Inspection on 03/07/07 for Church Farm

This inspection was carried out on 3rd July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

Church Farm 08/07/09

Church Farm 01/05/09

Church Farm 11/12/08

Church Farm 13/10/06

Church Farm 06/09/05

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

CARE HOMES FOR OLDER PEOPLE Church Farm Yarmouth Road Hemsby Great Yarmouth Norfolk NR29 4NJ Lead Inspector Hilda Stephenson Unannounced Inspection 3rd July 2007 09:30 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 Church Farm DS0000064306.V345035.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. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Church Farm Address Yarmouth Road Hemsby Great Yarmouth Norfolk NR29 4NJ 01493 730181 01493 531599 rsonshomes@btopenworld.com rsonshomes@btopenworld.com R Sons (Homes) Limited 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) Mrs Anne Morley Care Home 40 Category(ies) of Dementia - over 65 years of age (28), Old age, registration, with number not falling within any other category (12) of places Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th October 2006 Brief Description of the Service: Church Farm offers residential accommodation to a maximum of 40 service users in the registration category of older people. The building is a period residence that has been adapted over the years to meet the needs of older people and extended to include purpose built accommodation. Service users rooms are situated on the ground and first floor of the building. Twenty-four of the rooms have en suite facilities and all others have washbasins with access to WCs and bathrooms close by. There are four separate communal areas and a conservatory, which has been designated a smoking area for staff and residents. The grounds are well maintained comprising of a garden and large car park at the front of the property and a courtyard in the centre of the home. Church Farm is located in the seaside village of Hemsby, 5 miles north of Great Yarmouth. The home is situated in a quiet location away from the main centre of Hemsby and is within walking distance of the local shop. There are very few local facilities, however it is a short drive to the town of Great Yarmouth, which has numerous shops and other facilities. The surrounding areas of Hemsby also offer a number of pubs and restaurants situated on the edge of the broads that can provide some very pleasant outings. The fees range from £281 to £450 per week with hairdressing, chiropody, nespapers and toiletries being an extra charge. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit to the home was conducted as an unannounced key inspection during the day on 3rd July 2007. The evidence was gathered by speaking to eight of the thirty five residents, four staff, two relatives and the manager, and by examining care records, staff files and the certificates and records required by regulation, and obtaining comments from the comment cards that were returned to the office prior to the visit. The home is a residential home to cater for the needs of frail older people and specifically for residents suffering from dementia, and was found to be clean and tidy with the residents carrying on with their own daily routine. During this site visit the home was having the carpet replaced in the large lounge and dining room so the usual routine of the home was slightly disrupted. Due to the nature and limitations that short-term memory impairment can bring, most of the evidence was obtained through observation and feedback from relatives. What the service does well: What has improved since the last inspection? Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 6 The statement of purpose and service user guide has been updated to include the current proprietors and is available for all prospective residents. The manager has improved the checks carried out when recruiting new staff to ensure the safety of residents. Records of staff training have been implemented. 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. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 7 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 Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 8 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): Standards 1,3 & 6 were checked. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Written details are available prior to admission to assist prospective residents and their relatives. All residents’ individual needs are assessed before moving into the home. Residents requiring intermediate care are not currently admitted. EVIDENCE: The statement of purpose and service users guide has been updated to include information regarding the change of ownership. The new documentation was available to residents and placed in their rooms with a copy in the front hall. The documents were in plain English with picture prompts in parts. The manager explained the admission process and records of the latest resident admitted to Church Farm and this was examined. The manager visits each prospective resident either at home or in hospital to assess their immediate needs. This pre-assessment forms the basis of the care plan. The Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 9 manager discusses what happens at the home with the resident and their relatives and invites them to visit first. Due to the majority of residents having some cognitive problems the manager explained it was normally relatives that visited the home. The written information about the service is available to the prospective residents. During the initial assessment visit the manager obtains assessment details from the social worker and hospital. The home does admit residents on a short-term respite basis but not for intermediate care. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 10 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): Standards 7,8,9 & 10 were checked. Quality in this outcome area is good. Resident’s health care needs are generally met. A safe system for the administration of medication is in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care records were thoroughly examined and found to contain clear, concise information regarding the physical, mental and social needs of each individual. Each of the care plans contained risk assessments in relation to their moving and handling needs, medication involvement, with indicators in place to monitor nutritional needs by assessing pressure care, weight and nutritional management and the home is proactive in the management of continence. Some pages were not signed within the care plan so a requirement for the scriber to sign and date all pages should be carried out. Residents who could express their wishes and relatives spoken to confirmed that they were regularly kept up to date with changing care needs and written aspects of the care plans. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 11 Evidence of specialist services such as chiropody, hearing, dental and psychiatric services were regularly sought for those who required these. The manager explained that expertise from the community nurses was sought when specialist pressure equipment was required, and it was observed during the tour of the building the home has a variety of beds in place. The senior carer on duty administers all medication and the lunchtime round was partially observed. The medication records were checked for the three residents involved with case tracking and found to be accurate. There were no residents who self medicated although this facility was available. All the rooms have the residents name on them with signs and symbols in place to prompt those who have dementia care needs. It was observed that staff spoke politely and in a manner that was befitting to adults with dementia cares needs, taking time to explain the upheaval the home was undergoing the day of the inspection. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 12 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): Standards 12,13,14 & 15 were checked. Quality in this outcome area is good. Residents are generally content with the food offered. Social activities are adapted to suit resident’s individual tastes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs an activities coordinator each Wednesday, who organises a bingo session in the morning and either a quiz or singing session during the afternoon. Written records showed that these two activities were very popular with residents and could get quite crowded at times. Care staff organised games, cards, reminiscence, singing, parties and the occasional outing in the garden or down to the local shop. It was observed that staff respected those residents who did not wish to take part in activities and preferred to stay in their room, although it was noted that some staff were sitting talking with residents at various times during the day. Some residents were too physically frail to take part in more organised activities it was noted that the home provided talking books, music and reminiscence discussions. Those residents with a memory impairment had photograph albums of family and friends to help jog heir memories of their past life. The care plans contained life histories of residents to assist staff to raise topics with them for reminiscence topics. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 13 During the day, several visitors were seen, the home has four lounges and one is kept as a quiet private lounge if visitors wish for more private time with their relative. The home does not organise large outings as they have been unsuccessful in the past, preferring to take residents out on a one to one basis. The home has two enclosed outside areas and residents tend to use these during the summer months. The manager explained that a small amount of community events are organised throughout the year, and has the local vicar visiting each month. Comment cards received confirmed that relatives were made to feel welcome when they visited the home. The kitchen was found to be clean and the chef was preparing lunch of mince and cod in parsley sauce and fresh vegetables. The large lounge dining room floor was being replaced so the usual dining area had been moved. Care staff were assisting residents during lunch time, it was observed to be a sociable occasion and residents passed comments about how the ‘food was tasty and plenty of it’. The requirements from the previous environmental health officer’s visit on May 07 had been completed. The fridge and meat temperatures were recorded and the insect repellent was in place within the kitchen. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 14 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): Standards 16 & 18 were checked. Quality in this outcome area is good. Residents and their relatives are confident that the manager would deal with their complaints satisfactorily. Residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the previous inspection no complaints had arisen. The majority of relatives and residents spoken to confirmed that they would speak to the manager if they had a concern or complaint. The complaints policy is advertised within the service user guide, with guidelines on how the manager would deal with a complaint. Staff had all attended the local adult protection training that is provided at the home, staff records showed that this training is provided each year. Care staff confirmed they were aware of the whistle blowing policy and that they would report any issues to the manager. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 15 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): Standards 19 & 26 were checked. Quality in this outcome area is good. Residents live in a safe, clean and well-maintained home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is clean, tidy and well maintained. All areas are accessible to residents, although guards were placed above the stairs with an access code to reduce the risk of injury. There are two enclosed areas of the garden that residents can safely access with garden furniture and small flowerbeds. The 4 lounges contained a variety of homely furniture. Relatives could use one of the lounges if they wished for a private area. The large lounge and dining room was having the flooring replaced during this site visit, although the dining area was in use, the lounge and its furniture had been placed within the other communal areas and these were a little overcrowded. Although past inspections confirmed that the home is always well laid out. Staff were seen reassuring residents throughout the visit that the upheaval would last for a short period. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 16 Several residents’ bedrooms were seen and contained a variety of personal items, furniture and photographs relevant to the individual to make their environment more homely and familiar to them. The home has a CCTV within the home although no areas contravene resident’s privacy. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 17 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): Standards 27,28,29 & 30 were checked. Quality in this outcome area is good. Residents are cared for by polite, friendly staff. The care home is adequately staffed the majority of time to meet the needs of residents. Staff are trained to care for resident’s physical, mental and social needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During this site visit the home had five care staff on duty with the manager undertaking care duties due to staff sickness. The proprietors must ensure the manager is not included on the staff rota and that adequate numbers of staff are on duty at all times to ensure the frailer residents needs are always met. It is recommended that staff numbers are adequate for the number and dependency needs of residents and size of the building. The latest member of staff who had recently completed the induction training programme stated that the staff and manager ‘were very supportive’. Staff records showed that mandatory training had been carried out this year. It was observed that the call bell did not ring for long when residents wanted some attention from staff. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 18 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): Standards 31,33,35,36 & 38 were checked. Quality in this outcome area is adequate. Management arrangements are meeting the needs of residents, although improvement is required to the premises and records. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been in post for two years and has worked at the home for the past six years. She regularly attends training to keep up to date with current trends, and has achieved the registered managers award and demonstrated her understanding of her role and responsibilities. At times the manager works as part of the care rota and due to the size of the home it is recommended that she be supported to undertake managerial responsibilities. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 19 There is a shortfall on regular formal supervision of staff and the manager is recommended to monitor staff supervision. The home monitors quality assurance of the home although do not currently publish the results of the surveys. It is required that the manager informs relatives and residents of the outcomes and changes made after these are conducted. The manager holds personal spending money for several residents; these records were checked and were appropriately recorded. Records show that health and safety issues are attended to with regular maintenance of fire equipment and training. The accidents at the home showed no abnormalities and were audited by the manager. Risk assessments for individual residents were seen in care plans, with general assessments following the homes policy and procedures to ensure the safety of the staff too. The water temperatures are monitored although there are still eleven of the hand basins in bedrooms, which can pose a risk to residents; these are required to correspond with the recommended safe temperature. The proprietor visits the home on a regular basis to support the manager, staff and residents. The registration and insurance certificates were up to date. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 20 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 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 2 x 2 Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 21 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 2 Standard OP7 OP33 Regulation 17.1a & 3a 24.2 Requirement The scriber of care plans must date and sign each entry. The results of the quality assurance must be published to ensure residents and relatives have been informed of any changes. Eleven of the hand basins in resident’s bedrooms must be fitted with the water temperature valve to eliminate risk of scalding. Timescale for action 30/08/07 30/12/07 3 OP38 13.4a 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP27 OP31 OP36 Good Practice Recommendations Sufficient numbers of care staff must be on duty at all times. The manager must not be included on the duty rota. The manager is recommended to increase the supervision of staff. Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 22 Church Farm DS0000064306.V345035.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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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