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Inspection on 02/12/05 for Beck Farm House

Also see our care home review for Beck Farm House for more information

This inspection was carried out on 2nd December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users are encouraged to make their own decisions and to speak up for their rights. They are expected to take responsibility for their actions. The service employs and trains the right staff to care for service users and meet their needs.

What has improved since the last inspection?

The home is now using a company-wide quality assurance system to check the service of care provided to service users. The service users are now a more settled group of adults because they have come to know each other better and have a consistent level of care from staff.

What the care home could do better:

Service users could be better protected from abuse and self-harm. They could be more informed and consulted on the quality assuring and monitoring of the service of care provided. Service users and staff could be more protected from the risk of fire. Service users could be cared for by staff in greater numbers than is currently being provided. All of these improvements have been listed under the statutory requirement section of the report.

CARE HOME ADULTS 18-65 Beck Farm House Beck Farm House Beck Lane Barrow upon Humber North Lincs DN19 7AF Lead Inspector Janet Lamb Unannounced Inspection 2nd December 2005 09:30 Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 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 Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 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. Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Beck Farm House Address Beck Farm House Beck Lane Barrow upon Humber North Lincs DN19 7AF 01469 532988 NOT KNOWN YET beckfarm@tiscali.co.uk 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) Voyage Ltd inc. Thelma Turner Homes Mr John Michael Egbury Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Manager must be registered with the Commission for Social Care Inspection as soon as a satisfactory CRB clearance for working with both adults and children is received The Manager must obtain satisfactory CRB clearances for working with both adults and children for all staff prior to admitting any service users (the clearances must be retained for inspection purposes). Beck Farm House is to be registered for 7 young adults with a learning disability between the ages of 16-25 only. The home can accommodate service users aged 16-17 years of age conditional on there being no service users over the age of 25 years of age at the home. (Supplementary standards for care homes accommodating young people aged 16 and 17 will apply). 25th July 2005 2. 3. Date of last inspection Brief Description of the Service: Beck Farm House, registered August 2004, is a detached property in Barrowon-Humber, providing care and accommodation on two floors, to 7 adults with learning disability. Young adults with very complex needs and particular disabilities with challenging behaviour are placed in the home as stated in the homes statement of purpose and as a result programmes of care and behaviour management are very defined and strongly adherred to. All rooms are single with en-suite facilities. There are sufficient and suitable communal areas and an enclosed garden. Shops and services in Barton are accessed by car daily and service users often walk to Barton as part of their exercise plan. Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of Beck Farm House, one of two inspections required each year, took approximately 6 hours to complete. The inspection involved interviewing the Acting Manager, staff and one of the service users and viewing staff and service users’ files. Other service users were spoken to informally and observed interacting with staff. Information was also gathered as part of a Protection Of Vulnerable Adults investigation. What the service does well: 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. Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 6 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 Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 7 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): These standards were not assessed at this inspection. EVIDENCE: Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 8 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): 7 only. Service users have good opportunities to make decisions about their lives and receive a good level of support in doing so. EVIDENCE: Service users have opportunities to make their own decisions about their lives, but the very nature of their needs requires they are provided with an extremely intensive programme of care and behaviour modification. This would result in an expectation that their decisions in life are compatible with their programmes of care, otherwise breakdowns in relationships with other service users and staff may occur. Service users were observed making decisions and one handled a disappointing situation well when it became clear the choices made would not take place. Service users are a more settled group because they have come to know each other better and receive consistent care from the staff. Discussions with the management revealed service users are provided with intense levels of one-to-one and sometimes two-to-one staffing cover to Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 9 enable them to enjoy the support they require to be able to make their own decisions and carry them out. See standard 33 below. Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 10 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): 16 only. Service users have good opportunities to exercise their rights and to take responsibility in their daily lives. EVIDENCE: Service users exercise their rights in a variety of ways, through leisure and health choices, in making decisions about their daily routine (with support from staff and where possible always within the bounds of their programmes of care), and in accessing the facilities and services in the local community. Service users go out daily, use local shops and services, and are registered on the electoral role and claim benefits according to their need, eligibility and rights. Case files contain details of programmes of care, activities undertaken, and decisions made by service users. Discussion with service users about their daily plans and forthcoming events, confirmation from staff, and evidence in diary notes etc. show how and when service users exercise their rights. Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 11 Service users were observed accessing their rooms, for which they have a key, opening their mail, interacting very well with staff and each other, and generally using the home according to their choosing. Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 12 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): These standards were not assessed at this inspection. EVIDENCE: Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 13 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): 23 only. Service users are not always well protected from abuse and self-harm. EVIDENCE: In conjunction with the inspection a joint North Lincolnshire Council Social Services Department and CSCI Protection Of Vulnerable Adults (POVA) investigation of an allegation of abuse was undertaken. Whilst this was not completed at the time, it was determined that a staff member admitted to using inappropriate action to deal with an incident in the home. Prior to this there has been another POVA investigation taking place, which has not to date been completed or concluded. The Registered Provider, Voyage Ltd, must inform the CSCI of how it intends to safeguard and protect the service users and staff within the home, in future. Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 14 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): These standards were not assessed at this inspection. EVIDENCE: Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 15 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, 33 and 34. Service users are quite well supported by qualified staff and are well protected by the home’s recruitment systems, but the number of staff deployed in the home each day is not sufficient to meet their needs. EVIDENCE: There are now four staff with NVQ level 2 equivalent or above and there are another seven staff working towards achieving the qualification. There are 19 staff employed (includes one bank staff, but not the Registered Manager or Acting Manager) and therefore 50 with NVQ level 2 or above is almost achieved. The recruitment systems are robust and have been tested recently with the recruitment of another 6 care staff that are awaiting the results of their CRB checks before being deployed. Two current staff files were viewed and both contained all of the documentation required in Schedule 2 of the Care Homes Regulations 2001. Staff spoken to confirmed the process they went through to take up employment in the home and confirmed the training they have since undertaken. There have been some recent incidents of restraints, which have brought into question some of the staff practices that come under standard 32.3, and which Voyage Ltd are required to action and change. One decision already taken by Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 16 Voyage Ltd is to retrain all of the staff working in the home, in the use of behaviour management techniques. The staffing rosters for two weeks, 21/11/05 to 04/12/05 inclusive, were viewed and one week showed approximately 760 staff hours were provided. The CSCI’s annual return document, received November 2005, shows approximately 720 weekly contracted staff hours are available. The Residential Forum staffing guidance show the home should be providing 899 hours per week. In view of the service contracts with local authorities requiring the home to provide all service users with one-to-one care for 15 hours per day and two service users with two-to-one care for four hours each per day, the staffing hours are not sufficient to meet the assessed needs of the service users. Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 17 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 and 42. Service users are partially involved in the running of the home and their health, safety and welfare are promoted, but they could be included more in the monitoring and quality assuring of the service. EVIDENCE: The Inspector was informed that the Registered Manager and the Deputy Manager have now completed the NVQ level 4 Registered Manager’s Award. There are job descriptions available to them and both undertake appropriate training as necessary. None of this could be verified on the day of the inspection however. Service users are not completely understanding of the home’s monitoring and quality assuring systems in use, but are aware that staff take time to find out whether or not they are satisfied with certain aspects of their care and daily lives. This is recorded on the home’s computer monitoring system, which has developed further since the last inspection. At that time Beck Farm was using its own quality assuring system, but Voyage Ltd has now developed a corporate one. Evidence of this was viewed on the home’s computer. Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 18 The home maintains a level of safety for all service users and staff in line with standard 42 with the exception of fire safety. Evidence shows the Fire Prevention Officer’s requirement to carry out the home’s stated policy in respect of providing staff with fire safety training every 6 months, is not being met. Also there is evidence showing the last annual maintenance check on the emergency lighting system was done in June 2004. Action is needed to remedy this. The staff are completing weekly checks on the emergency lights and alarms, and holding monthly fire safety drills. These are recorded. Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 1 3 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Beck Farm House Score X X X X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 2 X DS0000060660.V268978.R01.S.doc Version 5.0 Page 20 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. 1 Standard YA23 Regulation 12 and 13 Requirement The Registered provider must protect service users from abuse and self-harm. The Registered Provider must notify CSCI in writing of the steps it will take to ensure that service users are protected from abuse and selfharm. The Registered Provider must train and equip staff to ensure they have the competence and qualities to meet service users’ needs. The Registered Provider must ensure that there are at all times staff working in the home in such numbers as are appropriate for the health and welfare of service users. The Registered Provider must better inform and consult service users about the service of care provided. The Registered Provider must maintain safety of service users and staff in respect of fire safety within the home including: • Provision of fire safety training to staff every six months which should be DS0000060660.V268978.R01.S.doc Timescale for action 31/01/06 2 YA32 18 and 19 28/02/06 3 YA33 18 31/01/05 4 YA39 24 31/03/06 5 YA42 23 31/01/06 Beck Farm House Version 5.0 Page 21 • recorded Evidence of a current check of the emergency lighting system must be provided to CSCI. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Beck Farm House DS0000060660.V268978.R01.S.doc Version 5.0 Page 23 - 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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