Inspection on 20/07/05 for Farmhouse Residential Rest Home

This inspection was carried out on 20th July 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Farmhouse Residential Rest Home 13/05/08

Farmhouse Residential Rest Home 13/06/07

Farmhouse Residential Rest Home 17/05/06

Farmhouse Residential Rest Home 12/10/05

Farmhouse Residential Rest Home 09/02/05

Farmhouse Residential Rest Home 29/09/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Farmhouse Residential Rest Home Farmhouse Care Limited Talke Road Red Street Newcastle ST5 7AH Lead Inspector Norma Welsby Unannounced 20 July 2005 10.30am/5.30pm th 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 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 Older People. 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. Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Farmhouse Residential Rest Home Address Farmhouse Care Limited Talke Road Red Street Newcastle ST5 7AH 01782 566430 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Farmhouse Care Limited Care Home 21 Category(ies) of 3 DE registration, with number 8 PD of places 21 OP Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: That a suitable manager is appointed and makes application to be approved as the registered manager within 3 months of the date of registration That the manager pursues the registered managers award by 2005 Date of last inspection 09 February 2005 Brief Description of the Service: The Farmhouse Residential Rest Home is a private care home situated on the edge of Red Street, near Newcastle. The home provides good access to a range of local shops and community facilities, including a small community centre located opposite and a regular bus service that runs directly outside of the home.On September the 23rd 2004 the home had changed hands and is now owned by Mr Pargan Dhadda and Mr Sukvinder Kandola, who already own another care home in Staffordshire. They have appointed a Homes Manager, Miss Sara Wright, who has submitted an application to be approved as the Registered Manager by the Commission for Social Care Inspection.The Farmhouse is registered for 21 older people, including 8 residents with a physical disability and 3 who may be mentally frail. At the time of this inspection, the home was fully occupied. The Farmhouse provides accommodation on two floors; the first being accessed by a shaft lift and a staircase. In total there are 19 single and one double bedroom, which was occupied by a married couple. There are three assisted bathrooms and adequate separate toilets. The kitchen and food stores are situated adjacent to the dining room and the laundry and separate sluice are also conveniently located. During the past 10 months the new proprietors have made several improvements to the physical environment, including the redecoration and refurbishment of several bedrooms and some alterations to the small lounge, which has improved its size, appearance and comfort for residents. Some aspects of the physical environment remain below the National Minimum Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Ms Norma Welsby carried out this Unannounced Inspection on the 20th of July 2005, between 10.30am and 5.30pm. The Inspector was pleased to find that further improvements had taken place at The Farmhouse and the inspection findings were generally satisfactory. What the service does well: What has improved since the last inspection? What they could do better: The Inspector was concerned that staff files did not include appropriate information to evidence that thorough recruitment procedures had been followed. This was discussed thoroughly with the home’s manager. Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 6 The staffing structure of the home, notably the provision of senior carers to cover/manage shifts when the manager or deputy is off duty would be a significant improvement that would have many benefits. The home has extensive gardens, but they are not very usable and it was apparent that they are not used very much at all by residents. In view of the home’s plans to build a conservatory, (which is intended to address the shortfall in communal space), the Inspector raised the possibility of also creating an enclosed safe garden that all residents throughout the home could access and enjoy. 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. Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4 & 5. Standard 6 not applicable as The Farmhouse does not provide intermediate care. The Inspector was satisfied that the home was undertaking appropriate pre admission procedures and meeting the needs of current residents. EVIDENCE: During this inspection the Inspector discussed the pre admission assessment procedure with the home’s manager and it was confirmed that the manager and deputy always undertake a home/hospital assessment. Opportunities are always offered for prospective residents and their families to visit The Farmhouse to view the home and vacant bedroom and to meet other residents and staff. During this inspection, the Inspector saw some evidence of pre admission assessments, but care must be taken that the written documentation is always kept with the residents’ personal information and individual care plan. Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 9 An extensive discussion about the individual needs and nature of dependency of current residents confirmed to the Inspector that The Farmhouse was meeting needs appropriately and that dependency levels were commensurate with the home’s Categories of Registration. A discussion with the home’s manager about identifying and meeting needs appropriately, reiterated that The Farmhouse more successfully meets the needs of residents with less complex needs and the manager informed the Inspector that this was something she was mindful of during recent admissions. Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9 & 10 Care plans had improved since the last inspection. The management and administration of medication was found to be satisfactory. The Inspector observed positive interactions between staff and residents confirming that residents at The Farmhouse are treated with respect. EVIDENCE: The Inspector examined a 20 sample of care plans and was pleased to find that there had been improvements made since the last inspection. These improvements included a more detailed assessment of need and a more thorough approach to reviews. The Inspector discussed with the home’s manager the importance of ensuring that care plans are maintained at a satisfactory standard, as ‘live documents’ that properly reflect the actual current needs of residents and suggestions were made about effective systems of review. Since the last inspection The Farmhouse had introduced a new monitored dosage system, as supplied by Boots the Chemist. All staff had been given appropriate training. Medication administration records were examined and Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 11 found to be satisfactory. Medication is stored is a suitable medication trolley. However it is conspicuously located and consideration should be given to finding an alternative, preferably lockable storeroom, but in the meantime the trolley should be secured to the wall. Furthermore any resident who self medicates must be provided with a lockable facility within their bedroom. Throughout the period of this inspection the Inspector made several observations of interactions, as well as having extensive discussions with residents, staff and a visitor to the home. The Inspector was satisfied that residents are treated with respect, their dignity upheld and that they’re right to privacy maintained. Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 & 15 Residents were being encouraged to enjoy daily routines suited to their expectations and preferences. A range of activities was being provided along with opportunities for trips out and using local facilities. Without exception positive comments were received in respect of the provision of meals at The Farmhouse. EVIDENCE: The Farmhouse employs an Activity Assistant for 6 hours a week, carrying out three 2-hourly sessions. Several residents spoke positively about this input, telling the Inspector about music and movement, reminiscence, quizzes and scrabble sessions. Opportunities for residents to enjoy trips out have also improved, recent ones including a visit to the theatre, the heritage centre and garden centres. A summer fair was planned for the end of July and residents were being encouraged to take part in the preparations. The home’s manager told the Inspector that monies raised contribute to the Comforts Fund which is used for Christmas and birthday presents and payment of tickets/entrance fees on trips out. Discussions with staff indicated that residents are encouraged to maintain contact with family and friends and that visitors are made welcome and several Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 13 residents and a visitor to the home confirmed this. Use is made of the local community centre located opposite the home and nearby shops. During this inspection, the Inspector observed residents being offered choices and being encouraged to make decisions, for example at mealtimes. On the day of this inspection both the hot cooked lunch and the light evening meal was observed. Good portions were provided and food was nicely presented and appeared appetising and nutritional. Residents were very positive in their comments about the provision of meals and refreshments and the Inspector received some comments that the quality of food had improved in recent months. Discussions with the full time cook, confirmed that suitable arrangements were in place for ordering of dry and fresh produce and a good stock of food was noted. The Inspector was also pleased to note that the home had been provided with a better supply of crockery and cooking utensils. Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The Farmhouse has a complaints procedure in place. There have been no complaints made since the last inspection. A copy of Staffordshire County Council Vulnerable Adult Procedures was also seen on site. EVIDENCE: The complaints procedure was seen on display in the home. When asked several residents told the Inspector that while they did not have any specific complaint at the time, they would feel comfortable about raising any concerns with either the manager or deputy. Following a requirement of the last inspection, The Farmhouse has its own copy of Staffordshire County Council’s Vulnerable Adult Procedure, which was seen during this inspection. Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20 & 26 Since the change of ownership in September 2005, there have been steady improvements made to the physical environment and further work is planned. The provision of a safe and accessible garden for residents to use throughout the summer needs addressing. During this unannounced inspection, the home was generally found to be clean, pleasant and hygienic, but work to bring the laundry up to an acceptable standard remains outstanding. EVIDENCE: An ongoing programme to improve the safety, comfort and attractiveness of the environment is in place. For example radiators in communal rooms have been fitted with attractive covers and there are plans to do bathrooms and bedrooms. The Inspector appreciates the cost implications of this programme, but this is an outstanding requirement for the previous inspection and the Responsible Individual is requested t notify the CSCI in writing of the envisaged timescale for the completion of this programme. Corridors and Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 16 several bedrooms have had new carpets fitted and new furnishings have been provided in communal areas and some bedrooms. The shortfall in the provision of communal space, reported in previous inspection reports, is due to be resolved with the building of a conservatory, planned for the near future. This would provide an ideal opportunity to create a secure and accessible garden for residents to use and this was discussed with the home’s manager. During this unannounced inspection, the Inspector toured most of the home, including several bedrooms and found the environment to be clean and pleasant, although one bedroom did have a slight malodour and this was discussed with the manager. Furthermore it was noted that the laundry room had not been improved to meet the necessary standards and this work must be completed by the 1st of September 2005. The Farmhouse employs a domestic assistant for 30 hours each week. Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 & 29 The Inspector found the staffing arrangements in place at The Farmhouse to be satisfactory. Adequate provision was made in respect of care, catering and domestic hours. Progress had been made to provide suitable training including NVQ training. Recruitment procedures were not satisfactory. EVIDENCE: On the day of this unannounced inspection, the home was staffed as follows: Home’s Manager: 8am/5pm 5-Day Care Assistants: 2 x 8am/3pm; 1 x 12pm/10pm; 2 x 3pm/10pm 2 Night Care Assistants: 2 x 10pm/8am 1 Cook: 8am/1pm 1 Domestic Assistant 8am/2pm (left early to attend a funeral) The Home’s Manager told the Inspector that an average of 500 staffing hours are deployed each week, including the manager’s own hours and catering and domestic hours. All staff had recently completed COSSH, Manual Handling, Medication and Fire Awareness. Five staff had completed Food Hygiene, with others scheduled to do in the near future. While just three staff, plus the manager hold an NVQ, the majority of others were due to commence NVQ training. Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 18 An examination of a sample of staff files revealed a number of concerns to the Inspector. There was no recorded evidence of references having been taken or POVA checks and not all had CRB checks. For example a member of staff recruited in April did not have on file any evidence of the above, which is unacceptable. The Inspector emphasised the importance of thorough recruitment procedures to the home’s manager and clarified the expectations of the CSCI. An immediate requirement was made about this finding. Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 & 35 The home’s manager had submitted an application to be approved as the Registered Manager and this application was being processed by the CSCI. Regulation 26 visit reports must be submitted to the CSCI every month. The Inspector was unable to examine the records of the personal finances of the one resident whose monies were being managed by the home, as these were not on the premises. The Inspector advised the home’s manager that this was an unacceptable practice. EVIDENCE: There had been a delay in processing the home’s manager’s application to be the Registered Manager due to problems in getting references. However an interview had taken place the day prior to this inspection. Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 20 The home’s manager reported a very positive rapport with the Responsible Individual Mr Pargan Dhadda, advising that weekly meetings, also involving the deputy, take place. However the Inspector does not always receive a copy of a monthly report, as outlined in Regulation 26 and this was again highlighted. The Inspector was told that the home only manages the personal allowance of one resident, whose money is held by Social Services. However it was not possible for the Inspector to examine the home’s records of expenditure as it was advised that the keyworker had taken the gentleman’s money and record book to make some necessary purchases. The Inspector advised that this was an unacceptable practice – records must always remain on the premises and transactions entered in along with receipts confirming what purchase had been made. Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 2 x x x x x 2 STAFFING Standard No Score 27 3 28 2 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x x x 1 x x x Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 22 yes 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 31 Regulation 26 Timescale for action The responsible individual/or This partner must visit the home at requiremen least once a month and prepare t had not a written report of the conduct of been fully the home, a copy of which must complied be forwarded to the Commission with since the last for Social Care Inspection inspection and must be with immediate effect. The programme to guard all This radiators and associated pipe requiremen work must be completed t had not been fully complied with since the last inspection. The Responsibl e Individual must notifiy the CSCI in writing of the target date for completion Version 1.40 Page 23 Requirement 2. 25 13 & 23 Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc 3. 26 13 & 16 Hygiene and Control of Infection issues pertaining to the physical environment must be addressed as a matter of priority, notably the laundry room and damaged flooring in bathrooms and toilets. 4. 35 16 & 20 5. 29 19 schedule 2 23 6. 19 Financial records pertaining to the management of a residents finances must always remain on the homes premises and be available for inspection. Staff files must contain evidence that thorough recruitment procedures have been followed, including two written references, POVA and CRB checks An enclosed safe garden must be provided for all residents to access and enjoy The laundry room still needed attention and this work must be completed by 1/9/05 With immediate effect and to remain ongoing With immediate effect and to remain ongoing To be completed when conservatr oy is built 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 9 27 Good Practice Recommendations A more suitable location should be found for the medication trolley but in the meantime it should be secured to the wall. Consideration should be given to developing a more robust senior staff structure, to provide cover when the manager or deputy is not onduty. Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Farmhouse Residential Rest Home E51-E09 S60611 Farmhouse Residential V239998 200705 Stage 4.doc Version 1.40 Page 25 - 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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