Inspection on 23/01/06 for Dixons Farm

This inspection was carried out on 23rd January 2006.

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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Dixons Farm 25/09/08

Dixons Farm 17/08/07

Dixons Farm 06/07/06

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Dixons Farm Wigan Road Bamber Bridge Preston Lancashire PR5 6AS Lead Inspector Val Turley Unannounced Inspection 09:30 23 and 31st January 2006 rd Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 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 Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 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 Adults 18-65. 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. Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Dixons Farm Address Wigan Road Bamber Bridge Preston Lancashire PR5 6AS 01772 334832 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) Progress Adult Services Limited Miss Jessica Elizabeth O`Neill Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home is registered for a maximum of 6 service users in the category LD - (Learning Disability). The Service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. N/A Date of last inspection Brief Description of the Service: Dixons Farm is one of the three homes operated by Progress Adult Services Ltd, which is a company caring for young adults whose severe learning disabilities are compounded by severe challenging behaviour. The service aims to provide an individualised, integrated service within which, communication therapy and high quality care, combine to reduce challenging behaviour and reinforce and maintain positive changes. The home is a detached property with a large enclosed secure garden to the rear and side, and parking area to the side of the property. The home offers accommodation over three floors to six young adults who each have their own bedroom. There are two bedrooms located on the first floor, which have en-suite facilities and are adjacent to a bathroom. There are two further bedrooms on the second floor. The property has a self –contained annexe with its own lounge with dining area, a kitchen, bedroom and bathroom. In addition, the home has a large lounge, a dining room and kitchen. There is a small conservatory to the rear of the house. There is a separate staff area, office and laundry. Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over two days in January 2006 by one regulation inspector. The inspection took 6 hours. This was the first inspection of the home following registration. The inspection involved discussion with and observation of the young adults who lived at the home and also discussion with and observation of the staff working there, an examination of records, policies and procedures and a tour of the premises. As part of the inspection, the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allowed the inspector to focus on one of the young adults living at the home. All records relating to that individual are inspected along with the room occupied at the home. The young adult was invited to discuss thier experiences of the home with the inspector, however this was not to the exclusion of other people living at Dixons Farm. A concern regarding an adult protection issue had been raised and at the time of the inspection this was being investigated by the relevant agencies. What the service does well: Dixons Farm was well managed by an experienced member of staff who was clear as to how the home should be run for the benefit of the young adults. The home was comfortable, well furnished, spacious and clean. It was furnished to meet the needs of the young adults with their safety in mind and bedrooms were furnished to reflect their interests. The home was well situated with access to local facilities. The home undertook in depth pre-admission assessments and from this developed detailed and meaningful care plans for the benefit of the young adults ensuring as far as possible that the admission process was successful. The young adults were given opportunities to make decisions and choices for themselves and care plans were reviewed on a monthly basis to ensure that the needs of the young adult were being addressed. The young adults were encouraged and supported to participate in a variety of activities, which were based on their interests and needs. Activity timetables were flexible to allow the young adult to make choices and decisions. Meals were balanced and varied and were prepared with the dietary needs and preferences of the young adults in mind. The home had good policies and procedures in place to protect the young adults and the training in these areas was to be held more frequently to ensure that staff were aware of their responsibilities. Training opportunities were good providing staff with the skills to communicate effectively and sensitively with the young adults. Staff felt well supported by Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 6 the management team and as a result they were motivated and enthusiastic about their work. What has improved since the last inspection? 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. Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The pre-admission process was detailed and thorough, ensuring the home was clear about the support needs of any prospective service user. EVIDENCE: The file of a young adult recently admitted to the home was examined. There was a variety and wide range of information in place, which had been obtained from the funding authority, and this outlined the support needs of the young adult. The home had undertaken its own assessment of the young adults needs and had worked on an outreach basis for two weeks prior to admittance. The young adult and the staff at the home who had been involved in that process confirmed this. A pre-placement meeting had been held and a record of this was held on the file. All of the information had been used to develop a care plan. Risk assessments had also been undertaken prior to admission and a positive handling strategy had been developed. The young adult was able to make choices and decisions and these were being used to help to develop the care plan as they settled into the home and their support needs became clearer. Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Care plans were thorough and detailed and the young adults were involved as far as possible in their development enabling them to make choices and decisions on an individual basis. EVIDENCE: The care plan examined had been generated from a variety of recent professional assessments. The plan outlined how the involvement of a number of social and health care professionals would provide additional support and guidance to help ensure that the care and support provided was appropriate and effective. The care plan included any restrictions on the young adults choice and freedom and the agreed strategies to manage any challenging behaviour to safeguard the young adult from harm. The plans were reviewed on a monthly basis. As the young adult struggled with the concept of a careplanning meeting, the options and choices available were discussed with them enabling them as far as possible to make choices and decisions on a day-today basis. Staff were observed to work with her in this way on the day of the inspection. Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 17 Staff supported service users to participate in a range of appropriate home and community-based activities that service users had indicated a preference for or an interest in. The young adults were provided with balanced and varied meals with their specific dietary needs and preferences being taken into account. EVIDENCE: The home arranged a variety of activities for the young adults living at the home. These were based on the young adults interests and abilities and were community based wherever possible. One young adult was observed being supported by the staff to go out for a walk. The file examined in detail contained an outline of the activities that had been arranged for the young adult who had been recently admitted. These activities included shopping, trampolining, craft activities and feeding the ducks in the nearby park. The young adult confirmed that she took part and enjoyed these activities especially shopping for craft materials. She also discussed with staff the swimming session that was being planned and worked towards. As the young adult was still settling into the home the timetable was being adjusted to meet Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 11 her needs on a daily basis. She said that she liked her room and was happy to point out her personal possessions including her craft materials. The manager stated that staffing ratios in the home were based on the different activities that were planned. Support staff on duty confirmed this. The young adults were provided with a range of balanced and nutritious meals with choices available to suit individual needs and preferences. Breakfast was observed to be flexible, depending on the preferences of the individual young adults. Lunchtime was observed to be relaxed and unhurried, with staff offering support and encouragement when appropriate. The care plans included details of any assistance the young adults required at meal times as well as details of any specific likes, dislikes, allergies etc. The young adult whose care was tracked was able to confirm that the details in her file regarding her dietary needs were correct. Discussion with staff indicated that they were aware of her individual needs. Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The homes medication was generally well managed however some additional work must be undertaken to safeguard both young adults and support staff. EVIDENCE: The homes management of medication was good. Records had been completed appropriately and the manager had a good understanding of the needs of the individual young adults. Accredited training in the administration of medication had been arranged for staff. The service users consent to medication had not been obtained because of the service users communication difficulties. It was required that some guidance be prepared for staff regarding the individual service users mannerisms and routines when medication is being administered so that staff are able to make an informed decision as to whether a service user is consenting to or refusing medication. Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home had good policies and procedures in place in order to protect service users however staff were not necessarily fully aware of these. EVIDENCE: The home had a comprehensive complaints policy and procedure, which contained all of the detail as outlined within the National Minimum Standards. Monthly care planning meetings and regular contact with family and friends provided the young adults with support that would enable any concerns or views to be recognised and acted upon. Written comments from one of the parents stated that the staff were ‘very helpful and co-operative’ and maintained ‘a close contact’. The individual communication needs and techniques of each of the young adults was documented and guidance was provided for staff to enable them to communicate effectively with the young adults, giving them opportunities to express their feelings and wishes. The homes policy on the Protection of Vulnerable Adults had been recently reviewed. This contained all of the necessary detail and identified the need for refresher training for all staff to ensure that they were always aware of the relevant policies and procedures. A recent incident within the home had indicated that support staff were not fully aware of their responsibilities in respect of these policies and procedures. Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The home was clean and comfortable and provided a pleasant and safe environment for both the young adults and support staff. EVIDENCE: The home was comfortable, homely, spacious and clean. It was furnished to meet the needs of the young adults with their safety in mind. Bedrooms were personalised to reflect their interests. The home was situated in its own large gardens and this was fenced for the safety of the young adults. Repairs in the home were dealt with as required, ensuring that the environment was always safe. The home was well placed for the local country park, supermarkets and a local shopping area. Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 34 Staff were competent and skilled but the homes recruitment procedure was not always followed precisely leaving young adults potentially at risk. EVIDENCE: During the course of the inspection the staff were observed supporting the young adults. They were observed to communicate well with the young adults and support them sensitively in a variety of situations. The young adults responded well to the staff demonstrating confidence in the support that they received. From discussions with members of staff with regard to training, it was evident that the staff were well supported by the management team and that the induction training and subsequent training gave them the necessary skills to support the service users in an effective and meaningful way. The organisation was continuing to work towards having 50 of its work force achieve a relevant qualification in care; additionally staff were encouraged to apply for external training courses The files of three members of staff were examined to determine if the selection and recruitment procedures of the organisation were thorough and robust to ensure the protection of the service users. All the necessary documentation on two of the files was found to be in order with the relevant checks having been undertaken prior to the staff commencing work within the care home. However the third member of staff had commenced work, providing support within the home, prior to a second written reference being received. Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 The home was well managed by an experienced member of staff providing a well-staffed, well-organised, safe, comfortable and clean environment for the young adults and staff team. Quality assurance processes in the home needed to be strengthened to ensure that the young adults are provided with a relevant and appropriate service. EVIDENCE: The homes registered manager had qualifications and experience relevant to the role and was working towards the registered managers award. She had a clear view as to how the home should be run for the benefit of the young adults. She had undertaken additional training for senior staff within the organisation and this included fire safety training and management training. The organisation had recently appointed a member of staff to take on the responsibility of quality assurance within the organisation. As a result of this a number of policies and procedures were being reviewed. Monthly monitoring visits were made to the home to ensure that the service provided was satisfactory and reports were submitted to the Commission for Social Care Inspection. Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 17 The manager undertook a number of regular checks to make sure that all documentation in the home was in place and up to date and that the environment was safe for both the young adults and the staff. The organisation had achieved the Investors in People Award which is a quality assurance award accredited by an outside body. Care planning meetings were held monthly to review the support provided to the young adults and make any necessary changes. Although the home was in regular contact with the families of the young adults and they were encouraged to play an active part in reviewing the care approach, their views, and where possible the views of the young adults should be sought about the services provided. The results of this survey should be published and made available to interested parties. The views of involved health and social care professionals should also be sought. Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 2 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Dixons Farm Score X X 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X X X DS0000064059.V264966.R01.S.doc Version 5.0 Page 19 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 13(2) Requirement Guidance regarding the service users consent to medication must be developed for each service user. The registered person must ensure that all staff are fully aware of their responsibilities in respect of Vulnerable Adult Procedures. The registered person must not employ a person to work at the home unless the necessary checks have been made. Consultation must take place with the service users and their representatives with a view to improving the service provided. Timescale for action 31/03/06 2 YA23 13(6) 31/03/06 3 YA34 19 28/02/06 4 YA39 24(3) 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA32 Good Practice Recommendations The home should continue to work towards 50 of its staff achieve a relevant qualification in care. DS0000064059.V264966.R01.S.doc Version 5.0 Page 20 Dixons Farm 2 YA39 The views of health and social care professionals should be sought as part of the homes quality assurance audits. Dixons Farm DS0000064059.V264966.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Chorley Local Office Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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