Inspection on 19/12/06 for Frognal Farmhouse

This inspection was carried out on 19th December 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

Frognal Farmhouse 26/11/08

Frognal Farmhouse 14/12/05

Frognal Farmhouse 29/06/05

Frognal Farmhouse 09/02/05

Frognal Farmhouse 26/01/05

Frognal Farmhouse 13/02/03

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

CARE HOME ADULTS 18-65 Frognal Farmhouse Lower Road Teynham Sittingbourne Kent ME9 9BY Lead Inspector Graham Cummings Key Unannounced Inspection 19th December 2006 09:30 Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 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 Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Frognal Farmhouse Address Lower Road Teynham Sittingbourne Kent ME9 9BY 01795 521764 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) www.caremanagementgroup.com Care Management Group Ltd (trading as CMG Home’s Ltd) Susan Janet Lewis Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th December 2005 Brief Description of the Service: Frognall Farmhouse is a care home providing personal care and accommodation for 16 people with learning disabilities. The home is located on the outskirts of Teynham in a rural setting. It is within walking distance of the village where there are shops and other amenities. Public transport, both rail and bus is located about half a mile away. The home has its own minibus. Accommodation is split between the main house (in which there are eleven beds) and three detached bungalows near by, one for a single person and the other two each accommodating two residents. Within the grounds there is a skills centre which provides a day service for residents choosing to attend. The fees range from £620 to £980 per week. The overall quality of the service provided is good. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspector carried out the site visit on the 20th December 2006 to complete the Key Inspection. The site visit consisted of talking to the Manager, Staff and Service Users. Documentation was seen that included two care plans and two staff files, the Inspector also toured of the home. The home was clean and tidy and there was a relaxed and friendly atmosphere. The home’s Statement and Purpose and Service User Guide are being reviewed and updated. Service Users have the opportunity to visit the home and they have their needs assessed by the company and home manager. The Inspector saw contracts on Service User files. The Inspector looked at two care plans, these were comprehensive and informative, the documents were signed by individual Service Users concerned and had been evaluated at regular monthly intervals. Individual Service Users have access to Canterbury and Sittingbourne colleges and also use the local community including the cinema, theatre, Gateway club and shopping. The home also travel to another home owned by the company where they have the use of a gymnasium and sensory room. The menu includes takeaway, restaurants, and pub meals. The Service Users’ healthcare needs are met within the local community, none of the Service Users self medicate. An Aroma-therapist was visiting the home for the first time on the day of the inspection. There have been no complaints received by the Commission or the home. The company have their own training department based in Wimbledon that run courses on a regular basis, external training is encouraged when appropriate. The environment is in good condition, the work on the laundry room has been completed, changes to the layout of the home has allowed work to commence on increasing the size of a smaller bedroom, the lounge area has been redecorated, this was completed during the night hours to cause minimal disruption to Service Users. The Inspector saw several bedrooms with Service users permission and was informed by one that they were very happy in their new room and that the home was nice and friendly with good staff, the bedrooms were well decorated and The Inspector looked at two staff files and found that they contained all of the relevant information required, however one of the application forms was Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 6 lacking in details of education and work history. Supervisions records were in place and signed by both supervisor and supervisee. All transactions relating to Service Users finances required 2 signatures to protect Service users from financial abuse. The Manager is completing their Registered Manager’s Award and works Monday to Fridays with the Service Users from 7am to 9am. A quality assurance survey has just been completed with the Service Users, next of kin and care managers, the results are being collated at the companies head office. The Manager has an open door policy for Service Users and staff, during the inspection Service Users came to the office to discuss the buying of Xmas presents or travel arrangements to get home for Xmas. What the service does well: What has improved since the last inspection? What they could do better: Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 7 It is hoped that some Service Users may be able to gain some part time employment in the local community. 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. The summary of this inspection report can be made available in other formats on request. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5 Quality in this outcome area is good. Prospective Service Users have their needs assessed and have information available to make an informed choices about living at the home. Service Users can be confident that they their own have written contracts on file. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector saw evidence on the Service Users individual files that pre placement assessments had been carried out and that the funding authorities assessment of need had also been made available to the home. Prospective Service Users transition to the home was based on what was deemed best by the individual and significant others. The home offered day and overnight visits prior to any placement becoming permanent. The home’s Statement of Purpose and Service User Guide were in the process of being evaluated and updated. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 10 The Inspector looked at two Service Users files and both contained contracts with terms and conditions that were signed by the Service User. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good. Service Users are involved in making their individual plans that meet their changing needs. Service Users are supported to take risks as part of independent living and participate in the decision making process wherever possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual care plans are written with the input from the Service User, care manager, staff and key-worker and family members. The Inspector saw two care plans and both contained detailed information relating to the needs of the individual. This included the individual likes and dislikes, care needs and routines, risk assessments for internal and external activities including fire risk. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 12 The key-worker evaluated and wrote monthly reports that were signed and dated by the key-worker and Service Users; these reports were then used to provide a six monthly review report. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Quality in this outcome area is good. Service Users have opportunities and choice to participate in appropriate activities for their own personal development. Service Users benefit from being able to use use the local community and from their family and friends being encouraged to visit home at any reasonable time. Service Users benefit from being able to participate in the running of the home. Service Users benefit from having access to a healthy and nutritious diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 14 The home does not have a rolling menu rota but the cook has monthly meetings with Service Users to plan the menu for a month at a time. The menus seen were varied and choices were available each day. Service Users’ families are encouraged to visit at any time. Some visits are at the individual’s family home and these are usually supported by staff. The home provides transport wherever possible but if the home visits are frequent and some distance away extra funding can be requested from the funding authority. Some Service Users attend courses at Canterbury and Sittingbourne colleges for art and craft and cookery. Service Users have a healthy and nutritious diet that includes going to restaurants, pubs, cafes and takeaway meals. The company has a skills centre on site that is used for Service Users from other company homes in Kent and Service Users from Frognal can access this if they choose to. The Manager is hoping to find some paid part time employment within the local community for some of the more able Service Users, the home has made good contacts and use of the local facilities in the village and surrounding area. Service Users’ activities since the last inspection have included attending the theatre, cinema, swimming, sports centre, meals out, shopping, go karting, golf, bowling, gardening and bike rides. The company own another home in Essex and weekly trips are organised to visit and use their facilities of a gymnasium and sensory room. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21 Quality in this outcome area is good. Service Users’ support is provided in ways that they prefer. Service Users can be confident that their health needs will be met. Service Users can be confident that their wishes regarding illness and death are recorded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Service User care plans seen by the Inspector set out how the individuals would prefer their support to be delivered by the staff team, such as having a cup of tea before washing and dressing in the morning or after they are dressed. All of the Service Users are registered with a local GP, Dentist and Optician, a chiropodist visits approximately every two months. Wherever possible Service Users attend the Doctor’s surgery for any treatment. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 16 None of the Service Users currently living at the home self medicate, however there are policies and procedures in place should this ever be the case. Service Users wishes regarding illness and death were recorded and seen by the Inspector in the individuals file Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. Service Users can feel confident that their views are listened to by staff. Service Users are protected from harm because staff have received relevant training with regard to the protection of vulnerable adults. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Neither the Commission nor the home have received any complaints since the last inspection. Staff receive training that is mainly supplied internally by the company who own the home. The home is able to purchase external training if required. Health and Safety training was carried out in July 2006 and Protection of Vulnerable adult training was carried out in August 2006. Service Users financial transactions are checked, recorded and signed by two staff. Service Users’ views are listened to through 1-1 discussions with key-workers along with regular Service User meetings. The cook goes to all Service Users individually on a monthly basis to get their choices for the menu. The Manager has an open door policy for Service Users to speak to them, this happened at least 3 times on the day of the site visit. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,28,30 Quality in this outcome area is good. Service Users’ bedrooms meet their needs and they live in a comfortable, homely, clean, safe and hygienic environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was clean and tidy with Xmas decorations having been put up. Following the office moving to the lower ground floor the old office has been converted to a lounge area, this was redecorated during the night so that minimal disruption to Service Users was caused. The work required in the laundry mentioned in the last report has been completed and the undersized bedroom has now become the staff sleep in room. New carpets have been purchased for the lounge and some bedrooms, a quote has been requested for a further five bedroom carpets. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 19 The Inspector saw several bedrooms with Service Users permission and was informed by one that they were ‘very happy in their new room and that the home was nice and friendly with good staff’. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 Quality in this outcome area is good. Service Users benefit from having an effective, well trained, qualified and supervised staff team supporting them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff files seen all had job descriptions on them with staff also having been given a copy, staff spoken too were aware of their roles and responsibilities within the home. The Inspector saw the training matrix, although not fully up to date, due to the responsible person being off sick. It was clear that appropriate training is provided for staff to enable them to provide a good quality of care. The home has currently got six staff using West Kent College distance learning course in Medication. The Manager has almost completed their Registered Managers Award and 44 of staff have an NVQ level 2 or more, further staff are enrolled to start in the New Year. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 21 The home’s recruitment policy follows good practice guidelines and no new staff are able to provide personal care or to be left alone with a Service user until their CRB has been received. The Manager informed the Inspector that the CRB’s were usually being received within 4 weeks of being applied for. The home is looking to recruit more permanent staff in the New Year to reduce agency and overtime. Staff meetings are being held approximately every 4/6 weeks and minutes of these were seen, they were signed and dated. Individual staff supervisions are carried out at least 2 monthly. The Manager supervises the Deputy, the Deputy supervises the 4 Seniors and the 4 seniors supervise the care staff. The Manager gets good support from the Company Area Manager. The Inspector saw written evidence of supervisions that had been signed and dated by both the supervisor and supervisee. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41,42, Quality in this outcome area is good. Service Users benefit from living in a well run home into which they have a daily input into the running of it. The care of Service Users is enhanced because the home has a competent manager and the home’s record keeping systems are good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well run and has a good management structure with a deputy and four seniors. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 23 Service Users’ views are listened to through 1-1 discussions with key-workers along with regular Service User meetings. The cook goes to all Service Users individually on a monthly basis to get their choices for the menu. The home’s record keeping was good and the individual daily notes seen were comprehensive and informative giving food received, approximate amounts eaten and activities participated in. The Manager works with the Service Users every weekday morning from 7am to 9am and has an open door policy for Service Users to speak to them at all times when they are on site, this happened at least 3 times on the day of the site visit. All transactions relating to Service User finances has two signatures. All monies are kept in individual sealed ‘purses’ that are locked in a cash tin that is stored in a locked cabinet. The home has an appointed health and safety officer who carries out weekly checks around the home and records the outcomes. A Quality Assurance exercise has recently been conducted with Service Users, Next of Kin and Care Managers. The responses are returned to the company head office in Wimbledon, who collate them and then send the home the results. The home then takes any action required to resolve issues or improve the service provided. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X 3 3 X Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 25 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 Home’s Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 YA32 Good Practice Recommendations That the application forms are fully completed to include a full work history for the last 10 years or since leaving education and that all items listed in Schedule 2 are in place. Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Frognal Farmhouse DS0000024073.V323038.R01.S.doc Version 5.2 Page 27 - 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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