Inspection on 24/10/06 for Easterbrook Farm

This inspection was carried out on 24th October 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 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

Easterbrook Farm 27/01/09

Easterbrook Farm 20/10/07

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 Near Okehampton Devon EX20 3QY Lead Inspector Helen Tworkowski Unannounced Inspection 24th October 2006 09:30 Easterbrook Farm DS0000063712.V303216.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.V303216.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.V303216.R01.S.doc Version 5.2 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.V303216.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14/2/06 Brief Description of the Service: Easterbrook Farm is registered to accommodate eight people with a learning disability. The Granary can accommodate four people, whilst the main farmhouse accommodates a further four people. It is planned that Easterbrook Farm will eventually accommodate two more 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 poly-tunnel that is used for growing plants. 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 are a further three 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 four bedrooms (three are en-suite), a large dining room, lounge, and kitchen. There is also a large office, small office, staff bedroom 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 as they 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. The current scale of charges range from £790 to £1215. The following items are not included in the fee, and service users are expected to pay for these items: toiletries, magazines, drinks and other comfort items, chiropody (£7 per person), hairdressing, holidays, personal outings external recreation, transport, clothes & shoes, public transport, items for bedrooms (excluding items set out in the minimum standards), additional crafts items (T-shirts, plates, pots, pens and pencils), mobile phones, CD’s, DVD’s and videos, concerts, upgrading furniture in bedrooms. A copy of the Service User Guide is given to each Service User who is to move to the Easterbrook. A copy of Statement of Purpose is kept in the conservatory/ office and is available for any one to read. Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included two site visits to Easterbrook Farm. The site visit on 23/10/06 between 2pm and 5pm was “unannounced”, whilst the visit between 9.10am and 4.50pm was “announced”. Surveys were sent to each of the eight Service Users who currently live at Easterbrook Farm, four were returned. Staff survey forms were sent to each of the members of staff employed, four were returned at the point this report was written. As part of the visit to the farm the inspector looked at all communal areas, and was shown four of the bedrooms by Service Users. The Inspector spent time with Service Users working in the poly-tunnel, and spoke with seven Service Users about life at Easterbrook. The Inspector looked at the care and support that three of the service users received: speaking with them and looking at their records. The Inspector also spoke with three members of staff about their work at Easterbrook Farm. The Inspector phoned and spoke to one care manager and two relatives of Service Users about their experiences of Easterbrook Farm. Other relatives and Care Managers were contacted but were not available. What the service does well: Easterbrook Farm provides a high standard of accommodation, it clean, comfortable and homely. Nearly all of the bedrooms are en-suite, and Service Users were clearly very satisfied with the accommodation and proud of their own rooms. Each person who had moved to the farm had received a thorough assessment, and for some people this had been over a considerable time period. This had helped to ensure Service Users different needs were known about and could be taken into account when they moved. Mr Rooke confirmed that the time invested in these assessments had helped to ensure that the move to Easterbrook Farm had generally gone very well. Service Users are currently offered a good range of activities: they are taking part in horticultural activities, including growing their own vegetables, cooking meals, and arts and crafts activities. Service Users said that they enjoyed the food, and meals are well cooked with fresh ingredients. The information about how Service Users needs are to be met by staff is clear and easy to read. There are risk assessments that help ensure that Service user, are not exposed unnecessary risk, though some improvements are needed in this area. There is a good level of staffing, who appear very committed to ensuring that Service User are involved in activities at Easterbrook Farm. Staff who Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 6 responded to the survey, or were spoken with, felt that they had sufficient skills and support to do their work. Service Users spoken with said that they were happy with life at Easterbrook Farm, and knew who to speak to if they weren’t happy. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 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.V303216.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users can be confident that their needs will be known prior to a move to Easterbrook. EVIDENCE: Six new Service Users have moved to Easterbrook Farm in the last few months. Mr Rooke, the Registered Manager, explained that he had the opportunity to get to know most of the individuals over a period of six months, and so get to know them and their needs. 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 had known about individual needs, though for some individuals this information had been more limited. Service Users and their families had had the opportunity to visit Easterbrook Farm before they moved. Some of the individuals who had moved to Easterbrook had known each other prior to the move. Moving to Easterbrook had meant that they could continue to be friends. Two of the relatives confirmed to the Inspector that their expectations about Easterbrook, from brochures and from visits, were being fulfilled. Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff know Service Users’ needs and preferences, and Service Users are given a good level of support to be able to participate in life at Easterbrook Farm. However some aspects of the way information is stored or recorded needs to be improved, so that records are comprehensive and secure. The house “rules” made for all Service Users appear unnecessarily restrictive for all Service Users and there is no proper record of agreement of these limitations on each individual. EVIDENCE: Service Users who responded to the Surveys said that they felt well cared for at Easterbrook Farm. Those spoken with on both visits said that they were happy with their lives. One person who was not able to comment directly had started to use more words and to participate in activities, indicating that he is satisfied with life at Easterbrook. The Service User Plans for three people who had recently moved to Easterbrook Farm were looked at. Service User Plans should provide clear Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 10 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. The ones at Easterbrook Farm were clearly written and in a straightforward format so that it was apparent what help was needed by each Service User. Amendments had been made to these documents as needs had changed. However it was not clear who had completed the document and when, or when amendments had been made. It is important to know if these documents are current and for changes to be tracked, this is part of the process of monitoring care and of accountability. The Registered Manager said that the Service User Plans had been developed with Service Users; thought there was no record of this. There are risk assessments for individuals, these relate to various aspects of life at Easterbrook. In general these risks assessments were clear and had been regularly reviewed. However a few of the recent risk assessments have been carried out in relation to a group of Service Users. But the risks that each Service Users might experience may be different, and the measures needed to avoid unnecessary risk or harm should reflect this. Also not all risks had been assessed- for example in relation to seizures. 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. Service Users spoken with said that there were rules in the house. They had to be up at 8am during, they had to participate in activities, no swearing, no elbows on the table, and they have to phone their parents. Each Friday there is a Service Users meeting, and records of the meetings confirmed that house rules were regularly discussed. These included such rules as everyone must be in their bedroom by 10pm, each person must phone home once every week, and that bedrooms would be spot-checked by the Manager each week to ensure they are tidy. The Inspector discussed with the Manager the need to ensure that unnecessary rules were not made or applied to a group when they related to an individual issue. Risk assessments could be used to see if Service Users could for example stay up late without the supervision of staff. Where there are rules these should be made clear in the Service User Guide, so that individuals know what is expected of them prior to moving. Where there are restrictions placed on an individual these should be part of the Service User Plan and agreed with that individual. Service Users have two files- the files with day to day information about how needs are to be met, are kept in the lounges. Diaries which provide a record what each person has done, are also kept in the lounges. Information about Service Users needs to be kept in a confidential and secure manner, rather than left for anyone to read. Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 11 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): 12,13,15,16, and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users are given a good level of support to lead active lives at Easterbrook Farm, though many of the activities and resources are still in the process of being developed. Service Users are offered a good diet of fresh well cooked food that they may have been involved in producing. EVIDENCE: Service Users spoken with about how they spend their time said that they enjoyed the things that they were doing. Each of the Service User files had an activity plan that outlined the sorts of things each person would be doing. Also there was a record of the activities in which people had actually been involved. On the first day of the unannounced inspection three Service Users were just going into the local town on a shopping trip, whilst three other service users were working in the poly-tunnel. Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 12 On the second day of Inspection two Service Users were out shopping in Exeter for the day, others were working in the poly-tunnel and one person was helping to cook the meals for the day. One relative commented that every time she had visited Easterbrook, Service Users were occupied in various activities, including making plans about what things they were wanted to do. Service Users explained to the Inspector what was growing and what had been grow in the poly-tunnel. They had been involved in constructing the beds in the tunnel, and one person had their own area of garden. Service Users were being involved in planning what was to be grown next year. Service Users said that the surplus vegetables that had been grown were sold in the local community shop in the village. Some of the Service Users are given the opportunity to drive the mini tractor, and clearly have developed skills in this area. This is done under the supervision of the Farm Manager. One Service User said that he and the Farm Manager were going to attend a course together on weed control, at the Eden Project. It was noted that care was taken to lock all tool away at the end of the day, and those that posed a particular danger were kept in a separate area. Easterbrook Farm is a relatively new service and many of the projects are in the early stages of development or are still in planning. The Inspector was told of plans to develop a second poly-tunnel, to build a forest walk, keep chickens, and develop a separate arts room. Service Users currently are involved in a range of interests and activities, such as pottery, horticulture and arts & crafts. Service Users using the local facilities such as the local pub, and shop in the village. One relative commented that she would like her daughter to have the opportunity for more participation in the local community and work. Mr Rooke confirmed that they were looking at different options for people, though there were limited by the resources in the area. A cook is employed to prepare the main meal of the day for Service Users in both the Granary and Farm House four days per week. She stated that individual service users take it in turn to work with her preparing the meals: chopping vegetables, mixing and stirring. The cook said that the ingredients are of good quality and fresh, and some of it was their own produce. Service Users have been involved in making jams and chutneys, with fruit and vegetables that they have grown and picked at Easterbrook. This year they had a bumper crop of tomatoes and plums. The Inspector asked two Service Users about the food, and both said that they enjoyed it. On the second day of the visits to Easterbrook the Inspector spoke with the Service User who was cooking, he spoke about how he enjoyed what he was doing and was clearly proud of his achievements. Menus returned with the Pre-Inspection Questionnaire indicate that a wide range of meals are provided from Italian Chicken, to vegetable bake and roast Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 13 lamb. The cook said that she was aware of individual preferences, and where an individual did not like what was on the menu an alternative meal was provided. Where Service Users did not enjoy a particular meal then it was not repeated. The menus are chosen by the cook and these are then discussed at the weekly Service User meetings. The menu is in a written format, and the contents explained to Service Users. The Inspector discussed with the Manager how Service User could be more involved in choosing what goes on the menu, and in providing the information in a more accessible format. Main meals are eaten in both the Granary kitchen and Farm House dining room. The cook said that the food is carried across the yard from the Farm House to the Granary, in suitable containers. Breakfasts and light meals are prepare in the Granary and Farm House. Service User Plans looked at during the inspection confirmed that some Service Users are able to prepare their own breakfasts and light meals. Service Users said that they maintained contact with their relatives. In addition to the phone, the home has a “web cam”. Issues relating to rules and restrictions have been noted earlier in this report. Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 14 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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service User’s physical and emotional health care needs are well met by supportive staff. Medication is generally well managed though improvements are needed in relation to the management of “homely remedies”. EVIDENCE: A monitored dose system is used to manage medication at Easterbrook Farm. The medication is prepared in bubble pack system by a pharmacist and administered by staff. The pharmacist had trained staff in relation to the system, and records of administration seen were of a good standard. At the last inspection it was noted that the medication policy/ procedure needed to be more comprehensive. The policy/ procedure has been revamped, however it still does not cover all relevant issues such as homely remedies and how medication received is checked in to the system or medication returned to the pharmacist. The medication cupboard included some items that had been bought without a prescription such as “night nurse” and “day nurse”. Homely remedies should only be kept and administered following agreement of the GP. This is usually achieved by agreeing with the GP a list of medication that can be administered to each person for minor aliments such as coughs and headaches. Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 15 There was information on each person’s file about their health needs and clear guidance to staff on what to do in particular circumstances. All staff had attended a first aid course as part of their induction. Service Users who responded to surveys commented that they felt that they were well treated, relatives of service users confirmed that they felt that they had settled in well and this was a good indication that they were happy and that their needs were being met. As has already been noted, one person is starting to speak much more and to participate more; this is a good indicator that needs are being met. There are health records on each file and where people have particular health care needs there is clear guidance on how to deal with these issues. The Manager explained how guidance was sought in relation to particular health issues. All of the interactions observed between staff and service users were very positive, service users were spoken to with respect. All of the people at Easterbrook Farm were well dressed for the jobs they were undertaking, and the Service User Plans give clear indications of where each person needs particular help. Issues around rules about bedtimes have already been noted earlier in this report. Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 16 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 and 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: All of the Service Users who responded to the Survey said that they knew who to speak to if they were not happy. The Inspector spoke with one relative who confirmed that that she felt confident that she would be able to raise any concerns, and that her daughter had the confidence to do this too. There is a complaints procedure that is part of the Service User Guide. This document is yet to be provided in format that is accessible to each individual. The Manager, Mr Rooke, said that no complaints had been received since the last inspection. The Commission has received no complaints. Mr Rooke said that he was in the process of getting external training in relation to the protection from abuse for the most recent staff employed. Staff who had being employed for a longer period had received training in this area. One of the ways that Service Users can be protected from abuse is by preemployment checks on staff. Criminal Records Bureau checks have been completed for all staff working at Easterbrook. The Inspector was told that all of the Service Users at Easterbrook Farm manage their own money, some with support from their families. One person has their money held for them by staff. The manager confirmed that receipts are kept following purchases, however there is no record of these transaction. Such a record must be kept. Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 17 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 and 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: The first day of the site visit was unannounced, communal areas and two of the bedrooms were seen on this occasion. Both the Granary and the Farm House were clean and tidy. It was evidently a home: Service Users personal items were around both houses. The Inspector was shown four bedrooms in the Farm House by Service Users. These rooms very much reflected the personal tastes of both individual’s. One person was asked about whether he had a key to his bedroom, he said that he did not need one. Other Service Users had keys and used them. There is plenty of communal space in the Farm House- there is a large dining room and lounge used by Service Users who live in the Farm House. There is also a further large lounge used by all Service Users. Space is more limited in the Granary, where there is a lounge and a kitchen diner. All of the rooms seen were well furnished, airy and clean. Service Users appeared very comfortable and treated the house like their home. Changes have been made to the layout Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 18 to the Farm House since the last inspection. Simon Rooke, the Registered Manager, now uses the conservatory as an office. There is a separate laundry room, with washing machines and dryers. The Service Users who responded to the Surveys all felt that the home was fresh and clean. Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. Service User are well supported by competent staff who are committed in their work. However recruitment and induction practices are not robust and potentially could lead to people who should not be appointed working at Easterbrook Farm. EVIDENCE: Copies of the Rota were forwarded to the Commission prior to this inspection. These rotas show that there are generally three staff on duty throughout the day, and on some occasions there are four. On the first day of this inspection one person was working with a Service User in the kitchen, one in the Polytunnels, a further member of staff was taking one person shopping and one person was sick. From the Inspectors observations and from the feedback in survey forms there are sufficient staff, and service users are able to be involved in a range of activities. The recruitment files of 3 Care Staff who had started in recent months were looked at. One of the ways of ensuring that Service Users get a good service is by recruiting staff who are suitable and competent. The records for each person included an application form, (which had a work history), a record of the interview, references that had been taken and a copy of a check to see if the applicant had a criminal record. Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 20 It was noticed that two of the employment histories were not complete, one did not cover all gaps in employment; another did not include one long period of employment although the applicant gave this employer as a reference. Some of the written references were received after the individual had started their induction. Not all references were available for checking. The Criminal Records Bureau checks seen had all been received prior to employment. Staff spoken with confirmed that they had been inducted and those that responded to the survey all felt that there was time and funding for relevant training, and all felt that they had sufficient expertise to support the people they were working with. The Manager said that the induction had included a number of training sessions including first aid, food hygiene, fire and moving and handling. The record kept of this training was limited, and there was no record of any of the induction work that the manager had carried out himself in relation to staff. It is important to keep a record of induction as it identifies where gaps in training have occurred. The Inspector spoke with staff who had worked at Easterbrook for sometime, and they confirmed that they had been able to access courses that were appropriate to their roles. The Inspector spoke with three four staff about their role at Easterbrook, all were very enthusiastic about their work, had a good understanding of their role, and were observed working positively with Service Users. Some Staff were in the process of completing their National Vocational Qualifications, awards for proof of competence, and looking forward to further training. Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 21 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, 39 and 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 and all efforts are taken to ensure the quality of the service and that Service Users are protected from unnecessary risk. EVIDENCE: Mr Simon Rooke, is the Registered Manager and has experience of managing care homes and working with people with a learning disability. The rota and discussion with staff shows that is very much involved in the day-to-day running of the home. Staff surveyed said that they felt well supported in their work with Service Users. 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. As has already been noted there are weekly meetings with Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 22 Service Users and Staff Meetings every 2 months. Mr Rooke said that they had started to work towards gaining an external quality assurance award. As part of this inspection health and safety records were look at. There was a record of fire checks being carried out, there were checks on hot water (to avoid Legionella) and there were risk assessments. The house and outbuildings are well maintained, and care was taken to lock tools away, after they had finished being used. Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 23 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 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 4 25 X 26 X 27 X 28 X 29 3 30 X 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 2 X 2 2 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 2 x 3 X 3 X X 3 X Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 24 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 YA20 Regulation Reg. 13 (2) Requirement Timescale for action 01/01/07 2 YA34 Reg. 19 (1) (b) Sch. 2 3 YA7 Reg. 17 (1) (a) Sch. 3 The Registered Person must make arrangements for the recording, handling, safekeeping, safe administration, and disposal of medicines received into the care home. (This must include a comprehensive policy and procedure, which should include “homely remedies”). The Registered Provider must 01/01/07 not employ a person unless they have obtained two written references, (as described in regulations) and a full employment history, with a satisfactory explanation of any gaps. The Registered Provider must 01/01/07 keep a record of any limitations agreed with the service user as to the service user’s freedom of choice, liberty of movement and power to make decisions. (This relates to house rules that have been made). Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Easterbrook Farm DS0000063712.V303216.R01.S.doc Version 5.2 Page 26 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. 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