Inspection on 18/07/06 for Barnfield Farm

This inspection was carried out on 18th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Barnfield Farm 29/11/07

Barnfield Farm 05/12/05

Barnfield Farm 17/05/05

Barnfield Farm 12/10/04

Barnfield Farm 18/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Barnfield Farm Greenacre Farm Communities Luppitt Honiton Devon EX14 4SJ Lead Inspector Susan Lyons Key Unannounced Inspection 18th July 2006 08:30 Barnfield Farm DS0000021883.V294528.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 Barnfield Farm DS0000021883.V294528.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. Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barnfield Farm Address Greenacre Farm Communities Luppitt Honiton Devon EX14 4SJ 01404 891627 01404 891963 barnfieldfarm@roc-uk.org 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) Greenacre Farm Communities Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th December 2005 Brief Description of the Service: The home is registered to accommodate up to 15 adults who have a learning disability. The home has reduced the number of people living there to 12. Barnfield Farm is in a rural setting on the edge of the village of Luppitt with extensive grounds. The nearest main town and shopping facilities are in Honiton. There are two main buildings, one very old thatched house known as Long Barn, which is a listed building and a separate modern house known as The Shippon. There are several outbuildings, which are used as workshops and for keeping pets. Residents bedroom accommodation is on the first floor of each house. The rooms in the older building are only accessible via very steep and narrow staircases. The home is operated by Robert Owen Communities, previously known as Greenacre Farm Communities. Currently the fees for the home are £467 - £750 per week. The home is looking at ways in which they will make the CSCI reports available to people. Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place at 08.30 and the inspector was able to meet and speak to all of the residents. Although the home is registered to take eleven people, on the day of the inspection only five residents were accommodated. Several previous residents have moved into more independent settings and a major refurbishment is taking place at the home. This will mean that nine of the rooms will have ensuite bathrooms and two rooms will share one bathroom. There will also be kitchen areas in the buildings away from the main house to encourage residents to be independent and so that they have access to drinks and snacks at all times. As well as talking on an individual basis the inspector sat and had lunch with some of the residents and was shown some of the grounds by a resident. A tour of the building took place and some records were seen. Before the inspection the home completed a pre inspection questionnaire and survey cards were sent out as follows: Surveys Sent To Staff members Relatives Residents Care Managers GPs Specialist Health Care Professional How Many Sent 7 0 11 8 1 0 How Many Returned 2 0 8 2 0 0 What the service does well: The home engages residents well with what is happening within the home. When the inspector arrived the residents were all aware of what was going on with the building work and were excited about their new rooms which they have been involved in choosing the décor for. Residents also relate well to their individual key-workers and appear confident about speaking to them if they have concerns. The assessment process is thorough and care plans are person centred with residents being aware of what is in them. Residents are involved in decision making and assessing the quality of the service not only within the home but also through a representative in the larger Organisation. Residents have varied activities to take part in and although the home is in a rural setting residents go out to access services rather than them being Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 6 brought in to them. Family relationships are encouraged and the routines within the home are flexible. Residents are encouraged to eat a healthy diet and are involved in the choosing, shopping and preparing of meals. Support is offered to residents in the way in which suits their needs and there is an emphasis on residents being as independent as possible. Medication is stored and was seen to be administered appropriately. The complaints procedure is written in a format which residents will be able to understand and residents feel confident about speaking to people within the home about concerns they may have. Staff are aware of adult protection procedures and there is a whistle blowing policy. The home is currently subject to major alterations but cleanliness was seen to be maintained and residents are fully involved in the changes taking place. There is an expectation that all staff will undertake NVQ training. Additional training is also provided through the Organisations own training department. In the absence of a registered manager the home is being managed by the Area Manager and safety checks are being maintained within the home. What has improved since the last inspection? What they could do better: 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. Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 7 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 Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment process ensures that residents can be confident that their needs will be met within the home. EVIDENCE: The home has its own comprehensive assessment, copies of which were seen, completed for all the residents. The area manager is clear that they will need to obtain a copy of the shared assessment (Health & Social Services) for any new residents admitted to the home. Prospective new residents have been able to visit the home and it is planned to have a day when they can all visit with their families so that everyone will be able to get to know each other. A resident said that he had met some of the new residents who will be moving to the home, when they came to look round. Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is generally clear and consistent care planning and risk assessment in place, which provides staff with the information required. This will be further enhanced by some minor adjustments. The systems within the home for resident consultation are good with evidence that residents’ views are sought and acted upon. Measures need to be adopted so that residents are assured of confidentiality. EVIDENCE: Care plans were seen for all the residents they are person centred plans and generally contain details of the support which individual residents need. They also contain details of residents’ wishes for the future which includes things they would like to do and activities they may wish to take part in. Additional detail is required in relation to the way in which staff respond to specific behaviour for one resident, to ensure that all staff are saying the same thing. Annual reviews are held and the home has now introduced a procedure to ensure that the care plans are reviewed in addition to the annual reviews. Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 10 Residents were aware of their care plans and said that they had been discussed with them. Some residents have signed to say that they have agreed them. There was no record that residents had been asked about their spiritual or religious needs and residents were unable to recall whether they had been asked. Regular residents’ meetings are held and residents said that they are able to go shopping to choose their own clothes. Most recently they have been consulted about the colour of the decoration in their bedrooms and residents were clear about what they had chosen in the way of paint and carpets. Individual risk assessments as well as generic ones for the home were seen. They cover aspects of risk, the degree of risk and how they are to be managed. However it was noted that many of the assessments had not been reviewed for over a year. In particular one made reference to the fact that it needed to be reviewed in a multi disciplinary setting and although this was said to have happened there was no record of it. Residents’ records are stored in one of the offices, which is secured when not in use. However the daily recording is completed on one form, with all residents’ names on the same form and some of the detail is quite personal to that individual. In one case the entry indicated that it had also been recorded elsewhere, but it could not be found. This system of recording does not ensure that confidentiality is maintained. Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Links with the community are good with residents participating in a variety of activities, which enrich residents’ lives. Residents benefit from support to maintain links with relatives and friends and from a varied diet, which they help plan. Residents’ day-to-day involvement within the home is good as their rights and responsibilities are acknowledged and encouraged. EVIDENCE: One resident has recently finished a college course and undertakes some voluntary work at a local brewery for a half day a week. Other residents attend a day service, which is run by the same organisation. Residents also spoke about other activities which they take part in including walking, dancing and craftwork. Although the home is in a rural setting and there is no access to public transport residents do access the local community. They talked about days out they have had, shopping trips for personal things, going out to have their hair cut and to help with food shopping. One resident mentioned going to a local Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 12 folk festival and one talked about being in a pantomime. Residents also attend a social club if they wish and keep in touch with people who have lived at the home previously. Residents said that they telephone their relatives and they are able to come and see them. If they want to see their visitors in private then they may use their bedrooms. There is an open door policy about visitors but often relatives phone before visiting to ensure that the person they are visiting is not out. Daily routines within the home are flexible; residents said that they are able to go to bed when they wish. They said during the week they are called if they are going out but at weekend they have a lie in. Currently bedroom doors do not have locks but it is intended that they will be fitted to the doors when the building work has been completed. Residents said that their letters are given to them before they are opened. They are encouraged to help- around the home and on the day of the inspection one resident was seen to help prepare vegetables and with the washing up. Residents said they help to choose what is on the menu and then a list of food required is made and they help with the shopping. One resident was seen to be offered an alternative lunch as he did not like what was being served. Residents are encouraged to eat healthy and weight is monitored. Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. 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. Personal support in this home is offered in a way which promotes and protects residents’ privacy, dignity and independence. Good systems are in place to monitor residents’ healthcare needs and they are protected by the medication practices and procedures. EVIDENCE: Residents said that the staff helped them and they were helped to do things for themselves. Residents knew who their key worker was and felt that they were the person they would talk to about issues. They confirmed that staff knock on their bedroom doors before coming in. Staff were aware of how to maintain residents privacy and dignity if offering support for personal care. Residents said that staff helped them and gave examples of this. Each resident has a Health Care Diary, which contains an Assessment under OK Health check for adults with Learning Disabilities. One of these was seen to have been completed by a community nurse. Details were seen of additional health appointments being undertaken such as optical, dental and chiropody and good records are maintained of the outcome of appointments thus ensuring that residents’ health care needs are met. Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 14 The home uses a monitored dosage system from a pharmacy. Currently none of the residents self-medicate therefore all medication is stored in a locked cupboard. Staff receive training from the pharmacy to ensure that they understand the procedures. The administration and recording of some medication was seen to be undertaken appropriately Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. 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. Residents are protected by the complaints and adult protection procedures within the home. EVIDENCE: The home has a complaints procedure, which has been written for residents, which includes photographs of staff. It has been recognised that it needs to be updated as most of the staff featured have now left. Residents mentioned that they would either go to their key worker or the area director if they were unhappy about something within the home. The home has had no complaints since the last inspection and none have been received by the Commission. Training in Adult Protection is included in the training package, which all staff at the home undertake. The member of staff who spoke to the inspector was clear about what she would do if she saw a resident being treated inappropriately. The home has a whistle blowing policy to ensure that staff report any incidents of concern. Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Residents will benefit from a home which provides additional facilities and from being involved in choose making. Residents benefit from a clean and hygienic home. EVIDENCE: The home is currently undergoing a complete refurbishment and builders were on site undertaking this work. The main building is a listed building so although it had been anticipated that all rooms would have their own bathrooms two will have to share due to restrictions in relation to one window. Residents were fully aware of what was happening and were excited about having new bedrooms and bathrooms. They said that they have been able to choose the colours they will have in their rooms. Furniture and carpets within the main house are to be changed with the alterations, which have been made. Consideration has been made in the way in which the work is being undertaken to ensure that residents have as little disruption as possible. Even though the whole area was subject to dust etc. from the building works being completed the home was seen to be clean on the day of the inspection and there were no unpleasant odours. There is a laundry in the main house, which is due to be decorated, and new flooring put in with the changes. Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 17 Disposable gloves and aprons are available when needed to ensure that a risk of infection is controlled. Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from qualified and trained staff and are protected by the recruitment procedures. EVIDENCE: Currently the home has five members of staff. One member of staff is undertaking NVQ level 2. One is undertaking level 3 but as she has now been appointed as Deputy is going to undertake level 4. Three of the other staff have yet to complete their first six months at the home and will then start NVQ training. Recruitment records were seen for staff; they are stored securely and well organised. They contain the necessary checks required such as references and Criminal Records Bureau (CRB) checks. This means that residents are protected. The home is intending shortly to undertake further recruitment to increase staffing levels for when new residents arrive. One member of staff said that she felt the induction she had received at the home had met her needs. The Organisation has its own training department and all staff complete a package of training, which includes Food Hygiene, First Aid, Dealing with Challenging Behaviour, Bereavement & Loss and Autism. Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from good leadership within the home and from opportunities to give their views in relation to quality. With some adjustments residents will be assured that their needs in relation to safety are met. EVIDENCE: Currently the home is without a Registered Manager. However a new manager has been appointed and is due to start next month. In the interim period the area manager has made the home his base. A member of staff who spoke to the inspector said that she felt supported and able to discuss issue she may be concerned about with the area manager. The home sends out an annual questionnaire to residents and their families the responses from these questionnaires are analysed and appropriate action taken if required. In addition to this a regular newsletter is sent out to families. Residents are represented at the quarterly Services Committee meetings and Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 20 as well as the residents meetings within the home there are also East Devon Service Users’ Meetings, which are held four times a year. Within the larger organisation there is a commitment towards Quality Assurance with the monitoring of the homes being checked at each management level. Fire records were seen, there was a period earlier in the year when the check of the fire alarm was not taking place on a weekly basis. However records now indicate that fire safety checks are being undertaken within the required timescales. Records in relation to other safety checks indicate that they have been undertaken at appropriate intervals. The area manager was unable to confirm that on each shift, including at night, there was at least one member of staff who was trained in First Aid. Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 21 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 X 2 3 3 X 4 X 5 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 22 N/A 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. 1 Standard YA42 Regulation 4 (c) Requirement You should ensure that at least one member of staff on each shift is trained in First Aid. Timescale for action 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA6 YA6 YA9 YA10 Good Practice Recommendations It is recommended that additional detail is included in one care plan, identified at the inspection. It is recommended that residents’ spiritual & religious wishes be recorded. It is recommended that risk assessments be reviewed regularly. It is recommended that daily recording is on an individual sheets for each resident Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 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 Barnfield Farm DS0000021883.V294528.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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