Inspection on 02/08/05 for Fenners Farmhouse

This inspection was carried out on 2nd August 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 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

Fenners Farmhouse 31/08/06

Fenners Farmhouse 13/02/06

Fenners Farmhouse 02/03/05

Fenners Farmhouse 10/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Fenners Farmhouse Fersfield Diss Norfolk IP22 2AW Lead Inspector Jenny Rose Unannounced 2 August 2005 nd 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Fenners Farmhouse Address Fersfield, Diss, Norfolk. IP22 2AW. 01379 687269 01379 687234 fenners@clara.co.uk Fenners Limited 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) Mrs Gillian Frances Bradfield, RNLD Care Home 9 Category(ies) of Learning Disability (9) registration, with number of places Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration other than the home can accommodate 9 service users with learning disabilities. Date of last inspection 2nd March 2005 Brief Description of the Service: Fenners Farmhouse provides residential care and support for up to 9 adults with learning disabilities, in a sixteenth century farmhouse with an extension, set in half an acre of grounds, it is in a rural setting about three miles from the town of Diss. The home has been registered to provide this service since 3 October 1989. Transport is available in order to access local facilities. Accommodation is on two floors, offering 9 single rooms. A purpose built art studio/day care facility is situated in the grounds with easy access from the main home. Day care is provided on and off site. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, taking place on a weekday over 6 and half hours. There were 9 service users in residence on the day. Mrs Angela Carver was in attendance throughout the inspection. Pre preparation had taken place in the CSCI office. There was a tour of the building and records were seen. Four members of staff were spoken to, including the Manager, Mrs Gillian Bradfield. All the service users were spoken to and two in private. What the service does well: What has improved since the last inspection? * There had been new flooring in an upstairs toilet. * The outside of the building has been redecorated. * The outside paths have been paved for wheelchair access and there is hard standing in the car park. * The drainage to the car park area has been improved. * There is now disabled access in and out of the sun room. * A safe, paved garden, with seating and a pergola, has been created with the addition of a gate. * A water feature has been installed in the safe garden. * There is diarised time for staff to regularly review policies and procedures, including those for fire. * The General Manager has recently qualified as a trainer in Adult Abuse Awareness. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 6 * * * * There is regular, recorded staff supervision. A new policy and procedure had been added to deal with a Sudden Death. Discontinued goals in care plans are reviewed and signed by service users. There has been a Quality Audit by the ‘Friends of Fenners’, which has been submitted to the Commission for Social Care Inspection to ensure that the home is run in the best interests of service users. 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. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 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 standard(s) 2 There is a clear procedure for admissions to ensure that individual needs are assessed and recorded to ensure, as far as possible, that the service user and their relatives know that the home will meet their needs and aspirations. EVIDENCE: The home had not admitted any new service users for two years. However, there was one recent admission in an emergency, via a referral from a Social Worker. The home’s policy is that this is not an ideal situation, but they had followed a clear procedure to assess the prospective service user’s needs by a check list against the Standards and by visiting him at his previous address, meeting with his previous carers and the day centre he attended. There was also a staff meeting before this visit to discuss which questions to ask the service user to ascertain whether his needs would be met within the existing group of service users in the home. The service user’s relatives visited the home and were provided with a Statement of Purpose, Terms and Conditions and Complaints Procedure. The service user had visited with his carers for the day and the home sent photographs before he made his decision to move several days later. A few weeks afterwards, the service user celebrated a significant birthday party in the home to which he invited 50 people, both relatives and friends and significant people connected to the home were also introduced. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 9 There was to be a three months review when the service user would be supported to decide whether the admission would be permanent. The home’s work in this regard is to be commended, in the circumstances of an emergency admission. There is accessible information in the house for readers and non-readers using photographs, videos, tapes, leaflets and symbol assisted information, particularly for a new service user to understand the routine of the home. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 There were comprehensive care plans and risk assessments ensuring that staff supported service users in caring for their needs and achieving personal goals. EVIDENCE: Service users were engaged with their Care Plans and where necessary pictures, or photographs were used to ask questions, or to illustrate what had been agreed, where there was limited verbal communication. Health professionals’, i.e. psychologist, neurologist, psychiatrist, physiotherapist and language therapist, advice, social care and risk assessments were used as the basis for Care Plans and were developed by emphasis on individual preferences and strengths and weaknesses. Service users were encouraged to be responsible for their personal care, wherever possible. Previous associations, where appropriate, for example, with previous carers, were noted and efforts made to ensure that these were continued. There is a keyworker system and ongoing reviews with the service user and/or their representatives. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 11 Photographs of service users were stored electronically with their care plans and the Manager explained that the home were in the process of transferring the care plans to the computer. Care plans, as well as an assessment of needs, included appropriate goal setting and means to achieve these goals and risk assessments if appropriate. One service user had flown to Glasgow recently, where she won two bronze medals for Boccia (a bowling sport) at the national Special Olympics. Another service user had won medals at a regional horseriding competition in Cambridge. There were weekly service users’ meetings to discuss weekly menus and personal concerns and interests. Various jobs in the home were keenly sought by individual service users, such as bringing in the post, putting photographs of those on duty from the staff rota on the notice board and recycling. Service users also participate in ‘domiciliary days’ when they were supported by staff in domestic activities, e.g. cleaning their rooms and laundry tasks. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,15,17 The home gives high priority to opportunities for service users’ personal development and appropriate activities in and outside the home. Service users engage in menu planning and are supported in choosing a healthy diet, all of which factors contribute to the good quality of life for service users. EVIDENCE: At the time of the inspection, service users were choosing whether to go on a shopping trip in the home’s vehicle. Service users in the home were seen watching television, in two locations and one was sorting playing cards, another drawing. The General Manager reported that arrangements were being made for those service users who chose to do so to go on a fishing trip. As described elsewhere in the report there are many opportunities for personal development, four service users had gained certificates for Horticulture from Easton College, others had certificates for swimming, which were displayed in the ‘quiet’ sitting room. Individual programmes were arranged with other local colleges, including work related placements, if appropriate. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 13 There had been two holidays, one in May and July, at locations of the service users’ choice, at Trimingham and Hemsby, which service users said they had enjoyed. Two service users were observed in the Studio where there are many facilities and opportunities for art and craft work of all kinds. The home was about to put on an Art Exhibition of Service Users’ work. This is to be commended. This was organised in a professional manner and was being covered by the local Press. Service users are enabled to attend places of worship, if they wish, and representatives of religious bodies visit the home. In particular, appropriate contacts had been put in place for the most recent service user to meet his spiritual needs. Two service users had recently changed rooms, on which there had been consultation. Both service users were spoken to and were happy with this arrangement. Service users help to prepare the evening meal, also laying tables for this and for breakfast. Service users are able to make their preferences for food known at the weekly service users’ meetings and one service user was observed making her ‘pack up’ for the following day from photographs of healthy foods. There was also written guidance regarding food for people with swallowing difficulties. There was a communal dining room, but service users could choose to eat their meal at separate tables and on their own, if they wished. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 18, 20 Service users appear to receive personal support in a way acceptable to them. The home supports one service user in administering his own medication and the policies and procedures ensure as far as possible that other service users are protected. EVIDENCE: Service users spoken to and could communicate verbally, confirmed that they received support in the way which they find acceptable. There were good details of sleep patterns and individual preferences for personal care in the care plans. Medication was observed being administered to a service user in the office in an appropriate manner. The MAR sheets were in order and medications checked in locked medicine cupboard in office. The stock cupboard was randomly checked and found to be up to date, and not overstocked. Homely remedies were also accounted for. There is one service user who administers his own medication, for which there is a risk assessment. The member of staff spoken to had been trained inhouse in medication and in addition had received additional training in the administration of rectal Diazepam. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 15 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 standard(s) 22, 23 Service user’s complaints were taken seriously and acted on. A procedure for evaluating the staff’s understanding of Adult Abuse Awareness would further protect service users’ from such possibilities. EVIDENCE: It is evident that service users’ complaints are taken seriously and acted on. There had been a complaint by one service user concerning a matter outside the home. The home’s action was documented in detail, resolved and signed by the service user concerned. Two service users spoken to said they would know to whom to speak if they had any complaints. The home had also devised a procedure in the Probable Risks assessment to include Malicious Allegations and also notes of any unusual behaviour on the daily record. The General Manager had recently completed an Adult Abuse Awareness Trainers Course and was intending to hold in house training on this subject with all staff in the home. She also reported that such issues were frequently discussed at staff meetings. However, there is a recommendation that a procedure should also be developed for evaluating the staff’s understanding of the particular issues. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 16 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 standard(s) 24, 25,28,30 There have been several improvements to the outside of the building, ensuring that the home provides a comfortable, safe and pleasant environment for the benefit of service users. EVIDENCE: The communal rooms, three sitting rooms, namely the lounge, sunroom and quiet room also the dining room, are comfortably furnished in a homely manner with good quality furniture and photographs of service users and friends, together with a display of certificates of achievement of service users in one area. The service users’ bedrooms seen were personalised and reflected the preferences of the individual service user with pictures and collections of videos, DVDs and books. These too were comfortably furnished and each service user is supported in keeping their rooms clean and tidy once a week. There had been several improvements to the outside of the building. The house had been painted, there were improvements to the car park and a paved walkway around the house. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 17 There is now a safe garden with pergola seating, a paved area and a water feature, with the addition of a gate, which makes a pleasant area in which to sit for service users. All areas of the home seen were clean and hygienic. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 36 There is an enthusiastic, effective and flexible staff team, which ensures that service users needs are met as far as possible. EVIDENCE: Two members of staff spoken to confirmed that they are enthusiastic and enjoy their work. One said the…”good thing about working here is that the service users have a lot to do and they make you feel welcome” (when coming to work). She also confirmed that there was a good staff team and that the management were open and approachable for any difficulties. She was particularly appreciative of being consulted on a new staffing rota, which was newly in force. There are regular staff meetings every 2 to 3 weeks and care meetings in between. One comparatively new member of staff confirmed that she had undergone induction training in house and a course in the administration of rectal diazepam. There was regular, recorded staff supervision. Staff are also very flexible in terms of roles and covering outings and activities. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 19 As mentioned previously, one service user daily updates the staff rota on the photograph board, so that all service users know which members of staff are on duty. There are two members of staff at present undertaking NVQ3 and a new member of staff who will be acting as a Relief Carer has an NVQ3. The General Manager has the NVQ4, Registered Manager’s Award, is an NVQ Assessor and has recently qualified as a Trainer in Adult Abuse Awareness and will be providing in-house training. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39, 42 The management approach of the home is open and inclusive and the Quality Assurance Audit confirms that the home is run in the best interests of service users. EVIDENCE: The management structure of the home is open and inclusive, and service users, spoken to, and staff confirmed that the management team were approachable with any difficulties. Service users are consulted over all decisions which affect them and can regularly put forward their views at the weekly service users’ meetings. There had been a recent Quality Audit undertaken by the ‘Friends of Fenners’ to measure future improvements in the home and to seek the views of service users on the service provided. Also all members of staff were seen over the course of these visits which took place on 13 January, 22 February and 4 April 2005 based on 10 Quality Standards including such areas as good practice, Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 21 record keeping systems and gaining knowledge of areas requiring improvement, as well as service users’ views. This was based on the BILD booklet ‘My Life’. Overall this appears to have been a positive exercise. On the issue of advocacy, there had been a gap in knowledge of staff identified and this would be carried forward to management. Staff had also felt they would appreciate training in other aspects of communication skills. There is a regular newsletter giving news of events, past and future, service users’ achievements and changes and/or news of staff. There now a procedure, which was seen, to diarise staff time for updating themselves on policies and procedures and in particular to the requirement from the last inspection regarding Fire Procedures within the home. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 22 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 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x 3 x 3 Standard No 11 12 13 14 15 16 17 4 3 x x 3 x 4 Standard No 31 32 33 34 35 36 Score x x 3 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fenners Farmhouse Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 23 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA23 Good Practice Recommendations It is recommended that a procedure be developed to evaluate the staffs understanding of Adult Abuse Protection issues. Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Road Norwich NR3 1YF 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 Fenners Farmhouse I55 s27455 Fenner Farmhouse v241674 UN 020805 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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