CARE HOMES FOR OLDER PEOPLE
Farmhouse Rest Home 87 Water Lane Totton Southampton SO40 3DJ Lead Inspector
Tracey Box Unannounced 15/08/05 9:30am 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 Rest Home H54 S48027 Farmhouse RH V243440 150805.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Farmhouse Rest Home Address 87 Water Lane, Totton, Southampton, SO40 3DJ 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) 023 8086 8895 023 8086 8865 info@richardkitchen.com Richard E Kitchen Mrs Jean Hunt CRH 20 Category(ies) of OP - 20; DE(E) - 20 registration, with number of places Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: N/A Date of last inspection 10.11.04 Brief Description of the Service: The Farmhouse is a registered care home providing personal support and accommodation for up to twenty older people with dementia type needs. The home comprises of ten single and five shared bedrooms, eleven of which have en-suite facilities. Communal space includes two lounges and a dining room. Car parking and a small enclosed patio can be found at the rear of the property. The home is privately owned by Mr and Mrs Kitchen. Mrs Jean Hunt is the registered manager. The Farmhouse is situated in a residential area on the main road close to the centre of Totton. Local shops are a short walk and public transport is easily accessable. Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection took place over five hours, the inspector was assisted during this inspection by the manager, Jean Hunt. The people living at The Farmhouse prefer to be referred to as residents, therefore will be referred to as this throughout the report. The inspector had the opportunity to speak with one relative and one visitor who was providing staff with training, both commented on the high level of care the residents appear to receive. The visitor said she often provides training to staff at the home. The inspector spent time with two residents as they looked at their care plans and witnessed good interacting between residents and staff. Staff, residents and visitors were asked for their views and experiences of the home, all responded positively about the care and support received. One visitor said “I am always made welcome here. One resident said “I wouldn’t want to leave, I am settled here.” The manager showed the inspector the layout within and surrounding the home, which appeared clean and comfortable. The inspector received eleven comment cards from residents, family/representatives. All commented that the residents appear happy living at The Farmhouse, and cannot fault the care provided. What the service does well: What has improved since the last inspection?
Risk assessments are in place for activities identified as potential risk to any resident, the home has a risk assessment in place for the building. The manager ensures appropriate checks are complete for new staff prior to them commencing employment. Staff complete an induction programme within the home, subjects covered are signed and dated by the staff member and the manager.
Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.doc Version 1.40 Page 6 Records of resident’s monies are up to date. Staff receive formal supervision. The commission for Social Care Inspection receives monthly reports of Regulation 26 visits to the home from the provider. Lighting has been improved in the communal rooms. Residents have new beds, bedding and bedside lamps. The home has benefited form some internal decorating and curtains have been replaced in the lounges. A number coded lock has been installed on the gate to the patio area to improve security. Magnetic door release systems have been installed on all fire doors. 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. Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.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 Rest Home H54 S48027 Farmhouse RH V243440 150805.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 A comprehensive procedure for assessing the needs of potential new resident is in place to ensure the residents and the homes needs are met prior to admission. EVIDENCE: The inspector saw two residents’ files that included a pre-assessment form completed by Jean Hunt, and a client assessment form which was completed by the residents social worker. The information included likes and dislikes, medical and family history and other relevant information to ensure the home is able to provide the care the individual requires. Family/representatives are invited to participate in the completion of the assessment to obtain as much information as possible The manager explained she visits the prospective resident to assess their needs, with a social worker (if appropriate) with family / representative present. Both residents recalled the manager visiting them prior to their admission, which included a meeting to assess their needs. One resident said “ I visited Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.doc Version 1.40 Page 9 the home to see if I liked it, when I moved in I had one month to see if I wanted to stay, we had another meeting and I wanted to stay.” Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.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 Residents health, personal and social needs are set out in individual’s care plans. EVIDENCE: Two residents explored their care plan with the inspector, they explained what was included in their care plan and risk assessments which demonstrated the amount of involvement the resident has in completing all aspects of these documents. One resident said “staff care for me as I wish, all I have to do is ask”. The manager explained care plans are reviewed on a monthly basis, unless needs change sooner. The inspector witnessed this procedure. Staff confirmed the care plans provide them with the information they need to satisfactorily meet the residents needs. Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.doc Version 1.40 Page 11 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) 13,15 Contact with family/friends/representatives and local community is encouraged as the individual wishes. Dietary needs of residents are well catered for with a balance and varied selection of food available that meets residents taste and choices. EVIDENCE: The inspector asked some of the residents what sort of activities they enjoy participate in, all explained how much they enjoy spending time perusing their own interests, which included reading, watching television, and spending time with their visitors. Some residents attend a club called ‘Chin wagers’ every Wednesday, a local mini bus provides transport, the home donates money to help pay for this. The inspector received one comment card which suggested “ a chance to go for a short walk to get some fresh air.” The manager said this could be encouraged. A record of visitors to the home was seen, which showed family visits, the inspector talked to one visitor who expressed their happiness with the care and support their relative receives. Transport to enable residents to attend appointments is supplied by family members. staff encourage residents to participate in activities if they want to. Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.doc Version 1.40 Page 12 All residents ate their choice of lunch in the dining room with Staff support if needed. Two residents confirmed they could eat wherever they wished, and choices are available. There was a well stocked fridge, freezer and store cupboard, fresh fruit and vegetables were available. The home does not restrict times for activities such as meals/bed/visitors or going out. Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.doc Version 1.40 Page 13 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 The home has a satisfactory complaints procedure in place with evidence that residents feel that their views are listened to and acted upon. EVIDENCE: The inspector asked four residents if they had made a complaint in the past, all replied “No, I haven’t felt the need to.” The inspector asked if they felt able to should the need arise, all responded “I am aware of what to do, and I feel the home would do it’s best to improve things should I need to complain.” The inspector witnessed the homes complaints procedure, which gives clear guidelines of process. A copy of the complaints procedure can be found in the homes policy file. The inspector looked at the complaints log which had not had any entries since 1996, the inspector asked staff if complaints are being logged, staff confirmed to their knowledge non had been made. The inspector recommended that the pages of the log are numbered consecutively to show a true record of complaints received. Two visitors spoken with were aware of the procedure, but have not felt the need to do so ( this is also evident from the comment cards the inspector received prior to this inspection), they were confident the home would take appropriate action should a complaint be made. One resident wrote on their comment card “ I know I can speak to the boss lady if I have any worries, she gets what I need and helps me.” Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.doc Version 1.40 Page 14 Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.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) These standards were not assessed on this occasion. EVIDENCE: These standards were not assessed on this occasion. Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.doc Version 1.40 Page 16 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) 29,30 The arrangements for the recruitment, induction and training of staff are good, staff clearly demonstrate their understanding of their role and responsibility, however, some practices must be improved to ensure residents protection. Staff are trained and competent to do their job. EVIDENCE: The manager explained the recruitment process and showed the inspector the homes written procedure. Three staff files were sampled, one of which belonged to a staff member who was employed approximately two weeks ago. Individual files showed evidence of CRB clearance and checks against the POVA list. All other recruitment checks had been completed, however, none of the files contained staff photographs. The manager must ensure that photographs of individual staff are held on their files. The manager explained the procedure for the induction of new staff, the inspector saw a written record of training received. The manager must ensure all new staff receive adequate induction/foundation training in line with Skills For Care guidelines. Staff explained the variety of training they had received enables them to carry out their role effectively, the visitor who provides training also confirmed staff receive adequate training. Staff files included certificates of training completed. Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.doc Version 1.40 Page 17 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) 35 Residents financial interests are safeguarded. EVIDENCE: One residents prefers to handle their own financial affairs, supported by the manager. There was a procedure for storing and monitoring resident’s money, which was found to be working well. Other residents living in the home prefer their family/representative to deal with their money. Two residents said that they prefer their family to deal with their money, one visitor confirmed this id their relatives wish. Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.doc Version 1.40 Page 18 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 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3
COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x 3 x x x Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.doc Version 1.40 Page 19 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 OP 29 Regulation Schedule 2 Requirement The manager must ensureall relevant information and documents are held on staffs files as stated in schedule 2 Timescale for action 15/09/05 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. Refer to Standard 16 Good Practice Recommendations To number the pages of the complaints log consecutively to show a true record of complaints received. Farmhouse Rest Home H54 S48027 Farmhouse RH V243440 150805.doc Version 1.40 Page 20 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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