CARE HOME ADULTS 18-65
Blamsters Farm Blamsters Farm Mount Hill Halstead CO9 1LR Lead Inspector
Brian Bailey Final Report Unannounced 1st June 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. Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Blamsters Farm Address Mount Hill 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) 01787 479491 01787 479406 TLC Care Homes Limited Glen Harms Care Home 15 Category(ies) of Learning disability registration, with number of places Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 15 persons). Date of last inspection 13th October 2004 Brief Description of the Service: Blamsters Farm is a care home providing accommodation for fifteen adults with learning disabilities. The home is situated in a rural setting on the outskirts of Halstead town centre. The manager is Glen Harms. The home consists of four self-contained units within the grounds. The original farmhouse has accommodation for five people in single bedrooms, the adjacent cottage has two single bedrooms, a detached property known as the Coach House has two single bedrooms and an adjacent property, Blamsters Green, has six single bedrooms. The property is within walking distance of the town, where there is a range of amenities including a library, cinema, pubs a supermarket, post office and general shops. Residents have the use of four minibuses and 2 resident vehicles for outings into the community. The spacious grounds were well maintained and provide views across open countryside. Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 1st June 2005 from 11.00am until 5.00pm. This was the first inspection of Blamsters Farm in the inspection year 2005/6. The focus of this inspection was on Blamsters Green and the Farmhouse. The manager was on leave, but the two deputy managers were on duty and the owner was available and contributed to the inspection process. The majority of residents were seen and spoken with in each unit. A partial tour of the premises took place, a random selection of care plans and staff records were inspected and the views of staff were obtained. Observation of residents in a variety of settings contributed towards the assessment findings in the report. Twenty National Minimum Standards were assessed at this inspection; all were met with one only recommendation. What the service does well: What has improved since the last inspection?
Building work was almost complete on a new detached building in the grounds to accommodate a new office suite, Jacuzzi, wet room and a snoozelum. During the past few months, improvements have been made in the Cottage that include a new kitchen, bathroom and windows; the Farmhouse has new carpets and the main hall was redecorated and in the Coach House, a new kitchen and floor were installed and a bedroom redecorated. An new mini bus has been made available to take residents out into the community.
Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 Page 6 The management team has been strengthened with the appointment of a second deputy manager, who is based at Blamsters Green. The home has provided a set of corporate aims and objectives for the home, which are resident centred and are in line with the National Minimum Standards. 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. Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 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 Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 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) 1, 2 & 4. The admission process is managed well and residents are given clear information regarding the services and opportunities to visit and assess its suitability. EVIDENCE: The home’s statement of purpose contains a wide range of information about the home, including its aims and objectives, the facilities offered and the staffing structure. Information about the home was available to residents in a variety of formats such as Makaton signs and symbols. Previous inspection reports were available at the home. Care records sampled showed that the home obtains assessments for prospective residents and undertake their own assessments. Discussions with staff indicated that prospective residents are encouraged to visit the home prior to admission to see for themselves the facilities available and to meet other residents and staff. It was evident from training records, discussions with residents and staff and from observation, that staff had the skills, motivation and experience to communicate effectively with service users and to care for them appropriately. Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 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. Residents’ care needs are well documented and individual risk assessments are in place. EVIDENCE: Each resident had an individual care support plan. Three care records sample checked clearly identified each person’s needs and how these were to be achieved. Care plans were reviewed periodically, signed and dated and from those checked, reviews were up to date. Relatives and service users are invited to attend reviews. Daily care records showed that staff were working in accordance with the objectives stated in the care plans. Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 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 & 17. Residents undertake an interesting and stimulating range of activities that are appropriate to the people involved. Residents have a balanced varied and enjoyable diet. EVIDENCE: Care records and the home’s timetable for Spring 2005 showed that an interesting and comprehensive range of educational and social activities were provided to all residents. Each resident has a programme arranged to meet his or her individual needs. The home’s mini buses were in use daily to take residents out. Menus and good food stocks were available that showed the home was able to provide residents with a varied and healthy diet. Records were available to show when a resident had selected an alternative to the menu. Residents spoken with indicated or said they liked the food. From observation, the meals were appetising and well prepared. Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 Page 11 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) 19. Arrangements are in place to meet residents’ physical and emotional health care needs. EVIDENCE: Care records showed that arrangements were in place for meeting the health and personal care needs of residents. Residents observed during the inspection were well dressed in age appropriate clothing and were clearly enabled to maintain their skin and hair in a healthy condition. Records indicated when staff were required to support residents with personal care. Appointments with health care professionals were recorded, which included GP, dentist, optician, chiropody, dietician, aromatherapy, speech therapist, occupational therapist and district nurse. Weight checks of residents are taken and recorded at intervals depending on need. Records showed that residents receive specialist support and advice when needed. Staff were observed to respond to residents’ needs appropriately. They were knowledgeable about residents’ needs and their likely behaviour patterns. During the inspection, a resident was observed to become increasingly agitated over a situation that had developed. Staff ensured other residents were not involved and patiently supported the resident until the issue had been defused. Residents were seen to be at ease in the company of staff.
Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 Page 12 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) 23 The home has appropriate arrangements in place to protect residents from abuse. EVIDENCE: The home had policies on Adult Protection and Prevention of Abuse, Whistle Blowing, Bullying and a copy of the Essex POVA Guidance. The home’s adult protection policy covered appropriate issues. All staff had attended training in the Prevention of Abuse, which was included in the LDAF induction and National Vocational Qualification training that many of the staff have completed. Further training on the prevention of abuse has been arranged. The manager had a video training pack on Managing Challenging Behaviour. Criminal Records Bureau disclosure checks are obtained for all new staff. Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 Page 13 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, 25, 26, 28 & 30. Residents are provided with a comfortable and safe range of accommodation. EVIDENCE: Blamsters Farmhouse and Blamsters Green are quite different in appearance and layout but both offer single room accommodation that is safe, comfortable and accessible to residents. All rooms looked at were clean, tidy and pleasant smelling. The quality of furnishings and decoration was good. Adequate communal rooms were available. Ventilation, lighting and heating were satisfactory. At the time of the inspection an additional bedroom had been created in Blamsters Green that met the required standards. The home has applied to CSCI for a variation to their registration to increase the overall number by one. Some redecoration and a new carpet had been fitted in the Farmhouse. The Cottage had been redecorated downstairs and new windows, kitchen and bathroom installed. The Coach House had also been redecorated and a new kitchen and flooring fitted. A good standard of hygiene and cleanliness was observed in the kitchens. The extensive grounds were attractive and well maintained.
Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 Page 14 A new building in the grounds to accommodate offices and some facilities for residents was nearing completion. Two residents were happy to show the inspector their bedrooms and indicated that they liked them. It was evident that each bedroom was individual in appearance and they contained many personal items. Residents are able to move freely around the home and have access to local community facilities. Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 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) 34 & 36. Residents benefit from effective staff recruitment procedures and receive care and support from a well motivated staff team. EVIDENCE: Staff files looked at during the inspection showed that the home was following the correct procedures and carrying out all the necessary recruitment checks for new staff. Criminal Records Bureau disclosures for staff were checked and a recommendation was made regarding where they are kept to ensure confidentiality is maintained. The staff files were well maintained, consistent in layout and were kept secure in the office. It was evident from discussion with staff and from records seen that staff are supervised on a regular basis. Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 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) 37, 39, 42 & 43. Residents benefit from a well run home where the management team and staff are committed to providing a good standard of care and a safe environment. EVIDENCE: The manager, who has experience of caring for adults with learning disabilities, is currently undertaking further management training. The standard of record keeping, policies and procedures is good. Discussions with the provider and deputy managers indicated that the management team are effective and committed to providing a service that benefits residents. A survey carried out by the home in April 2005 showed that feedback from relatives was positive about the quality of service and that constructive recommendations made were to be addressed. The home’s stated objectives were in agreement with the National Minimum Standards and some of these outlined the intention for more involvement by residents in the running of the home, such as the staff recruitment process. Records showed that health and safety matters were up to date and dealt with appropriately. The fire alarm system and fire extinguishers had been serviced
Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 Page 17 and the most recent fire drill was carried on 26/5/05. Basic health and safety training is provided and clear records enabled the manager to know the training needs of all staff. Good food stocks, materials, staffing levels, training, transport and furniture and fittings showed that the home was run with adequate budget provision. Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 Page 18 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 3 3 x 3 x Standard No 22 23
ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 x x x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 x 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x x x 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Blamsters Farm Score x 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 3 I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 Page 19 yes 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 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 34 Good Practice Recommendations The manager should ensure that Crminial Record Bureau disclosure checks are kept separate and secure. Blamsters Farm I56 I05 S17772 Blamsters Farm V230585 UI 01.06.05 STAGE 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Fairfax House Causton Road Colchester COl 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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