of cooked meal was fish pie or liver.The residents we spoke to about the meal served on the day were not complementary. One resident told us that they didnt like fish pie and it was difficult to find the fish.And added that they had liver once when it was tough.One resident told us that they chose the fish pie which they dont like as they like liver even less.We were told at feedback at the end of the inspection that they do have a choice and could have had something else. It is surprising to see fish and liver on a menu on the same day as from experience and from what residents told us people usually love or hate liver and not everybody likes fish. The meal was presented nicely and staff took time to support those residents who needed assistance with feeding in a respectful and patient way. We were also told that the menus have been changed and discussions were being had with residents to see if they like the changes made to the menus before they are introduced. The cook took care with the presentation of meals and support was available during the meal for people who needed assistance to eat. The kitchen and food stores were clean and food was stored appropriately.Cleaning schedules and fridge and freezer temperatures were in the main up to date. Care Homes for Older People Page 16 of 28 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. Systems are in place to deal with complaints and to keep residents safe from harm. Evidence: Residents had been provided with information at the point of admission on how to make a complaint. Relatives of a resident confirmed this. Policies and procedures for dealing with complaints were in place and this included a recording system for the complaints received. Comments and complaint had been made since the last inspection. Examination of the records revealed that these had been resolved satisfactorily within the prescribed time limit. Residents spoken to during the inspection confirmed that they knew who to speak to if they had a complaint and this was also confirmed by the people that completed comment cards. Residents are protected by the home by adherence to the employment procedure and the homes whistle blowing policy. We were told abuse procedures are discussed with staff at induction and in ongoing training. Policies and procedures were in place to ensure that people living in the home were safe from abuse. Some staff had received training in how to recognise abuse and the procedures to follow if abuse was alleged or suspected. The remaining staff group had scheduled protection of vulnerable adults training dates during 2010 with the local authority that had been booked the week before the inspection. Care Homes for Older People Page 17 of 28 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, 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. 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. A rolling programme of redecoration and maintenance ensures that residents are provided with a safe,pleasant and comfortable living environment. Evidence: We were told in the AQAA,Fieldhouse is purpose built and takes pride in its appearance both inside and out. It is paramount that a rolling maintenance, decorating, renewal and refurbishing programme is maintained and this is apparent in the way the home is kept. The home complies with all aspects of the fire and environmental authorities and evidence of this can be seen in house.All lounges and bedrooms have been fitted with free view boxes,after the digital take over. The Acting Manager was a member of the Infection Prevention and Control in Nursing/Care Homes Working Group.This commenced in December 2009 and benefited the way the home is educated regarding infection control and its up to date policies.A resident told us, keep it very clean and usually do what you ask. We had a look around the home. This included the lounge areas,the dining room, bathrooms, toilets and a sample of bedrooms. The home was found to be clean and hygienic and unpleasant odours were identified in one of the bedrooms we looked at. Care Homes for Older People Page 18 of 28 Evidence: In all other areas there were no unpleasant odours.We were told at feedback that arrangements would be made to have this bedroom carpet thoroughly cleansed. Some of the double glazed windows in the bedrooms we looked in were misted meaning that residents wouldnt be able to look out of the windows with ease. The double glazed units need replacement. At feedback we were told that this would be looked into. The building is designed to provide access and support to people with disabilities, including specialised bathing and showering facilities. A redecoration and maintenance programme was in place to ensure that a safe, comfortable and pleasant environment was provided for residents. During the inspection residents were observed to utilise the outdoor seating arrangements. We were told by residents that the homes environment suited their needs and that they had been able to bring some of their personal possessions in with them on admission. One residents visitor told us that this had meant a lot to them and had made the transition from their own home less traumatic. Laundry facilities are provided. A member of staff explained that residents clothing was marked with the individuals name which ensured that clothes were returned to the correct person. Policies and procedures were in place for the control of infection in the home. Care Homes for Older People Page 19 of 28 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Recruitment procedures safeguard residents welfare by selecting staff that have the right level of qualifications, experience, skills and personal qualities. Evidence: We were told,Fieldhouses turnover of staff remains minimal which reflects in the standard of care the service users receive, due to continuity.This is difficult to achieve and perhaps the recruitment procedure is working, enabling the home to employ the right kind of staff. Five staff personnel files were examined for evidence that care had been taken to make sure the staff recruited were suitable to work with older people. All files contained copies of the required pre employment checks and two written references, one of which was from their most recent employer. The home has a formal training programme in place. Training is obtained through the local council and also other agencies.The acting manager told us that, this reflects in the standard of care that is given and staff development. We were told that 10 staff had received formal training in prevention and control of infection and 4 staff have have received training in malnutrition care and assistance with eating,including those who prepare and serve food.Twenty one staff have Care Homes for Older People Page 20 of 28 Evidence: received training in safe food handling. Nineteen of the twenty six permanent care staff have NVQ 2 level 2 or above(The NVQ is in Care or Health and Social Care).This exceeds the national minimum standards which states a minimum of fifty per cent should have this qualification. Staff told us, I have a great sense of pride working for Fieldhouse.Very good Establishment a pleasure to work for.We were also told that, the home could improve as,in emergencies they will take(staff) off the floor.Staff also suggested that the home could improve by, employ more care workers and give more training to existing staff members. We were also told that the home would benefit from, more staff as some of the residents are very dependent.Employ more staff suitable for the role. A resident said the home could do with, more staff.A further resident told us, friendly staff. On the inspection it was noted that sufficient staff had been deployed to meet the assessed needs of people living in the home. We were told the home has 8 care staff on duty in the morning and five staff in the afternoon. Three night care assistants,one of which is a senior are on waking duty throughout the night. We were told that previously 9 staff were on duty in the morning and 6 staff in the afternoon but this wasnt currently needed. One of the directors told us that the staffing levels are worked out on the needs of residents and will be altered to meet their dependency levels and assessed needs and is kept under review. We were told by a resident,The call bell service is not always satisfactory.When you are not the patient you do not always realise how long a five minute wait can be.We spoke to residents on the inspection and those who commented said that staff responded to the call bell when they needed them and although there was sometimes a delay;as staff are looking after someone else,people should be mindful that they are not the only one who needs help at Fieldhouse. Care Homes for Older People Page 21 of 28 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. Residents live in a home that is safe,well managed and run in their best interests. Evidence: The home had a registered manager who left her employment at the home in April 2009. A senior member of the management team was appointed to the role of acting manager but has since obtained alternative employment. Currently the area manager and another member of the senior team are managing the home. The home annually audits all 38 standards and its own policies and procedures in conjunction with new legislation. The home is audited by various individuals, therefore obtaining a holistic account of the home and its achievements. The home is a member of Dignity Challenge and continues to update information which is passed onto staff to enable them to contribute to the home in whichever field they may work in.We were told that dignity in care questionnaires had been completed by residents which led to a discussion and debate. Care Homes for Older People Page 22 of 28 Evidence: We were told that the home were approached by Rochdale Council with a view to them purchasing a block bed of one, so that service users and their families can pre book respite time. This was approved by the council and Fieldhouse agreed to commit to this contract. This we were told is working well and is ongoing. Two staff members said the home could do better bywork more on communication skills.One added, I feel communication can sometimes cause problems.One staff member said the home was, very well organised.We asked to look at the records of staff meetings. We were provided with some notes from a meeting earlier in March 2010 and we were told that the previous acting manager had held two other meetings with staff which had not been written up. It is important for staff to have regular meetings with senior managers and also there colleagues to provide them with an opportunity to influence what goes on in the home and to share their views or opinions. The area manager told us at the end of the inspection that she was wanting to arrange regular staff meetings for each staff group to enable them to have an opportunity to meet together and share information and views to assist in the development of Fieldhouse. We observed a number of residents and visitors come to the office to speak to senior staff. Residents concerns and queries were given priority over the inspection visit,which is good practice. It was evident that senior managers have a good relationship with the residents of the home. We saw the area manager going to residents individually to ask how they were and spend some time talking to them. A health and safety policy was in place and risk assessments of the premises and safe working practices had been carried out.This is to ensure that both residents and staff had relevant information to enable them to live and work in a safe environment.Fixed gas and electricity appliances had been regularly maintained and a periodic test of portable appliances and lifting equipment had been carried out and good records are kept.These checks mean that the safety of residents,staff and visitors are given priority. A sample of health and safety records was examined for evidence that the homes equipment was being checked regularly.The records we looked at were accurate and up to date. Accidents are recorded in the homes accident book. Completed reports are removed Care Homes for Older People Page 23 of 28 Evidence: and stored in a file in accordance with the Data Protection Act. As reported on the last inspection the majority of the residents living at Fieldhouse, relied upon their relatives to handle their financial affairs. Some relatives left money at the home for staff to give to individual residents as they needed it.We didnt check on this inspection the personal monies for residents. Care Homes for Older People Page 24 of 28 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 Older People Page 25 of 28 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 9 12 Ensure that all medication is 30/04/2010 recorded when administered and if residents refuse or do not need medication that a recognised symbol is used to detail what has happened to the medication. To keep residents safe and well and to promote their health care needs. 2 31 8 An application must be 30/06/2010 made to the Care Quality Commission for a suitable person to become registered as the manager of Fieldhouse. In line with regulations and to ensure a suitable person is employed to manage the home. Care Homes for Older People Page 26 of 28 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 1 The manager will need to change the address of the Commission in the statement of purpose /service user guide to reflect recent changes and include the qualifications of the staff team. Ensure that when care plans are reviewed that this is clearly recorded on the individual care plan so it is clear what the residents care needs and support are. Daily records should further detail how residents cultural, religious and social needs have been met in a person centred way. 2 7 3 8 Ensure that when it is assessed that residents need to be weighed that they are weighed and this is detailed in the individuals care file and action taken to support the resident to stay well is also recorded. Ensure that for residents who self administer any part of there medication that a risk assessment is completed to promote there health and wellbeing which is kept under review as identified in the risk assessment and this is recorded. Provide all staff who have the responsibility of administering medication to residents with updates and refreshers to there training. To evaluate staff practice and routine when administering medication undertake periodic competency assessments of staff which are recorded and used to identify what staff do well and if any training or support is needed to undertake their job in line with policies and procedures and to keep residents safe and well. 4 9 5 6 19 33 Repair or replace the double glazed units within residents bedrooms which are identified as misted. Continue with the development plans to have regular staff meetings to enable all staff to meet with their managers in a group and influence the development of the home To evidence that all staff have undertaken fire drill training best practice indicates that staff sign next to there printed name on receipt of this training.To ensure the safety of residents and staff maintain accurate and up to date records of all staffs attendance to fire drill training. 7 38 Care Homes for Older People Page 27 of 28 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. 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