Inspection on 20/10/07 for Easterbrook Farm

This inspection was carried out on 20th October 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 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 24/10/06

Easterbrook Farm 14/02/06

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 Okehampton Devon EX20 3QY Lead Inspector Anita Sutcliffe Unannounced Inspection 20th October 2007 10:00 Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 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.V349414.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V349414.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Easterbrook Farm Address Exbourne 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 10 Category(ies) of Learning disability (10) registration, with number of places Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following caregory of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is 10. 24th October 2006 Date of last inspection Brief Description of the Service: Easterbrook Farm is registered to accommodate ten people with a learning disability between the ages of 18 and 65. All people who use the service currently are young adults of similar age. The home consists of three separate buildings, each with bedrooms, a lounge and kitchen area. The main communal lounge and kitchen, and the office, is in the Farm House. There is a laundry and staff sleeping accommodation. 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 poly-tunnel. There are also ponies and chickens. The service is staffed 24 hours per day. People who use the service are encouraged to be involved in a range of activities and abide by house ‘rules’ and expectations, which are to promote a sense of responsibility. The registered manager says that current scale of charges is £930 plus £16 an hour for any one to one care provided and this is agreed with the individual and stated within their contract. Additional charges are made for toiletries, personal items and a contribution may be required towards holidays in the future. A copy of the Service User Guide is given to each person who is to move to Easterbrook. A copy of Statement of Purpose is kept in the conservatory/ office and is available for any one to read. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 5 Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included two unannounced visits to Easterbrook Farm, one on a Saturday. Surveys were sent to people who use the service, their families and staff. As part of the visit to the farm we looked at all communal areas, and were shown two of the bedrooms. We observed a meeting where people who use the service were planning the week’s menu. We spoke with several people and observed them with staff, both working and chatting socially. We looked at the care and support that three people received, speaking with them and looking at their records. We spoke with the deputy manager and three staff and to the registered manager following the visits. What the service does well: People who use the service said: “I like it here. Best home I’ve ever been to” and “I’m happy. I like it here doing animals, cleaning, shopping, going on holiday, stuff like that”. Family comments included: “The dedication of the staff is admirable” and “They provide a secure supportive environment where people can be as independent as possible. The staff have a good relationship with (my son) and he feels relaxed”. People who use the service are well supported by management and staff who have a good understanding of how to provide person centred care. People are treated as individuals of value. They receive praise for their achievements and support to improve their skills and behaviour where necessary. They are encouraged to be involved in the running of the home and helped to understand the consequences of their actions, where good and not so good. People at the home have fun. They have a broad range of age appropriate activities to enjoy, whilst they also learn life skills. Staff are safely recruited, well supported and supervised. They are encouraged to be involved in the running of the home. It is a happy and relaxed place. One staff member said: “The service provides a very happy and relaxed home atmosphere for the service users. This projects on to the staff. Service users are heavily involved in the running of their home and farm, which seems to give them a good sense of purpose. Although sometimes hectic, life at Easterbrook is just like that of many busy households which seems to me both positive and healthy”. Easterbrook Farm offers a good standard of accommodation. and adequately furnished. It is clean, safe Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Medicines should be handled in a safer way. People who handle their own were not found to be at any particular risk from doing so, but an assessment of risk must be in place within their plan of care and it must be regularly reviewed. There was confusion over whether a tablet had been taken or not and, where a prescribed medicine could be taken ‘as required’ or ‘as necessary’ the circumstance under which it could be taken was not recorded. This must be part of care planning. The use of ‘over the counter’ remedies is now clearer, but could be further improved. People who use the service should have access to information in a format that they can understand and comment on. This should at least include the complaints procedure, what is happening at the Farm/planned activities, and the guide to the service they receive. The whistle blowing policy, which informs staff what to do if they have concerns, should include contact details for the Local Authority Safeguarding team so that staff can take advice and alert concerns anonymously if they wish to. When staff start employment before the required Criminal Record Bureau (CRB) check is completed they must have a named staff member supervising their work. This ensures the safety of the vulnerable people they are working with. Care plans are lacking important detail. They do not describe how staff, for example, should help a person ‘manage their anxiety’. Assessment of risk was the same. Although staff had identified risk, and worked with people to reduce those risks, they were not recorded. Without a structured approach to risk management the risk is not fully managed. The home needs to develop how it will promote positive health by knowing the risks to people of this age group and arranging appropriate health checks. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 8 There must be a named staff member to supervise any new staff who starts work before the Criminal Record Bureau (CRB) has been received. This protects vulnerable people from staff unsuitable to work with them. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 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 Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that their needs will be known prior to a move to Easterbrook. EVIDENCE: Of people who use the service six said they were asked if they wanted to move into the home, one said they were not and one said it had been an emergency. Seven said they received the right information about the home before they moved in so they could decide if it was the right place for them. Two new people have moved to Easterbrook Farm in the last few months. We looked at the current information available to them and existing people who use the services, about the home. Although all aspects of the service are described in the guide, only people with fairly advanced reading skills would be able to use it. It is therefore of limited use the people at the Farm. We have no doubts that all the information would have been described to people, but the service user’s guide, in particular, should be an ongoing reference for them, which it is not in this format. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 11 The care of a person newly admitted to the home was examined. There was information on file about individual needs that had been recorded as part of the assessment. There was also information from the previous providers about how they had met needs. Staff confirmed that they were given up to date information about the needs of people. The registered provider visited potential service users to discuss Easterbrook Farm and their personal requirements. Both they and their families had had the opportunity to visit before they moved in. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Whilst people who use the service can be assured they will be supported to live the lives they choose, be consulted and helped to develop as individuals, the planning of care and recording of risk need more development, so that staff will be well informed and consistency is assured. EVIDENCE: All people using the service appeared relaxed and interaction with staff was friendly. Two told us they liked it at Easterbrook Farm. One family member said: “They understand the needs of my son and provide appropriate support”. We looked at two support/care plans and discussed them with a member of staff and the deputy manager. These plan should provide clear guidance to staff about the needs that each individual has, what staff are to do to meet these needs, taking into account individual needs and preferences. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 13 We spoke with and observed the people to whom the plans referred. Each plan had a similar degree of detail and information. One, as part of the person’s assessment, identified that ‘anger management skills’ were necessary and ‘help is needed for the person to keep calm and plan changes’. However, the plan of support/care said: ‘staff are to assist the person in their anxiety’. There is no detail of how staff are to do this, nor steps to be taken should a situation escalate. Nor was there an assessment of risk, which might be associated with their anger. Despite this we observed staff managing an angry outburst and the person’s care manager said at their review meeting: “management of anger is improved”. The registered manager said they have organised a staff meeting to review each person’s care and care planning. Each of the eight staff surveyed said they are given up to date information about the needs of people using the service but one added that person centred plans “are not detailed enough”. We found this to be the case. There are risk assessments for individuals but not all risks had been assessed, for example the management of medication. The process of risk assessment is important as it can help ensure that risks are managed rather than avoided by ceasing to do any activities where there might be an element of risk. This has been mentioned in a previous report. We observed another person who uses the service working with a member of staff to test fire safety equipment. They had an excellent rapport and the one to one time appeared very valuable, enjoyed and well managed. We looked at the current Service User’s Guide. It describes in detail the ‘house rules’, including: having to be up at 8am, participate in activities, no swearing, no alcohol in the home. We spoke with a two staff with two people who use the service. They agreed that ‘house rules’ were not an issue at the home. The registered manager said the ‘rules’ may be more ‘expectations’ to instil a personal sense of responsibility. No person using the service mentioned them. Five people who use the service said they always make decisions about what they do each day and three said they usually do. Five said staff always listen and act on what they say. Two said they sometimes do. There is a weekly meeting at the home, observed during a visit, where people who use the service plan the following week, including the menu. Staff have a good understanding of how to promote independence and support people. We were told: “Staff are involving service users more and more. Each has a personal diary in their room”. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 14 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): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to live a full life and develop their interests and skills, but spiritual needs are not taken into account. EVIDENCE: Seven people who use the service said they can do what they want to do during the day and one said they could not. All said they could do what they wanted to do in the evening and at weekends. However, one person added that they would like to go to church and the relative of another person said: “My daughter is confirmed and occasionally went to church”. The registered manager was unaware of this. We observed people who use the service helping with the weekly fire alarm testing and preparing lunch. We were told that some attend arts and crafts or personal development training at Okehampton College, and some do voluntary Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 15 work in the area. They look after the chickens, ponies and garden at the farm. Where one person prefers to work alone they have their own patch of garden rather than shared. All recently spent a week at an Outdoor Activities centre and said how much they had, or had not, liked the climbing and the heights. Most went to a recent local carnival. They talked about the rides and the prizes they won. Some go swimming and horse riding. People’s individual files have an activity plan. We were also shown a record of the activities planned for the week and how staff would be delegated for this. Staff said: “We promote choices for service users and provide a good environment for service users to learn about their interests”, “We ensure service users take responsibility for planning and carrying out tasks required for the running of the farm and home” and “We provide active care for individuals working outside as well and inside in a close family type environment”. People who use the service are encouraged to enjoy age appropriate activities. They live a lifestyle typical of young people in their 20’s and are able to achieve goals and improve their skills and confidence. Their family have involvement in the home but some felt communication could still be improved adding: “I have spoken to the manger about lack of communication and he has assured me that there will now be a weekly phone call to update me on all issues”. Another said: “Weekly phone calls were set up from him to me, and these happen 95 of the time, unless his key worker is away”. Staff do assist people who use the service to keep in touch with family, for example sending post cards when they were on holiday. We observed people planning the week’s menu using picture cards, although some are able to use written recipes. There is a varied menu. We heard people being encouraged to make healthy dietary choices, but less healthy choices were also accepted, sometimes having been adapted a little. The two meals observed at the home, one shared, were nicely prepared, tasty, healthy and used fresh ingredients. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Physical health and emotional well being are promoted and medicines generally handled to an adequate standard, but there is room for improvement. EVIDENCE: It is very clear from care/support plans and discussion with staff that people are encouraged to be responsible for their personal care so that they will develop skills and responsibility. Of four survey replies from people’s family one said the home always gives the support or care to their relative that they expected and agreed; two said they usually do. Comments include: “On a couple of occasions I’ve had to draw attention to some hygiene issues but these have been immediately been addressed.” Each person who uses the service, all of whom are relatively new to Easterbook Farm, is registered with a local general practitioner and has had an initial visit to them. They are supported to receive appropriate health care where a problem is identified. We discussed with the deputy manager and the manager the need for health care checks (well-woman and well-man) to Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 17 promote positive health through the prevention of problems. We were told that family are heavily involved in this and that consideration will be given to this when care and care plans are reviewed in the near future. We discussed the handling of medicines and looked at how medicines were being kept. Where a person is able to manage their medicines themselves they are supported to do so. However, although any risk was well considered, there was no formalised assessment or review. This would demonstrate and ensure that risk is fully considered and reviewed. Medicines are kept securely in a locked cupboard in a locked room. The home uses a monitored dosage system to reduce the likelihood of mistakes. Staff receive training and the registered manager says their competence is checked. However, in one case a tablet had been removed out of date sequence and the deputy manager was not sure why or what had happened. We also saw that where people have medicines prescribed to be given ‘as required’ or ‘as necessary’, there was no instruction, as part of planned care, as to when staff could give the medicine. This leaves staff having to make personal judgements and these might differ from those of other staff. There is now a more detailed policy of which ‘over the counter’ medicines, such as cough linctus, can be given at the home, but this should be agreed with each person’s general practitioner. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service User can feel confident that their views will be listened to, and there are systems in place to protect them from potential abuse. EVIDENCE: It is clear from observing people who use the service and staff together that there is a good rapport and trust between them. They are therefore more likely to mention any concern rather than keep it to themselves. Each person surveyed said they knew who to speak to if they were not happy. Some named staff they would go to. Most said they knew how to make a complaint. Four family of people who use the service said they knew how to make a complaint and two said they did not. Asked if the home responded appropriately to any concerns that have been raised three said always and two said usually. One added that concerns should be dealt with more quickly now there is a deputy manager. There is a complaints procedure that is part of the Service User Guide. This document remains in format that is inaccessible to each individual. It should be provided in a pictorial form where this will be of benefit. The Deputy Manager said that no complaints had been received since the last inspection. The Commission has received no complaints. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 19 Each of the eight staff surveyed said they knew what to do if a service user/relative or advocate had concerns about the home. We were told that each member of staff will be receiving training in how to protect vulnerable adults from abuse. The deputy manager was able to describe correctly how to respond to any allegation that might be abuse. We looked at the home’s whistle blowing policy, information which would inform staff what to do should they have concerns. It contained information on how staff should respond if they had concerns and includes contact details for the Commission. However, it should also include contact details of the local authority Safeguarding team and make it quite clear that concerns can be made directly to them. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Easterbrook Farm provides a good standard of clean and comfortable accommodation. EVIDENCE: A third building at the farm has recently been brought into use as accommodation. Although its bedrooms are complete the kitchen and lounge area is still being finished. We saw each of the three houses. Each was well furnished and maintained. Both bedrooms seen were individual and contained a good standard of furniture and fittings. Communal areas are well equipped and comfortable. People who use the service said they liked the home. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 21 There is a separate laundry room, with domestic washing machines and dryers suitable for the needs of the home. The office is situated next to the main sitting room and is easily accessible to both the people who use the service and staff - people wandered in and out throughout the inspection. The outside areas of the farm are large and well used by people at the home. We found nothing to suggest that the home was anything other than clean, safe, comfortable and interesting to people who live there. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are well supported by competent staff, properly recruited and supported in their work. EVIDENCE: Seven people who use the service said the staff treat them well and one said they sometimes do. Their family’s comments include: “The dedication of the staff is admirable”. Families felt staff have the risk skills and experience to look after people properly. For the first visit, on a Saturday morning, we found three staff on duty for ten people using the service. A forth was also expected so that people who use the service could attend the local carnival. Three staff surveyed said that there are enough staff to meet people’s individual needs and five said there usually are. Most felt that their induction training covered everything they needed to know about the job and all said they are given training which is relevant to their role, one adding: “I have Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 23 recently started work at Easterbrook and have already been offered a varied amount of relevant training”. All eight survey replies from staff confirmed that checks were carried out before they started work at the home. We looked at the records of two recently employed staff. Both had a full employment history, references and relevant checks to ensure they are safe to work with vulnerable adults. Whilst both had started work before the full Criminal Record Bureau (CRB) check had been received, which is acceptable, there should be a record of who the person is with the responsibility of supervising them. Training is encouraged. Specialist training, including the Learning Disability Qualification, is being considered by some staff, but we were told that most wish to complete the National Vocational Qualification (NVQ) training first. Both are indicators of staff competence. We interviewed one member of staff. She said support at the home has improved, supervision is monthly and is now more in depth and effective; “goals are set and it’s more structured”. Staff whose opinion was surveyed said they meet with their manager and are supported and able to discuss how they work, one adding: “Since starting work at Easterbrook both managers have been very supportive. I am asked regularly how I am feeling about my work. I have also been given a date for a supervision”. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Easterbrook Farm is generally well managed, efforts are taken to ensure the quality of the service and people who use the service are protected. EVIDENCE: Mr Simon Rooke is the Registered Manager and has experience of managing care homes and working with people with a learning disability. He was not able to be present during the inspection visits, but was spoken with subsequently. The recently appointed deputy manager is also experienced. She was able to demonstrate a very good knowledge and understanding of how to provide people who use the service with a high standard of support and care. It was also clear from observation that people who use the service have confidence in her. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 25 Staff feel well supported. Staff comments include: “Morale is high betweens service users and staff”, “The service provides a very happy and relaxed home atmosphere for the service users. This projects on to the staff” and “It is a good environment for both staff and service users. We as staff give the service users a great deal of choice. Staff also have a fair amount of choice”. Family of people using the service said: “As a new home things are always improving and the staff have always been open to suggestions” and “There is always room for improvement in new ventures”. There are weekly meetings for people who use the service, regular staff meetings and opinion was surveyed in February 2007 as part of the home’s quality monitoring. The home has recently gained an external quality assurance award. Mr Graham Axford, the Responsible Individual, visits Easterbrook Farm each month to monitor and report on what is happening and to check the quality of the service. Copies of these reports, which are very thorough, are sent to the Commission. Asked what the home could do better staff said: “Communication between staff could be better at times but for the size of the home we have it is manageable” and “Slightly better communication between staff”. The deputy manager said this had already been noted and they had devised a better method of passing information from one staff member to another. A staff member interviewed confirmed that communication had indeed improved. Some family of people who use the service also said they would like improved communication, one saying: “I would like to be told what my son is doing” and “It is difficult to say if the home provides the care and support agreed because there has been a lack of contact from Easterbrook”. We observed weekly fire safety checks and people who use the service were very clear what they should do if the alarm sounds. We found no aspect of the home where health and safety were compromised. However, the handling of medicines and depth of care planning and assessment of personal risk must be improved. We anticipate that the managers and staff have the knowledge and ability to continue to improve this fairly new service, taking their knowledge and ideas forwards to the benefit of people who use the service. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 26 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 2 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 2 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 2 3 X 2 X LIFESTYLES Standard No Score 11 2 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 3 3 X X 3 X Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 27 No 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 YA11 Regulation 16(2)(m) Requirement People who use the service must be consulted on their spiritual needs and, should they wish, enabled to meet those needs. Medicine records must tally with the amounts of medicine still to be administered to ensure that they are being handled safely and mistakes will not occur. Where a medicine is to be given ‘as required’ or ‘as necessary’ it must be detailed in the individual’s plan of care under what circumstance it may be given. This will ensure consistency and therefore be safer. Risk associated with any aspect of the handling of medicines, including where the person administers their own, must be assessed, reviewed regularly, and be part of the care planning process. This ensures risks can be identified and ways of reducing risk can be put in place. Where a newly employed staff member starts work at the home prior to completion of the CRB check, they must have a named DS0000063712.V349414.R01.S.doc Timescale for action 15/11/07 2. YA20 13 (2) 29/10/07 3. YA20 13(2) 15/11/07 4. YA20 13(2) 30/11/07 5. YA34 19 30/10/07 Easterbrook Farm Version 5.2 Page 28 supervisor accepting responsibility for them. 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 4 5 6 Refer to Standard YA1 YA6 YA9 YA19 YA22 YA23 Good Practice Recommendations The Service User’s Guide should be in a format appropriate to them. It is their guide and so should be of use to them. The service user’s plan of care should describe in detail how their changing needs and goals will be met, so that this is always appropriate and consistent. It should be clear that all aspects of risk have been considered and this should be part of the person’s plan of care. There should be age and gender appropriate health care checks to ensure good health is promoted. The complaints procedure should be in a format suitable for the people who use the service so that they are aware how to make a complaint. The whilst blowing policy should include contact details for the Local Authority Safeguarding team so that staff have this information readily available should they feel the need to use it. Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Easterbrook Farm DS0000063712.V349414.R01.S.doc Version 5.2 Page 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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