Inspection on 02/07/07 for Beck Farm House

This inspection was carried out on 2nd July 2007.

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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beck Farm House 01/07/09

Beck Farm House 18/06/09

Beck Farm House 05/07/06

Beck Farm House 02/12/05

Beck Farm House 25/07/05

Beck Farm House 07/12/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Beck Farm House Beck Farm House Beck Lane Barrow upon Humber North Lincs DN19 7AF Lead Inspector Christina Bettison Key Unannounced Inspection 2nd July 2007 09:3 Beck Farm House DS0000060660.V345040.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 Beck Farm House DS0000060660.V345040.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. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 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 Position Vacant Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 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). 5th July 2006 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 and people that present behaviour that may pose a risk to themselves or others 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 adhered 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. The minimum and maximum charges made by the service are £1,276.96 and £3,613.77 per week. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a key inspection and the unannounced site visit took place over 1 day on 02/07/07. One advocate survey was returned, all seven service user surveys were returned, eleven staff surveys were returned and one health and social care professional survey was returned. The registered manager, one team leader, and support workers were spoken to on the day of inspection. Observations of care practices were undertaken to check if service users were receiving appropriate care to meet their needs. Service users that were at the home on the day of the visit were spoken with. The inspector looked around the home and looked at records. Information received by the CSCI since the previous inspection was also considered in forming a judgement. Prior to the visit the inspector referred to complaints received and notifications sent to the Commission for Social Care Inspection, the event history for the home over the past year and the completed pre-inspection questionnaire. The site visit was led by Regulation Inspector Mrs C Bettison and the visit lasted seven and a half hours. Weekly fees range from £1,276.96 and £3,613.77 per week. Information on the service is made available to current service users via the statement of purpose, service user guide and inspection report What the service does well: Service users and their relatives have enough information that is easy to read so that they know what to expect from the home. Service users have an assessment so that the staff know what they need to do to meet their needs and each service user has a range of plans that help the staff to know how their needs must be met. Service users at Beck Farm House have complicated needs and some of them present behaviours that may be a risk to themselves or others and as such have detailed plans to tell staff how to manage this behaviour and protect people. However this approach is providing good outcomes for service users in their development and going out in the community. All service users have a single room that is to their own taste, providing them with an area where they can spend private time or receive visitors, service users were proud to show the inspector their rooms. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 6 Service users are helped to enjoy lots of activities both in the home and in the community and holidays that meets their diverse needs. Relatives and parents are kept in contact with and service users are helped to go and visit their relatives. The kitchens are kept clean and service users are helped to eat a healthy diet resulting in positive weight loss outcomes for service users and a healthier lifestyle. Service users and their relatives concerns are listened to and staff make sure they take action to sort problems out quickly. The staff and managers know that they need to make sure service users are protected from harm. When new staff are employed they are checked to make sure they are safe to work with the service users. The staff are very caring and competent and most of them treat service users with respect and dignity. The registered manager is qualified and competent to fulfil her role as the manager. The home is safe, comfortable and meets service users individual needs. What has improved since the last inspection? A new manager is in place at the home and in general staff said that they are managed by a supportive manager. When service users present behaviour that is harmful to themselves and others the action taken is now been recorded in full and reported to CSCI. Feedback from a care manager “Since Sandy has taken over as manager Beck Farm House has significantly improved in all areas, this has been apparent in ………….behaviour which has improved dramatically” Relatives, staff and service users have been asked about the running of the home. Relatives commented; - “………………seems very happy at Beck Farm House and it is the homeliest placement she has had over the past 8 years”. “I feel …………has made great progress since she has been at Beck Farm House” “…………seems very happy at Beck Farm House”. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 7 “I feel that Beck Farm House has turned …… into a fine and polite young lady since her move there”. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 8 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. Beck Farm House DS0000060660.V345040.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 Beck Farm House DS0000060660.V345040.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 and 2 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users needs are assessed in full by a range of professionals and service users and their families are given sufficient information about the home so that they can be assured that the home can meet their needs EVIDENCE: The home has a statement of purpose and this details all of the information required by this standard and Schedule 1 of the Care Homes Regulations 2001 for adults 18-65 years. A service user guide is available and this contains all the information required by National Minimum Standard 1.2 and is provided in a format that to help service users understand it. Discussion with managers confirmed that all service users are funded up to £200 towards the cost of a 7 day holiday or a series of one day outings by the organisation as part of the contract price. It states in the homes own Service User guide “Milbury will pay the costs and staffing for one 5-day holiday per year or 5 day outings”, however, it does not specify the amount, the service Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 11 user guide needs to be amended to accurately reflect what happens in practice. It was also stated in the homes Service User guide that service users will have to pay for “a contribution of £25 per month for the use of the home vehicle” this is not an equitable arrangement as some service users don’t use the transport and some use it more than others. Managers confirmed that this is being looked into further and service user agreements being amended. The care files of two service users were examined. This contained a copy of the Local Authority Community care assessment and care plan and a range of assessments carried out by a variety of professionals. The staff team had enough information on the assessed needs of the service user and this enabled them to provide an individually tailored service to meet the service users complex needs and ensure their emotional stability and healthy lifestyle. Beck Farm House DS0000060660.V345040.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 and 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users needs are met by the provision of service users plans, risk assessments and a knowledgeable, skilled staff team. EVIDENCE: Two care Files were examined as part of the inspection process. All service users have a care file, and the inspector is aware that Milbury care are in the process of introducing new service user planning paperwork. Each file contained a personal profile, which gave staff a quick overview of a service users needs. Although all of the assessment information was available to ensure that all of the service users assessed needs were identified and met, the care planning process and paperwork was a little disjointed and spread all over the file. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 13 The home used a service user plan format that contained detailed plans of care that covered most of the areas required by this standard. Behaviour management guidelines and risk assessments supported the information. Plans did not include much detail of cultural and religious needs or finances and the recording of actions/plans and outcomes needs to be improved to ensure that the home can evidence the good work that they are doing and demonstrate how the service users needs are being met and how individuals are developing. Service users at Beck Farm House have complicated needs and some of them present behaviours that may be a risk to themselves or others and as such have detailed plans to tell staff how to manage this behaviour and protect people. However this approach is providing good outcomes for service users in their development and going out in the community. Feedback from professionals and discussion with service users evidenced that service users and relatives were happy with the service and that there needs were met and independence promoted in many ways. Both service user files contained copies of their care review coordinated by the care management team, however these were only convened annually. The inspector advised that a 6 monthly review must be held and it would be beneficial if these were done using a person centred planning approach. A number of risks had been identified, assessed and were being minimised by the production of risk assessments that staff were familiar with and followed and a number of these related to measured risk taking allowing service users to develop and maintain their independence. All service users had a key worker. Staff and service users confidential information was observed to be securely kept and handled in accordance with the Data Protection Act. Lockable facilities were used and service users are consulted about when and where there information can be shared. Staff were observed to knock on doors and to ask permissions to enter bedrooms. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,and 17 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users are assisted to continue their personal development and access a range of leisure pursuits of their choice. Family contact and personal relationships are maintained and all service users enjoy a healthy diet that ensures good outcomes in maintaining a healthy lifestyle. EVIDENCE: Some of the service users at Beck Farm House have Prader Willi syndrome and others have significant needs and all require a high level of support from the staff team. Therefore none of the service users have work placements. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 15 In one of care files examined the service user activity plan identified swimming, bowling, walks, shopping, visiting animals, bike riding and listening to music and in the other the service user plan consisted of swimming, bowling, shopping, visiting garden centres, baking, and watching TV and all service users undertake some domestic chores and bedroom management with staff support. Three service users will be attending college placements in September to undertake courses in Animal care, woodwork, life skills and horticulture. The manager stated that one of the service users is being supported by staff to attend his brothers wedding in August and he has been to get his suit fitted. There was evidence in the file and staff spoken to confirm that on the whole these activities take place regularly however staffing limitations do create problems on occasions. Service users holidays are being undertaken this year with one service users going to a caravan in Barmston and another had just returned from staying with his dad in Spain. The manager and staff promote a healthy eating menu. Breakfast is cereals and toast. The lunch menu consists of soup, toasted or ordinary sandwiches, and hot dogs. The evening meal menu consisted of shepherds pie, curries, baked fish, pastas, stew and salads and on Sundays a full roast dinner. Restrictions regarding meals and/or lack of choice where clearly documented in the service user plans and guidelines and recommendations from psychologist and Dietician were being incorporated. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users physical and emotional needs are met, by the provision of a wide range of healthcare professionals and outside agencies and a caring team of staff that promotes their privacy, dignity and respect. However this could be improved by better identification, planning and recording of outcomes to meeting health needs. EVIDENCE: Records examined confirmed that service users health needs were met by GP, dentist, chiropody and that they had access to a wide range of other health professionals e.g. psychiatrist and psychologist and dietician. However there needs to be some improvement in the screening, identification and planning to meet health needs. Health action plans had not yet been produced. In addition to this the recording of outcomes to health appointments were inconsistent dependent on the member of staff who had the responsibility Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 17 therefore this could made it difficult to track if health needs had been met or not. Milbury care has medication policies and procedures that include receipt, storage, administration and disposal of medication. Medication systems were on the whole well managed in the home, the home uses a monitored dosage system. There was no one self medicating and at the time of the visit and there were no controlled drugs in the home. However there were signature omissions on the MAR sheet and quantities of medication received was not being recorded. All staff are given medication administration training and the manager has assessed staff to ascertain their competence. Some service users are prescribed medication for pain relief and for behaviour management purposes. The protocols for the administration of medication on a “as and when required” basis need to be clearer so that staff know when to administer PRN medication and when second doses can be given. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 18 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 and 23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users are protected from harm by a robust complaints procedure and a Protection of Vulnerable Adults policy and procedure that the staff and manager are aware of their responsibilities within this. However this would be further improved by the provision of staff in adequate numbers and with the skills and competence to meet service users needs. EVIDENCE: Milbury Care have a complaints procedure. This contained contact details for the CSCI and the ombudsman and gave an assurance that service users and their families would not be victimised for making a complaint. There had been some minor complaints since the previous inspection, which had been taken seriously, investigated and resolved appropriately. The manager checked the complaints log on a regular basis. The home had a copy of the “Multi agency Guidelines for the Protection of Vulnerable Adults” in respect of alerting, referral and investigation. There was evidence from the home’s recruitment and selection processes, staff training records, complaints log and the use of risk assessments that the Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 19 manager ensured that on the whole service users were protected and safeguarded from abuse. Training records evidenced that staff had received training on the protection of vulnerable adults. However there had been some incidents of physical assaults from service users to service user, one of the service users stated “ I don’t like it when other service user pull my hair” although incidents had been reported to the placing social workers of the service user, this needs to be reported to the Local Authority under the Safeguarding Adults Policies and Procedures. Some of the service users present with significantly challenging behaviour that may pose a risk to themselves, to other service users and to the staff. On these occasions staff have to use restrictive physical interventions, However all staff have received training in either SCIP- R or Therapeutic Crisis Intervention and behaviour management plans are explicit in what techniques can be used with each service user and robust record keeping is maintained. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users live in a home that is safe, homely and comfortable and is in the local community and meets their assessed needs, however it would benefit from being better maintained as is showing signs of considerable wear and tear. EVIDENCE: Beck Farm House is a detached property in Barrow-on-Humber, providing care and accommodation on two floors, to 7 adults with learning disability. Young adults with very complex needs and particular disabilities and people that present behaviour that may pose a risk to themselves or others are placed in the home. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 21 All rooms are single with en-suite facilities. There are sufficient and suitable communal areas and an enclosed garden. The home was registered and opened in August 2004 and at the time of inspection was showing considerable signs of wear and tear. There were holes and damage in some of the plaster, carpets were worn and dirty, some of the flooring in bathrooms were lifting, decoration is looking tired and some of the curtains and curtain poles had been pulled down. The manager stated that there is a handyman that is shared between three houses and they can access him at Beck Farm House once every three weeks. This does not appear to be effective in meeting the maintenance requirements of the home and must be addressed. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35, 36 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The current staff although caring and ensuring good outcomes for service users, the current arrangements are not sufficient to meet the needs of the service users, staff are not being adequately supervised and some staff are not up to date with mandatory and specialised training. EVIDENCE: The inspector was informed that the home has 22 staff in total, comprising of • • • • 1 x Registered manager 3 x team Leaders 16 x support workers 2 x waking night support workers The manager stated that there have been significant problems with staffing at the home due to its geographical location and transport problems and they currently have 112.5 support workers hours vacant. They had appointed staff however for various reasons people had not been able to take up post or remain in post. However the majority of the staff have been at the home and Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 23 working with the service users for a considerable length of time, this ensures continuity and consistency of staff and approach with service users. The manager stated that all service users are funded 1:1 and some need 2:1 for specific activities and community participation. The rota evidenced that there are rarely 7 staff on shift and with the current vacancies staff have to work a lot of additional hours to make up the shortfall on the rota. In addition to this currently the manager and team leaders have to make up part of the care hours and this makes it difficult to keep up with the paperwork and other managerial duties. This is clearly unacceptable and must be addressed with some urgency. There are also 2 waking night staff however following review the home are moving to a position of having one waking night staff and one sleep in staff. In addition staff have the responsibility of cleaning bedrooms bathrooms and all communal areas, the preparation, cooking and serving and cleaning up after 3 meals per day, supporting service user to attend appointments, activities, undertake shopping and gardening and in addition to this attend to the care needs of service users. One member of staff spoken to stated that they had “had no probationary period/interviews, no induction (not even basic fire induction), received no supervision and has had no mandatory training and no service specific training and had no previous experience of care work”. They also commented “there’s not enough staff on duty, we don’t have seven staff on duty sickness is very high and staff work a lot of hours” This clearly demonstrates that there are not enough staff on duty to meet the assessed needs of the service users. 5 new staff files were examined in the course of the inspection. All had completed application forms, had 2 satisfactory references and CRB clearances prior to commencing employment. Staff had started their probationary period but there were no evidence of interviews and staff had not completed their basic induction. Two staff had had no supervision sessions and three staff had had one supervision session in February 2007 but none before and none since. The manager must ensure that new staff are given basic induction into the home on commencement and commence LDAF induction and complete it within 6 weeks of commencing employment and that Millbury’s policy and procedure regarding probationary periods are followed. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 24 The home had a training plan and the manager has completed the Registered managers Award and 1 x team leader has NVQ level 2 and the other has started it and 5 x support workers have NVQ level 2 and 3 are currently undertaking it. The inspector was informed that a pilot scheme had been introduced in January 2007 in some Milbury services using the Elbox electronic system. The pilot scheme was successful and all staff within Milbury care will now be using this method to update some of their mandatory training and complete NVQ and LDAF. In addition to this a training provider will be taking the staff that are under 25 through their NVQ level 2. The manager was aware and this was evidenced in staff files that staff were not up to date with their mandatory training, however she was making plans to ensure that this was planned. Most staff had completed safeguarding adults training. Service users have presenting needs in Prader Willi syndrome and other complex needs and some present behaviours that may pose a risk to themselves or others, there was evidence that not all staff had received updated training in these areas that met their identified training needs. The registered person is required to provide care staff hours in sufficient numbers in the home to ensure that they can meet the complex needs of the service users and to ensure that staff are appropriately trained for their role. The registered person is also required to ensure that staff complete their induction and probationary periods and are up to date with all mandatory training and service specific training is provided Prader Willi syndrome and training in other areas. Beck Farm House DS0000060660.V345040.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): 37, 39 and 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a home that is well run and managed by a competent manager. EVIDENCE: Beck Farm House is part of Milbury Care Services which is a national provider of care and support services for people with a learning disability. Milbury is part of the Paragon Health Care group, which is a UK wide organisation that specialises in providing a range of services to vulnerable people. Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 26 The registered manager of the service has significant experience in the field of learning disabilities and has been in post for about a year. She has completed the registered managers award. The manager is awaiting registration with the CSCI. The manager confirmed that when she had taken over from the previous manager there were significant areas for improvement identified within the home. Feedback from a care manager “Since Sandi has taken over as manager Beck Farm House has significantly improved in all areas, this has been apparent in ………….behaviour which has improved dramatically” The restrictions of the current staffing structure and number of provided within the home mean that although the staff are willing they do not have the time within the shift to undertake all of required to ensure that service users complex personal, health needs are met. care and the and hours caring duties safety As part of the inspection maintenance records were examined and were up to date. Milbury care services have a QA system, which includes regular audits and monitoring of the service and consulting with service users, relatives and stakeholders and culminating in an annual service review. The area manager undertakes regulation 26 visit on a monthly basis, this and the QA monitoring and checking process has highlighted the areas for improvement and the CSCI are satisfied that the home will make progress to ensure all requirements are met within the timescales specified. Beck Farm House DS0000060660.V345040.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 2 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 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 x 33 2 34 2 35 2 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 3 3 x x 3 x Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 28 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 YA1 Regulation 5 (1) Requirement The registered person must review and amend the service users guide to ensure that it accurately reflects the service provided. The registered person must ensure that service users care is reviewed on at least a six monthly basis. The registered person must ensure that medication given is signed for and that stock control is effective. The registered person must ensure that there is a maintenance and renewal plan for the home and repairs and redecoration are attended to in a timely manner. The registered person must ensure that new staff are given basic induction into the home on commencement and commence LDAF induction and complete it within 6 weeks of commencing employment and that Milbury’s policy and procedures regarding probationary periods are followed. The registered person must DS0000060660.V345040.R01.S.doc Timescale for action 30/10/07 2 YA6 15 30/10/07 3 YA20 13 (2) 30/10/07 4 YA24 23 30/10/07 5 YA34 18 30/10/07 6 YA33 18 30/10/07 Page 29 Beck Farm House Version 5.2 7 YA34 18 8 9 YA36 YA35 18 18 ensure that the home has an effective staff team with sufficient numbers and skills to support service users assessed needs at all times. Staffing levels must be regularly reviewed to reflect service users changing needs. The registered person must 30/10/07 ensure that new staff are subject to probationary periods and service users must be involved in their review. The registered person must 30/10/07 ensure that staff receive supervision at least 6 x per year. The registered person must 30/10/07 ensure that all staff are up to date with mandatory training and be provided with service specific training. 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 YA19 Good Practice Recommendations The registered person should ensure that health screening is undertaken, health action plans produced and records of outcomes are kept to ensure that service users health needs are identified and met. The registered person must ensure that at least 50 of staff are qualified to NVQ level 2 The registered manager should ensure that the team Leaders carry out their responsibilities regarding safeguarding adults and alert the Local Authority when service users assault other service users. 2 3 YA35 YA23 Beck Farm House DS0000060660.V345040.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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