CARE HOME ADULTS 18-65
Bawden Manor Farm West Polberro St Agnes Cornwall TR5 0ST Lead Inspector
Lowenna Harty Unannounced Inspection 7th November 2006 09:30 Bawden Manor Farm DS0000008966.V318860.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 Bawden Manor Farm DS0000008966.V318860.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. Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Bawden Manor Farm Address West Polberro St Agnes Cornwall TR5 0ST 01872 552237 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) mail@deact.org Spectrum Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21st December 2005 Brief Description of the Service: Bawden Manor Farm is a care home providing accommodation and personal care for up to 7 adults of both sexes, who have a learning disability. The registered provider is Spectrum, an organisation that specialises in providing services to people with autistic spectrum disorders. Spectrum employs a manager who is registered with the Commission and a team of care staff to run the home on a day-to-day basis. Senior managers, who are based outside of the home, are available to provide specialist input and support to the residents as required. The home is a detached, two-storey building, set in its own, extensive grounds with a spectacular view of the Cornish coastline. All of the residents have individual bedrooms and are able to access a large communal lounge, a smaller, quiet lounge and separate dining room. Some of the bedrooms have en-suite bathrooms and there are separate toilets and bathrooms in addition to these. The home has a communal kitchen and car parking space outside the main building. The home has separate office facilities with space for staff to sleep in. The homes main entrance is accessible by steps but there is a separate entrance with level access and there are bedrooms on the ground floor of the building. The building could be adapted to meet the needs of people with physical disabilities if necessary. There is a lift that goes to the first floor of the building, but it is not currently in use. The home is in a quiet, secluded area on the outskirts of the village of St. Agnes. The village is within walking distance and local towns are accessible by car. Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, which took place on 7 November 2006 and lasted for approximately seven hours. The purpose of the inspection was to ensure that service users’ needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus is on ensuring that service users’ placements in the home result in good outcomes for them. Information received from and about the home since the previous inspection has also been taken into consideration in making judgements about the quality of outcomes for the service users living there. The inspection included observation of all of the service users and brief interviews with three of them. Two members of staff were interviewed and there were opportunities to directly observe aspects of service users’ daily lives in the home and staff interaction with them. Other activities included an inspection of the premises, examination of care, safety and employment records and discussion with the manager of the home. Case tracking of four service users involved a more in-depth review of how the home meets their needs, with particular reference to their age, racial and cultural origin, religion, gender, sexual orientation and disabilities. Fees range from £825 to £2397 per week. There are no additional charges to service users, according to information supplied by the home’s manager, subsequent to the inspection. Information telling service users about the home is held on their personal files and is available in pictorial formats, if required. What the service does well:
Service users are assessed prior to moving into the home and have good information about it so that they can be sure it will be suitable for them. They appeared to be settled and comfortable in the home, and well matched with each other as a group, at the time of the inspection. Service users have written care plans that consider their personal, health and social care needs. Their care plans include consideration of their background and culture, age, religion, gender, disabilities and sexual orientation. Their care plans are given to them in appropriate formats or explained to them in ways that they can make sense of, as far as possible, so that their views are considered. Service users were observed using a variety of different communication methods and tools to indicate their choices and preferences about things that
Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 6 were important to them. This included choosing when to get up in the morning, what to eat at mealtimes and how and where to spend their free time, for example. Staff described how they support and help them to make decisions so that they can develop their skills and independence. Service users are encouraged to take part in a wide range of activities in and out of the home, which often involve some degree of risk. They are not overly protected in this sense, but encouraged to take part in activities that are designed to improve their skills and confidence and enhance the quality of their lives. Examples of activities include going swimming, horse riding and for country walks and drives. Some of the service users had recently been on a camping trip. They are assisted to maintain contact with their families and friends outside of the home as far as is possible, and go to parties at other Spectrum homes so that they enjoy a good quality of life. They are informed of their rights and responsibilities as residents of the home in their individual contracts, which are also available in translated formats that are more readily accessible to them. Service users are helped to choose the foods they like and are provided with different communication tools so that they can show staff what they want to eat. At the time of the inspection they were observed choosing breakfast and lunch items and appeared to enjoy their meals, which they took together with staff. Service users access NHS healthcare services in the local community so that they maintain good health. This includes specialist services, if they need them, in most cases. Medicines are mainly managed in ways that are safe for service users so that they are provided with the medicines they need in ways that are safe for them. Service users are given opportunities to make comments about the care and services they receive in the home, so that they can be improved. There are good systems in place to protect them from harm and abuse so that they can feel safe. The home’s environment provides service users with a clean, comfortable and safe place to live in, which offers privacy and access to the local community. It provides them with an ordinary, domestic-style setting, which is not overly institutional so that they can develop independence and skills in ordinary everyday activities. Staff either have or are working towards achieving formal qualifications in care and have good access to ongoing training so that service users can have confidence in their knowledge and skills. They are recruited fairly and on the basis that they are suitable to work with vulnerable people in a care setting so that service users can have confidence in their competence and integrity.
Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 7 The home is generally well managed and safe and run in the best interests of the service users living there. What has improved since the last inspection? What they could do better:
Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 8 Service users need to be given improved information about the cost of their placements in the home so that they can make better informed decisions about whether to continue to stay there. The manager said that he is currently taking action, however, to update their individual contracts so that they will have this information in the future. Service users without families who are actively involved with overseeing their welfare should be provided with independent advocates so that they have someone outside of the home and are not isolated in it. This is particularly important for those with communication difficulties, who may find it more difficult to express their wishes and views. Male service users should be provided with more choice about the gender of staff who work with them, particularly with regard to assisting them with intimate personal care tasks, so that their dignity is respected. They should also be helped to access more specialist healthcare and support services if they need them, in relation to managing sensory disabilities, for example. Whilst more staff have received training in basic handling of medicines, more need to have completed formal training in this respect so that service users have improved protection from medication errors. The manager said that is currently being arranged for them. The manager would benefit from attending multi-agency training on protecting vulnerable adults from abuse that is available locally so that he is able to gain familiarity with how different organisations should work together to do this. The manager, whilst being in charge of the home for quite some time, has not yet submitted his application to be registered with the Commission. He should do this as soon as possible so that service users and their representatives can have confidence that he is a suitable and fit person to be in charge of a care home. 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. Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 9 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 Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Current and prospective service users have good information about what the home provides so that they know it will be suitable for them, although some improvements are needed. Admission to the home is on the basis of an assessment of service users’ individual and diverse needs so that they can be assured their needs will be met. EVIDENCE: Service users currently placed in the home have copies of the home’s service users’ guide, which also acts as a placement contract for them, on their individual files. Copies are provided to them in pictorial formats so that they can access more of the information directly. These need to be updated so that they are each provided with information on the total cost of their placement in the home and how their personal contribution is calculated. The manager is arranging for this to happen, further to recent changes in the regulations in this regard. The manager said that several of the service users have lived in the home for several years and are very familiar with what it provides, through their experience of living there. Those who have become resident more
Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 11 recently, underwent detailed transition plans to help them move comfortably from their previous placements, records of which are on their individual files. There is detailed assessment information on most of the service users’ files, which indicates that their health, personal and social care needs are fully considered prior to their moving into the home. Records indicate that there is due consideration of their racial and cultural origins, any additional disabilities, gender, age, religion and sexual orientation so that they can be sure that the home will meet their needs in these respects. Some service users, who have lived at the home for many years, did not have initial assessment information available, but there were detailed records containing historical and background information about them. The service users appeared to be comfortable and relaxed in the home during the course of the inspection and in this respect, it appeared to be meeting their needs well. Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 12 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 & 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users have detailed individual care plans, which fully address their personal, health and social care needs. They are regularly reviewed and updated. Improvements are currently being implemented so that service users will be more involved in the process and have clearer goals to work towards. There have been improvements to ensure that some service users have better assistance to communicate their decisions so that they have improved levels of choice about things that are important to them. Service users are supported to take risks in a managed way so that they live full and active lives. They are encouraged to develop their confidence and independence with due regard for their welfare and safety. EVIDENCE: Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 13 Copies of service users’ care plans are held on their individual files and the manager explained the changes to the care planning process so that it will become more person centred in the future. Records indicate that the new systems are in the process of being implemented. A service user and staff member were observed working together to develop a life story as part of the new process. Service users’ personal, health and social care needs are fully accounted for in their care plans. This includes issues relating to their racial and cultural origin, gender, any additional physical or sensory disabilities, faith needs, age and sexual orientation. The new care plan formats provide service users with more detailed and specific goals so that they will be better able to measure their achievements and understand the purpose of their placements in the home. Service users were observed making choices about when to get up in the morning, what to have for breakfast and lunch and how to spend their free time during the inspection. Staff gave examples of how they support service users to make decisions for themselves about things that are important to them, using a range of different communication tools. This includes pictorial and symbol tools, some of which are available to service users on a computer in the dining room. The manager described how he has actively advocated for some service users to be referred to specialist NHS speech and language therapists, so that they can be assisted to develop their communication skills. This will enable them to communicate their views and wishes more easily. There was considerably more interaction between staff and service users observed at this inspection to previous ones as a result of this. There are detailed written risk assessments on service users’ individual files, which suggest that risks are fully considered as part of the care planning process. This includes risk assessments of specific activities that service users engage in. Their daily care records indicate that they are not prevented from taking managed risks to develop their skills and independence and they take part in a wide range of activities in and out of the home. Some of them had recently returned from a camping trip with staff, for example. The home’s accident book indicates that there is a low level of physical injuries to staff and service users, which suggests that risk assessments and management plans are effective. Bawden Manor Farm DS0000008966.V318860.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): Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 15 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. Service users take part in a wide range of activities in and out of the home so that they enjoy a good quality of life, which are suitable in terms of their ages, interests and backgrounds. They are supported to maintain contact with their families and meet people outside of the home so that most of them are not isolated there. Improvements should be made for people whose families are not actively involved so that they have someone from outside of Spectrum to oversee their welfare. Service users’ rights are respected and they are informed of their responsibilities although some service users should be provided with improved access to external advocacy so that they have an independent person to oversee their best interests. Service users nutritional needs are met so that they are well fed and stay healthy. EVIDENCE: Service users were observed taking part in a variety of different activities in and out of the home. Staff who were interviewed said that there were enough of them employed to enable service users to undertake activities in accordance with their individual care plans. Service users were able to point out the various activities they enjoy, using pictorial symbols and photographs. Service users’ individual daily records indicate that they take part in activities such as horse riding, swimming, hydrotherapy and country walks during the day, as well as practical tasks to develop their skills in the home. Service users were observed enjoying less structured time in their own rooms or in the lounge when not engaged in more structured activities. The manager said that most of the service users have families who advocate for them but some do not see them often, so there is a risk that they could become isolated in the home. Care staff who were interviewed said that some service users maintain contact with their families and one described how she had recently supported a service user to return to their family home for a visit recently. The manager said that they attend parties and social functions at
Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 16 Spectrum’s other homes so that they can meet other people, with similar ages and interests, with staff to support them, as necessary and one recently held a birthday party in the home, to which they invited people from Spectrum’s other local homes. Service users’ individual contracts set out their rights and responsibilities as residents. These contain information on their rights to access personal information about themselves, for example, and their rights to obtain independent advocacy. They also set out expectations of service users in order to develop their skills and independence. This includes assisting with household tasks, for example. Service users are able to access their contracts in translated formats so that this information is directly available to them and further work is being undertaken to enable them to develop the communication skills they need to be able to understand more about their rights. In the meantime, there is evidence on their files that copies of their contracts are sent to their social workers and families who can agree them on their behalf. Service users appeared to be physically healthy and were observed choosing items of food for breakfast and lunch. Staff were available to support them at mealtimes and took their meals with them. Mealtimes appeared to be flexible, depending on service users’ individual activities. Their care plans consider their dietary needs and preferences so that appropriate menus can be provided. Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 17 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 adequate Service users are supported with their personal care and are encouraged to develop their independence so that they maintain their dignity, but some improvements are needed so that male service users can have more choice about the gender of the staff assisting them. They have good access to healthcare services and the home’s manager advocates for them so that they stay well and access specialist services they need although specific support is needed with regard to accessing specialist services for people with sensory disabilities. Systems for managing medicines are mainly safe and sound although more staff should receive formal training so that service users are protected from medication errors. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has adequate facilities for service users to receive personal care in private, and several of the bedrooms have en suite bathrooms. The manager
Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 18 said that most service users are quite independent with regard to their personal care although some need more support. Currently there is a lack of male staff on the team so that male service users who need intimate personal care lack choice about the gender of the people who assist them at times. This should be addressed. Service users’ personal files contain information that indicates they regularly access a range of NHS healthcare providers outside of the home. This includes routine checks with NHS professionals, including GPs, dentists and opticians for example, so that they maintain overall good health. The manager has advocated so that some have received support with regard to their speech and language needs and this is continuing so that all those who need this form of support are able to receive it. This needs to be extended with regard to ensuring that people are supported adequately with any additional sensory disabilities. There are clear written instructions for staff with regard to medicines management and medicines are safely stored in a lockable filing cabinet. There were no excess stocks at the time of the inspection and records appeared to be clear, up-to-date and accurate. Not everyone on the staff team is trained in the safe handling of medicines as yet, although all of them have received instructions on what to do. All staff who handle service users’ medicines should be provided with sufficient training as to protect them from the risk of medication errors. Bawden Manor Farm DS0000008966.V318860.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. Service users have opportunities to make their views known and they are taken seriously so that their rights are respected. They are well protected from harm and abuse so that they can feel safe in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager said that there had not been any formal complaints since the previous inspection. There were records of questionnaires that are put to service users and their representatives asking them for their views on the quality of the care and services at the home and the manager was able to describe the actions he has taken to address their comments, so there is a more pro-active approach to dealing with their concerns. Service users and their relatives are provided with copies of the home’s formal complaints procedure, which is included in their placement contracts. Staff were confident about what they would do if they suspected a service user was being abused. They and the manager said that because they work as a team and there are good systems for staff to communicate between each other, service users are well protected. There are suitable written procedures to guide staff on the formal steps that they need to take if they suspect a service user has been abused. Staff are subjected to checks upon recruitment with regard to their suitability to work with vulnerable adults in a care setting.
Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 20 The manager said that he has applied for multi-agency training on safeguarding vulnerable adults. Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. Service users live in a comfortable environment, which meets their needs and is in a suitable setting so that they benefit from living as part of a local community. The home is mainly clean and hygienic although further improvements are needed to staff training so that service users are better protected from crossinfection risks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well situated so that it provides service users with space and privacy but is close to a large village community nearby. Service users appeared to be comfortable in their surroundings at the time of the inspection, and were making use of the choice of communal spaces as well as their individual bedrooms. The home felt warm and comfortable and looked homely and attractive in most parts. There have been a number of recent improvements, which were observed. The manager is in the process of
Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 22 arranging for service users’ bedrooms to be re-decorated and some had already been completed at the time of the inspection. There are suitable environmental adjustments made to ensure that service users with disabilities or additional health care problems can be cared for safely in the home. These were observed during the inspection of the premises. The home looked clean and tidy throughout at the time of the key inspection, which was unannounced. The manager described improvements that have been made, with regard to the management of heavily soiled laundry and the provision of clearer cleaning guidelines to staff so that they are better informed and service users are better protected from cross-infection. This represents a substantial improvement, but more staff should be provided with training in infection control. The manager said that this has now been arranged and he hopes they will attend it shortly. Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 23 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, 34 & 35 Quality in this outcome area is good. Staff either have or are working towards achieving formal qualifications in care so that service users can have confidence in their abilities to work with them effectively. They are recruited on the basis of fair, safe and effective recruitment and selection practices so that service users can be confident that they are suitable to work in a care setting. Staff have good access to ongoing training so that they are able to work safely and competently with service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s manager said that all the staff either have or are working towards completing NVQ level 2 in care and there are records in the home to support this. Staff who were interviewed said that they felt they were recruited fairly. Their recruitment records suggest that they were recruited on the basis of suitable
Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 24 checks and equal opportunities interviews that test their suitability to work with vulnerable adults in a care setting. Staff who were interviewed said that they have good access to ongoing training and there are records of this on their individual electronic record files. The manager was able to produce a whole staff team training plan so that their individual training needs can be identified and met. New staff have completed a five-day induction training course prior to commencing work in the home. Records to confirm this are held on the home’s computer. Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 25 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): Quality in this outcome area is good. The home is generally well and competently managed for the benefit of the service users living there although the manager needs to register with the Commission so that service users can have confidence in their fitness to manage the home. Service users’ views are considered appropriately with regard to making improvements so that they benefit from changes that are made. There are systems in place to ensure the health and safety and welfare of service users so that they can feel secure in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 26 The manager is experienced in working for Spectrum and as manager of this home and there have been several notable improvements completed since his appointment. Spectrum has supplied information to the Commission about his qualifications, experience and suitability to manage a care home but a formal application still needs to be submitted to fully demonstrate his fitness to take on the role of registered manager in this setting. Staff described the ways in which they involve service users in the home’s quality assurance systems and the manager confirmed that their relatives and placing authorities are also consulted. They are sent questionnaires, which invite them to comment about what the home provides and copies were available for inspection. Senior managers from Spectrum’s head office visit the home regularly and submit copies of their reports to the Commission on a more regular basis than previously. There was a copy of the home’s annual development plan on the wall in the office, so that it is available to staff. The manager was able to describe improvements that have been introduced to health and safety in the home, with particular reference to improving fire safety. He said that there are now designated shift leaders to ensure that regular tests and checks are done and ensure that there is accountability in terms of maintaining a safe environment. Fire safety training and records were improved as a result. The manager has completed a risk assessment of the home’s environment in addition to service users’ individual risk assessments, to account for their welfare and safety. Staff who were interviewed said that they felt the home was a safe place to work in. Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 27 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 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 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 3 3 X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 2 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 X 2 X 3 X X 3 X Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 28 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 YA16 & YA15 YA18 Good Practice Recommendations Service users without families, who can actively oversee their welfare, should have independent advocates, particularly those with communication difficulties, so that they are not isolated in the home. Male service users should be provided with a greater degree of choice about the gender of the staff who provide them with intimate personal care so that their dignity is respected. Service users with additional sensory disabilities should be assisted to access specialist services and sources of support so that they are helped to manage the effects of their disabilities in accordance with best practice. All Staff handling service users’ medication should undergo training in the safe handling of medicines, so that service users have increased protection from medication errors. The home’s manager and senior staff should attend local multi-agency training in the protection of vulnerable adults from abuse.
DS0000008966.V318860.R01.S.doc Version 5.2 Page 29 2. 3. YA19 4. 6. YA20 YA23 Bawden Manor Farm 7. YA37 The manager should submit an application to be registered with the Commission as soon as is possible so that service users can have confidence that he is a fit person to be in charge of a care home. Bawden Manor Farm DS0000008966.V318860.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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
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