Inspection on 11/11/08 for Camphill Devon Community

This inspection was carried out on 11th November 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Camphill Devon Community 06/12/06

Camphill Devon Community 14/11/05

Camphill Devon Community 18/05/05

Camphill Devon Community 03/11/04

Camphill Devon Community 25/05/04

Camphill Devon Community 27/01/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Camphill Devon Community Hapstead Village Buckfastleigh Devon TQ11 0JN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Baines     Date: 1 2 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Camphill Devon Community Hapstead Village Buckfastleigh Devon TQ11 0JN 01364642631 01364644188 devon@camphill.eclipse.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) William John Southcombe Type of registration: Number of places registered: Camphill Devon Community Limited care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The home may accommodate two persons with Learning Disabilities over the age of 65 Date of last inspection Brief description of the care home The Camphill, Hapstead Village is a large site in a remote rural setting near the village of Buckfastleigh. The site comprises residential accommodation in five houses, workshops, offices, agricultural land and farm outbuildings. An outdoor swimming pool is also available for people who use the service. The Community grew out of the national Camphill movement with which it maintains a loose affiliation. Founded on the anthroposophical principles of Dr Rudolf Steiner, the service aims to provide home, work, religious, social and cultural life as well as therapeutic activities within a villagestyle community for up to 45 adults with learning disabilities. The Community also provides supported living with which this inspection is not concerned. 48 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced Inspection took place over two days, during November 2008. The home had been notified that a review of the home was due and had been asked to complete and return an AQAA (Annual Quality Assurance Assessment). This shows us that the home has managed the quality of the service provided over the previous year. It also confirms the dates of maintenance of equipment and what policies and procedures are in place. Information from this document was used to write this report. As part of the Inspection process CSCI likes to ask as many people as possible for their opinion on how the home is run. The Inspector sent questionnaires to some of the people using the service. At the time of writing this report responses had been received Care Homes for Adults (18-65 years) Page 5 of 29 from seven people who said that they were given information about the service before moving in, are able to make decisions about their lifestyle and also know who to speak to if they have a problem. During the Inspection the Inspector visited all five houses and met with residents, managers and staff on duty. On both days the Inspector ate with the residents and staff. The Manager spoke with the Inspector and provided records and information about the service and any future plans. We were joined for this inspection by an Expert by Experience and their supporter. Experts by Experience are people who have used the type of services we are inspecting. Their role is to bring a different and independent view to the inspection process by working alongside inspectors, observing and gaining the views of people who use the service. The Experts by Experiences background knowledge of using services enables them to ask different questions and explore different themes. They are able to pick up on and note details, such as care practices, accessibility within the home, interaction and nonverbal communication between staff and people who use the service. People who use the service are able to talk openly and differently to the Expert by Experience and this makes them feel valued. Following the visit the Expert by Experience sent us a report on their findings. Information from this has been included in the main report (Lifestyle). What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 7 of 29 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may be thinking about moving to the Camphill Community are provided with sufficient information to enable them to make an informed choice about where they live. People can feel confident that their needs will be fully assessed before they move in, and will continue to be reviewed as part of the homes on-going care plan process. Evidence: Anyone wishing to move to the Camphill community is provided with a range of information to help them make a decision about whether or not the service will meet their needs. As part of the admissions process the home provides people with a color brochure and written information about the home and the facilities available. People are then invited to visit the home and meet with staff and residents. The home will then arrange a two week trial to allow prospective residents to stay overnight and experience some aspects of community living. During these initial visits the home undertakes an assessment of the individuals needs to ensure that the service is appropriate. These assessments are discussed at the end Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: of the trial period when a decision is made about whether a placement will be offered. During the admissions stage the home also involves an independent advocacy service to ensure that people who may move into the home are fully involved and understand the decisions being made. When a person decides to move into the home a contract is completed between the home, the individual and their representatives and a review date agreed to look at how well they are settling into their new environment. During the inspection two people were visiting the home with a view to moving into the community. One person was staying overnight. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a clear and consistent system in place for assessing and reviewing the needs of the people who use the service. This ensures that staff are aware of why and how people need and choose to be supported. People are supported to make choices and take risks as part of an independent lifestyle. Evidence: A sample of care records were examined in each of the five houses. All people using the service had a written care plan detailing their needs and how these would be met. Discussion with some people who use the service and staff confirmed that the plans accurately reflected their needs and interests. It was noted that some people had difficulty with communication and although various systems were in place to support these needs this was not in all cases documented within individual care plans. One person had a plan detailing the support required and goals agreed to move into more independent living. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: All the care plans examined had been reviewed regularly. Each section of the review contained My View and Staff view, and had been signed by the staff member and individual concerned. There are well developed systems at Camphill to involve people in making decisions about their individual needs, home and lifestyle. The Community has regular contact with independent Advocacy services and opportunities are available for people who use the service to meet with an advocate either individually or in a group setting. One person spoken to had plans to attend a week long residential conference to look at issues relating to Independence and Choice. Throughout the inspection people were being supported to make decisions. People spoken to said that they are able to attend a number of different meetings within the home and the community to discuss any issues that may affect them. These include house meetings, circle groups and advocacy meetings. People with communication difficulties are supported by a range of communication aids including, pictorial timetables, communication passports, and signs and symbols around the home and community. People spoken to said that they were able to make choices about their daily activities and were able to choose whether to use the facilities provided by the community or to access other opportunities. One person had chosen not to use any of the Camphill day time activities and is supported by staff to access facilities within the local community. Another person had been very involved in planning a new kitchen in one of the houses and one care plan detailed the arrangements for a individual who had very specific requests about which staff members he wanted to support him. Risk assessments were included alongside each care plan. These had been reviewed regularly and demonstrated how people could take reasonable risks in a managed way. Risk assessments were being regularly updated for one person who had recently moved to the home. The staff wanted to ensure that the information that had been provided was relevant to the persons new environment and would not restrict them from being as independent as possible. All people who live at Camphill are supported to manage their finances as much as possible and this information is documented within their individual care plans. People are provided with a lockable storage space and bedrooms have locks so that people can keep their money and personal belongings safe. Most people have their own bank accounts and where the service looks after or provides support with individual finances this is documented and audited on a regular basis. Records inspected were found to be in good order and up to date. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Camphill are able to make choices about their social and leisure arrangements. People are offered a healthy and varied diet and enjoy their meals and mealtimes. Evidence: The Camphill Community provides day care and social activities for all people who use the service. Discussion confirmed that people can choose whether or not they want to use these facilities. In addition to the Camphill facilities people also attend local colleges and access a range of facilities within the local community. Transport is provided for people who are unable to travel independently. The Expert by Experience who visited with us spoke to people about their social and leisure opportunities, and provided a report of their findings. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: The home is like a big farm up a track uphill from the village. There are five residential houses and lots of animals on the farm including pigs, cows, and ducks. I saw cats and dogs wandering around. I went to four of the houses, the pottery and copper workshop and chatted to residents and staff. Residents were called villagers and residents called house managers house mother and house father. Although I was told they are now called house managers. Residents said they chose to do college courses and things in the community.One lady has got a job in a charity shop. It is voluntary and she would like to get a paid job. Residents seem to do cleaning in the other houses.This is also voluntary. Some residents go to church if they want to. Residents go on shopping trips. I was told that transport is available and residents can walk to the village.This seemed quite a long way to me and along a narrow track. Residents told me they choose where they go on holiday. Some went with their family, others went with staff. In one house I was told that staff generally chose the meals but if someone wanted something different they could. The residents I spoke to said they can make themselves a drink when they want to. One resident said the staff look after their money. Some of the residents said they had partners. I asked if they could stay for tea and/or sleep over. The residents said they could stay for tea but did not know if they were able to stay. They asked staff in the house and they did not know either. I liked the pottery workshop as I thought everyone was included. They made some good things and sold these to the public. The residents I spoke to seemed happy and said they liked living there. Staff were extremely respectful towards the people who use the service throughout the inspection. This was evident in forms of address, respect for peoples private space and in the style of interaction. Staff were observed responding gently and sensitively when people displayed behavior that could be considered difficult and challenging. The Inspector joined staff and residents for two meals. Both occasions were relaxed and sociable. Both meat and vegetables are produced on the Communitys farm which operates on Bio dynamic principles. Menus showed a varied and wholesome diet which included fresh produce from the farm and gardens. Both of the meals sampled were of a high standard. It was noted that meals are served at a set time and one residents meal was left on the table as they did not choose to join the others at the normal meal time. Staff and residents did confirm that although there are set meal times people can choose to eat at different times if they wish. Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the Camphill Community are supported with their personal and Healthcare needs in a way that suits them. Systems for the administration of medication are well managed. The organization recognizes that peoples needs change due to the aging process and/or ill health and continue to look at ways of addressing these changes and providing the best possible care and support. Evidence: Most of the people living at Camphill are physically fit and able. Therefore personal support mostly takes the form of prompts and guidance. The plans of care that were looked at gave clear direction to staff to ensure that care and support is provided in a consistent way. Health care issues were clearly identified and any specific issues were followed up. Examination of individual files showed the involvement of a variety of healthcare workers. These included Nursing, Psychology, Speech and Language and Occupational Therapy. There were also records of routine medical appointments such as eye and dental checks. Feedback from a visiting Community Nurse confirmed that appropriate referrals are made when support and advice is required, I have always Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: found the staff to be open, and keen to work with other agencies. Daily records showed that staff are aware of and comment on individuals emotional well being, and 1:1 time with staff gives people time to talk about any issues that might be causing them concern. There were good recordings relating to incidents around behavior that may challenge the service. Systems for the administration of medication were examined. This involved inspecting a sample of records in each house. Risk assessments were seen for people who are able to administer and manage their own medication. Secure storage and auditing systems were in place to support these people. Other medication was securely stored in each house. There was additional security and storage for controlled drugs. Where Homely remedies were in use an approved list had been obtained. Medicine administration records were found to be up to date and in good order. Since the last Inspection the home has developed written guidelines for how medicines prescribed to be administered when required are to be used. Records showed that staff had received training in the administration of medicines and we were told that some staff had received training relevant to some peoples specific health needs. Referrals had been made to the specialist Learning Disability service to request support and assessment of people who may be suffering from Dementia. Records also confirmed that staff attend training in this area of care. Discussion with the Registered Manager confirmed that consideration is being given to the long term care needs of people as they become older, and ways the service can meet these changing needs. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can feel confident that their concerns will be listened to and taken seriously. There are effective systems in place to protect people from abuse. Evidence: Each house had a complaints procedure, which had been produced in a format appropraite to the people using the service. People spoken to said that they knew who to speak to if they had a concern. An independent advocate visits the community regularly and people can choose to attend a group advocacy meeting or individually. There are a number of other groups relating to the running of the community, these include The cultural group and weekly coffee mornings. The Inspector was invited to attend the social coffee morning and could see that this was an opportunity for staff and residents to mix and talk about events inside and outside the home. People spoken to said that there are also regular meetings within each house. Minutes were available for these meetings, which confirmed that people are involved in the running of theie home and individual views and concerns are addressed. The service keeps a record of any complaints they deal with documents in full the outcome of the issues raised. The Commission has not recieved any complaints relating to this service since the last Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: key inspection. There were robust systems in place to protect people from abuse. Records showed that staff recieve training in the protection of vulnerable adults as part of their induction and that this training is updated as part of the homes on-going training programme. Staff spoken to demonstrated a good understanding of different types of abuse and were able to say what they would do if they thought an incident of abuse had occured. The homes AQAA stated that since the last inspection the home has worked hard to develop improved links with the community police service. Local Police officers have met with residents to give them information about their role in the community and advice on keeping safe. A sample of staff files were looked at and confirmed that checks are carried out to ensure they are suitable to work with vulnerable people. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment within this home is generally good providing people with an attractive and homely place to live. People benefit from ample communal space and a range of in-house facilities if they choose to use them. Evidence: The Camphill Hapstead Community consists of five houses. Hapstead village is sited within extensive grounds which include gardens, a farm and woodland. Although the five houses are located within close proximity of each other they are all detached with large gardens. There are communal facilities such as an outdoor swimming pool and new hall, which is used for a number of social events and day time activities. The site also has workshops for pottery, copper work and woodwork. During the visit the Inspector toured all five houses and communal areas. Some of the people living in the houses were happy to show the inspector around and were proud to show off their home and own bedrooms. Each house was found to be clean, comfortable and mainly free from obvious hazards. The stair carpet in one house was worn, which could be a potential tripping hazard. This was pointed out to the home manager who passed the information to the Registered Manager. We were informed Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: during the inspection that this would be addressed as a matter of urgency. Peoples bedrooms had plenty of personal belongings and one new resident said that they were waiting for some of their own furniture to arrive. One of the houses had recently been updated and a resident talked about their involvement in planning the new kitchen area. It was noted that some of the bedrooms and communal areas were in need of redecoration and that parts of some houses felt cold. This was discussed with residents who did not express any concern about the heating. Some of the furniture had been made on site by the residents who work in the workshops. Many of the pictures, paintings and photo frames had also been made by the people who use the service. People confirmed that they were involved in cleaning as part of the everyday routines of the houses. Some people had particular roles, which were detailed as part of their care plan. Communal wash hand basins were generally supplied with liquid soap and towels. Staff and residents were wearing aprons during the preparation and serving of meals. Laundry areas were equipped with washing machines and dryers with hot wash cycles. Floors in the laundry were impermeable and walls cleanable. Staff are employed to work specifically within the communitys workshops. Health and safety notices were clearly displayed and equipment stored safely. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient numbers of skilled and qualified staff to ensure that people who use the service are well supported. The Registered Manager is supported well by senior staff in providing clear leadership throughout the homes with all senior staff demonstrating an awareness of their roles and responsibilities. Evidence: The staff group comprises of short- term and long- term volunteers as well as paid workers. Some of the staff are recruited from abroad and may have experience of working in other Camphill Communities overseas. Some of the short- term volunteers spoken to said that they may work in the Community for anything between four months and one year. The majority of staff live and work on site. Each house has a House manager, in some cases these are couples who live on site, some with their children. There are also co- workers who provide care and support to the people using the service. The Registered manager said that in more recent times the staffing arrangements have changed and their are now more paid staff making up the core team within each home. Although the staffing arrangements appear complex people using the service who were able to comment said that they were happy with the arrangements and liked the staff who cared for them. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: The number of people who live in each house varies. Staffing levels and the rota are planned to reflect these numbers and individual needs. A number of examples were given of when additional funding had been requested for additional staffing and these arrangements were clearly set out in the individuals care plan. The whole staff group is overseen by the Registered Manager who is supported by a small administrative team. The Inspector was able to meet with all but one of the house managers and staff on duty. All staff and managers spoken to had a good understanding of the needs of the people they were caring for. Some of the staff spoken to had only worked in the home a short time but said they were being well supported by their colleagues. Managers spoken to had a good understanding of issues relating to choice and independence and were able to demonstrate a number of examples of how these are promoted within a community living setting. The Registered Manager explained the process for recruiting new staff. Some of the volunteers apply through the National Camphill Website, some may apply individually or through an agency. When information is received the individual is then invited to make an application. A full application form is completed, which includes information about previous experience and employment. A sample of staff files were examined, this included the records of staff recently recruited. Files showed evidence of safe recruitment practices. All files seen held two references, Criminal Records Bureaus checks and evidence of identity checks. Further checks had been undertaken for workers recruited from abroad and the Registered Manager said that these were in line with the new Home Office rules for overseas recruitment. Records and discussion confirmed that all new staff undertake a full Induction process and do not work alone with residents until they have completed the Induction and feel confident to do so. New staff spoken to said that they felt well supported by their colleagues and house managers and were able to access and understand the information they needed to fulfill their role. English lessons are arranged for foreign staff and hand over meetings ensure that information is passed verbally as well as in writing. The house managers are well qualified and all hold a Level 4 NVQ in Care, as well as other relevant qualifications. House managers said that details are passed to the Registered manager about staff training needs and the skills required of new staff. The Registered manager said that in recent months more consideration has been given to appointing staff with relevant experience and qualifications. This was evident when Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: examining some recent applications made to the home. Individual staff training programmes are updated annually. These records were seen and confirmed that as well as Induction training staff undertake a range of mandatory and specialist training courses. Training is provided in-house by the organization as well as externally by other training bodies. The homes AQAA stated that due to the age of many residents and changing needs all staff now undertake training in Dementia Care. Records confirmed a structured plan for support and supervision of all staff. House managers are responsible for supervising their staff team and the house manager is supported and supervised by the Registered Manager for the service. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from an open, inclusive and positive style of management. The manager has a clear development plan and vision for the home, which he has effectively communicated to residents and staff. Evidence: Mr John Southcombe was registered as the manager of Camphill Hapstead Community in April 2004. He holds the Registered Managers Award and NVQ Level 4 in Care. Mr. Southcombe has previous managerial experience in a service for people with Learning Disabilities. Discussion confirmed that he continues to update himself with current legislation and Good Practice issues. Mr Southcombe has demonstrated a willingness to work closely with other agencies and organizations with a view to gaining and sharing knowledge and further improving the services available to the people at Hapstead village. The Community is guided by a Board of Trustees and three residents are now Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: represented within this group. An administrator carries out day-to-day administrational duties, and a financial Administrator deals with all financial matters relating to the running of the home and people who use the service. Since his Registration Mr Southcombe has overseen numerous changes in the systems and practices of the Community. These have brought measurable benefits to residents. There has been further developments of care plans and risk assessments. A full review of the environment has taken place to further meet individuals needs and develop independence. People are being supported to access facilities outside of the Community and consideration being given to people who may wish to move into a more independent setting or require additional support due to illness and/or the aging process. All staff now receive training in Dementia Care. On-going improvements in Person Centered Planning were discussed. One resident had a very detailed person centered plan outlining their wish to move into supported living and the steps and support required to achieve this goal. Mr Southcombe was very supportive of his staff and was keen to point out their commitment to the Community and the people they care for. Health and safety issues were examined. The staff training programme included Health and Safety topics and training had been regularly updated. Residents also receive Fire safety training and one resident was keen to show the Inspector the Fire exits located near their bedroom. Risk assessments were in place to cover environmental hazards such as risks relating to upper floor windows and hot surfaces. Health and Safety records were examined which included routine safety and maintenance checks of equipment and fittings. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 All care plans should include information about peoples communication needs and how these needs are going to be met. This information should be reviewed as part of the care plan process. Meals should be served at the time that people choose to eat them. If a resident chooses to eat a meal outside of the usual meal time arrangements should be made to ensure that the food served is fresh and adequately heated. All carpets within the home should be checked to ensure that do not present a risk of tripping to residents. Any identified must be addressed as a matter of priority. Regular checks should be carried out to ensure that all areas of the home including communal parts and residents bedrooms are sufficiently heated. 2 17 3 24 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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