Inspection on 03/07/09 for Duckyls Farm Centre

This inspection was carried out on 3rd July 2009.

CQC 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 CQC judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Duckyls Farm Centre 30/07/08

Duckyls Farm Centre 13/06/06

Duckyls Farm Centre 21/12/05

Duckyls Farm Centre 20/07/05

Duckyls Farm Centre 04/11/04

Duckyls Farm Centre 28/06/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Key inspection report CARE HOME ADULTS 18-65 Duckyls Farm Centre Selsfield Road West Hoathly West Sussex RH19 4QY Lead Inspector Annette Campbell-Currie Key Unannounced Inspection 3rd July 2009 10:00 Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 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 Mr Brian James Jack Care Home 7 Category(ies) of Learning disability (0) registration, with number of places Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only – (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD) The maximum number of service users to be accommodated is 7. Date of last inspection 30th July 2008 Brief Description of the Service: Duckyls Farm Centre is a care home registered to provide accommodation and personal care for up to seven people who have learning disabilities. Mr Brian Jack owns the service. Mr Jack is also the registered manager for the service. 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. Staff accommodation for four staff and a sleep-in room is also provided on the site. There are extensive grounds with an organic vegetable garden and livestock. The current fees are £529.19 per week for personal care and £194.12 per week for day care. Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that people who use the service experience adequate quality outcomes. The previous key unannounced inspection took place on 30th July 2008. We (the Commission) carried out the site visit over four and a half hours. Mr Jack and the assistant manager helped with the inspection. The information and documents that we needed to help make an assessment of the service were available. There were seven people living in the home; one person has moved in since the previous inspection. Mr Jack had completed an annual quality assurance assessment (AQAA) before the inspection. The AQAA was detailed and provided evidence of the service the home provides for people living at Duckyl’s Farm. The information was used to help plan the site visit. We sent out surveys to people living in the home, to staff and to health and social care professionals. No completed surveys were received although Mr Jack said that some had been returned. All the people living in the home were seen and three people were spoken with. A member of staff was also spoken with to find out about their experience of the home. We saw the communal areas including the bathroom and shower room. We also saw two bedrooms. The following documents were read: The case records for three people including whole of life risk assessments, minutes from meetings with people living in the home, the recruitment record for one newly appointed member of staff, the complaints policy, staffing rotas, staff meeting minutes, samples of policies and procedures and samples of medication records. The medication storage facilities were seen and the administration of medication at lunch time. The outcomes for people have been assessed in relation to twenty-three of the forty-three National Minimum Standards for Care Homes for Younger Adults, including those considered to be key standards to ensure the welfare of people living in the home. The two requirements made at the previous inspection have now been met. Three requirements have been made following this inspection. What the service does well: Duckyl’s Farm Centre provides an opportunity for seven people who have learning disabilities to live on a working small holding and to be involved in producing some of their own food. Some of the staff who provide daily care are Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 6 also involved in the work on the farm. People benefit from living in a rural setting and the home provides a supportive homely environment. People are encouraged to enrol in college courses and to take part in community and leisure activities of their choice. Some people are supported to attend a local church and are involved in social activities arranged by the congregation. Everyone has the opportunity to have an annual holiday and people were enthusiastic about their next planned holiday. People are supported to maintain contact with relatives and some people have home visits arranged. People spoken with were happy with their home and the atmosphere was relaxed and comfortable. There are regular staff meetings that are also used as training workshops to keep staff up to date with any changes in people’s needs and key policies and procedures. What has improved since the last inspection? What they could do better: The home must ensure that a multi disciplinary decision is obtained with regard to the method of restraint used in the home in order to protect people from harm. A requirement has been made regarding this matter. The home must ensure that prospective staff provide a full employment history so that any gaps in employment can be explored as part of the recruitment process. Newly appointed staff must not begin work until a POVA First or Enhanced Criminal Record Bureau (CRB) check has been carried out and the results received. A requirement has been made regarding the recruitment process. Since the site visit we received a letter from Mr Jack informing us that the issue of the CRB check was an administrative error and that a CRB is obtained before newly appointed staff begin work. The storage facilities for controlled medication must meet with current legislation and all creams and over the counter remedies must be kept in a lockable facility. A requirement has been made regarding these matters. Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 7 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 8 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.V376007.R01.S.doc Version 5.2 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments are carried out before a decision is made about someone moving to the home. People are supported to visit the home before they make a decision about moving in. EVIDENCE: Six of the people who live at Duckyl’s Farm moved in when the home opened. The people spoken with and staff said that they know each other well and get on together. Staff understand their care needs so that they can support people to have a good quality of life. Mr Jack said in the annual quality assurance assessment (AQAA) that the home operates to three principles that apply to people living in the home and to staff: ‘They want to be here, they fit within the community and that they are benefiting from the situation’. Someone new has moved into the home in the past twelve months. The social worker who arranged the placement carried out assessments and at the time Mr Jack said that he had also assessed this person to make sure the home could meet his needs and that he would be compatible with other people living in the home. The person interested in moving to the home made several visits and over night stays and Mr Jack had said that he was available at these times Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 10 to carry out the assessment. The social worker was involved in planning these visits and making sure that a care plan was provided when a decision was made about the person moving to the home. Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s changing needs and personal goals are noted and changes are reflected in the records that are kept. People are supported to make decisions about their lives within a risk assessment framework. EVIDENCE: The home does not use a standard format for care planning. A full review of people’s needs is carried out with them once a year and all aspects of their care are discussed and new objectives noted. Parents, social workers or care managers are invited to join the person and staff at this meeting and to make a contribution or raise any issues. Individual care needs are also discussed in staff meetings and guidance is recorded in the minutes of these meetings. We (the Commission) read the review notes for three people. A person centred approach had been taken with all aspects of the person’s care discussed. Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 12 Photographs of events and activities the person had taken part in during the year and aspects of their achievement were also included. A list of goals or objectives had been noted for each person, although these did not cover all aspects of each person’s daily care needs that would usually be recorded in a holistic care plan. Mr Jack said in the AQAA that each person is provided with a copy of their review. It was clear that people are supported to make some choices in their lives and to be as independent as possible and to make use of opportunities that are provided. One person had been supported to use public transport independently to visit a relative. There is a clear structure to the day at Duckyl’s Farm and there are tasks that have to be undertaken. There is an expectation that people living in the home contribute to the running of the farm and the home in some way, either by working on the small holding or contributing to domestic duties such as cleaning, food preparation and cooking in the home. Mr Jack said in the AQAA that there is a degree of flexibility in the tasks that people are involved in each day and at weekends the daily structure is less formal. Whole of life risk assessments have been carried out and also environmental risks have been assessed; as the home is a working farm this presents possible dangers to people’s safety. The risk assessments that we saw covered aspects of individual risk and included some guidance to staff about ways to avoid risks and ways to support people with their independence. Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12, 13, 15, 16 and 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to take part in activities that they choose and are supported to use some community facilities. People are supported in their friendships and their contact with their families. People’s rights and responsibilities are recognised in their daily lives. A healthy diet is provided and mealtimes are social occasions. EVIDENCE: People who live at Duckyl’s Farm choose to live in a rural environment and to take part in the running of the farm. The duties that have to be fulfilled each day include planting and tending vegetables on the farm and carrying out domestic duties in the home. People have a small remuneration at the end of each week. Mr Jack said that all the produce from the farm is used by the home so that fresh vegetables are available at mealtimes. A meeting is held Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 14 each morning and daily tasks are allocated. The assistant manager said that staff have to make sure that there is a balance for people to ensure each person has an opportunity to work outside or in the home so that their days are varied. People are also supported to attend college courses. Three people had been attending a sports course and two a maths course. People are now choosing which courses they would like to apply for the new academic term. Mr Jack said that there has been some difficulty accessing courses due to a change of college policy that means that some courses are now expensive. One person enjoys football and plays in a local team. Other activities include swimming, horse riding and going to the pub one evening a week. There is a social club that several people go to once every three months. On Tuesdays there is a music session and people pay £30 from their allowance if they wish to join in. Staff also arrange outings to places of interest. Recently there was a trip to Brighton and the day following the site visit everyone in the home were planning to go to a show at Ardingly. Some people choose to attend a church service on Sunday mornings and one person is involved in spiritual and social activities arranged by the church. There is a range of activities and games available in the home and one person said he/she enjoys yoga and meditating. One person said: ‘I like the countryside and go for walks near the farm’. Everyone has the opportunity of a holiday and this year a holiday at Bognor Regis has been arranged. People were looking forward to the trip. People living at Duckyl’s Farm are encouraged to maintain contact with relatives and friends and family members are always invited to the annual review if the person whose care is being discussed agrees. There is a policy about supporting people in their relationships and Mr Jack said health care professionals are consulted when people need support in this area of their lives. The menus are planned with the people living in the home and staff provide support with this to ensure that they receive a balanced diet. There is a weekly shopping trip that people take turns to be involved in. Some of the food is produced on the farm so that people have fresh fruit and vegetables that they have been involved in planting, tending and picking. The main meal of the day is at lunch time and everyone sits around a large dining table. This is a social occasion when people share their experiences of the day so far. People are involved in food preparation, table laying, clearing away and washing up so that they work alongside staff as part of the community. Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal support in the way they need and prefer. People’s healthcare needs are met. The medication practices do not fully protect people living in the home. EVIDENCE: Some people in the home need support with personal care and others need supervision. The care needs were noted in some of the case records, for example: ‘X is getting used to our routines regarding bringing down his/her dirty laundry and can manage showering with minimal assistance’ and for another person: ‘X is very independent with his/her personal hygiene. X needs no encouragement to change his/her clothes’. People have support with their physical healthcare needs. One person has a Health Action Plan that he/she has been involved in completing. This process is person centred and helps to ensure that people are involved in taking some responsibility for their own health and welfare. The completed forms also help Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 16 to ensure that there is detailed information about all aspects of people’s physical and mental health needs. The assistant manager said that everyone in the home will be completing a Health Action Plan. Mr Jack and the assistant manager said that the home has a good relationship with the local primary care team so that people receive the health care support that they need. Mr Jack said in the AQAA that a local general practitioner (GP) had said that the home communicates clearly and works in partnership with them and that the home has a clear understanding of the care needs of people who live at Duckyl’s Farm. A member of staff is responsible for overseeing the medication practices. Mr Jack said that all staff who administer medication have received training to make sure they have the knowledge and skills that they need. We looked at the medication storage facilities and samples of medication records. Not all the records showed the dose of the medication that had been prescribed and the member of staff said that this would be rectified immediately. There were some over the counter and homely remedies and creams that were not being kept in a locked cupboard; this could present a risk to people in the home. There are no storage facilities for controlled medication that meet the current legislation. A requirement has been made about the storage facilities for medication. Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel their concerns or complaints would be listened to. There are some procedures in place to help protect people from harm or abuse however people are not fully protected by the recruitment process. EVIDENCE: There is a complaints policy and any complaints made would be recorded. No complaints have been received in the past twelve months. In the AQAA Mr Jack said that everyone living in the home is taken out for lunch once a month to a venue of their choice. This meeting gives people the opportunity to talk about any concerns or complaints so that they can be addressed at an early stage. The home follows the West Sussex multi disciplinary procedures for safeguarding vulnerable people. The home does not yet have a copy of the revised and updated procedures. Staff are provided with a training video regarding adult abuse and the member of staff spoken with was clear about his/her responsibility to immediately report any concerns that abuse may have occurred. West Sussex Adult Services carried out a safeguarding investigation into the restraint method used for one person living in the home. The investigation has concluded and the outcome of the Case Conference was that there was evidence of institutional abuse because of the method of restraint that was Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 18 used to control the person’s behaviour. Mr Jack does not agree with this conclusion. A number of actions were agreed at the Case Conference and a review meeting is due to be held to consider whether or not every point has been satisfactorily followed up. The policy of the home is that restraint should only be used as a last resort. Mr Jack and the assistant manager said that since the incident last year there has not been a need for restraint to be used. Mr Jack said that he has provided guidance to all staff about a method of restraint that was developed from Team Teach. There has been no multi disciplinary decision about the training or guidance for staff in the home with regard to the use of restraint. Until this is in place it is not clear that the methods being used are suitable and protect people living in the home and staff from harm. A requirement has been made regarding this matter. There is a system for protecting the finances of people living in the home. Mr Jack is responsible for ensuring that receipts are kept for all transactions and that staff are appropriately assisting people in managing their personal allowance. The recruitment records for a newly appointed member of staff showed that he/she had started work before a Criminal Record Bureau (CRB) check had been received, this practice does not protect people from the risk of abuse. Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is comfortable and safe. EVIDENCE: Mr Jack said in the AQAA that safety checks of the property and equipment has been carried out as required. We saw the communal areas of the home including the lounge, dining room, kitchen, laundry room, bathroom, shower room and hallways. We also saw two bedrooms. The landing has been decorated, also two bedrooms. The assistant manager said that other bedrooms would be decorated while everyone is on holiday. Blinds have been fitted in the bathroom and shower room to protect people’s privacy. The net curtains in one person’s room have been replaced. Two people spoken with said they are very happy with their room and both had personal items that reflect their lifestyle and interests. Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 20 Some work has been carried out in the bathrooms to reduce the mould around the tiles. The window ledges have been painted. Mr Jack said there is a programme of redecoration planned to make sure the home is in good decorative order. A new craft room is being refurbished for people to use. The staff and people living in the home are responsible for cleaning duties. People are supported to be as independent as possible and carry out cleaning and laundry tasks as part of their daily responsibilities. The home was comfortable and clean. Two members of staff have received training in infection control. Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by competent staff. The home’s recruitment policy does not fully protect people. Staff receive training so they have the knowledge and skills they need to do the job. EVIDENCE: There are nine staff who work at Duckyl’s Farm. There were three people on duty at the time of our visit including the assistant manager. Samples of staffing rotas were seen and showed that four people are on duty from Monday until Wednesday, three on Thursday and Friday and two on Saturday and Sunday. In the evenings there is one person on duty except for one evening when two people are on duty so that people who wish to can go to the pub. The assistant manager said that is there is a particular need one evening then it would be arranged for additional staff to be on duty. Either Mr Jack or the assistant manager is always on call in the evenings and at weekends. Four staff live on the premises although there is no agreed policy Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 22 about any of them providing back up for the person on duty in the evening should this be needed. Mr Jack said that he has made arrangements for new staff to have additional support when they are on duty on their own. The issue of one member of staff being on duty for seven people in the evening was discussed with Mr Jack and the assistant manager. This arrangement limits people’s opportunity to take part in evening activities and if there was an emergency there may be no one on site to provide help for the member of staff on duty. Mr Jack said that people are tired in the evening and if people wanted to go out it would be arranged for another member of staff to come in. We saw the recruitment records for a newly appointed member of staff. The application form did not make it clear that a full employment history should be provided so that gaps in employment could be explored. Mr Jack said that an interview is held over the course of a day to find out about people’s suitability for the work. People in the home have the opportunity to spend time with prospective staff and give their opinion about the person. There was no written evidence that an interview had been carried out and any gaps in employment explored. A requirement has been made about the need for the recruitment process to be robust. Two written references had been obtained including one from the person’s most recent employer. The records showed that the person had begun work before a Criminal Record Bureau (CRB) check had been received. Mr Jack said that this was an administrative error and provided evidence in writing following the site visit to confirm that this was the case. The home uses volunteers from Germany through an organised scheme. There was evidence to show that police checks had been carried out in the country of origin before they came to the home. The AQAA showed that two of the nine staff have achieved the National Vocational Qualification (NVQ) in care at level two or above. The assistant manager and another member of staff are enrolled on the NVQ level four award and another member of staff is studying for the level three award. There is an induction and training programme that is carried out in the home. Mr Jack provides training in the form of videos or at staff meetings. The mandatory topics are covered including fire safety, safeguarding adults and health and safe Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People usually benefit from living in a home that is well run however there are aspects of their safety and wellbeing that are not fully protected. People’s views are taken into account in the development of the service although there is no formal system for seeking people’s views about the service. EVIDENCE: Mr Jack is responsible for running the home alongside the assistant manager who works part time. Mr Jack has many years of experience of working with people who have a learning disability and of running a business. There are systems in place to ensure the efficient running of the service and all the required records were available for inspection. The two requirements made at Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 24 the previous inspection have now been met. Requirements have been made following this inspection regarding the following matters: the need to ensure a multi disciplinary decision is obtained to ensure that a safe method of restraint is used to protect people from harm, the need to ensure that the recruitment process is robust and that all the required checks are carried out before someone begins work and the need to ensure that the medication storage facilities protect people and meet current legislation. There is no formal system for seeking the views of people living in the home and of other people involved with the home about the quality of the service to ensure it is kept under review. Mr Jack said in the AQAA that people living in the home have a one-to-one meeting with him every month so that they can make any comments about their care. House meetings are also held so that people can make comments or raise any issues. There are health and safety policies and procedures in place for most aspects of daily life. Incidents or accidents are recorded and monitored by Mr Jack and the assistant manager. Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 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 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X 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 1 X 2 X 2 X X 3 X Version 5.2 Page 26 Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA23 Regulation Reg 13 (7) Requirement The registered provider must ensure that a multi disciplinary agreement is obtained regarding an acceptable use of restraint in the home in order to protect people from harm. The registered provider must ensure that storage facilities for medication meet current legislation and protect people from the risk of harm. The registered provider must ensure that the recruitment process is robust so that a full employment history is obtained with gaps in employment explored before a decision is made about offering someone a job. Timescale for action 31/08/09 2. YA20 Reg 13 (2) 31/08/09 3. YA34 Reg 19 31/08/09 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 Good Practice Recommendations DS0000014490.V376007.R01.S.doc Version 5.2 Page 27 Duckyls Farm Centre Standard Duckyls Farm Centre DS0000014490.V376007.R01.S.doc Version 5.2 Page 28 Care Quality Commission The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT National Enquiry Line: Telephone: 03000 616161 Email: enquiriessoutheast@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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