Inspection on 23/01/06 for Farmhouse Rest Home

This inspection was carried out on 23rd January 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Farmhouse Rest Home 12/01/10

Farmhouse Rest Home 02/11/09

Farmhouse Rest Home 12/10/09

Farmhouse Rest Home 28/09/09

Farmhouse Rest Home 19/08/09

Farmhouse Rest Home 17/08/09

Farmhouse Rest Home 09/06/09

Farmhouse Rest Home 17/06/08

Farmhouse Rest Home 02/08/06

Farmhouse Rest Home 15/08/05

Farmhouse Rest Home 10/11/04

Farmhouse Rest Home 10/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Farmhouse Rest Home 87 Water Lane Totton Southampton Hampshire SO40 3DJ Lead Inspector Tracey Box Unannounced Inspection 23rd January 2006 10:00 X10015.doc Version 1.40 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 Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 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 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 DS0000048027.V279225.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Farmhouse Rest Home Address 87 Water Lane Totton Southampton Hampshire SO40 3DJ 023 8086 8895 023 8086 8865 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) Richard E Kitchen Mrs Elizabeth Kitchen Mrs Jean Hunt Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th August 2005 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 accessible. Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over five hours. The people living at The Farmhouse prefer to be referred to as residents, therefore will be referred to as this throughout the report. At the time of the inspection twenty residents lived at the home (two residents were in hospital, the inspector was aware of this as the home had sent the required notification to the CSCI, as required in regulation 37 of the Care Standards Act (CSA) 2000). The inspector witnessed lunch being prepared, fresh produce was used, resulting in a nutritious, home cooked meal. Three residents agreed that meals are always very good, and are home made as apposed to pre packed. One resident said “Cakes are made fresh each day for our afternoon tea. Records were seen and the inspector asked residents and staff for their views and experiences of living and working at The Farmhouse. One resident stated “This is my home now, I like it here very much” Three residents, when asked, commented on how polite, helpful and friendly the staff are at the home. Staff were observed knocking bedroom doors and waiting for a reply before entering, three residents said that they felt staff respected their privacy and dignity. The manager showed the inspector the layout within and surrounding the home, including communal areas and a few bedrooms, all areas appeared clean and comfortable, providing a pleasant environment for residents. What the service does well: What has improved since the last inspection? Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 6 Individual’s staff files include the information required in Schedule 2 of the CSA. The complaints log has been revised, each page is numbered consecutively to show a true record of complaints received. A shed has been built in the garden to store the freezers, this will allow easier access. Staff receive adequate induction/foundation training. Three bedrooms have been redecorated to the residents taste. The home has a full complement of staff. 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 DS0000048027.V279225.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 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 the following standard(s): 1,6. The home does not provide prospective service users with the information they need about the home The Farmhouse does not provide intermediate care. EVIDENCE: The registered person must produce a ‘Service Users Guide’ and Statement of Purpose to ensure prospective and exciting residents are aware of the service the home provides. The manager said it is the home’s policy not to provide intermediate care. Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 8,9,10. Residents health care needs are set out in individual’s care plans ensuring the individual’s needs are fully met. Residents are protected by appropriately trained staff, who follow the homes policies and procedures for dealing with medicines. Personal support within the home is offered in such a way as to promote and protect residents’ privacy and dignity. EVIDENCE: The inspector looked at two care plans, both included pre assessment paperwork, the information in these assessments is used to compile to individuals care plans and risk assessments. The care plans are comprehensive and include information about the individuals health, abilities, strengths, needs and wishes, any special requirements, mobility, religion and family details Care plans are reviewed monthly, signed documentation showed this practice occurred. The inspector spoke with two residents who agreed that the information in their care plan is exactly as they had specified. One resident said their doctor had visited them recently, records of this were found in the individuals care Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 10 plan, records in the daily notes explained why the resident wanted the doctor to visit them. Other records showed visits to residents by the district nurse, hospital, residents feeling unwell and episodes of residents being aggressive. One resident said “staff care for me as I wish, all I have to do is ask”. Staff confirmed the care plans provide them with the information they need to satisfactorily meet the resident’s needs. At the time of the inspection, staff administer all of the residents medication. Staff told the inspector that residents prefer them to store and administer resident’s medication for them, one resident told the inspector this was their wish, this was also recorded in the care plan. The inspector saw medication being correctly administered, staff followed the homes medication policy and procedure, (the home uses the monitoring dosage system and monitoring administration record sheets) the records kept in conjunction with medication received and returned to the pharmacist were found to be correct. Records of all staff trained to administer medication were found to be in order. The inspector witnessed staff address individuals in their preferred manner, as stated in individuals care plans. Staff were observed knocking bedroom doors and waiting for a reply before entering. One member of staff recalled privacy and dignity being part of her induction and foundation training. Two residents commented on how polite, helpful and friendly the staff are, and how they feel staff respect their privacy and dignity. Staff receive Dementia care training, one member of staff said the training helped them to understand peoples behaviour better, it made her more aware of why some people seem forgetful at times, and how she can help the resident. Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 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 the following standard(s): 12,14. Residents feel the home matches their expectations and preferences, their social, cultural, religious and recreational needs are met. Practices in the home demonstrate that the home promotes individual choices and encourages residents to have control over their lives. EVIDENCE: One resident said “I was told I would be happy living here, they were right, I am very happy.” One resident explained how they felt about moving from their home where they required very little support, to moving into a care home providing everything. They said “I am here because I cannot manage on my own anymore, although I am more dependant on staff to cook meals and do my laundry, I didn’t expect to feel so at home.” “I get support and help to do what I want, staff encourage us all to take part in activities, sometimes I do, staff are understanding if I don’t want to. My family take me out.” One resident stated “I moved here recently and have settled in well, I feel very at home here, I cannot fault the staff. I see the manager on a very regular basis, she makes sure we are happy here and I can speak to her about any concerns I may have. The food is good, my bedroom is comfortable and I have my own personal belongings with me. I am encouraged to keep active with the activities the home offer, I enjoy doing the chair exercises with staff. I have a Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 12 daily newspaper delivered to me every day. I attend a group called ‘Chinwaggers’ once a week, which I enjoy as I meet other people and have a good chat! I go to bingo once a week as well. I try and take part in most things, staff respect my wishes if I do not wish to participate. My visitors are made welcome. What more could I want.” The manager confirmed staff use a variety of ways to enable residents to make choices, for example, when choosing which clothes to wear, the staff member will arranging the options in front of the resident to enable them to choose. One resident said “I choose what I want to wear and staff help me to get dressed.” The manager said residents choose colours schemes when areas of the home are being redecorated or refurbished. The inspector asked some of the residents what sort of activities they enjoy participating in, all explained how much they enjoy spending time perusing their own interests/hobbies, which included reading, plating card games, watching television, and spending time with their visitors. Some residents enjoy ‘chair exercises’ and visiting the local group called ‘Chinwaggers’ and bingo. Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 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 the following standard(s): 18 The home has satisfactory procedures for protecting service users’ form abuse. EVIDENCE: The inspector saw the homes adult protection procedure, and a whistle blowing policy. Records showed each staff has received a clear enhanced Criminal Records Bureau (CRB) disclosure, however, one CRB was issued approximately one month after the staff member had commenced employment. Records of a Protection Of Vulnerable Adult (POVA) checks being completed prior to the CRB disclosure being returned were not available. The inspector saw staff training records, which showed that staff had received training on abuse. Awareness of abuse and the correct procedures to follow is covered in the induction process of new staff, and documents showed staff have read and agreed they understand the procedures to follow, including the home’s Whistle blowing procedure. One member of staff said “ I am aware of the correct procedure to follow, I know where the procedures are kept should I need to access them, there is always a more experienced member of staff on duty to ask.” Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 19,26. Residents live in a safe, pleasant environment. Some areas require attention in order to keep them clean, hygienic and well maintained. EVIDENCE: The provider must ensure there is a ratio of one assisted bath to eight residents. At the time of the inspection, eighteen residents were sharing one assisted bath. The kitchen is shabby and in need of refurbishment. The risk of cross contamination would be reduced if hand towels were replaced with paper towels. The manager showed the inspector around the home, which appeared clean, staff were observed wearing protective clothing whilst cleaning. The inspector saw records within the homes maintenance file, details included the fault and the action taken, all records are signed and dated to monitor progress. Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 15 One resident said their room was very pleasant, clean and warm, they were encouraged to bring their own personal belongings, furniture and pictures to make it feel like home. “if I want anything fixing or putting up on my wall, all I have to do is ask and it’s as good as done.” A random selection of bedrooms were seen, all were found to be clean, warm and furnished with personal items. One resident said “I feel safe here, as well as being free to come and go as I please”. The home’s radiators and pipe work are safe ensuring that all potential hot surfaces are kept to low temperature. The patio garden is well maintained, the gate leading to the car park is kept locked to maximise security. Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28. The staff at the home are well trained, supported and employed in sufficient numbers to meet the residents needs. This has resulted in residents feeling safe and comfortable at the home. EVIDENCE: The residents spoken with said “Staff do training, sometimes it is held here at the home, other times it is at colleges.” All the residents spoken with said there was sufficient staff around and that the staff appear to know what they are doing. Two staff told the inspector “I receive more than adequate training to enable me to carry out my role” “I am encouraged to do training, I really enjoy doing it, and working here”. At the time of the inspection, appropriate numbers of skilled staff were on duty, ensuring the residents safety, The rotas showed that there were sufficient staff on duty to meet the residents’ needs, staff confirmed this. The manager stated the home is fully staffed at present with no vacancies. Four staff files were sampled, one of which belonged to a staff member who were employed recently. The files contained photographs of the individual, along with other evidence of the individual’s identification. The inspector saw evidence that appropriate Criminal Records Bureau (CRB) disclosures had been completed, however a record of one staff POVA clearance was not available. Staff files and the homes training records showed that staff had completed the following mandatory training: Induction and foundation, moving and handling, food hygiene, first aid and fire training. Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 17 Certificates showed all staff have attended training to cover abuse awareness and dementia care. Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 18 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,38. The home has a registered manager who runs the home in the best interests of the service users. Practices within the home demonstrate the protection of residents and staff’s health, safety and welfare. EVIDENCE: The registered manager is registered with The Commission for Social Care Inspection (CSCI) to run the home. The manager confirmed she gets feedback on the running of the home on a daily basis by talking to residents, their families and staff. The home operates a keyworker system, which means each service user has a named member of staff who has specific responsibilities for the service user. The manager confirmed the home ensures the residents are consulted, in a very informal way, about issues surrounding the running of the home, the Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 19 residents respond well to this, therefore no formal documents have been completed. The home would benefit from developing a more formal way of recording the outcomes of these consultations, to show that the home is run in the best interests of the residents. The CSCI has not received a copy of the provider’s monthly unannounced visits to the home since July 2005, therefore the provider is required to comply with regulation 26 Care Standards Act 2000, and supply the CSCI with a copy of the report following the visit. The inspector saw certificates to show staff had received health and safety training, moving and handling and first aid training. The home has adequate risk assessments for working practices, staff, visitors and office space, thus ensuring a safe environment. The inspector viewed certificates for the servicing of systems and radiators were covered and had thermostatic controls. Staff confirmed their awareness of health and safety procedures, and were aware if the homes policy and procedures, and where to find them. Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 20 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X X X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X X X 3 Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No 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. 2. 3. 4. Standard OP1 OP12 OP19 OP33 Regulation 4,5.1,2,3 Sch.1 5.1,2,3 23.2j 26.1,3,4. 5,a,b Requirement Timescale for action 23/02/06 The registered person must produce a ‘Service Users Guide’ and statement of purpose. The registered person must 23/02/06 produce a ‘Service Users Guide’ The provider must ensure there 23/04/06 is a ratio of one assisted bath to eight residents. The provider must visit the home 23/02/06 at least once a month unannounced. 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 OP26 Good Practice Recommendations The risk of cross contamination would be reduced if hand towels were replaced with paper towels. Farmhouse Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hampshire Office 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 © 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 Rest Home DS0000048027.V279225.R01.S.doc Version 5.1 Page 23 - 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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