Inspection on 07/12/05 for Farm View

This inspection was carried out on 7th December 2005.

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 View 17/10/06

Farm View 06/10/05

Farm View 07/02/05

Farm View 15/09/04

Farm View 06/02/04

Farm View 08/09/03

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Southfields

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33 St John`s Church Road

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

CARE HOME ADULTS 18-65 Farm View Highlands Farm Woodchurch Ashford Kent TN26 3RJ Lead Inspector Lois Tozer Announced Inspection 08:10 7 December 2005 th Farm View DS0000023420.V266894.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 View DS0000023420.V266894.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 View DS0000023420.V266894.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Farm View Address Highlands Farm Woodchurch Ashford Kent TN26 3RJ 01233 861515 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 Jayne Shilling Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Farm View DS0000023420.V266894.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 4 People with learning disabilities aged between 18 - 65 years. Resident with acquired Brain injury to be restricted to one whose dob is 12/09/1973 6th October 2005 Date of last inspection Brief Description of the Service: Farm View is registered to provide accommodation, personal care, and support to four people who have a learning disability, aged 18 - 65, of mixed gender. The home is a modern bungalow situated on the grounds of Highlands Farm, Woodchurch. This is also the home of the South of England Rare Breeds Centre, a major tourist attraction. The home is set in its own spacious garden with a large, furnished patio. A beech hedge has been recently planted around the perimeter of the garden, to complement the large screen fence to increase privacy from all directions. The home is an ordinary, domestic dwelling, and has two communal bathrooms and toilets, and a large lounge / diner for communal use. The kitchen is spacious and has a breakfast bar type seating arrangement. One resident has a full en-suite facility. The site itself offers many opportunities for community contact, and some residents have unpaid work placements within the rare breeds centre. The home has access to a vehicle to enable residents to get into the wider community. Community activities and education is a regular feature of life in the home. Farm View DS0000023420.V266894.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory announced inspection took place on 7th December 2005 between 08.10am and 1.00pm (by arrangement). There are currently four people living at the home, and all residents were able to give feedback before they went off to their work placements and chosen day activities. Observations of staff with the individual in the home indicated that they all got on very well. Residents commented, or indicated (paraphrased) ‘I like it here, the staff are nice’. ‘I have a key worker X, and she is my friend’. ‘We go out shopping, I go to clubs’. ‘I enjoy my work placement, it really suits me’. ‘No, I wouldn’t wish to live anywhere else, I get on well with everyone here’. ‘I have a free-view box!! I really like my room, yes, I chose how it looks’. Paperwork seen included medication and administration documents, menu, training and recruitment records. A tour of the communal parts of the home and one bedroom took place. Most of the inspection was spent talking to residents and observing staff interact with them. Staff were happy in their role and said they felt well supported. The home has an easy-going, happy, atmosphere. Residents are free to come and go as they please, and staffing is sufficient to enable those who need support when outside of the home. Some discussions took place regarding easier ways to present information that would help staff and manager alike. The manager was keen to reduce paperwork and felt that suggestions were relevant. What the service does well: The home is clearly run with the inclusion of residents in most aspects of everyday life. There is a very high level of educational and practical work experience opportunities available to everyone. Each person has an individually tailored day plan and records indicate the residents are happy with the chosen activities. One – to –one key worker days for shopping and personal activities are planned into the rota. There is a high level of activities available to residents and the range of choice for activities outside of the home is extensive and well supported both financially and by staff availability Communication is strongly encouraged, and the home reports a big increase in an individual’s range of expressive and relevant vocabulary. Residents are actively involved in the recruitment and selection of new staff. Farm View DS0000023420.V266894.R01.S.doc Version 5.0 Page 6 Staff are supported by a competent and friendly manager who strives to increase training opportunities and residents involvement in all matters. Residents really like the staff and feel respected. Staff clearly treat the residents as equals and support them in a friendly, informal manner. 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 View DS0000023420.V266894.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 View DS0000023420.V266894.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): 2 Existing residents have had their needs assessed prior to moving into the home; the manager now has possession of the current assessment documentation used by the Trust. EVIDENCE: The assessment tool available to assess prospective service users aspirations and needs covers all elements needed to ascertain if the service can meet an individuals needs. Farm View DS0000023420.V266894.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 A variety of methods are used to enable people to make decisions. All residents participate in the day-to-day running of the home in a meaningful way. Assessments are in place and describe the actions that reduce risks to enable people to retain independence. Documents are stored safely and securely. EVIDENCE: Symbols and picture cards are used where needed, to help people make choices and decisions (such as menu planning). Staff offer positive support to reinforce involvement in the running of the home, giving opportunities to be involved at the level right for the individual. Risk assessments highlight what action staff must take to enable activities to take place safely, these are reviewed regularly. All information is stored securely, and residents have chosen their folder colour, enabling recognition of their particular files. Farm View DS0000023420.V266894.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 16 Personal development is a key feature of the service. Activities within and outside of the home are relevant to adult lifestyles and have been chosen by the individual. Rights and responsibilities are recognised by service users and staff alike. EVIDENCE: All residents have lots of opportunity to use practical life skills; those who are more able take a unsupervised lead in domestic activities and work placements. Staff actively support other residents to personally develop by inclusion in daily tasks and encouraging communication, and have had measured success. Some residents have unpaid employment within the Trust, and enjoy this very much. Seeking paid employment opportunities with individuals who have had significant work experience is strongly recommended. Staff and residents have positive relationships, and a key worker system is in place that residents are clear about. Residents indicated that they were comfortable with staff and felt respected. Farm View DS0000023420.V266894.R01.S.doc Version 5.0 Page 11 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): 19, 20 Health needs are simply but effectively documented, enabling staff to consistently meet service user needs. Medication management is robust. EVIDENCE: Personal support requirements are well documented, and residents say that they are given the support they need. Periodic healthcare needs are expressed on a dated chart, enabling staff to easily remember and support the individual – also providing a very easy and quick to complete document. Residents have appropriate support with their medication. Alternative remedies are obtained from a qualified therapist and are fully documented. Homely remedy protocols are being updated for each individual. Farm View DS0000023420.V266894.R01.S.doc Version 5.0 Page 12 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 All residents know how to make a concern known and feel that they will be listened to. EVIDENCE: In discussion with three residents, it was clear that all understood how to complain; who to take concerns to and what they could expect to happen. Staff support all residents to express themselves, and greater support is given to people with communication difficulties. Key workers play an important role in supporting people to make their feelings known. A system of using symbols as a way of residents independently expressing feelings was discussed; this could be developed as part of the quality assurance process. Farm View DS0000023420.V266894.R01.S.doc Version 5.0 Page 13 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, 25, 26, 27, 28, 29, 30 The home is comfortable, homely, and safe. Bedrooms are highly personalised. Shared space is limited to two rooms, but is well maintained. Adaptations are minimal, as per individual assessments. The main bathroom is homely and pleasant; the second shower room is rather clinical, but infrequently used. The home is clean and hygienic throughout. EVIDENCE: The bungalow is an ordinary shared home, with the minimum of adaptation, most of which are grab rails in the bathrooms. It is well furnished and cheerfully decorated. Resident’s individual rooms are highly personalised and meet their needs. Shared space consists of a lounge / diner and the kitchen. Staff have a small office with a bed for ‘sleep in’ duties. One resident has a full en-suite facility. Both bathrooms are fully functional, one has benefited from a new floor. The shower room is quite stark, however, is seldom used for daily use. It is situated off the laundry, conveniently for showering after working with the farm animals. The home operates a strict infection control policy for clinical waste collection. Maintenance support has been increased, and this is reported to now be swift and effective. Farm View DS0000023420.V266894.R01.S.doc Version 5.0 Page 14 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): 31, 32, 34, 35, 36 Staff have clear job descriptions. Staff understand the service users needs, and are competent in their roles. Training appropriate to the needs of individual’s been provided. Recruitment procedures need improvement to ensure they comply with these Regulations and offer equal opportunities for prospective employees. A programme of supervision is in place, enabling staff to meet formally with their manager regularly. EVIDENCE: Staff know their job roles and are supported with a job description. Induction training covers all aspects of each individuals support requirements, and staff are never left to support alone until both they and the resident feel comfortable. Inductions cover health and safety in depth, the social care aspect is explored separately, but would benefit from greater focus on specific issues and conditions of learning disability. One staff member had not completed the Trust’s TOPSS taught programme, and a discussion about the revised ‘Skills for Care’ common induction standards took place and may be a way of linking a greater service user specific focus into the induction package (www.skillsforcare.org.uk). Additionally, this may be a way of using the managers’ skills in NVQ assessment to good use, enabling the induction programme to be more responsive. NVQ training is well supported, two staff members are close to completion, and further staff start in January 2006. Records showed that regular supervision takes place. Staff files showed that robust recruitment procedures were not being followed, previous employment in the care sector had not been followed up and Farm View DS0000023420.V266894.R01.S.doc Version 5.0 Page 15 references were extremely brief, and had not been verified as authentic. Discussion about equal opportunities revealed that interview notes are not kept, and potential staff are not asked standardised questions. The recruitment policy and procedure is currently under central review. Detailed feedback was left. Farm View DS0000023420.V266894.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 Work to make quality assurance processes more accessible to service users has commenced, and further work is planned to simplify further. EVIDENCE: A simpler, more meaningful, pictorial, quality assurance questionnaire has been drawn up and trialled with a resident, who found it easy to use. Discussion took place about ideas to simplify it even further for another individual, to complement the process now in place. The key worker felt that asking a few meaningful questions only was the way forward, and would develop this with the resident themselves. Farm View DS0000023420.V266894.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 X 1 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Farm View Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X X X DS0000023420.V266894.R01.S.doc Version 5.0 Page 18 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 YA34 Regulation 19 Requirement Revise and make robust the recruitment procedure against Schedule 2 of the Care Homes Regulations (Year 2004 amendment 1770). Previous employment in the care sector must be followed up & documented. Timescale for action 01/01/06 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 YA12 YA34 Good Practice Recommendations Seek paid employment opportunities with individuals who have had significant work experience. At least one reference is verified verbally to validate the content. Interview process should be based on equal opportunities processes. Further simplification of quality assurance for specific resident, presented in a manner they may understand, with pictorial aids as necessary, and hold relevance for the individual. 3. YA39 Farm View DS0000023420.V266894.R01.S.doc Version 5.0 Page 19 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 View DS0000023420.V266894.R01.S.doc Version 5.0 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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