Inspection on 14/02/06 for Easterbrook Farm

This inspection was carried out on 14th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Easterbrook Farm 27/01/09

Easterbrook Farm 20/10/07

Easterbrook Farm 24/10/06

Easterbrook Farm 25/10/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Easterbrook Farm Exbourne Near Okehampton Devon EX20 3QY Lead Inspector Helen Tworkowski Unannounced Inspection 14th February 2006 03:00 Easterbrook Farm DS0000063712.V283713.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 Easterbrook Farm DS0000063712.V283713.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. Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Easterbrook Farm Address Exbourne Near Okehampton Devon EX20 3QY 01837 851674 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) easterbrookhq@btconnect.com Easterbrook Farm Limited Mr Simon Rooke Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th October 05 Brief Description of the Service: Easterbrook Farm is registered to accommodate 8 people with a learning disability. The Granary can accommodate 4 people, whilst the main farm house will accommodate a further 4 people. It is planned that Easterbrook Farm will eventually accommodate 10 people when an extension is completed. Easterbrook Farm is north of the village of Exbourne, and surrounded by it’s own farmland. The farm has a number of farm and out buildings, including a new poly-tunnel. The Granary consists of a lounge, kitchen/dining room toilet, and a wheelchair accessible bedroom with en-suite shower room. On the first floor there is are a further 3 en-suite bedrooms. There is also a separate laundry (which will be used by everyone at Easterbrook Farm) and staff sleeping accommodation/ office.The Farm House has 4 bedroom (3 are en-suite), a large dining room, lounge, conservatory and kitchen. There is also a small office and utility room. The service is staffed 24 hours per day and Service Users are to be encouraged to be involved in a range of activities at the Farm that are to be developed. This will include horticulture and arts & crafts. The aim of the service is to develop skills and independence, in a comfortable rural home. Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 3pm and 6pm on Tuesday 14/2/06. Easterbrook Farm is currently registered to accommodate 8 people however only 3 Service Users have moved in at present. The inspection included a tour of both the Granary and the Farm House, time was spent with the two service users who were at home, records were examined and there were discussions with both the staff on duty and the manager, Simon Rooke. What the service does well: What has improved since the last inspection? What they could do better: There is no comprehensive medication system or information about the medications that are being administered. Such a policy is important as it guides the actions to be taken in both routine and unexpected situations, and helps keep Service Users safe. It is recognised that Easterbrook Farm is a new service. One area that needs further development ensuring that Service Users know what is happening in the home, for example the menu. Other documents such as the Service User Plans and Risk assessments need to be made readily available, so that they can be used by staff. Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 Page 6 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. Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 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 Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 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 and 3 Prospective Service Users can be confident that their needs will be fully assessed before a move to Easterbrook Farm. EVIDENCE: The last inspection identified that Service Users were being assessed prior to moving to the farm however this information was not properly recorded so that it could be the basis for planning how care needs are to be met. The Manager, Simon Rooke, was in the process of assessing prospective service users. This included collecting information from a number of sources and by meeting with the individual and their carers. This information is then developed into a comprehensive assessment, and should provide the basis for good care planning. There was evidence of each Service User being written to regarding the services that they will be offered. Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 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): 6,7,9 Service Users can be confident that their needs are known. EVIDENCE: The Service User Plans contained information about how individual needs are to be met. These contained detail about what staff were to do to meet needs. Mr Rooke confirmed that these documents have been read by care staff. However the documents are locked in a filing cabinet in the manager’s office, so unavailable to staff to use on a daily basis. The Service User Plan is a working document, and needs to be regularly updated as and when needs change. It is recommended that the storage and use of Service User Plans is reviewed. One individual’s health needs had changed markedly; care and thought had gone into recording and meeting these needs. Risk Assessments have been developed for each individual Service Users; again these are kept in the manager’s office. The storage and use of these documents should be reviewed, so that they are working documents changing as needs change. Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 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): 12,13,15,16 and 17 Service Users are being given the opportunity to lead active lives and to develop their interests. EVIDENCE: Two Service Users were at home during this Inspection. Both individuals had spent time helping around the house and had been involved cooking a cake and dinner. Service Users and staff talked about their plans for the evening and for the next day. Activities that both individuals were involved in included horse riding, music therapy, playing football and going shopping. The inspector was told that work had started on preparing beds in the polytunnel and there were plans for planting seeds. Service Users were being involved in all of these tasks. Service Users helped prepare and eat a pasta bake with salad followed by chocolate mouse for the evening meal on the day of the inspection. They both clearly enjoyed the food and were given plenty of time and support to eat the meal in their own way. It is recommended that thought is given into how the Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 Page 11 menu can be produced in a format that is more accessible to the Service Users. Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 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): 18,19, and 20 Service Users can be confident that their care needs will be met. There is no medication policy that should guide the safe management of medication. EVIDENCE: One Service Users needs have changed during the short time he has lived at Easterbrook Farm. However there was evidence that advice and guidance had been sought to ensure that this individual’s needs could continue to be met at Easterbrook Farm. Staff and Service Users confirmed that Service Users are able to choose when their daily routines. A bubble pack system for medication, prepared by the pharmacist, is used. Staff had recently received training from the pharmacist in relation to medication. The medication administration records were in good order. However there was no proper medication policy, which had been a requirement at the previous inspection. A comprehensive medication policy must be developed. This should cover all aspects of the management of medication including a risk assessment process for service users who wish to self medicate. It was also of concern that there was no information on the premises about the how different medications worked. It is important that staff have a basic knowledge of the medications they are administering so that they know when they might need to contact the pharmacist or GP for advice. Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 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 Systems are being developed to ensure that Service User views are listened to and that they are protected from abuse. EVIDENCE: There is a complaints procedure that is part of the Service User Guide, and the Guide has been explained or read to Service Users. The Inspector discussed with Simon Rooke the way in which an individual’s behaviour may indicate dissatisfaction or unhappiness. There are now copies of the Adult Protection Alerter’s Guide on the premises, and staff have received training in this area. CRB checks are to be completed on new staff. Service Users are to be encourage to be in regular contact with their families, and so will have people from outside the service involved in their lives. Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 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 and 30 The Granary and Farm House provide a high standard of accommodation, which will develop it’s character further when more people move and make their own impression on their home. EVIDENCE: The inspector looked around the Granary and the Farm House during this visit. The Farm House is not in use at the moment. Both building offer a very high standard of accommodation. Service Users have started to add their own possessions and to put their own stamp on the Granary, only three of the 8 rooms are currently occupied so there is someway to go. The accommodation was clean and in good order. Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 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): 32,33,34,35 Robust systems are being developed for the recruitment and induction of staff. EVIDENCE: No new staff have been recruited since the last inspection, however the manager Simon Rooke was able to show changes to the recruitment system for prospective staff. A staff rota is now kept and this shows that there is at least one staff on duty at all times and at times two, this is sufficient for the three service users currently accommodated. As noted no new staff have been recruited since the last inspection, the existing staff have started NVQ’s in care and are starting on the Learning Disability Awards Framework Induction. All new staff must receive a comprehensive induction that is appropriate to their role, for staff working with people with a learning disability the Learning Disability Awards Framework should underpin this knowledge. Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 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): 39 and 42 Easterbrook Farm is a safe and well managed care home. EVIDENCE: Risk assessment have been developed, and there was evidence that regular checks are being made. There was evidence that the temperature of hot water was being checked, this was in relation to Legionella. There was also a record of fire checks. The Responsible Individual, Graham Axford, has visited Easterbrooke on a regular basis and has provided comprehensive reports on the running of the home. These visits have included time spent talking with Service Users, inspecting records and in touring the premises. It is recognised that this is a new service and not fully occupied, however it is recommended that consideration is given to the development of a full quality assurance system as described in the National Minimum Standards and Regulations. Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 Page 17 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 3 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 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 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x X X 3 X X 3 X Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 Page 18 Yes 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. 5. Standard YA20 Regulation 13 Requirement The Registered Person must ensure that there is a medication policy, to govern the management of medication. Staff must have a basic knowledge of medication and access to information about the medications they administer. Timescale for action 01/04/06 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 2 3 Refer to Standard YA9YA6 YA17 YA39 Good Practice Recommendations The storage and use of Service User Plans and risk assessments should be reviewed so that are working documents that guide care provided. Documents such as the menu should be provided in a format that is accessible to the Service Users. A comprehensive Quality Assurance System is developed taking into account the National Minimum Standards and Care Home Regulations. Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. Extracts may not be used or reproduced without the express permission of CSCI Easterbrook Farm DS0000063712.V283713.R01.S.doc Version 5.1 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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