CARE HOME ADULTS 18-65
Duckyls Farm Centre Selsfield Road West Hoathly West Sussex RH19 4QY Lead Inspector
Mrs J Aston Unannounced Inspection 13th June 2006 10:15 Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 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 Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 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. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Duckyls Farm Centre Address Selsfield Road West Hoathly West Sussex RH19 4QY 01342 811111 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) Mr Brian James Jack Mrs Karen Heidi O`Neill Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21st December 2005 Brief Description of the Service: Duckyls Farm Centre is a care home registered to provide accommodation and personal care for up to seven people between the ages of 18 and 65 years with learning disabilities. Mr Brian Jack privately owns the service. Mrs Karen O’Neill is the Registered Manager and is responsible for the day to day running of the home. Duckyls Farm Centre is in a rural area, located on the outskirts of the village of West Hoathly in West Sussex. The home has many of the characteristics and features of a traditional farmhouse. Communal rooms are on the ground floor and seven single bedrooms are on the first floor. There are extensive grounds with an organic vegetable garden and livestock. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. A random inspection was undertaken on the 27th April 2006 to follow up on action taken on requirements made at the last inspection. The findings of that inspection were put into a letter to the Provider and will also be incorporated into this report. This inspection is called a key inspection, and has assessed the key Standards as determined by the Commission for all homes for Younger Adults. It also determines the frequency of inspection hereafter. Planning for the inspection was undertaken prior to the visit to the home. A pre-inspection questionnaire was sent to the home for completion however this has not been returned to the Commission. A site visit took place on the 13th June 2006 and was an unannounced visit. Four and a half hours were spent in the home. A tour of the premises was undertaken, two members of staff were interviewed and a sample of records was examined. Six service users were seen during the visit however very limited conversations were held with each service user due to communication difficulties. Comment cards were sent to all relatives, Social Workers/Care Managers and the service users GP surgery immediately after the inspection. Where their views have been obtained they have been included in this inspection. What the service does well:
Duckyls Farm is quite a unique service that provides care and support to six service users. They live in a residential setting on a working farm in a family type environment. The home is staffed by six members of staff who support service users but are also responsible for the running of the farm. Two members of staff live on the premises in separate accommodation. The service does not fit readily into the National Minimum Standards for Younger Adults in a Care Home setting but provides an inclusive, individual and stimulating lifestyle for each service user. The Inspector therefore has made judgements on the outcomes for service users and used discretion about records that must be in place. Duckyls Farm provides service users with accommodation that is suitable for their needs and in keeping with a farm setting. Service users are supported to work on the farm but to also take part in a range of activities outside of the farm that ensures they lead a busy and fulfilling lifestyle. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 6 Most members of staff have worked at the home for some time and know service users well. Social Workers spoken with after the inspection said they were generally satisfied with the service and support provided. A Social worker said, “he always seems to be in a good mood and cheerful.” A relative said, “ Duckyls Farm Centre is the answer to my son’s long held dream of being on a farm with animals and having a job. It cannot be improved upon in my opinion; it has eased my mind after so many years of unsatisfactory placements. It is truly an amazing place.” What has improved since the last inspection?
At the random inspection earlier this year it was noted that the recruitment checks for a new member of staff were in place. Discussions with Mr Jack and the Registered Manager expressed the importance of undertaking Criminal Record Checks and POVA first checks before a new member of staff starts working in the home. The Inspectors were informed at the random inspection that there are no service users who control their own medication so the need for a review of the safety procedures for this is not required. However if a new service user is admitted who has the capacity to self-medicate and then a risk assessment will need to be completed. It was identified at the random inspection that risk assessments had been undertaken on safe working practices and risks for service users whilst working on the farm and from any challenging behaviour. At this inspection a member of staff confirmed their responsibility for updating risk assessments and that this would be undertaken shortly. At the random inspection Mr Jack explained the financial procedures and system used for managing residents’ finances. Since the last inspection the Registered Manager has commenced monthly monitoring of the entries made in the residents’ purchases’ book. Mr Jack also monitors this account. The errors that were noted at the last inspection have been corrected. Mr Jack was advised to check if the service users parents have power of attorney. Mr Jack and the Registered Manager confirmed that there has been no need to use physical restraint with any resident since 2005. Mr Jack stated that physical restraint does not comply with the philosophy of the home and that behaviour management techniques are used. It was demonstrated that members of staff had written guidance available about how to work with each service user when they may be exhibiting challenging behaviour. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 7 The Registered Manager confirmed that guidance on using these techniques is given as part of the induction programme. Therefore the Inspectors accepted that training in restraint is not required at this time. Mr Jack and the Registered Manager confirmed that the laundry is not used to prepare or store food. There was no evidence of this at the time of the random inspection or at this key inspection It was confirmed at the random inspection that Mr Jack holds some financial records relating to service user benefits and service user contracts with Local Authorities. Mr Jack confirmed that they would be made available in the home at short notice. The Registered Manager confirmed at this key inspection that all other records are available to her. Members of staff spoken to at the time of the inspection confirmed that they had received individual supervision with the Registered Manager and attend monthly staff meetings. Members of staff confirmed that they had received more training since January this year. A new member of staff confirmed that they had received induction training. The Registered Manager confirmed that further training would be arranged once the safe handling of medication modules had been assessed. Mr Jack confirmed at the random inspection that negotiations are still ongoing with the contracts department of local authorities regarding service users annual holidays. What they could do better:
The kitchen requires refurbishment/upgrading as per the Environmental Health Officers requirements at their last inspection. The bathroom on the first floor requires redecorating/refurbishment to provide a clean and pleasant bathroom. A requirement has been made in this report for this to be addressed. The Registered Person must supply an action plan to the Commission that outlines how the requirement will be met and confirm that this will be within the timescale given. This must be submitted to the Commission no later than the 7th August 2006. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 8 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. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 9 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 Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 10 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 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The needs of prospective service users would be appropriately assessed. EVIDENCE: A Statement of purpose and service users guide is available for prospective service users and their relatives to read before making a decision about living in the home. The Statement of purpose was updated in 2004 but now requires updating to include the Registered Manager’s name and details. Once updated a copy of the revised Statement of Purpose and Service User Guide must be sent to the Commission. No new service users have been admitted for some time so the admission and assessment procedure could not be assessed. Discussions were held with the Registered Manager about the assessment she should undertake before a new service user is admitted and that a record of the assessment should be kept. The Registered Manager confirmed that a new service user would not be admitted without a full needs assessment from a Social Worker/Care Manager. A new service user would be offered visits to the home and would be admitted to the home on a trial basis for three months. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 11 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, 7, 9. Quality in this outcome area is good. These judgements have been made from evidence gathered both during and before the visit to this service. Service users needs and wishes are recorded appropriately. Service users receive support and assistance from members of staff to make choices and decisions in their lives. Where service users lack capacity members of staff have to make decisions in the best interests of each service user. Service users are supported to lead their lives within a risk management framework. EVIDENCE: At the site visit all care plans were seen. They were basic but provided necessary information. Social Workers/Care Managers, relatives and service users are invited to a formal annual review for each service user and records demonstrated this. Two service users had recently had an annual review in June and a Social Worker had attended both meetings. Mr Jack and the Registered Manager provide a written review for each service user before each meeting that provides information and a few appropriate photographs on aspects of achievement, health matters, activities and any concerns.
Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 12 Each service user holds a copy of the review and it is made available for staff to read. At the random inspection there was evidence that a service user had added her views about the review in writing and this was attached to the minutes of the review. All reviews are held dating back for ten years. A Social Worker said, “We are always invited to the review meetings and they provide us with a copy of the report.” Members of staff spoken with at the time of the inspection confirmed that service users are supported to make decisions and choices in their daily lives and they are able to say “no” and this is respected. Staff said that daily routines are based around activities but there is flexibility. A service user said that she gets up at a certain time in the week but at weekends it is different and she can lie in. Members of staff spoken with explained that a meeting is held each morning with service users where they are supported to complete a daily schedule that indicates what activities they would like to do each day. The schedules are kept in the dining room in an individual file that each service user has access to. The schedules also provide an educational tool to assist with writing and spelling. A list of Key and common words used when completing these are kept at the back of each folder so that service users can refer to them. These were examined at the site visit. At the random inspection it was demonstrated that risks are considered for service users and members of staff in respect of working on the farm and using machinery. Where necessary risk assessments and guidelines are in place to assist members of staff to deal appropriately with challenging behaviour. At this site visit the risk assessments were again examined. Risk assessments are kept in the Policy and procedure file that also provides information about the five steps to risk assessments. A member of staff spoken with confirmed that they hold responsibility for updating the risk assessments and this would be done shortly. Service users are supported to take responsible risks within the environment they live in and within the community. It was demonstrated from the reviews examined that some service users have been attending college where they are undertaking a transport course and have been using local transport. The Registered Manager informed the Inspector that other college students would be visiting the farm for a barbecue and using public transport to get from the college to the farm and back. It was observed that the service users were cleaning the barbecue in preparation for this. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 13 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, 15, 16, 17. Quality in this outcome area is good. These judgements have been made from evidence gathered both during and before the visit to this service. The service users currently accommodated are supported to live in an environment that meets their needs and provides them with a fulfilling lifestyle. Service users are supported to maintain contact with family and are provided with a varied menu that includes healthy eating. EVIDENCE: From previous inspections and at this site visit it has been demonstrated that service users are supported to live a varied and fulfilling lifestyle and undertake a range of activities. Service users were placed at Duckyls Farm in order to participate and work on a working farm. Day care therefore was provided in the form of working at the Farm Centre. Other activities are organised so that service users attend college, go swimming, horse riding etc. Within the home there is an activity room that has a range of equipment and material for service users to use. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 14 A service user spoken with confirmed that she likes doing Yoga and Drama at college. Another service user plays in a football team at a local day centre. On the Farm there is a football pitch at the end of the garden area. The Inspector was shown around the farm including the farm garden. Service users work on the garden and each have their own patch where they grow vegetables. The produce grown by each service user is then used within the home so service users can see how their produce is put to use. Service users are also supported to look after eight cows and a number of sheep. Members of staff spoken with felt that service users had a brilliant lifestyle and one that suited their needs. A Social worker said, “he has been accessing the community a lot more and developing independence and building confidence.” A relative said, “He’s taken to college, to many excursions, horse riding twice a week, swimming every week.” The last inspection identified that service users had paid for an annual holiday and that this should be part of the basic contract price. Mr Jack confirmed at the random inspection that he was in negotiation with Local Authorities about this matter. He had not received a satisfactory response and will be continuing to pursue this. It was evident that service users are supported to maintain contact with relatives. At the time of this key inspection two service users were out of the home visiting family, one in Scotland and one in Surrey. A service user spoken with said they phone family and write to them. The main meal of the day is usually provided at lunchtime. Produce from the farm is used in the meal provision. A large bowl of fresh fruit was in the dining room. Members of staff confirmed that they are involved in the cooking of meals and where possible service users become involved in the preparation of vegetables. It was observed that members of staff take tea breaks with service users and also eat lunch with them. It was observed that service users are also encouraged to participate in clearing away after lunch and doing their laundry. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 15 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): 18, 19, 20. Quality in this outcome area is good. These judgements have been made from evidence gathered both during and before the visit to this service. Service users personal care and health needs are met appropriately. The medication in the home is stored safely and appropriate records are kept. EVIDENCE: It was evident from care plans and reviews that the service users accommodated require only minimal support with personal care. A member of staff confirmed that sometimes a service user may require reminding or supervision with shaving, or bathing otherwise they are independent. A Social Worker said, “He always looks well kept.” It was observed at the time of the inspection that a service user was in the laundry folding clean clothes and putting them away and service users were observed to be clearing away after lunch and washing and drying up. This demonstrated that service users are encouraged to be involved in daily tasks within the home to promote and maintain some independence. Care plans and reviews indicate that service users are supported with medical needs and have regular check ups with Health professionals.
Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 16 There was evidence that all service users have recently had a sight check. A Social Worker said, “they monitor is health appropriately.” Another Social Worker said that members of staff have not been assisting a service user to use communication aids. They should address this to ensure his communication is improved outside of the home. Reviews also indicate medication required and any changes in medication. All service users are registered with a local GP. A G.P. stated through a comment card after discussions with other GP.’s at the practice that, “ the patients nearly always visit us, we rarely see them and feel we are appropriately used. We have no problem areas and assume therefore the home is well run and managed.” The Inspectors were informed at the random inspection that no service users now self medicate. The need for review in this area is not required unless a new service user is admitted who has the capacity to self medicate and then a risk assessment should be completed. The storage and records relating to the administration of medication was examined at this site visit. Medication was stored appropriately and records kept were in good order. Medication is kept in a locked cabinet. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 17 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, 23. Quality in this outcome area is good. These judgements have been made from evidence gathered both during and before the visit to this service. Complaints are dealt with appropriately. The service has ensured as far as possible that service users are protected from abuse. EVIDENCE: The Commission has not received any complaints in respect of this service. The Registered Manager informed the Inspectors that there have been no complaints made to the home. Standard 22 was met at the last inspection. At the random inspection Mr Jack and the Registered Manager confirmed that although some service users have challenging behaviour physical restraint is not required. Mr Jack stated that physical restraint does not comply with the philosophy of the home and that other behaviour management techniques are used. Members of staff spoken with confirmed that they have received training in recognising signs of abuse this year. Members of staff confirmed that physical restraint is not required or used in this setting but guidance has been provided about how to work with challenging behaviour. At the random inspection the system of dealing with service user finances was explained and discussed. The records of the spending for service users was examined and found to be in order. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 18 Members of staff spoken with confirmed at the site visit that they are required to keep receipts for everything; they assist service users to spend their personal allowance or use the company’s credit card. They confirmed that service users always have money to spend when they are out on activities. Mr Jack keeps comprehensive records of service user spending based on figures kept by the registered manager. Any monies spent over the service users individual personal allowance (larger items etc) may be purchased using the company’s credit card. Mr Jack then arranges for the service user to pay it back. It appears confusing but there is a system in place and there is no evidence that this system does not work or that service users lack anything because of this. A Social Worker said, “there is no problem with finances, he has money available.” Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 19 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, 30. Quality in this outcome area is adequate. These judgements have been made from evidence gathered both during and before the visit to this service. The standard of accommodation provided is in keeping with a working farm and meets the service users needs. Some refurbishment/upgrading is required. The cleanliness of the home could be improved. EVIDENCE: A tour of the premises was undertaken at this key inspection and records in relation to the safety of the property examined. The ground floor provides a utility room, kitchen, dining room/lounge, separate lounge and activity room. First floor provides all single bedrooms, bathroom and toilet and shower room and toilet. Service user rooms looked individually decorated and furnished and suitable for the needs of the service users. The home is in keeping with a farmhouse on a working farm and looked reasonably clean although this could be improved e.g. windows, windowsills and bathroom. Service users with the support from staff participate in the cleaning of the house.
Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 20 There is a shower room on the first floor for service users to use and was clean and hygienic. However the bathroom next to this requires either redecorating or refurbishment, as the tiles and grouting were very mouldy, paint peeling off the window frame and the paint on the ceiling stained and peeling. A service user said that he liked to have a bath not always a shower so this must be addressed. The Inspector was informed that the Environmental Health Officer at their last inspection identified that the kitchen required upgrading. The E.H.O. had set a timescale for this work to be done and although the work has started it is not yet complete. At this inspection the kitchen was generally clean but improvements are required to upgrade the kitchen. Records examined demonstrated that safety checks on the property and utilities are undertaken. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 21 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, 34, 35. Quality in this outcome area is good. These judgements have been made from evidence gathered both during and before the visit to this service. Service users are supported by a stable, experienced staff team that know them well and who have sufficient time to meet their needs. Appropriate recruitment procedures must be followed prior to any new staff working in the home. Members of staff are appropriately supervised. EVIDENCE: It was confirmed at the site visit that there have been no new members of staff employed in the home since the last inspection. At the random inspection it was demonstrated that the necessary recruitment checks had been undertaken although well after the member of staff had started working and living in the home. The Registered Manager confirmed that she is now aware of the requirement to undertake CRB checks and POVA first checks before employing a new member of staff. The home employs six members of staff. Two members of staff live on the farm in separate accommodation adjacent to service users accommodation. Members of staff confirmed that the staffing levels in the home are usually sufficient to meet the needs of the service users within the home and to take them out to their individual activities.
Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 22 A relative said, “I am always kept informed and consulted, there are plenty of excellent care assistants and all requests are acted upon quickly.” Members of staff spoken with confirmed that individual supervision had been provided and staff meetings were held once a month. The Inspector discussed the frequency of supervision and how this could be made more applicable to a small staff team in this kind of setting and how this should be recorded. Members of staff spoken with confirmed that the following training had been provided this year: - fire prevention, awareness of abuse, induction, food hygiene, challenging behaviour and safe handling of medicines. A member of staff spoken with had not undertaken food hygiene training so this should be provided. A new member of staff confirmed that an induction programme had been provided that included a period of observation, instruction from the Manager and some basic Health & Safety training. They had been made aware that training to National Vocational Qualification Level 2 would be supported. The induction had been recorded. A discussion was held with the Registered Manager about how to keep a record and evidence of training undertaken by each member of staff. It was confirmed that once the safe handling of medicines had been assessed further training would be arranged in other topics. The need for moving and handling training was discussed although not in respect of service users but for safe working practices for members of staff whilst working on the farm. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 23 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, 39, 42. Quality in this outcome area is adequate. These judgements have been made from evidence gathered both during and before the visit to this service. The home appears safe for service users. The safety of service users and members of staff is considered and risks minimised as far as possible. EVIDENCE: The Registered Manager has worked in the home for many years and knows the service users well. She is currently working through National Vocational Level 4. Improvements have been made in record keeping. The service does not operate a formal quality assurance system. However reviews are held annually with service users and relatives or representatives are always invited to this. Relatives who responded to the inspection through comment cards indicated that they were made welcome to the home, were kept informed and were consulted about the care of their relatives. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 24 A relative said through the comment card that Mr Jack meets with service users individually on a regular basis so they can “give him a full report.” Mr Jack does not undertake monthly inspections of the home under Regulation 26 as he visits the home almost on a daily basis. The requirement to provide Regulation 26 reports was discussed at the random inspection where Mr Jack agreed to consider a solution put forward as to how this may be met. The G.P. who responded through a comment card answered yes to the questions “does the home communicate clearly and work in partnership with you. Do staff demonstrate a clear understanding of the care needs of service users. Do management/staff take appropriate decisions when they can no longer manage the care needs of the service user. Members of staff confirmed that training has been provided in fire prevention, food hygiene and safe handling of medicines. A member of staff spoken with confirmed she had undertaken training to become an appointed first aid person two years ago and this is still valid. The need for moving and handling training was discussed although not in respect of service users but for safe working practices for members of staff whilst working on the farm. Records examined relating to the environment were examined. Recording of safety checks should be kept up to date, as some monthly checks had not been recorded for a while. It was demonstrated that checks are undertaken on the building for fire safety, this included emergency lighting, means of escape, fire equipment etc. There was an inspection being undertaken on fire equipment at the time of the inspection. Members of staff spoken with confirmed that fire drills are undertaken regularly and that service users respond really well to this and take appropriate action. Service users have storage heaters in their bedrooms; gas is used for cooking and is provided by a gas cylinder. It was noted that electrical appliances in the home had been checked for safety. Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 25 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 Standard No Score 1 3 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 3 x 3 x Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 26 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 YA27 Regulation 23 (2) (d) Requirement The Registered Person shall ensure all parts of the care home kept clean and reasonably decorated. The bathroom of the first floor requires either redecorating or refurbishment. Timescale for action 29/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Duckyls Farm Centre DS0000014490.V290638.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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