Inspection on 25/07/05 for Beck Farm House

This inspection was carried out on 25th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 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 02/07/07

Beck Farm House 05/07/06

Beck Farm House 02/12/05

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 Lane Barrow upon Humber North Lincs DN19 7AF Lead Inspector Janet Lamb Unannounced 25 July 2005 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 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 Stationary 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 J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Beck Farm House Address Beck Lane Barrow on Humber North Lincs DN19 7AF 01469 532988 Telephone number Fax number Email 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 Mr John Egbury Care Home 7 Category(ies) of LD (7) registration, with number of places Beck Farm House J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home accommodates younger adults from the age of 16years to 25 years. This is a condition requested by Voyage Ltd. Date of last inspection 07/12/04 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. 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. Young adults are placed in the home with very complex needs and particular disabilities with challenging behaviour 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. Beck Farm House J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took seven hours and fifteen minutes to complete and was one of the two inspections the home is required to have in each year. The Inspector looked around the house and talked to residents, the Manager and staff. Some of the records were inspected. Of the 6 residents living in the home three were interviewed and another two were briefly spoken to. The Inspector had lunch with five residents as part of the observation of how people relate to one another. The Manager was supervising five care staff working in the home, and there were two on an outing with one service user. Two care staff were interviewed. The Inspector observed how residents and staff got on together. What the service does well: What has improved since the last inspection? What they could do better: The service could encourage more staff to complete NVQ and specialist training in the care of service users with identified learning disabilities they present, to give service users more specific care. The service could instruct staff on how and why programmes of care are important, so that staff have a better understanding of what they are asked to do, and service users receive better care. Beck Farm House J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 Page 6 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 J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Beck Farm House J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 only. The Manager and staff do a good job of assessing service users’ particular and complicated needs and aspirations. EVIDENCE: Service users are assessed as needing care by their placing local authorities, and then assessed by the home Manager to determine the plan and programme of care needed to deliver their care, meet their needs and begin the modification of their behaviour. Plans of care follow standard 2.3, while programmes of care are very detailed and are devised to assist in changing behaviour. Service users spoken to who are able to understand, said they are aware of the documents held on file, view them at reviews, and sign contracts to agree programmes of care. They were observed discussing and testing programmes of care with staff and the Manager, and although they agree these, what they truly aspire to isn’t always what their programmes seek to achieve for them. This was concluded after listening to their conversations with staff and reading about their deviations from the programmes. For those service users with Prader Willy Syndrome the programmes of care are extremely defined and limited in terms of choice, to provide therapeutic and modifying success in changing behaviour. Beck Farm House J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9. The Manager and staff do a good job of informing service users that their needs and goals are reflected in plans of care, and of encouraging them to make decisions. They do a good job of supporting service users in taking risks to be independent. EVIDENCE: Service users spoken to who are able to understand are aware of plans and programmes of care, and agree changes made at reviews, so they know their needs and goals are reflected in the documentation. The staff team fully consult service users in the plan of care process, and support them in decision making about their lives. To some extent guidance and support from staff is ‘controlling’ to ensure service users follow the contracted agreements of their programmes of care. Elements of risk are assessed in documents on file, and if the risks are too great measures are taken to change or modify activities or chosen lifestyles, but on the whole service users take risks in their daily lives in an effort to be independent. All of this is documented in diary notes, risk assessments and plans and programmes of care, and where necessary, on incident forms. The Manager discussed these areas at length with the Inspector. Beck Farm House J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 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 standard(s) 12, 13, 15 and 17. The Manager and staff do a good, but difficult job of providing a healthy diet to service users, and of encouraging involvement and participation in activities and relationships appropriate to their age and responsibility. EVIDENCE: Service users spoken to who are able to who are able to understand explained about their daily activities and involvement with the community. They have connections with Bishop Burton College of Agriculture, attend Voyage Ltd funded wildlife activities, go swimming, walking and shopping etc. Services in Barrow and Barton are accessed daily, while trips to the coast take place at weekends. Some individuals travel each month to see family members, others see friends at clubs etc. All are encouraged to maintain relationships in and outside the home. Diary notes and activity records show details, as do plans and programmes of care. Food provision was observed to be healthy (a light lunch is taken in the middle of the day), but also according to set programmes of care for weight loss or gain. Service users said they liked the food and although no one spoke of being dissatisfied with their diet arrangements and amounts, one service user did comment on another’s intake as being Beck Farm House J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 Page 11 excessive. Another service user clearly rejects the contracted diet he is asked to follow for health reasons. Menus are planned and recorded, diets are carefully worked out for weight loss and staff work constantly to maintain routine and consistency. Beck Farm House J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 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 standard(s) 18, 19 and 20. The Manager and staff do a good job of supporting service users and meeting their needs according to their preferences, but mostly according to their requirements for maintaining a healthy lifestyle. EVIDENCE: Service users plans of care identify individual personal support needs, and diary notes, charts and review documents show these needs are met. Service users spoken to explained the levels of assistance they need and expressed a belief they are supported adequately. Plans of care show health needs, and records show visits to such as GP, chiropodist, dentist, etc. Staff spoken to are vigilant in observing health issues and monitoring intervention from professionals. Progress for some service users has been immense in respect of their healthy eating and weight loss and improved physical fitness. Progress has also been good regarding emotional and behavioural needs, although some service users’ preferences need to be controlled through the programmes of care in order to meet health and emotional needs. Service users do not currently retain or administer their own medication, as this is not appropriate. Given time some of them may be encouraged, instructed and supported to do so, but meanwhile five nominated staff administer medication according to written policy and guidelines. Storage of, accounting for and following an audit trail for drugs is good at the moment. Beck Farm House J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 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 standard(s) 22 and 23. The Manager and staff do a good job of listening to service users and taking action on their views. They do a satisfactory job of protecting service users from abuse, neglect and self-harm. EVIDENCE: There is a clear complaint procedure for service users, staff and relatives to follow, which is also in picture format for service users. Records of complaints are maintained and action to resolve and the outcomes of complaints are also logged. Service users spoken to were confident about going to the Manager to make representations or to question their programmes of care. Staff know the procedure for taking and passing to the Manager any complaint made to them. There are policies and procedures on adult abuse and child protection, as the home accommodates younger adults from the age of 16 years to 15 years. Both the Manager and Deputy have done the local Area Child Protection Committee (ACPC) child protection training as well as adult abuse awareness. Some staff have done adult abuse training and only those staff having completed the Strategies for Crisis Intervention and Prevention (SCIP) training are allowed to restrain a service user. Records are held on incidents in respect of behaviour and show details of restraints, if any, and injuries incurred. Behaviour programmes of care are changed and modified regularly in relation to using restraint and especially finding the safest technique for each individual. The aim of the programmes of care is to change behaviour and therefore reduce the level of incidents and especially restraints. Beck Farm House J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 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 standard(s) 24 and 30. The staff do a good job of keeping the home clean and hygienic, and of maintaining a homely, comfortable and safe environment. EVIDENCE: A tour of the building revealed there are 7 single en-suite rooms, which are personalised to service users’ wishes. The house is very clean and comfortable and is bright, cheerful and airy. There is a housekeeper, employed part time, who also works as a development worker, part time. All staff assist in keeping the home clean and follow procedures for hygiene maintenance and infection control. The home is maintained according to the local fire service department requirements, and the only outstanding issue from the Fire Prevention Officer (FPO) visit in April 2005, is the final fitting of hold open devices on bedroom and communal room fire doors. Beck Farm House J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 only. Service users’ individual and collective needs are satisfactorily met by trained staff, that are improving on their collective knowledge and skills. EVIDENCE: All staff undertake mandatory training courses in fire safety, health and safety, food handling, medication administration, moving and handling, and first aid and there are copies of certificates of attendance held in their files or pined up on the walls in the home. Not everyone has completed every course. For example there are only four staff and the Manager designated to administer medication. No staff member is allowed to restrain a service user until they have completed SCIP training and there is no alternative measure to prevent injury to any service user, staff or visitor. Staff are working their way through the NVQ qualification, but only four have completed level 2 to date. This is an area for improvement. Beck Farm House J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) There has been no judgement made because no outcomes were assessed in this section. EVIDENCE: Not applicable. Beck Farm House J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 Page 17 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 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Beck Farm House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 Page 18 Are there any outstanding requirements from the last inspection? Yes, but this is because they have not been checked. 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 YA5 Regulation 5 Requirement The registered provider must amend the statement of terms and conditions to meet the rquirements of regulation 5. It should be in a format accessible to service users. The registered provider must ensure staff have an annual training and development review. Training identified should include equal opportunities, race equality and cultural differences. Timescale for action 31/10/05 2. YA35 18 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA6 YA32 Good Practice Recommendations The registered provider should further develop the service users plans of care to ensure they are in an accessible format. The registered provider should ensure staff working with young people under 18 years have completed NVQ level 3 Caring for Children and Young People by the end of 2005. Beck Farm House J54 Beck Farm House S60660 V229599 AI 25.7.05 stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Unit 3, Hesslewood Country Office Park Ferriby Road Hessle East Yorkshire 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. 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