Inspection on 23/06/06 for Gilead Foundations Charity

This inspection was carried out on 23rd June 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gilead Foundations Charity 25/03/09

Gilead Foundations Charity 19/03/08

Gilead Foundations Charity 11/04/07

Gilead Foundations Charity 11/10/05

Gilead Foundations Charity 05/04/05

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

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

CARE HOME ADULTS 18-65 Risdon Farm Risdon Farm Jacobstowe Okehampton Devon EX20 3AJ Lead Inspector Jane Gurnell Unannounced Inspection 23rd June 2006 10:00 Risdon Farm DS0000061096.V290029.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 Risdon Farm DS0000061096.V290029.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. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Risdon Farm Address Risdon Farm Jacobstowe Okehampton Devon EX20 3AJ 01837 851240 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) Gilead Foundation Charity Miss Beth Rosanna Samuel Care Home 10 Category(ies) of Past or present alcohol dependence (10), Past or registration, with number present drug dependence (10) of places Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. The first of the three new bungalows must be completed and available for occupation by Service Users by 31st October 2006 The Farmhouse modernisation and extension programme must be completed by the 30th April 2007 The mobile homes/caravans must be removed from the site once the 3 new bungalows are occupied. (as per planning application) Upon completion of the first bungalow, no more than 2 service users may be accommodated in the Farmhouse. No more than 10 service users undergoing a detoxification programme for substance abuse may be accommodated at any one time. Upon completion of the first new bungalow, service users must only be accommodated in this bungalow and the Farmhouse. 11th October 2005 Date of last inspection Brief Description of the Service: The Gilead Foundation is a Registered Charity which provides care services and supported living in an extended family community which follows the principles of Christianity. Risdon Farm is registered to provide care and accommodation for people who wish to recover from drug and alcohol dependency. The current registration allows for the admission of up to 10 service users, referred to as students, of both sexes between the ages of 18 and 65. The home is part of a working dairy and livestock farm which provides opportunities for work and an income to support the charity. The home is set in a rural area near the town of Okehampton in Mid Devon. Accommodation is offered to female students in the farmhouse and to male students in temporary static caravans which are to be replaced with three large bungalows with modern amenities and single rooms. Some of the bedrooms are shared. There are sufficent bathrooms and toilets in the caravans and the farmhouse. Communal areas are provided in the caravans, farmhouse and the community centre. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on 23rd June 2006. The inspector spoke to the one student present at the time as other students were on holiday with the Registered Provider and his wife. The assessment and care plan for this student were reviewed as well as medication records. Currently the accommodation is provided in static caravans and the farmhouse. Work is in progress to build three large bungalows that will provide homes for the students receiving 24hr care services and their support workers, however this work has been delayed due to funding issues: one bungalow is scheduled to be completed by winter. What the service does well: What has improved since the last inspection? Window restrictors have been placed on the windows above ground level in the Farmhouse. Data sheets relating the cleaning materials used at the farm have been obtained to ensure staff are aware of any risks or precautions necessary in their use. The Registered Manager has completed the Registered Manager’s Award and is nearing completion of the Practitioners Course in the Management and Support of Substance Abuse indicating that she has the knowledge and skills necessary to manage the centre. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 Page 6 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. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 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 the following standard(s): 1, 2, 3, 4, 5 The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The students are given information to allow them to make positive choices about whether or not Risdon Farm is suitable for them. Assessments ensure that students’ needs are known prior to admission. EVIDENCE: Assessments are undertaken prior to the students being admitted to ensure that the student’s need are known in advance and can be met: this was evident in the file examined. Specialist health care needs are identified prior to admission and specialist services are available from the local Mental Health Community Team as well as the local GP practice. The student present at the time of this inspection described how she had been provided with information and had visited prior to making a decision to come to Risdon Farm. She said that she was aware that the farm was a Christian community and this was of particular importance to her. Whilst admission to Risdon Farm is not limited to those of Christian faith, all students are expected to respect the lifestyles and needs of each other and that of the community as a whole. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 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 the following standard(s): 6, 7, 8, 9, 10 The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. There is a clear and consistent care planning system in place that provides staff with the information they need to meet the students’ needs and allows students to be confident that they remain in control of decisions over their lives. EVIDENCE: The student spoken to described the support she has received as “invaluable”. She said that she has been supported to maintain contact with her family and they have been able to visit her at the farm. Her file included her care plan as well as weekly reviews to monitor her progress and to allow her to set goals. The student said that she understood why her movements and freedoms were restricted at this was a vulnerable time for her. She had been invited to attend the holiday with the other female students but had decided to remain at the home. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 Page 10 The student confirmed that she is involved in the running of the home by working in the office. Students are expected to work on the farm, in the kitchen and in the office dependent upon their abilities, preferences and needs as this is seen as part of the therapeutic approach for recovery. Regular meetings take place and students were encouraged to voice their opinions. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 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 the following standard(s): 11, 12, 13, 14, 15, 16, 17 The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The routines of the home are structured to promote an organised working lifestyle as well as leisure and social activities for people who may have lost this ability through drug and alcohol dependency. EVIDENCE: The philosophy of the recovery programme is well documented and is based on assisting the students to develop their personal and life skills through education and work. The students, staff and volunteers of all ages participate in Christian worship and activities that encourage social interaction. At previous inspections, the students said that they valued the opportunity to explore their faith and to use their faith to develop coping skills for their future recovery, and at this inspection, the student spoken to said she valued the Christian philosophy of the community. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 Page 12 The care home is a rural community where people live and work together. As students recover from addiction they visit the local town initially with support and eventually unescorted. Previously students described the relationship with the support staff as very friendly and that their individual needs were respected and valued, and the student spoken to at this visit confirmed this. Leisure activities are organised by the support staff and include trips and outings and music evenings, which enable students to develop their social skills and regain their confidence in social situations. On the farm there is TV and video, music and musical instruments, snooker and darts, a trampoline and table tennis. Staff and students observe the Christian principles of love and friendship. Close personal and sexual relationships are not encouraged. Indeed, are actively discouraged and form part of the moral principles under which the organisation operates. These are clearly stated in the service users’ guide. The student spoken to said she appreciated this restriction upon relationships as she felt protected from unwanted attention at this vulnerable time. The meals provided are of good quality. Much of the food is produced on the farm and is organic i.e. milk and cream, meat, vegetables and eggs. Some other food is supplied free from local retailers. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 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 the following standard(s): 18, 19, 20 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Personal support is offered in such a way to promote and respect the students’ dignity and independence. The staff support the students through their emotional upheavals and promote a return to healthy living by providing a safe and drug free lifestyle. EVIDENCE: Case files showed records and healthcare assessments, letters and details of physical and mental health care and treatments indicating that a holistic approach to care and support is taken to ensure all care needs, physical, social and emotional, are met and students are supported to plan for their future. Professional counselling is available to all students from a counsellor employed by The Gilead Foundation, who also undertakes and reviews risk assessments relating to student health, welfare and safety issues. Former students, who have successfully recovered from substance abuse and made a decision to stay at Risdon Farm, support newly admitted students. The relationship is designed Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 Page 14 not only to offer support and advise but also to ensure those students who may be vulnerable from self-neglect or self-harm are closely supervised. Students are admitted to Risdon Farm with a prescription for a detoxification regime from their GP. The students are then registered with the local GP who has expertise in substance misuse and oversees each student’s recovery, offering advise if necessary. The student spoken to said that she had received an excellent service from the local GP in health related matters. Should students require support for mental health issues, a referral is made to the local Community Mental Health Nurses through the Mental Health Community Team. Because of the nature of their conditions, none of the students manage their own medication. Medication is stored centrally and those records examined were found to be incomplete: the name of the medication was not written in full on the continuation sheets nor was the dose recorded. Not all medication had been signed for and it was not possible to assess whether students had received their medication as prescribed. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 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 the following standard(s): 22, 23 The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The home is run on Christian principles that treat people kindly and fairly, with dignity and respect which is very important to people who have lost their self respect through their addictive behaviour. EVIDENCE: At previous inspections students said their views were listened to when they attend meetings and in the 1:1 sessions they have with their house parents and responsible persons who support them and with whom they live: this was confirmed by the student spoken to at this inspection. They knew how and to whom to make a complaint. There was a complaints procedure included in the Service User guide. Staff have received training in the Protection of Vulnerable Adults. Valuables belonging to the newly admitted student were recorded upon admission. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 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 the following standard(s): 24, 25, 26, 27, 28, 29, 30 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. The living accommodation in static caravans is not suitable or safe for longterm care. EVIDENCE: Students live in either static caravans or in the farmhouse pending the building of three large bungalows in the grounds. Although the accommodation doesn’t meet the standards, the caravans were warm, homely and comfortable. Each person in the caravans has a small single bedroom: some bedrooms are shared in the farmhouse. The student spoken to at this inspection is living in the farmhouse and described the accommodation as adequate. She said that the house is clean and each student is responsible for the housework. Checks are carried out each week to ensure the accommodation is clean. The laundry room, kitchen and food storage areas were found to be clean indicating that regular cleaning is taking place. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 Page 17 The Activities Centre houses a very large activities room and the large dining room. A TV room is provided in one of the buildings on the farm. There are additional toilets and a shower room in the Activities Centre. A number of washing machines are available for use by staff and students. Personal clothing, bed linen, towels and working clothes are all washed in the laundry room. A further washing machine is provided in the kitchen to enable kitchen linen to be washed separately to prevent the risk of cross infection. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, ,34, 35, 36 The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Staff morale was high resulting in an enthusiastic dedicated workforce that works positively with the students to improve their whole quality of life. EVIDENCE: Staff fully understood their roles and responsibilities. There were job descriptions for each job. Many of the staff and volunteers live in the extended family community on the farm and provide round the clock support to the students. The student spoken to at this inspection said that she knew who was in charge and who to go to with any queries. The managers and support workers have experience and skills to support the students throughout their rehabilitation. All staff undertaking training in NVQ levels 2/3/4. Other ongoing training includes first aid, food hygiene, counselling and issues relating to substance misuse and rehabilitation ensuring that staff have the knowledge and skills to deal with emergencies and also to provide the necessary specialist support to students. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 Page 19 Those staff records examined contained written references and proof of identity as well as a Criminal Record Bureau disclosure indicating that recruitment practices protected students. Staff are formally supervised individually and in groups by senior staff and these are now recorded. The Counsellor undertakes formal staff appraisals every 6 months and these were evident of those staff files examined. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The care home and farm are generally well run by a team of qualified and experienced managers and senior support workers. EVIDENCE: The Registered Manager works as part of the senior team in running the home and has completed the Registered Managers’ Award confirming that she has been assessed as having the necessary skills to run a registered service. The home is run on Christian principles which promotes family values and respect for each other. Evidence of this was seen and the students confirmed that they felt valued and respected and were treated with dignity and fairness at all times. The home is run for the students and their welfare and recovery is of prime importance to the staff. A formal Quality Assurance process has commenced to Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 Page 21 gather the views of the students, their relatives or representatives in relation to how well the home is meeting its aims and objectives. The results of this consultation were not available as the Registered Manager was not on duty at the time of the inspection. The homes’ policies and procedures reflect and guide the practice seen and were available to staff and the students as appropriate. Records viewed were well maintained and securely kept to ensure privacy and confidentiality. Health and safety in the home and on the farm is a priority. Everyone has completed health and safety training and awareness, basic first aid and fire awareness training. At the time of the inspection, a Trading Standards Officer was inspecting the farm indicating that the farm is inspected against the relevant legislation. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 3 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 2 25 2 26 2 27 3 28 3 29 3 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 3 LIFESTYLES Standard No Score 11 3 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 2 X 3 3 3 3 3 3 X Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 YA24 Regulation 16 & 23 Requirement Permanent accommodation must be provided for students in one of the completed bungalows. This timescale has been extended. Medicines must be recorded in full on the medication administration records and these must be competed accurately at the time of administration. Timescale for action 31/10/06 2. YA20 13 31/07/06 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 YA39 Good Practice Recommendations The results of the formal quality assurance consultation process should be sent to the Commission. Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Risdon Farm DS0000061096.V290029.R01.S.doc Version 5.2 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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