Inspection on 08/01/08 for Farm Lane House

This is the latest available inspection report for this service, carried out on 8th January 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Farm Lane House 13/01/06

Farm Lane House 12/05/05

Farm Lane House 27/10/04

Farm Lane House 18/05/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Farm Lane House 59 Farm Lane Honicknowle Plymouth Devon PL5 3PH Lead Inspector Brendan Hannon Unannounced Inspection 8th January 2008 9:00 Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 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 Farm Lane House DS0000003528.V345260.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 Adults 18-65. 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. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Farm Lane House Address 59 Farm Lane Honicknowle Plymouth Devon PL5 3PH 01752 775848 01752 775848 H5M034Hannay@mencap.org.uk H4037@mencap.org.uk Royal Mencap Society 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) Ms Fiona Jane Hannay Care Home 9 Category(ies) of Learning disability (9), Physical disability (9) registration, with number of places Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 1 Service User over the age of 65 Service Users with a Physical Disability must also have a Learning Disability 5th October 2006 Date of last inspection Brief Description of the Service: Farm Lane House is a care home providing personal care and accommodation for nine people ranging in age from 18 - 65, who have a learning disability, and may also have physical disabilities. The Royal Mencap Society, a voluntary sector organisation, runs the home. The home is located in the residential area of Honicknowle, close to shops, pubs and other local amenities. The home was opened in 1987. It is purpose built, consisting of a single-storey building, suitably adapted for people who may need to use wheelchairs. All the home’s bedrooms are single though none have en suite facilities. There are separate lounge and dining rooms and there is an emergency call system throughout the home. The home has a patio area and garden that are well maintained and easily accessible. The home is staffed 24 hours a day including waking night staff. The weekly fees for this service are calculated on an individual basis depending upon each person’s support needs. Everyone that uses the service is receiving a high intensity support package, and local authority social services departments are purchasing their care. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was unannounced. Preparation for the inspection included analysis of the CSCI Annual Quality Assurance Assessment, the last inspection report, and contacts with the home over the last 12 months. An inspection plan was developed from this information. We were in the home from 9.00am to 4.00pm. We spent time with, or spoke to most of the people that use the service during the day of inspection. The Registered Manager was spoken with at length during the inspection and we also spoke with some of the staff. We fully inspected the building and found no issues of concern. An opinion on the service was sought from the Plymouth Community Learning Disability Health team and from community health services and their responses were all positive. Relatives of the people that live at the home were surveyed and the responses that were received were positive towards the service. Various areas of documentation were inspected to evidence compliance with the National Minimum Standards. Documents inspected included assessments of peoples’ needs and their care plans and risk assessments. Also various records were inspected including medication administration records, health records, personnel recruitment and training records, and health and safety records. All the information gathered during the inspection was considered in the writing of this report. What the service does well: There is plenty of good food. People have enough things to do to be happy. There are always enough staff to help and people get all the help they need. Each person can have their room just as they want it. The staff know how to help people and the staff do their best. The staff are safe to be with. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 6 If you want to live there the staff will make sure you can find out all about what it is like. The managers and the staff do everything they can to help everyone have the best possible quality of Life. A relative of a person that uses the service said, ‘I think the staff make a great effort to treat the residents as individuals and to run a cheerful and happy home’. What has improved since the last inspection? What they could do better: Farm Lane is providing a good service to everyone that lives there. However some improvements should be made. The plan of each person’s care, and the risk assessments that support this plan, should be more detailed so that staff can use the care plan to tell them how to support each person. When the home looks after a person’s medication it should always be written down when it has been given, there should be a record of every medicine that the person is receiving, and all medicines should be kept safely. Sometimes people cannot safely use one of their personal facilities and therefore they cannot have free access to the facility. When this happens the physical restrictions used should be made to look as ordinary as possible to ensure that the person’s dignity is protected. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 7 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. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s pre-admission processes ensure that people that are considering using the service are provided with information about the home, as well as having the opportunity to experience life in the home, before admission. This enables people to make a properly informed decision. EVIDENCE: There have been no recent admissions to the home. Mencap has an appropriate admission policy and procedure. Several peoples care files were looked at during this inspection. These files showed that everyone that uses the service has a completed assessment of their needs on their file. The preadmission process explores a persons support needs before they are offered a place at the home. A person that is considering using the service would be enabled to visit the home on different occasions to meet with the other people that live there and the staff. The Registered Manager stated that everyone that uses the service has received a Service User Guide and a Statement of Terms and Conditions of residency. Examples of the Statement of Terms and Conditions contracts were seen on peoples care files. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 10 The organisation provides a written language Service User Guide. A person that is considering using the service would be able, with the support of their advocates, to make an informed choice based on the information in the Guide, information from visits to the home, and information from the support staff. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a clear care planning process. This gives staff enough information to satisfactorily meet the needs of the people that use the service. People that use the service are enabled to manage as much choice as possible in their day to day to lives. EVIDENCE: There is a ‘personal profile’ care plan for each person and a sample group of these documents were inspected. These profiles contained information on how each person’s care needs are to be met and recorded review dates and signatures showed that these plans are regularly reviewed. It was evident from observation and discussion with staff and management throughout the day of inspection that staff were aware of how to support each person that lives at Farm Lane. There were assessments of risk covering every area within each person’s care plan. These risk assessments balanced risk against each person’s right to Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 12 choice. Many risk assessments were about everyday issues including personal care. The managers said that any restrictions on choice or freedom to reduce risk had been agreed with the person affected and other people involved in the person’s welfare. The management of the service could explain verbally all the restrictions in place and could show that they were made to protect the person’s health and safety. In general these arrangements were documented but some were missing including use of an audio monitor, and use of a personal medication cabinet key. It was important that all such protective arrangements are clearly documented so that these decisions can be regularly reviewed as part of the care planning review process. The care planning system in general provides staff with enough information to enable them to support each person. However there should be more detail on how staff meet each person’s needs. Similarly there should be more detail within each person’s individual risk assessments. It is important to write down all the information known about how to meet peoples’ needs and how to manage their risk issues, in order that staff can supply support as consistently as possible. There were no individual goals or aims listed within care planning. However goals for the next 12 month period were shown in peoples’ picture based Person Centred Plans (PCPs). Every person that uses the service has a PCP in place in addition to their care planning. Person Centred Plans enable people to express, and have taken into account, their wishes in both major life decisions and day-to-day choices. The service is developing new photographic introduction documents about each person that lives at Farm Lane. The Registered Manager was advised to keep these documents as a useful additional document to supplement the care plan. This document will help new staff to quickly gain an understanding of the people that use the service. The Registered Manager is part of Mencap’s Profound Multiple Learning Disability Group group. This group is promoting better communication and inclusion for people with complex needs that use Mencap services. This is being achieved through workshops for staff to further improve their skills in communication and inclusion. Due to the complex needs of the people that use the service many have a limited ability to make decisions independently. The care staff encourage people to make many decisions and choices on everyday issues, such as taking part in activities, and expressing meal preferences. Some people are able to assist with the day-to-day running of the home. Most people are supported by the service to manage their personal money but everyone has their own named bank account. There were records showing the involvement of advocacy services. It was felt that most people that use the service would benefit from having an advocate because of their communication needs, which make independent decision Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 13 making difficult. The Registered Manager is seeking further advocacy support for the people that live at Farm Lane. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people that use Farm Lane are supported to participate in individually appropriate activities ensuring that everyone has a reasonable quality of life. People can choose from a varied selection of good and nutritious food. EVIDENCE: The service encourages people to participate in social activities. The home does this by providing organisation, transport and staff support, to promote daily valued activity. Peoples’ files contained information about their activities. Local community facilities such as local shops and banks are used regularly. Some people attend regular community clubs and two people still have places at local day centres. The use of ‘enabling services’ from outside the home has become more important after the loss of day centre places. Most people are receiving enabling support and the management reported that these arrangements are operating successfully. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 15 The Registered Manager stated that everyone receives an individual support session each day from the home’s staff to ensure that everyone has a specific activity every day. There was a weekly chart describing what each person was doing on each day and naming the supporting staff member for each person’s activity. Some of the activities enjoyed by people that live at Farm Lane, outside the home include, clubs, the cinema, cafes, music and art groups, theatre trips, and trips in the Devon and Cornwall area. Within the home activities such as, aromatherapy, hand massage, newspapers, domestic activity, music, and television are some of the things people enjoy doing. The service plans to make good use of the sensory patio area, to the side of the home, during the summer months. This garden area adjoins the properties of the neighbouring housing. Managers and staff confirmed that the service has a good relationship with their local neighbours. Individual files held details of family contact and when and where this was maintained. One person visited their family in another part of the country independently using a coach service during the past 12 months. Families reported the good contact they had with their relatives. The home has recently obtained a new mini bus with an electric tail lift. In addition four people share ‘motability’ vehicles. The service has good transport available. There is a large accessible kitchen adjoining the dining room. We sat in the dining room with the people that live at the home, and the staff on duty, while everyone enjoyed there lunch. The atmosphere was relaxed and friendly and everyone enjoyed their meal. The homes menus were examined and staff confirmed there is a good budget to purchase food. The staff spoken with agreed that the home provides good quality and wholesome food. There is a professional cook in addition to the care staff team five days per week. There is a record of each main meal provided. Due to peoples health needs the community health dietician plays a major role in advising on both peoples’ individual diets and on the general menu plans. The menus are changed regularly and are informed by peoples’ likes and dislikes. There were a large number of photographs of meals hung on the dining room notice board to assist people in making a genuine choice of the foods they want to eat. A number of people have their food specially prepared so that they can consume it more easily. Food and fluid intake charts were seen being effectively used to support a number of people. Staff have received training from the community health team on how to best support people with specialist feeding needs. People that live at Farm Lane receive a choice of good quality food and their nutritional needs are met. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People that use the service receive good health care support and their privacy and dignity is respected. Support to address health care needs is sought as soon as issues arise. The service’s management of peoples’ medication is generally good. EVIDENCE: The care plans document peoples personal and health care needs. Three peoples’ care and medication files were looked at. Each person’s health is closely monitored in order to identify any changes, and any extra provision or support that is needed is arranged. This was documented in people’s records. Chart records are being used effectively to ensure that ongoing health care is based on accurate information. These charts record for example weight, fluid intake and food taken. The chart records were well organised and maintained. The staff seek advice from outside professional agencies as necessary. This support was mentioned frequently in peoples care planning and records. All the people that use the service have GPs who have a good knowledge of their health needs and of the care home. People that use the service receive health Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 17 support from the Speech and Language service, community dietician, and the community health learning disability service. People that live at the home receive regular dentistry, optician support, and chiropody as necessary. One community learning disability nurse commented on how the health of a person she had known for many years had improved since he had moved into Farm Lane. Staff were observed throughout the inspection providing people with personal support. This was carried out in private and the dignity of the people receiving personal care was maintained at all times. Moving and handling information is documented for the staff within individual risk assessments. Physiotherapist and Occupational therapist assessments are recorded on people’s individual files. Some people have been supported to purchase wheelchairs with custom made shaped seats to help them remain comfortable. The home has technical aids available including electrically manoeuvrable beds, bath hoist and ceiling track hoists. The service has all the necessary equipment to relieve pressure on peoples’ skin. The home has successfully supported treatment to heal a pressure sore that occurred while the person was being supported in another care setting. One person continues to receive treatment from the District Nursing service. Relatives of people that live at the home commented, ‘ The care of my son is very high, when we visit him he is always clean and tidy, even if we just call in without informing the home. Another relative wrote, ‘(They) Look after my brother well, treat him with respect and cater for his every need.’ The home has a key worker system in operation. Through their in depth knowledge of the person they support, e.g. their likes and dislikes, key workers help people to make daily living choices and decisions. The key worker is responsible for a number of tasks including review and amendment of the care plan, family liaison, personalisation of the person’s bedroom, and ensuring health checks take place. A monitored dosage system is used to administer the majority of medication that is in the safekeeping of the care home. This medication was locked away safely and tidily in the homes medication storage facilities. However one epilepsy medication was insecurely stored in one person’s bedroom. A medication administration procedure is in place. Medication administration records were adequately maintained. An active list (profile) of all the medication presently prescribed to each person was not on their medication file. There was good information on each person’s medication file about each of their medications including potential side effects. Each person’s medication is regularly reviewed by either their GP or the dispensing pharmacy. Staff receive medication administration training from the dispensing pharmacist. Medication to treat people when they are having an epileptic seizure can only be given by appropriately trained staff. This training is provided to the staff by Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 18 the community health learning disability service. Only staff that have received this specialist training are authorised to give this medication. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People that use the service are protected from abuse, neglect and self-harm. People that live at the home can be confident that the Registered Provider always deals with complaints or concerns seriously and takes action quickly. EVIDENCE: The homes complaints procedure is in a more accessible form using symbols as well as written language. This procedure was on display in the dining room of the care home. A copy of it is also in the Service Users Guide and in the homes Statement of Purpose. The Commission has not received any complaints, since the last inspection. The Annual Quality Assurance Assessment stated that no complaints had been received within the last 12 months and the Registered Manager restated this during the inspection. The relatives that responded to the survey questionnaires sent out by the CSCI and the professionals surveyed were all very positive towards the home and none made any complaint regarding the quality of the service supplied to people that live there. The Annual Quality Assurance Assessment stated that all the staff have received adult Protection training from Plymouth City Council. This information was checked during the sampling of staff training. This ensures they are aware of their responsibilities should they suspect a person is at risk of abuse. A copy of The Plymouth City Council ‘Alerters’ guidance was present in the home. Mencap has a policy of renewing staff Criminal Records Bureau checks on a regular basis to ensure the ongoing safety of the people that use the service. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People that use the service benefit from a homely, comfortable, and adequately maintained building. EVIDENCE: The home has been purpose built and the premises are accessible to everyone that uses the service or visits the home with level access throughout. We saw that the building was comfortable, well furnished, clean and free from odour. All bedrooms are single rooms and each person’s bedroom is decorated as the person wishes or to reflect their personality. Every bedroom contained many personal possessions and also often sensory equipment, such as bubble tubes and lighting. All the furnishings were of good quality. The service has purchased and installed five new ceiling track hoists in bedrooms and in the main bathroom since the last inspection. Seven of the nine people that use the service now have electric adaptable beds to assist their mobility and care. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 21 There are some physical restrictions of peoples’ facilities in place to protect peoples’ health and welfare. A small number of these adaptations should be of a more domestic type to prevent an institutional appearance. Specifically locks on cabinet doors and water tap adaptation. There is a large lounge and a large separate dining room which is also used through out the day as a second lounge area. The living room has a comfortable domestic atmosphere containing a fireplace, sofas and peoples’ personal adapted chairs. The home has recently bought a new large television. Unfortunately there are still some visible heating pipes in parts of the home including the living room. These are safe but do harm the appearance of the rooms in which they occur. There is an accessible patio garden area with seating to the side of the building. Decorations are available to make this a more pleasant area including wind chimes and pictures. The staff have begun to redecorate the main bathroom to help it feel more homely so that people using it can feel more comfortable. There is a large separate shower room that can incorporate a shower trolley. This shower room facility is well used by a number of people that live at the home. There are CCTV cameras on the outside of the building, monitoring the car parking area and people approaching both the front and side doors. This is for the protection of both people that use the service and the staff. The home’s laundry facilities are sufficient to meet the needs of the people that use the service. There is an appropriate industrial washing machine and an industrial dryer. The Annual Quality Assurance Assessment and sampling of staff records showed that all the staff have completed infection control training. Personal protective equipment, such as disposable gloves and aprons, are easily available to staff. Paper towels are available in all bathrooms and toilets for people to use to dry their hands. Guidelines are available on infection control practices and the procedures to be used. Incontinence materials are managed and stored sensitively to ensure that a domestic appearance is maintained in peoples’ rooms. People that use the service can be assured that the service is doing as much as possible to prevent infection. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff have a good understanding of the support needs of the people that use the service. There are enough well trained and experienced staff provided by the service to meet the needs of the people that live at the home. EVIDENCE: Farm Lane has a consistent staff team. The staff have a good understanding of the needs of the people that live there. Throughout the inspection staff were observed responding sensitively and respectfully to requests from people that use the service. The staff seen on duty were friendly and good-natured. They interacted well with the people that live at the home. Relatives of people that use the service made the following comments in their survey responses; ‘I think the staff do a very good job sometimes under difficult circumstances.’ Another wrote ‘I think staff make a great effort to treat the residents as individuals and to run a cheerful happy home’ One more commented ‘My son cannot speak but they always make sure he knows when I ring him’. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 23 Discussion and personnel records confirmed that the manager and staff are aware of when to ask for advice and guidance from other agencies, including the specialist learning disability services. Care plans and risk assessments highlighted that people that use the home have high support needs. The Registered Manager said that the following minimum staffing level is always provided and is sometimes exceeded. From 8am till 9pm there are at least 4 care staff, from 8pm till 8am there are two waking staff. The staff rota confirmed these arrangements. In addition to care staff there is a part time cook and 2 part time cleaners that support the care staff to spend more time with the people that use the service. The Registered Manager said that the staffing level was adequate to meet the needs of the people that use the service at present. A thorough training programme is run by the organisation to ensure that the needs of the people that use the service are fully met by skilled staff. The organisation is training new staff through a new induction programme that includes external teaching days as well as training within the home. This training gives staff specific skills to work with people with a learning disability. This induction training then forms part of an NVQ2 and enables staff to meet peoples’ needs soon after beginning work at the home. At present 68 of the staff team have an NVQ2, or above, qualification in care delivery. The Registered Manager and the organisation have supported the staff team to maintain this high level of qualification. Sampling of staff files showed that staff continue to receive their statutory basic training. This includes First Aid, Fire Safety and Moving and Handling. A sample of staff records were seen. These confirmed that the homes recruitment procedure is robust and ensures the protection of people that live there. The Annual Quality Assurance Assessment stated that all staff had a Criminal Records Bureau (CRB) check and a Protection of Vulnerable Adult (POVA) register check. This information was supported by sampling of staff personnel records. Key-worker and staff meetings take place on a regular basis. The managers of the home were seen observing staff practice and directly supervising the staff. Staff files sampled showed that staff are receiving regular formal 1:1 supervision meetings. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The day-to-day running of the home is being well managed to meet the needs of the people that use the service. EVIDENCE: The Registered Manager, Fiona Hannay, is a qualified Learning Disability Nurse (RNLD). She has many years of professional care experience and she has recently completed the Registered Managers Award. All records inspected were well maintained. The Registered Manager said she is continuing to improve the care-planning and recording systems to ensure that information is easily accessible and well understood by those providing care. The records of people that use the service are reasonably organised which assists the management to monitor the delivery of support and therefore helps the service to meet peoples’ needs. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 25 One professional from the Plymouth Community Learning Disability Team said they had, ‘No problems at all with the service. The staff and management are always very helpful. The staff are really good at what they do. I can just turn up at any time and walk in and I will find that everything is fine.’ The Annual Quality Assurance Assessment stated that all the necessary health and safety checks, servicing and training is being carried out. These statements were supported by sampled information obtained throughout the inspection. The fire protection system is well maintained. Maintenance checks on fire equipment are being carried out. Staff are receiving appropriate fire protection training to ensure they have the skills to deal with emergencies. Gas and electrical appliances are being routinely serviced and checked. All staff have completed statutory training in Fire safety, First Aid, Moving and Handling and Basic Food Hygiene. Thermostatic control valves have been installed at total immersion points in the home, such as at the shower. All other hot water is maintained at a reduced temperature by control from the central cylinder in the home. A Legionella risk assessment has been carried out to assess the safety of the management of the hot water system in the building. All the radiators in the building are covered to prevent any risk form hot surfaces to the people that use the service. Good health and safety practices help to keep the people that live at the home safe. The organisation has redeveloped the Quality Assurance system. A quality assurance process is carried out every year. The outcomes from the process carried out in late 2007 have not yet been concluded. When complete the outcomes will be used to inform the next Annual Development Plan. The present Annual Development Plan is discussed at every staff meeting. Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 2 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 3 3 3 X Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 27 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations Care planning and risk assessment should have more detail on how to meet people’s needs and on the arrangements in place to protect people from unreasonable risks. An up to date medication profile should be kept for each person. Each person’s record of medication administration should be signed consistently. When people’s medication is stored in their bedroom it should be kept secure at all times. Where physical restriction of a facility is in place to protect the health and welfare of a person that uses the service, it should be made as appropriate and domestic as possible. 2 YA20 3 YA26 Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Farm Lane House DS0000003528.V345260.R01.S.doc Version 5.2 Page 29 - 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. 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