CARE HOME ADULTS 18-65
Farm House Farm House Highlands Farm Woodchurch Ashford Kent TN26 3RJ Lead Inspector
Geoff Senior Unannounced Inspection 09:50 6 March 2006
th Farm House DS0000061263.V266806.R01.S.doc Version 5.0 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.V266806.R01.S.doc Version 5.0 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.V266806.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Farm House Address 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) Farm House Highlands Farm Woodchurch Ashford Kent TN26 3RJ 01233 861514 Canterbury Oast Trust Mrs Emma Christmas Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Farm House DS0000061263.V266806.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15th August 2005 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 dependancy needs. Currently all Service Users are male. The Registered Provider is Canterbury Oast Trust. Ms. E. Christmasis the Registered Manager in day-to-day control of the home. 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, vegetable patch, flower and herb borders and a patio area; 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 GP’s 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. Farm House DS0000061263.V266806.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection visit and was undertaken on 6/3/06 at 09:50. The focus of the visit was on action taken and progress made relating to the requirements and recommendations of the report of the announced visit of 15/08/05. The Inspector met and spent time with the Manager, Ms. Christmas. He also spoke briefly with other members of staff on duty and some of the service users. Interaction and exchange of information with a visiting relative was also observed. The Inspector viewed records and documentation relating to the requirements and recommendations of the last inspection report.. What the service does well:
The last report noted that…. Service Users benefit from a clean and homely environment where they are fully involved in the running of the home and say they are consulted about any changes and plan daily things like menus and events such as holidays and day trips. Service Users have regular opportunities to get out into the community and experience interesting and enjoyable activities; key worker days are used for Service Users to enjoy individual activities/day trips of their choice. A variety of developmental opportunities are available for Service Users through working at the various Canterbury Oast Trusts and outside schemes. Staff have good working relationships with professionals such as the Community Learning Disability Team (CLDT) and have developed and implemented programmes helping Service Users develop positive behaviours aided by a consist approach from staff. Service Users appreciate the Managers availability to them, stating she listens and “has brought a new lease of life” to the home and is “forward thinking” and “tries to expand us”. There was nothing noted at this inspection that would indicate any need for amendment to the above statement Farm House DS0000061263.V266806.R01.S.doc Version 5.0 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.V266806.R01.S.doc Version 5.0 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.V266806.R01.S.doc Version 5.0 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): 1,2,5. Existing and prospective Service Users are offered a copy of the service user guide to help them make an informed decision regarding admission to the home. Service Users each have a signed agreement in place. There are shortfalls in the homes ability to demonstrate its capacity to meet Service Users needs. EVIDENCE: Further to the requirements and recommendations of the previous inspection report the Manager reported that: Existing Service Users have now received a copy of the service user guide and have signed an acknowledgement. She also confirmed that future, prospective service users would be offered a copy to read and refer to at their leisure and to ensure they are aware of their rights and what the service can offer. The Manager confirmed that a Care Management full assessment of needs has now been retrieved for all but one of the service users and placed on file. The inspector was given sight of a COT pre admission needs assessment. It was for completion by the service user and/or relative. The previous report referred to the requirement of NMS 2.3 that; the home carries out an assessment to cover all points (i-xii) of the standard which was discussed at previous inspections. Service User agreements are reportedly now in place with Service Users/ representative signatures.. Farm House DS0000061263.V266806.R01.S.doc Version 5.0 Page 9 . Farm House DS0000061263.V266806.R01.S.doc Version 5.0 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): 6,7,10. Service User care plans are in place to inform and guide staff in their support of individuals. Service Users are consulted about decisions affecting the home and their day-to-day lives. Risks are managed in a way that does not limit individual development. Information is held securely EVIDENCE: The Manager reported that the revised care plans, discussed at a previous inspection, are now in place and provide a useful and informative working tool. They are readily available to staff and are more user friendly than the bulky files formerly in use. As part of the new care plan any restrictions on rights and choices have been discussed and agreed with the Service Users concerned. In the absence of, or reluctance to sign, an agreement, the discussion, verbal agreement and ongoing adherence needs to be acknowledged and recorded. It was suggested, for ease of reference, that risk assessments are placed with the care plans (with the area to which they refer) rather than separately stored. An appropriate vehicle for identifying, recording and monitoring goals that relate to an individuals development are still subject to discussion and consideration at house and management group level.
Farm House DS0000061263.V266806.R01.S.doc Version 5.0 Page 11 Service Users spoken with confirmed that they were consulted in both the way the home is run and the recent changes to the environment. Menus are planned weekly with Service Users. As each Service User has a house day to undertake their chores they also prepare and cook the evening meal with staff assistance if required. Farm House DS0000061263.V266806.R01.S.doc Version 5.0 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): Not assessed at this visit EVIDENCE: Farm House DS0000061263.V266806.R01.S.doc Version 5.0 Page 13 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): 20,21. The arrangements for handling, storage and administration of medication appeared to be generally satisfactory A written procedure is now in place relating to death and dying. EVIDENCE: The Manager reported that the requirements of the previous report have been acknowledged and addressed. She has liaised with the Service user GP regarding the continuing use and record of prescription creams and has taken appropriate action. Records and storage appeared to be satisfactory and up to date.. The Manager reported that she is satisfied with the competency of staff and level of training they have received in medication administration. A written procedure on death and dying is now in place. Wishes are to be recorded following consultation with the service user and representatives. Farm House DS0000061263.V266806.R01.S.doc Version 5.0 Page 14 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): 23 The recommended changes to the Service User finance records and to the ‘gifts policy’ have been implemented. EVIDENCE: The ‘acceptance of gifts’ policy has now been removed and replaced with additional paragraphs in the ‘ management of financial affairs’ guidelines. This clearly states what is expected of COT employees. The additional detail, recommended in the last report, is now recorded in the Service User personal finance ledger. Farm House DS0000061263.V266806.R01.S.doc Version 5.0 Page 15 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): Not assessed at this visit EVIDENCE: Farm House DS0000061263.V266806.R01.S.doc Version 5.0 Page 16 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): 34,36. Recruitment practices provide for the protection of service users. The staff team is well supported and supervised by the management. Issues relating to appraisal noted in the previous report have yet to be fully addressed EVIDENCE: The requirement relating to shortfalls in the recruitment procedure have been addressed following communication between the home and the H&R department. Relevant checks have been undertaken and details are now copied to the individuals file in the home and are available for inspection. . The Manager reported that she is working closely with all staff to ensure the ethos of the home is carried through into practice and that staff adopt a consistent approach with Service Users. All staff receive regular and frequent one to one supervision. Managers have undertaken staff appraisal training. This is planned for introduction in April Farm House DS0000061263.V266806.R01.S.doc Version 5.0 Page 17 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): Not assessed at this visit EVIDENCE: Farm House DS0000061263.V266806.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 X X 3 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X X 3 Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X x LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 3 X 2 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Farm House Score X X 3 3 Standard No 37 38 39 40 41 42 43 Score X X X X X X x DS0000061263.V266806.R01.S.doc Version 5.0 Page 19 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA36 YA6 YA2 Good Practice Recommendations Staff to receive appraisals (outstanding from previous inspections) Goal planning specific to aid the development of Service Users skills (outstanding from previous inspection) Assessment format which covers all areas of 2.3 (outstanding from previous inspections) Farm House DS0000061263.V266806.R01.S.doc Version 5.0 Page 20 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
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