Inspection on 29/06/05 for Frognal Farmhouse

This inspection was carried out on 29th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Frognal Farmhouse 26/11/08

Frognal Farmhouse 19/12/06

Frognal Farmhouse 14/12/05

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 Frognall Farmhouse Lower Road Teynham Sittingbourne Kent ME9 9BY Lead Inspector Alex Turner Unannounced 29/06/05 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. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Frognall Farmhouse Address Lower Road, Teynham, Sittingbourne, Kent, ME9 9BY 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) 01795 521764 Care Management Group Limited Manager yet to be registered with the CSCI. Registered Care Home 16 Category(ies) of Care Home for Younger Adults (18-65) with a registration, with number Learning Disability, 16 of places Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 09/02/05 Brief Description of the Service: Frognal 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 are located about half a mile away. The home has its own minibus. Accommodation is split between the main dwelling (in which there are eleven beds) and three detached bungalows near by, one for a single person and the other two each accomodating two residents. Within the grounds there is a skills centre which provides a day service for residents choosing to attend. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place during the course of one morning and early to mid afternoon in June 2005. Eight residents, the cook, two members of care staff, the manager and the deputy manager all contributed to the inspection process. A sample of records was inspected. Time was taken to walk round and inspect the premises. The inspector had lunch with some of the residents and staff. What the service does well: What has improved since the last inspection? 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. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 6 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 Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 7 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) 1, 2 and 3 The Statement of Purpose and Service Users guide presents accurate information about the home and can be made available to prospective residents, their relatives and or carers. The needs and aspirations of residents living in the home are routinely assessed and kept under review. The needs of residents in the home were being addressed. Where residents needs have increased the home takes action to ensure that these are taken into account. EVIDENCE: As was the case at the last inspection the home has a statement of purpose and accompanying service users guide that set out in a suitable format the services offered by the home. It was confirmed that service users guides had been made available to existing residents. Though no service users have been admitted since the last inspection the home has in place procedures to ensure that prospective residents needs are determined and a decision reached as to whether the home can meet these needs prior to an offer of a place being made. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 8 Eight residents were spoken to during the course of the inspection. They spoke positively about their experience of living in the home and indicated that in their opinion their needs were being met. Three residents were specifically discussed with the manager in the context of the homes ability to meet their needs. The manager had identified certain areas where needs may be exceeding the homes ability to meet them without additional support and described action being taken to address the shortfall. Documentary evidence was produced to back up the manager’s assertion. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 9 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, and 7 Care and support provided by the home is informed by individualised care plans that are based upon assessed needs. Plan to address confrontational and aggressive behaviour would benefit from greater detail. Value is placed on residents being able to make decisions about their lives; the home has done well to ensure that this has been born out in practice. EVIDENCE: Care plans relating to three residents were inspected. Though detailed in many aspects the plans did not include individualised procedures that focussed on positive behaviour, ability and willingness for two service users identified as likely to be aggressive or cause harm or self-harm. This was not the case for a third resident however for whom there were clear guidelines to reduce the frequency and ways to manage the occurrence of aggressive behaviour. This matter was discussed with the manager who was able to produce evidence that action was being taken to have such guidelines developed in conjunction with the community learning disability team. Care plans had been kept under review and there was evidence that residents had the opportunity to be involved in the process. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 10 The residents spoken to indicated that they felt able to make choices on a day to day basis for example with regard to how they spent their time, what they had to eat, what clothes they wore, who they saw and how they spent their money. Records indicated that efforts had been made to enable residents to take part in care reviews and were consulted with in regards to care plans and risk assessments. The staff members spoken to described ways in which residents have been encouraged to make choices and indicated that the right of residents to do so was taken seriously and respected. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 11 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) 15, 16 & 17 Residents are supported to develop and maintain contacts with people outside the home. They are treated respectfully as individual adults with rights and responsibilities. Dietary provision was to a good standard and residents enjoyed their meals. EVIDENCE: Residents confirmed that they had been able to maintain contact with their family and friends if they wished to do so. Ways in which the home had supported contact to be maintained and developed included staff escorts on trips home, the provision of transport and by welcoming visitors. Residents confirmed that staff were fair and respected their rights as individuals. Examples of how this was demonstrated in practice included privacy being respected, being treated as adults, being afforded common courtesies and being consulted with when decisions are made that impact upon their lives. Routines around the home were such that while serving to ensure there was a degree of organisation and stability they remained flexible to take into account the changing and individual needs and preferences of residents. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 12 The inspector joined residents and staff for the lunchtime meal. It was a sociable, friendly and relaxed occasion. The food was good, an opinion shared by all. The cook quite clearly took an interest in residents welfare and engaged with them in a positive manner. Residents were unanimous in the opinion that the quality of dietary provision in the home was to a high standard. Residents provided numerous examples of how their individual tastes and preferences had been taken into account with regard to the meals that they were provided. It was confirmed that those that wished to do so had the opportunity to help plan, shop for, prepare and serve meals. The menus were sampled and it was evident that variety, choice and nutritional balance had all been factored in. The dining facilities were adequate. The kitchen facilities were scheduled for a refit during the summer months. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 13 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 and 19 Those residents requiring personal support received it in a manner that was in line with their needs and wishes. The physical and emotional needs of residents in the home had been addressed. EVIDENCE: Residents comments indicated staff delivering personal support did so in a manner that preserved dignity and took into account personal preferences. Staff described the principles that they subscribed to with regards to providing personal care and support and these were in line with current good practice guidelines. Individual care plans and daily notes correlated with the accounts of residents and staff in relation to this matter. The physical and emotional needs of residents were addressed in the individual care plans. Daily records and correspondence documented the actions taken to meet these. Individual reviews summarised the outcome of ongoing intervention. Residents had been supported to access general medical services in addition to specialised services for people with learning disabilities. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 14 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 Residents in the home are protected by the homes procedures and practice in relation to complaints and adult protection. EVIDENCE: Residents spoken to all confirmed that should they have any problems in connection with life in the home that by speaking to the staff and / or manager these could be resolved. Residents were aware of their right to complain. The home has a written complaints procedure that is accessible to residents and others. Complaints that have been made in the past have been dealt with seriously and in a timely manner. The homes adult protection procedures have been inspected during previous regulatory visits to the home and were judged to be satisfactory. Staff spoken to described using de-escalation techniques in the instance of confrontation and aggression and asserted that physical intervention at these times was rarely required. Records inspected indicated that practice reflected this view. Residents spoken to confirmed that they felt safe living in the home. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 15 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) 24,25,26,27,28 & 30. The premises are well maintained and homely. Bedrooms reflect the needs and lifestyles of residents. Toilet and bathing facilities were satisfactory. The homes communal areas both inside and outside of the home are in line with the needs of residents and the function of the home. The home was clean though improvements to be made to the laundry facilities remain outstanding. EVIDENCE: The premises and facilities were in keeping with the statement of purpose. Furniture and fittings were on the whole satisfactory. Certain items of furniture were due for imminent renewal / replacement and specific areas of the home were scheduled in for maintenance, improvements and repair in line with the cyclical / routine and occasional need to do so. Examples of such work included the planned refit of the main kitchen and enhancements to the kitchenettes in the stand-alone bungalows, the replacement of floor coverings in some of the bedrooms and the replacement of furniture in one of the lounges. The home provides ample private and communal space for residents. There is a garden and patio area, which is maintained and regularly used by residents. The toilet and bathroom facilities were adequate. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 16 Resident’s bedrooms had been personalised to varying degrees according to needs, preferences and individual taste. Residents sharing a bedroom commented that they had chosen to do so and had been given the option of single rooms. The provision of stand-alone bungalows providing residents with the opportunity to develop independence is a commendable aspect of service provision. Laundry facilities are situated in an outbuilding close to the main premises. Washing and drying machines were suited to the function of the home. A requirement made in the last report in connection with the wall and floor coverings in the laundry area was followed up. Though improvement work had yet to be completed the manager offered the assurance that plans had been made to complete the work required. The requirement is repeated in this report. Residents spoken to all commented that they were quite satisfied with the accommodation. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 17 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) 31 Staff roles and responsibilities are well defined. EVIDENCE: Residents were able to make a distinction between the manager, the care staff and the ancillary staff working in the home. Staff were clear about their own roles and responsibilities and that of their colleagues. Previous inspections to the home have established that all staff has written job descriptions reflecting the policies, procedures, and statement of purpose of the home. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 18 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) 42 The health and safety of residents has been protected by the procedures and practice of the home. EVIDENCE: Established procedures are in place and used in practice to ensure the home is a safe place for those living and working there. Regular managerial monitoring of the homes operation takes into account this aspect of service provision and aims to highlight any shortfalls and prompt action to rectify these. Frognall Farmhouse H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 19 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 3 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 4 3 3 x 2 Standard No 11 12 13 14 15 16 17 x x x x 3 3 3 Standard No 31 32 33 34 35 36 Score 3 x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Frognall Farmhouse Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H56-H05 S24073 Frognall Farmhouse V235087 290605 Stage 4.doc Version 1.40 Page 20 yes 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 30 Regulation 16(2)(j) Requirement The registered provider must after consultation with the environmental health authority make suitable arrangements in the laundry to ensure that the walls and floors can be easily cleaned. Timescale for action 01/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 6 Good Practice Recommendations The manager should ensure care plans establish individualised procedures for service users likely to be aggressive or cause harm or self-harm, focusing on positive behaviour, ability and willingness. 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