Inspection on 26/11/08 for Frognal Farmhouse

This inspection was carried out on 26th November 2008.

CSCI found this care home to be providing an Excellent service.

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 19/12/06

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 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Frognal Farmhouse Lower Road Teynham Sittingbourne Kent ME9 9BY     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joseph Harris     Date: 2 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Frognal Farmhouse Lower Road Teynham Sittingbourne Kent ME9 9BY 01795521764 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): frognall@care-management-group.co.uk Care Management Group Ltd (trading as CMG Homes Ltd) Name of registered manager (if applicable) Susan Janet Lewis Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 16 The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning disability - LD Date of last inspection Brief description of the care home 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 Care Homes for Adults (18-65 years) Page 4 of 28 care home 16 Over 65 0 16 Brief description of the care home is a skills centre which provides a day service for residents choosing to attend. The fees range from £575.45 to £932.91 per week. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection process culminated in a site visit to the service on the 26th November 2008. The site visit commenced at 10:00 hours and lasted approximately 6 hours. During the course of the visit a tour of the premises was undertaken and discussions were held with the manager, staff, service users and the area manager for the company. A range of documentation was examined relating to residents, staff, medication, health and safety and the day to day running of the service. The home returned their Annual Quality Assurance Assessment when they were asked to which was also used to inform the inspection process. Care Homes for Adults (18-65 years) Page 6 of 28 Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Adults (18-65 years) Page 8 of 28 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users are supported to make an informed choice about the home and their needs are assessed. Evidence: The home has developed a statement of purpose and service users guide. These have been recently reviewed and updated and contain all required information. The service user guide has been developed in an easy-read format and provides a good description of service and facilities for service users and their relatives. Two new service users have been admitted to the home in the past 12 months. The home has a good assessment process in place that is tailored to suit the preferences and needs of each individual. Referrals are received both privately and through care management to a central referrals team for the company. The suitability of each prospective service user is matched with one of the homes in the organisation and key information relayed to the manager. The manager and one of the assessment team then visits the prospective resident in their current accommodation completing the homes own assessment form. The assessment form covers all key areas of need and Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: risk and is used as the basis of the initial care plan. One such assessment form was examined for one of the more recently admitted service users and had been completed in good detail. A series of trial visits and overnight stays are then arranged to ensure that the service user is comfortable in the home and that the service can meet individual needs. The manager was keen to emphasise that these visits are particularly important as they can identify how people interact with each other and enable residents to establish relationships. Care Homes for Adults (18-65 years) Page 12 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users individual needs and choices are clearly supported alongside a strong risk management process. Evidence: Two individual service user files were examined both of which had well developed plans of care. There are two main files for each service user, one containing care plans and risk assessments and the other consisting of Person Centred Plans (PCPs). The two files are closely linked to each other and provide clear information about levels of needs, aspects of support and individual preferences. Service users are involved in the development of all this information and key workers take lead responsibility for developing the PCPs with residents and updating and reviewing these documents. All information is reviewed monthly or as required and a review meeting is held with the service users, relatives and care managers every six months. There is a strong risk management process. All files examined had well developed risk assessments covering a wide range of topics that promote positive risk taking and Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: focus on the independence and choice of the service users. The risk assessments are also reviewed alongside care plans and PCPs. The organisation does not take on an financial appointee role for any of the service users and this responsibility is taken on by people independent of the service. the home provides safekeeping for small amounts of personal money. Records are maintained of all incoming and outgoing transactions. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have an active and positive lifestyle promoting independence and choice. Evidence: People who use the service have the benefit of a wide and varied range of recreational and occupational activities. The home is able to cater for the differing needs and wishes of all the service users. There is an integrated day service within the grounds of the home that offers occupational activities such as arts and crafts and pottery. Some of the residents impressive work was on display throughout the home. A number of residents do voluntary work at the local Age Concern and other local businesses. Some service users also attend Age Concern. The home offers other recreational activities with staff support such as Hydrotherapy, swimming and line dancing classes. One resident is currently having guitar lessons and others play the piano and guitar. Some service users enjoy karaoke and musical entertainment. Residents are offered annual Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: holidays to Cyprus or Centre Parcs. Additionally regular day trips are organised to local attractions. Residents are supported to take part in the running of the home completing cleaning and housework duties or assisting with cooking and shopping. All service users are expected to keep their rooms clean and tidy and are offered support with this as required. The home promotes the independence of people who use the service. There are two small bungalows where people can live a more independent lifestyle. Staff promote independent living skills in a planned way assisting residents to become more confident in areas such as cooking, budgeting, using public transport and other aspects of daily life. Visitors are welcomed into the home at all reasonable times and staff liaise with relatives of service users appropriately. The home ensures that the cultural and religious wishes of people who use the service are met. This is done in consultation with service users and their relatives. A number of residents attend the local Church of England services and other places of worship are accessed as required. The home has been established in the village of Teynham for over 40 years and is considered an integral part of the community with many of the local residents having worked in the home at some time. It was reported that service users are accepted with in the village and some people regularly go to the local shops independently. The home has two cooks that cover the cooking duties 7 days per week. The lunchtime service was observed and was a relaxed and sociable time. Meals are well presented and the cooks prepare changing menus each week dependent on resident choices. A healthy and balanced diet is provided and the home aims to use fresh, locally sourced produce where possible. Special and religious diets are catered for and, when required, health professional input is sought to assess nutritional needs, such as diabetic diets. All service users spoken to were very positive about the lifestyle choices in the home and residents were seen to be active and enjoying their time. Comments such as, Its good here, i like it, we do lots of things, i like the parties, I like the staff, we have a laugh and The food is nice were made by a number of different people. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of service users are met. Evidence: Service users preferences and needs with regard to personal care are clearly detail in care plans and Person Centred Plans. Staff were observed to work well with residents encouraging independence and supporting people as they required. Healthcare records are well maintained. Each service user has a health action plan detailing all healthcare needs. Records of appointments and consultations with healthcare professionals are kept with the outcome of any visits detailed. The plans demonstrate that health needs are monitored and referred appropriately. The manager stated that the home receives good support from the local Community Learning Disability Team and other health professionals. Complimentary healthcare is accessed such as Chiropodists, dentists and opticians. Medication records were examined. All documentation was well maintained and up to date. Medication Administration sheets were complete and records of received, returned and destroyed medication kept. Storage facilities are appropriate for the home, secure and well managed. The home has up to date information on the Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: medications in use. Staff receive medication training prior to administration responsibilities and the manager underpins this through the use of competency assessments. Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users views are listened to and acted upon and they are protected from abuse. Evidence: The home has complaints process in place meeting relevant requirements, this policy is summarised in the service user guide and displayed in the home. Service users are encouraged to air their views in a range of ways through keyworker 1:1 meetings, resident meetings and an annual company service users forum. The manager and staff are approachable and residents, throughout the inspection, appeared comfortable talking to staff and coming into the managers office. There have been no recorded complaints since the last inspection. Staff receive instruction in adult protection, abuse awareness and mental capacity issues. In discussion all staff spoken to demonstrated a good awareness of these and related issues and were seen to treat people who use the service with dignity and respect. There are clear policies and procedures in place relating to adult protection issues and abuse awareness. There have been no adult protection alerts raised in connection with the home since the last inspection. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is suitable for the individual and collective needs of the service users. Evidence: Frognal Farmhouse is located on the outskirts of the village of Teynham near Sittingbourne. The home is close to the train station and local bus routes and a short walk from the village shops. There is ample parking to the side of the building and an enclosed garden surrounding the house. The gardens are well-tended and there is a large patio area for use throughout the year. In the grounds there is an integrated day centre that is used by the residents on a daily basis. The home itself is split into three main parts. There are two semi-independent bungalows in the grounds with two bedrooms, a lounge, bathroom and kitchenette each. The main house is an older building with character and has an attached bedsit for a more independent resident. The house is warm, comfortable and homely. There is one double room in the main house shared by two people who have done so for many years and wish this arrangement to continue. The remaining rooms are single occupancy. All the bedrooms viewed showed evidence of being personalised and were suitable for the needs of the individuals. A ground floor room has been created for a service user who has had mobility issues to enable him to continue living in the home. There is a good range of communal space with comfortable lounges, a dining room and Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: a quiet room. The kitchen is linked to the dining room by a serving hatch and has all the necessary equipment which is in good working order. There is a separate laundry that is also sufficiently well equipped. There are toilets, bathrooms and showers located throughout the building. All hazardous substances are securely stored and procedures are in place to minimise the control of infection. It was reported that the home meets the requirements of the Environmental health and Fire departments. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a competent and well trained staff team. The home follows good recruitment practices. Evidence: The majority of the staff team have completed or are completing their National Vocational Qualification (NVQ) Level 2 in care or above. There is an expectation on all staff to achieve this award. Staff spoken to demonstrated a good knowledge of their roles and the needs of the people that use the service. Staff showed a caring, respectful and friendly attitude with service users. Some residents have communication difficulties and there were some excellent examples of staff interacting clearly and effectively in these circumstances. There is a minimum of three care staff on duty throughout the day supported by a cook, administrator and the manager. There is an on-call service out of office hours and 1 waking and 1 sleep-in staff at night. All staff spoken to felt that the staffing levels are suitable for the home. The manager stated that the staff numbers are flexible dependent on the needs of the service and can be increased whenever required. The staff training matrix was examined and demonstrated that staff are offered a good programme of training through the organisations own training department and Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: external trainers when required. All staff work through an induction programme based on the Common Induction Standards, competency assessments and BVS training videos are also used. The home and company monitor staff training needs and mandatory training is provided within reasonable timescales. Additional training covering service specific topics such as the Mental Capacity Act, Learning Disability issues and healthcare needs are also provided. Two staff personnel files were examined, one for an employee who has recently started working in the home. In both cases all required documentation was on file including evidence of CRB and POVA checks, a completed application form, two written references and proof of identity. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and in the best interests of the service users. The health, safety and welfare of people who use the service is maintained. Evidence: The manager has worked in the home for 9 years and has been manager for the past three. She is due to complete her NVQ level 4/Registered Managers Award by January 2009. Throughout the site visit the manager showed a very good understanding of all aspects of the home and has clearly developed good relationships with staff, service users and relatives. There are well established quality assurance processes in place. A senior manager within the organisation visits monthly to complete a monitoring visit. The organisation has a Quality Monitoring team responsible for conducting visits and developing processes. Annual surveys are sent out to service users, families, health professionals and staff and these results are collated into an annual report. There is a service users forum providing residents from homes around the country to meet up and discuss company issues contributing to the development of the service. The home has regular Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: resident meetings and the manager stated that service users are considered to be at the forefront of the decision-making processes. Documents relating to Health and Safety issues were examined. These included environmental risk assessments, accident records, fire safety records and safety checks and certificates. All information seen was up to date and complete. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!