Inspection on 20/06/06 for Farm House

This inspection was carried out on 20th June 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Farm House 06/03/06

Farm House 15/08/05

Farm House 30/03/05

Farm House 10/01/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Farm House Highlands Farm Woodchurch Ashford Kent TN26 3RJ Lead Inspector Mrs Sally Gill Unannounced Inspection 20th June 2006 09:05a Farm House DS0000061263.V297294.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 Farm House DS0000061263.V297294.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. Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Farm House Address Highlands Farm Woodchurch Ashford Kent TN26 3RJ 01233 861514 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) Canterbury Oast Trust Mrs Emma Christmas Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th March 2006 Brief Description of the Service: Farm House is registered to provide accommodation for up to 5 adults with a learning disability and admits people with low needs. Currently all service users are male. Canterbury Oast Trust (COT) owns the home and the registered manager Emma Christmas has day-to-day control. Farm House is an old farmhouse with accommodation on two floors. All bedrooms are singles. The service users have the use of two bathrooms, kitchen, lounge and dining room. The house has a private garden, which is laid to lawn, flower and herb borders, a patio area with seating and a greenhouse; one service user has a shed. The home is situated at Highlands Farm, which is a well-known tourist attraction in a rural area on the outskirts of the village of Woodchurch. A short drive will take you to the towns of Ashford or Tenterden, and approximately 3 miles away is Hamstreet train station. Within the village of Woodchurch there is the local GPs surgery, post office, church and two pubs. The home has transport which can be used for service users if they wish and a local bus service passes the farm. The current fees are £934.58 per week. Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 20th June 2006 between 9.05am and 5pm, the registered manager, Emma Christmas and three staff assisted with the process. Four people were living at the home with one vacancy. The inspector spoke to all four service users (one only in passing) during the inspection and support and interactions were observed. The inspector accessed all communal areas of the home, the garden and two service users bedrooms by invitation. The inspection process consisted of information collected before and during the visit to the home. Surveys were sent to service users, families, care managers and the Community Learning Disability Team (CLDT). Surveys were received from all four-service users (three were completed with support from staff) and from the CLDT. Feedback was generally positive and everyone is happy with the care and support they receive which was echoed by the CLDT. Various records were viewed during the inspection. What the service does well: Service users take pride in their home, which is clean, safe and homely and is run in their best interests. They are able to make decisions regarding their own lives as well as the day-to-day running of the home. Independence and participation is promoted at all times. A varied programme of activities, college and day trips are enjoyed by service users. The atmosphere at the home is inclusive and busy with plenty of joking and banter. The staff and registered manager are committed to the ethos of the home, which is developing service users skills and improving their independence. A thorough assessment is undertaken when service users first join the Trust using information from professionals and their own assessment tool. The service users gave positive feedback both during the visit and through their surveys. Comments included “the staff do a wonderful job and are so supportive”, “Emma (the registered manager) is the best thing since sliced bread”, “living here gives you a feeling of being safe and having security” and “this care home doesn’t feel like a care home it feels like home”. When asked what the home could do better “very easily they couldn’t its just a lovely house to be in”. Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 6 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. Farm House DS0000061263.V297294.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 Farm House DS0000061263.V297294.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to test drive the home and have information to make an informed choice. The home ensure that they can meet the SU assessed needs and aspirations following assessments. Not all SU have a contract of terms and conditions with the home. EVIDENCE: A copy of the statement of purpose (SOP) and service user guide (SUG) has been given to all service users. There have been no new admissions to home since the last inspection; the last admission was in August 2005. The home currently has a vacancy and parents and a care manager were viewing the home on the day of the inspection. The Trust has a proven history of a good admissions procedure with service users able to test drive the home prior to admission and this was true of the last admission. Thorough care management and the homes own assessments are held on files in addition to care manager care plans. These are all used to feed care/support plans. Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 9 Contracts are in place with all but one service user and this must be addressed even if details have to be changed at a later stage. Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 10 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, 8, & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have been made to care/support planning and service users are confident that their assessed needs and personal goals are reflected in their care plan. Service users make decision about their own lives and are consulted on and participate in all aspects of the home. Risk taking is supported to achieve independence. EVIDENCE: Two care plans and risk assessments were case tracked. Both were reviewed in April 06 and up to date. A new working folder has just been introduced and was discussed at the service users meeting the night before. The inspector was extremely pleased to see this development with the inclusion of good goal planning both to develop service users skills and also meet their aspirations. Service users were fully aware of what their care plans contained and there was plenty of discussion around their individual goals. Information discussed Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 11 and agreed at reviews had been brought forward into the care plan. Care plans were detailed and covered all areas, were user friendly and promote and encourage further independence in tandem with the ethos of the home. Service users confirmed during discussion that regular house meetings are held where they are able to voice their opinions. It was evident through observations and discussions with service users that they are fully involved in the decision making of the home and are able to and encouraged to make decisions about their own lives. Risk assessments were in place and reviewed in timescale. Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 12 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): 11, 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have opportunities for a wide range of appropriate activities and enjoy freedom of access to the local community. Service users enjoy a variety of personal relationships and support is giving where appropriate. Service users are very much involved in the running of the home and their rights and responsibilities are respected and encouraged. Service users plan the menus, prepare and cook the meals and enjoy a varied and healthy diet with sociable mealtimes. EVIDENCE: Improvements have been made as previously mention and there is very good goal planning in place to further promote independence and develop skills. Observations and discussions with service users throughout the day confirmed Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 13 that there has been a shift within the home, which is now run with the ethos to develop and promote more independent living and progress is certainly evident. Discussions and records confirmed opportunities for a range of activities, college courses, day trips (most recent a day trip to Thorpe Park) and also holidays. Service users are part of local community accessing events at the Rare Breeds Centre, the local pub and village and shops etc. Some service users are able to use public transport to travel independently. Service users talked of relationships (visits, holidays, phone calls) with families and friends. The CLDT are involved with one service user giving support on relationships. Throughout the day of the inspection there was good interaction with plenty of joking and banter between service users and staff. Observations and discussions with service users evidenced their involvement in all housekeeping tasks and that routines are flexible. The home has a tropical fish tank. The home is non-smoking and no service user smokes. Evening menus are planned weekly with each service user planning and cooking at least one meal. Lunch and breakfast is free choice and independent. Service users are encouraged to follow a healthy eating diet. Farm House DS0000061263.V297294.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are improvements in the way service users receive any personal support when appropriate and their health care needs are met. The medication systems are robust and protect service although a written risk assessment is needed. EVIDENCE: Support plans evidenced service users preferred routines around personal hygiene. Although mainly this is carried out independently staff are on hand to support/encourage that this is undertaken to ensure good hygiene. A key worker system in place and service users confirmed they are aware and happy with their current key worker. All health care needs met with a variety of health professionals in the community including regular check ups. Medication is stored securely and Medication Administration Record (MAR) charts are maintained correctly. A risk assessment is needed to record self – Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 15 administration of one medication. All staff have received medication training and competency checks are completed. Farm House DS0000061263.V297294.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. SU feel their views are listened to and acted on. SU are protected from abuse. EVIDENCE: There have been no complaints since the last inspection. Service users felt they could and would complain and that the manager or their key workers would resolve any issues they have. A complaints procedure in place and displayed within the home. Some staff have received adult protection training and others are booked to attend later this summer. Robust adult protection procedures are in place. Current there is an open adult protection alert at the home. COT has reported the incident, which then lead to the alert being raised and taken appropriate steps to safeguard all the service users. The inspector discussed with the registered manager regulation 37 reports when incidents involve more than one registered home within COT. SU monies are handled appropriately and records maintained. There are some shortfalls in clear record keeping but registered manager is aware of this and addressing the issue. Staff have enhanced disclosures in place. Some staff are trained in NAPPI and all staff are booked on a course in challenging behaviour later in the summer. Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 17 Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users take a pride in keeping their homely environment clean and hygienic. The home is well maintained. EVIDENCE: The home was clean, tidy, safe and homely. Staff confirmed that a dedicated team deals with maintenance problems usually in an efficient manner. Service users have free access to all parts of the home and to a large private garden where they grow herbs (used in their cooking) and flowers. There is a patio area where they enjoy meals or drinks as well as other seating areas in garden. There is a greenhouse and one-service user has a shed, which they can usually be found in undertaking woodwork projects. Two bedrooms were seen and service users were proud of the fact that they were both far tidier than on previous visits. Each room was personalised and Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 19 the service users stated they were happy with their rooms. Communal furniture was of good quality and suited the home and service users needs. Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A committed staff team supports service users who are competent and qualified although training is not linked to LDAF. A robust recruitment process protects service users. EVIDENCE: Three staff have NVQ level 2 or above and 1 is ongoing. Staff demonstrated a positive attitude and committed to developing service user skills and abilities wherever possible. Service users confirmed that they are happy to approach staff with any concerns. The staff team is male and female. Two staff files were checked and contained all relevant information and checks to evidence a robust recruitment procedure are followed. A training matrix is maintained alongside individual records and certificates of training. The inspector viewed the induction booklet, which is to TOPSS. Certificates evidenced all units from Skills for Care are covered. COT is implementing new induction programme in September 2006 which is to Skills for Care induction specification, which will be signed off by the registered manager. Training is still not linked to LDAF. Staff are trained in core and Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 21 specialist subjects and future course already booked include mental health and autism. Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home where their health, safety and welfare is promoted and protected. The home is run to create an open, positive and inclusive atmosphere. Service users views underpin the development of the home. EVIDENCE: Service users and staff confirmed that registered manager is supportive and has been a breath of fresh air in the home since taking up post. Emma is qualified to NVQ level 4 in care and management and has good experience within learning disability services. When service users are in the atmosphere in home is busy with plenty of interaction and banter. The registered manager as always demonstrated a Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 23 commitment to developing home in the interests of service users first and foremost. She has a good caring and calm attitude and all feedback about her from service users, professionals and staff was positive. The home has improved the amount of involvement service users have in the running of the home and the ethos is now clearly about promoting independence with a view to more independent living. House meetings provide good opportunities for service users to voice their views and observations confirmed that they are happy to do this whenever. Regulation 26 visits take place regularly where again service users are asked their views of the home and the commission receive a copy of the report. All H&S checks up to date. Good maintenance is maintained. The accident book was viewed and showed all accidents recorded appropriately. Staff are trained are in core subjects. Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 2 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 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 X LIFESTYLES Standard No Score 11 4 12 3 13 X 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 4 3 X X 3 X Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 25 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 YA5 Regulation 5(1) c Requirement The home shall draw up and agree a written contract with each individual service user Timescale for action 31/07/06 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 Refer to Standard YA20 YA35 Good Practice Recommendations Any self administration of medication must be recorded on a risk assessment Training to be linked to LDAF Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Farm House DS0000061263.V297294.R01.S.doc Version 5.2 Page 27 - 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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