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Inspection on 14/11/06 for Castle Farm Residential Care Home and Farmhouse

Also see our care home review for Castle Farm Residential Care Home and Farmhouse for more information

This inspection was carried out on 14th November 2006.

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

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

What the care home does well

A good admissions procedure is in place that ensures that only people whose needs can be met are offered places at the home. Prospective residents and their representatives have the opportunity to visit the home to see if they like it before they move in. Assessments and care plans are of a good standard. They are kept up to date to make sure that staff know how to care for the residents living at the home. A range of community health professionals support the care staff in looking after the residents and there is a good system for medication administration at the home. Staff were observed throughout the inspection to be treating residents with courtesy, and kindness and residents confirm that their privacy and dignity are respected at all times. There is a programme of activities on offer at the home that residents can join in with if they choose to. Residents are free to spend their days doing as they like. Visitors are always welcome at the home and residents are encouraged to maintain and develop relationships with people in the home and with their families and friends. Meals are varied and a choice is always available. Residents can have meals where they wish. The dining area is both pleasant and comfortable. The complaint and adult protection procedures reassure residents and their representatives that the well-being and comfort of residents is important to the home and that any concerns raised will be properly investigated and resolved. The home and grounds are very well maintained, comfortable and safe for the residents living there and anyone visiting. The home is kept clean and smells pleasant. Sufficient numbers of well trained and qualified staff are on duty throughout the day and night to be able to meet the needs of the residents. The home is well managed and organised. The care and contentment of residents is clearly at the heart of the way the home is run. Systems are in place and records kept, that demonstrate the homes commitment to keeping residents safe.

What has improved since the last inspection?

No requirements or recommendations were made at the last inspection. The home has continued to function at the high standard that has been noted at previous inspections.

What the care home could do better:

To make sure that only suitable people are employed at the home all pre employment checks must be concluded prior to their employment e.g. POVA 1st checks must be received as must references. Any documents collected, as part of the recruitment process, must be held on file. It would be good if the home had a recruitment procedure to underpin what they do. It would be good if the home produced an annual development plan.

CARE HOMES FOR OLDER PEOPLE Castle Farm Residential Care Home and Farmhouse Castle Farm Road Lytchett Matravers Dorset BH16 6BZ Lead Inspector Debra Jones Unannounced Inspection 14th November 2006 10:00 X10015.doc Version 1.40 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 Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.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 Older People. 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. Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castle Farm Residential Care Home and Farmhouse Castle Farm Road Lytchett Matravers Dorset BH16 6BZ Address 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) 01258 857642 01258 857482 www.larksleas.co.uk Castle Farm Care Limited Mrs Dawn Roessler Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. A maximum of three bedrooms to be used as doubles at any one time, from rooms Nos: 9,11,17,18, or 23. A maximum of two service users to be accommodated in the Farmhouse. Service users who have identified night-time care needs must not be accommodated in the Farmhouse unless additional staffing is provided within the Farmhouse. Any persons providing staffing cover in the Farmhouse must be subject to the same recruitment processes as other staff in the home, with required details held on them. 6th December 2005 Date of last inspection Brief Description of the Service: Castle Farm is registered to provide accommodation to a maximum of 22 adults over the age of 65 years. The farmhouse, which can accommodate 2 people, is not in use at present. In the main home the fourteen rooms being used as singles have en-suite facilities, whilst 3 of the rooms large enough to be doubles do not. There are 5 communal W.Cs, 2 communal bathrooms and one shower. The home has a lounge and conservatory area on the ground floor, with a small staff room and office also in this area of the home. There is a separate dining room. There is a through floor lift and one staircase is fitted with a stair lift. Residents have access to the gardens and patio areas, where seating is available. The home is on the edge of the village of Lytchettt Matravers with access to the local Doctors surgery, library and village store. Castle Farm has a minibus that can accommodate disabled people and has a ramp allowing access for wheelchair users. The current weekly fees range between £475 and £525. Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 14 November 2006 and was the anticipated key inspection of the year. During the inspection records were looked at and the inspector walked around some of the building. The inspector also spoke with residents and relatives in the lounge and in bedrooms. Mrs Roessler (Registered Manager) and her staff helped the inspector in her work. Prior to the inspection the Commission asked the home to send out a number of comment cards to get people’s views of the home. Forty-one comment cards were returned. Seventeen were from residents, 17 were from relatives/ friends, 4 were from health and social care professionals, and 3 were from GP surgeries. Comment cards returned were generally positive about the staff and service provided at Castle Farm and all said that they were satisfied with the overall care provided there. ‘I am very happy with the care my mother is receiving and mother is happy too.’ (a relative) ‘Small friendly care home – mum is well looked after.’ (another relative) ‘I find it delightful. I say to my colleagues – I have found the ideal care home!’ (another relative) ‘I like the general conviviality.’ (another relative) ‘My mother has severe dementia and has been a resident for 6.5 years. I’ve always found the staff helpful and caring.’ (another relative) ‘The matron is excellent.’ (another relative) ‘I’m always greeted by warm friendly and wholly professional staff.’ (another relative) ‘Very happy with their care.’ (a GP) ‘I am the visiting hairdresser. I regularly recommend this home to all of my clients and their families, as I think they all do a great job. It is a home I feel confident in recommending. In my career as a hairdresser to the elderly I have worked in 4 care homes in the past 20 years Castle Farm is my number 1 choice for care.’ ‘The manager and staff are always very helpful and informative; there is good liaison between them the community nursing team and GP surgery. As a team we would not hesitate to recommend Castle Farm to our clients.’ (a community staff nurse) ‘Castle Farm is a very well run and managed home. Clean and with excellent care.’ (a chiropodist) Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 7 No requirements or recommendations were made at the last inspection. The home has continued to function at the high standard that has been noted at previous inspections. 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. The summary of this inspection report can be made available in other formats on request. Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 & 5. 6 is not applicable to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good admissions procedure. Prospective residents and / or their representatives are welcome to visit the home to decide if the home suits them. The home makes an assessment, based on information collected, that informs their decision to offer a place. This process ensures that only residents whose needs can be me by the home are offered places there. EVIDENCE: The manager carries out all pre admission assessments. Copies of these assessments are kept on file along with the letter from the home confirming that their needs can be met. The inspector met with a few residents who had moved to the home since the last inspection. One was being visited by members of their family. The Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 10 resident talked to the inspector of how her family had found the home and had visited on her behalf. The relative talked of how she had seen it advertised in a local magazine and visited ‘I instantly felt right about it. The accommodation is lovely and I was impressed by the manager. She gave me a care advocacy leaflet that I found really useful.’ All seventeen residents who returned comment cards to the Commission said that had been issued with a contract. They also all said that they had enough information before they moved in to the home so they could decide if it was the right place for them. Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear, consistent care planning system in place, which provides staff with the information they need to meet the needs of residents. The health needs of residents are well met with evidence of good support from a range of community health professionals. The medication at this home is well managed promoting the good health and well being of residents. Residents are treated with respect and their privacy and dignity are promoted at all times. EVIDENCE: Files sampled contained thorough care plans, which were clearly laid out and specified the needs of the residents. A preliminary care plan is put in place when residents first move to the home and then the full care plan is drawn up when the resident has been at the home for about a month. Care plans cover Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 12 the same general areas for all residents but are tailored to the individual e.g. where there are specific conditions, individual needs, these are covered. Care plans are backed up by a variety of assessments. Each file contains a range of risk assessments e.g. pressure areas, hoists, falls, along with a manual handling assessment. Daily notes demonstrate how the care plans are delivered and any follow up action that is needed is clear. Care plans and assessments are reviewed every month. When asked ‘do you get the care and support you need?’ Sixteen of the 17 residents who returned comment cards prior to the visit replied ‘always’, with the other saying ‘usually.’ Some relatives spoken to at the visit commented on how their mum was always very comfortable when they visited and in their opinion was ‘very well looked after.’ When asked ‘do the staff listen and act on what you say.’ All 17 residents said ‘yes.’ Residents spoken to at the visit spoke fondly of the staff at the home ‘they are very nice,’ ‘very good,’ ‘they are very kind to me.’ A relative said he felt that his mum was ‘in safe hands.’ Sixteen of the 17 relatives/ friends who responded by comment card said that they were informed of important matters in respect of their relatives, the other said 3 said ‘not applicable so far.’ Fourteen said that where it was appropriate they were consulted about their care, with two saying this was not applicable and the other saying they were not ‘so far.’ Care records also showed the interventions of community professionals. The manager said that the home was very well supported by local GP surgeries and that residents had good access to community services such as nurses, occupational therapist, physiotherapists, dieticians, chiropodists, dentists and opticians. The local dermatology nurse was at the home on the day of the visit. Where residents are in need of aids to help them around the home, or in and out of bed, residents have been assessed and aids made available to them e.g. hoists, pressure cushions, bath seats, wheel chairs, zimmer frames etc. When residents need to attend hospital appointments the home always ensures that someone goes with them, either a relative or a staff member. Sixteen of the 17 residents who returned comment cards said that they ‘always’ received the medical support they needed. The other said that this was the case ‘usually.’ Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 13 The 3 GP surgeries and the 4 health and social care professionals that returned comment cards to the Commission said that the home communicated clearly and worked in partnership with them. They also said that the home took appropriate decisions when they could no longer manage the care needs of residents. GPs, health professionals and care managers all said that staff demonstrated a clear understanding of the care needs of residents. Medication at Castle Farm is only administered by trained members of staff and a sheet with their signatures is kept as per good practice. Medication administration records (MARs) sampled were up to date and properly completed. Any allergies known are clearly recorded, and where there are none known this is noted. The quantities of medicines coming to the home were signed as received on the MARs. Where staff had made handwritten changes to the MARs another member of staff had countersigned these entries. Most medicines at the home are delivered in monitored dosage packs and so it is easy to match medicines taken with the records and to know how much should be on the premises. Some medicines are in ordinary packets; some of these are prescribed to be taken ‘when required.’ A simple system is in place at the home to enable them to know how many of these tablets should be on the premises at any time i.e. they write on the packets the date they are brought into use. Clear reminders for staff to do this are displayed in the medicines room and in the trolley. Medication was tidily stored in appropriate places e.g. medication cupboards, trolleys and in the fridge. The temperature of the fridge is appropriately monitored to ensure that the medicines in it are stored at the right temperature. Proper records are kept of the medicines that are returned to the pharmacy. Each care plan contains a section on medication and a history of the medicines that the resident has been prescribed. The GPs and health professionals who returned comment cards, and felt able to comment, said that in their opinion medication was appropriately managed in the home. One relative commented ‘mum had problems taking her tablets and the home help her with this by putting them in yoghurt, the management of this is very good.’ Residents confirmed that they felt treated with respect and that their privacy was respected. ‘I have always found the care to be of excellent quality. All the residents are treated respectfully and with dignity.’ Activities co-ordinator. All those who returned comment cards to the Commission confirmed that they were able to see residents in private when they visited. Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ lives are enriched by the choices they are able to exercise in their daily lives, the social opportunities afforded by their visitors and the activities and entertainment available in the home. The meals in this home are very good offering both choice and variety and are served in a pleasant environment. EVIDENCE: As stated in previous inspection reports Castle Farm is run in a manner that supports residents to live their lives as they choose. Residents are never hurried and are supported during the day to do what suits them. Staff spend upwards of 30 minutes with some residents getting them ready for the day, spending quality time together and enabling residents to do as much for themselves as they can. There is plenty going on at the home for residents to join in with if they wish. Theatre groups and entertainers come to the home to perform for residents on Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 15 a regular basis. An activities organiser is at the home 3 times a week and seasonal events are celebrated. On the day of the visit a drama therapist was running one of her weekly sessions at the home. ‘It’s lovely here, they are a good group, receptive to the work I do.’ Residents can also enjoy playing games of bingo, reading newspapers and books from the library, watching TV or just enjoying the views from the home out into the countryside. Hairdressers regularly come to the home. A relative talked of how much her mother had enjoyed the mobile clothes shop that had come to the home recently. Preparations are being made for Christmas and an invitation to residents and relatives to come to the Christmas high tea was on display in the entrance hallway. Of the 17 residents who returned comment cards 16 said that they it was ‘always’ the case that there are activities arranged by the home that they can take part in and 1 said that this was true ‘usually.’ One relative talked of how impressed she was with the activities. ‘Every time I’ve been here there is always something going on.’ Residents talked of their families and how often they visited. They said that visitors were welcome to come at any time. The visitors’ book confirmed the number and range of visitors to the home. All of the relatives/ friends who returned comment cards to the Commission said that they felt welcome in the home at any time. At the visit one relative commented ‘It’s lovely to visit, we can sit in the lounge with other people or sit in the conservatory or in mum’s own room or the foyer.’ Residents are able to make choices in their lives, within the limitations of a group environment e.g. choosing where they spent their days, what they did, what possessions they had around them, who they saw and what they ate. A nutritional assessment is carried out by the home when residents first move to the home and their likes and dislikes are noted. Most residents are well able to say what they enjoy and to make their preferences clear. Menus are based around the known likes and dislikes of the residents, on providing a good wholesome diet and delivering appropriate meals for the time of year. Alternatives are always available and more adventurous tastes are catered for. Residents are offered meal choices on the day. If they go out, or have appointments at meal times a meal can be saved for them. One resident had a hospital appointment the day after the visit and home staff were arranging for him to take a packed lunch with him just in case he needed it. At the visit residents and relatives spoke highly of the food. The lunch on the day of inspection was smoked haddock and mashed potatoes or shepherds pie. This was served with mixed vegetables and broccoli. Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 16 Dessert was a choice of chocolate sponge or ice cream, yoghurts and fruit, which are always available. Supper was to be soup and sandwiches or cheesy potato bake. Food is also available later in the evening for anyone who wants it and those with diabetes are automatically given evening snacks. Appropriate food records are kept of what residents have eaten. Residents can have meals where it suits them. The home has a pleasant dining area that residents can eat in if they wish. Some of the residents prefer having their meals in their rooms or in the lounge. Some residents always like to have their breakfast in bed. The Commission received seventeen comment cards from residents prior to the inspection. Fourteen of the 17 said that they ‘always’ liked the meals at the home and 3 said that they liked them ‘usually,’ One resident commented ‘I’m not always happy with suppers.’ One relative said ‘I do think that the quality and quantity of food provided could be improved.’ At the visit one resident talked of how her preferences were always taken into account and said the home were very responsive ‘If I don’t like it I don’t get it again.’ A relative talked of how she could have a meal if they wanted ‘oh yes, I get fed too!’ The local Environmental Health office carried out a food premises inspection in June 2006. As a result of this visit the home got an award for their high standards in food hygiene, the cleanliness of the premises and food safety management. Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A system is in place to deal with complaints that are made by residents and their representatives. The home’s adult protection policy, pre employment checks and ongoing staff training demonstrates the homes commitment to understanding abuse and of protecting residents. EVIDENCE: The home has a complaints policy / procedure that is available to residents and their supporters; a copy is on display in the entrance hall. No complaints have been received by the home in the last 12 months. Residents spoken to said that they were confident that if they had any concerns they would raise them with the manager or staff and that they would be listened to. The comment cards sent to residents asked the question ‘Do you know who to speak to when you are not happy?’ Seventeen residents sent back cards. All answered ‘always’ to this question. In respect of knowing how to make a complaint all said yes ‘always.’ Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 18 Fourteen of the 17 relatives / friends who returned comment cards said that they were aware of the complaints procedure. Three said they were not. Sixteen people said they had not had to make a complaint, 1 said they had and commented ‘a problem occurred with my mother’s medication but this was satisfactorily resolved. I am very familiar with her tablets as I cared for her at home for 3 years.’ The home has an adult protection policy and there was evidence to show that staff had had training in this area. As part of the recruitment procedure new staff are checked against the protection of vulnerable adults (POVA) list, held by the Department of Health. Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Castle Farm manages to create an environment that is homely, comfortable and at the same time safe for the residents living there and for anyone visiting. Bedrooms are well decorated, well furnished and personalised to suit the residents. Adequate communal facilities are available to meet the number and needs of the current residents. The home is kept clean and smells pleasant thereby enhancing the daily life of residents. EVIDENCE: There have been no changes to the premises since the last inspection. The home has a warm and homely atmosphere. It is well decorated throughout. Lounges and dining areas are comfortably furnished. The grounds that the home are set in are well maintained and attractive. Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 20 There are a number of communal bathing areas in the home. The majority of bedrooms have en suite facilities. Aids and adaptations are available throughout the home e.g. grab rails, raised toilet seats, and some residents with particular needs have their own personal equipment to assist with their independence. Rooms were personalised with the furniture and general belongings of the residents. The home is registered as having 4 bedrooms large enough to share and can use 3 at any time. There is a passenger lift in the home, enabling easy access between the floors. A stair lift has been installed to make going up and down a set of stairs in the older part of the house easier. There are emergency alarm bells throughout the home. The home was clean and there were no unpleasant odours. The laundry was clean and tidy. It is equipped with suitable washing machines. All laundry is done at the home. Residents said they were very happy with the cleaning and laundry services at the home. Relatives commented ‘we just turn up, the home is always clean.’ All of the 17 residents that returned comment cards said that the home is ‘always’ fresh and clean. The home has obtained a copy of the new Department of Health guidance ‘Infection control guidance for care homes’ June 2006. Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient, well-trained care staff are employed and deployed to ensure that the needs of residents can be met. Recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home but evidence was not available to show that all checks that should be carried out prior to employment were. EVIDENCE: Duty rosters are kept showing who is on duty and when. On the day of the visit 2 health care assistants were on duty in the morning (7am – 2pm) along with the manager and her deputy. In the afternoon (2pm – 8.30pm) there were 3 health care assistants and the manager. At night there are always 2 health care assistants. The cook and cleaner were also working in the home. Care staff carry out some laundry duties but these are mostly done by the housekeeping staff. Residents were asked are the staff available when you need them? Thirteen of the 17 residents who responded said ‘always’ with 4 saying this was the case ‘usually.’ Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 22 Twelve of the 17 relatives / friends who returned comment cards to the Commission said that in their opinion there were always sufficient numbers of staff on duty, 4 thought there were not and one did not answer. The GPs and health care professionals who responded by comment card all said that there was always a senior member of staff for them to confer with when they needed to. Six of the twelve members of care staff at Castle Farm have achieved a National Vocational Qualification at level 2 in care. Four more are due to start. (The target set by the Department of Health is for 50 of care staff to have this qualification). In addition two staff are completing their NVQ level 3 in care. A system is in place to monitor ongoing staff training and to identify when refreshers are needed. Every year staff have training in minimal handling and first aid. Recent training has included diabetic care and abuse. Records are kept of staff induction. Evidence was seen to demonstrate that the home has developed the new (October 2006) staff induction / foundation programme by Skills for Care (the industry standard) for their own use. Three staff files of newly employed care staff were sampled to see how the home manages recruitment. All prospective staff complete application forms and are interviewed. Pre employment checks had been carried out, including checking the Protection of Vulnerable Adults (POVA) list (held by the Department of Health). However, it was not possible to evidence in one case that the POVA 1st check had arrived before the person had started working at the home. All files contained 2 written references but again some of these were received after the start date noted on the files. The home has a recruitment checklist to prompt the collection of employment documentation but the list did not include all the information required by law and makes no reference to documents needed for foreign nationals, although the home did have a copy of the home office guidance on preventing illegal working. The file of a worker from an accession state country was reviewed and contained confirmation from the Home Office of their registration with Worker Registration Scheme. A recruitment policy was not available. Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well organised and the daily management and running of the home centres round the care and contentment of residents. Good management practice, systems in place, and records kept, confirm the health and safety of all in the home. EVIDENCE: Dawn Roessler is the manager of Castle Farm. She has a nursing background and remains ‘live’ on the National Midwifery Council register. Mrs Roesssler also has the Registered Manager’s award, an accepted management qualification equivalent to the NVQ 4 in management. Relatives said that they Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 24 were impressed by Mrs Roessler’s management ‘she is super, magnificent,’ and liked the fact that she was still ‘hands on’ e.g. she still helped residents get up in the morning and to go to the toilet etc. The home sent out and made available comment cards for the Commission as requested prior to this inspection. Those that came back were very positive about the home. A very comprehensive report of the home’s own 2005 quality assurance survey was available. This report also included information about other quality assurance measures such as how many complaints there had been, what training staff had had etc. Some improvements were identified. This years survey has been carried out but the annual quality report is yet to be written. The inspector alerted Mrs Roessler to the recent changes to the Care Home Regulations in respect of ‘quality of care.’ Discussion followed of how an annual development plan could be developed partly based on the quality assurance report findings. The home is owned by Castle Farm Care Ltd, which in turn is part of the Royal Bay Care Homes group. The Responsible Individual registered with the Commission for this company – Russell Wilson – lives in the same grounds as the home. He is closely involved in the day-to-day life of the home and popped in on the day of the visit. The manager said that the owners were supportive of them ‘if we need anything for the residents we get it.’ The home holds some small amounts of money belonging to residents. This is kept safely locked away and appropriate records are kept of expenditure and balances. Regular audits are undertaken. All records kept in the home were made available to the inspector as requested and are appropriately stored. The registration certificate was clearly displayed, as was the home’s insurance certificate. Prior to the inspection the home submitted a ‘pre inspection questionnaire’ to the Commission. This showed that the home was up to date with their maintenance checks and fire safety equipment to ensure safety in the home. Internal checks of fire safety equipment are being carried out and records evidenced these regular weekly and monthly checks. Records also show that staff have fire training at appropriate intervals. Dorset Fire and Rescue last visited the home in October 2005 at which time the existing fire precautions were being satisfactorily maintained. They are due to visit again in September 2007. The home has completed a fire risk assessment that is regularly reviewed. The date of the last review was February 2006. Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 25 Information about what to do in the event of a fire is clearly displayed in the entrance hallway. Accident records were looked at. Records are well completed in that they are clear about how staff writing up accident reports knew about accidents e.g. if they came across someone who had fallen, if a resident told them of the accident. The manager carries out an accident analysis every 4 months and where appropriate, measures are put in place to minimise the risk of future accidents occurring. The inspector gave Mrs Roessler a copy of a Medicines and Healthcare products Regulatory Agency (MHRA) notice about the use of bed rails. Mrs Roessler agreed to build the checking of bed rails into the regular maintenance checks that are already carried out at the home to help keep residents safe. The home keeps data product sheets– for any hazardous substances in the home e.g. cleaning materials. These are kept in the office and are readily accessible to the staff using the products and are reviewed annually by the manager. Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation • Requirement All documentation as specified in the regulations must be kept on file and be available for inspection in respect of all staff employed at the home. All new staff must be checked against the POVA list and the result obtained of that check prior to them starting working at the home. Pre employment checks must be concluded prior to employment. Timescale for action • 1. OP29 19 01/01/07 • Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 28 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations A recruitment procedure should be in place that underpins practice at the home and acts as a reminder of all the aspects of recruitment the home has to abide by e.g. compliance with the Care Home Regulations, employment law, preventing illegal working etc. 1. OP29 Castle Farm Residential Care Home and Farmhouse DS0000026776.V320441.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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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