Inspection on 05/04/05 for Gilead Foundations Charity

This inspection was carried out on 5th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Gilead Foundations Charity 25/03/09

Gilead Foundations Charity 19/03/08

Gilead Foundations Charity 11/04/07

Gilead Foundations Charity 23/06/06

Gilead Foundations Charity 11/10/05

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 Jacobstowe Okehampton Devon EX20 3AJ Lead Inspector Jane Gurnell Sheila Giblin Announced 5 and 6 April 2005 th th 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. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Risdon Farm Address Jacobstowe, Okehampton, Devon EX20 3AJ 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) 01837 851240 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 D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. Emergency lighting must be installed where indicated by the Fire Authority by 02.01.05 2. Door closures must be installed where indicated by the Fire Authority by 02.01.05 3. The three new bungalows must be completed and available for occupation by 05.09.05 4. The Farmhouse modernisation and extension programme must be completed by 05.09.05 5. The mobile homes/caravans must be removed from the site once the bungalows are occupied (As per planning application) 6. South Little Down Bungalow must not be used for Service Users once the Bungalows have been commissioned 7. Miss Samuel must complete the NVQ4 Registered Managers Award by 1st December 2005 Date of last inspection n/a 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. The home is a newly registered service and this was their first statutory inspection under the Care Standards Act. 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 clients 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 in temporary static caravans which are about to be replced with three large bungalows with modern amenities and single rooms. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection conducted on this newly registered home. The inspection took place over 2 days and was conducted by two inspectors. The General Manager, the Registered Manager and other members of the management team were all present or available throughout the inspection. The inspectors met all the clients – known as students - looked at all the records required to be kept in a home, toured the farm and looked at the accommodation and living areas. The inspectors met staff at all levels including support workers, clerical and office staff, volunteers, general assistants and visitors. Currently the accommodation is provided in static caravans and the farmhouse. However, work is in progress to build three large bungalows that will provide homes for the students receiving 24hr care services and their support workers. What the service does well: The staff and managers at Risdon Farm support the students round the clock in a sensitive and respectful way while they withdraw from drug and alcohol dependency. The approach to recovery promotes healthy eating. Most of the food provided is home grown and organic. Risdon Farm provides a secure and positive lifestyle that values students and staff at all levels, and encourages a Christian approach to life. The managers and staff are dedicated to their work of supporting the students to overcome their problems and to get involved with work tasks on the farm, participating in personal development classes and education in daily living skills. The students spoke highly of the care they received when they were admitted to the home. Some said they felt they’d come to a sanctuary. Students appreciated being given the chance to live and work on the farm and elsewhere in the home. The atmosphere at the home was warm and welcoming. All the staff and managers were helpful and showed a sincere willingness to learn and improve their care services. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 6 At the end of the two days spent at Risdon Farm the inspectors felt positive and reassured that this home was providing a much needed and valued service to people who wished to change their lives for the better. 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 The students are given information to allow them to make positive choices about whether or not this home is suitable for them. EVIDENCE: The students described the admission process as warm and welcoming and there is a Service User guide that gives all the information to ensure prospective service users can make an informed choice Personal files showed an assessment of need and what they wanted to do with their lives once they were free from addiction Each student said they had chosen this home because of its Christian Values and the fact that it was a farm offering work opportunities and a life in the country. They also said they had chosen not to visit before being admitted for personal reasons. They knew they could visit if they’d wanted to. Each student had signed a contract and terms and conditions which were seen on their files. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 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) 6,7,8,9,10 There is a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet the students’ needs. EVIDENCE: Each student had read and signed their care plan. Students said they understood why their movements and freedoms were restricted and had agreed to these before entering the programme for rehabilitation. They said they understood why they were supervised when they first came into the home. Students said that they were involved in the running of the home by working on the farm and doing other jobs in the kitchen. They attended meetings and were encouraged to voice their opinions. Students said that they felt confident to share their experiences with senior staff who would respect their privacy as appropriate. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17, Staff support students in a professional and friendly way within the moral codes of the Christian faith as seen during the inspection. The routines of the home are structured to promote an organised working lifestyle 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. 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. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 11 A leisure coordinator organises trips and outings for leisure. On the farm there is TV and video, music and musical instruments, snooker and darts, a trampoline and table tennis. Students said they were happy to live and work around the farm. 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 students felt that although their freedom and liberty were curtailed this was in their own best interest while they were on the path to recovering from drug and alcohol addiction. There is a 10.30pm curfew whereby students must be in their own accommodation. Everyone said how much they enjoyed the meals provided and praised the quality of the food served. Much of the food is produced on the farm and is organic ie milk and cream, meat, vegetables and eggs. Some other food is supplied free from local retailers. During the two days of the inspection, wholesome home cooked food was served in the dining room to staff, students and visitors. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 12 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) 18,19,20,21 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: Students described how well they were looked after when they were admitted to the home. Case files showed records and healthcare assessments, letters and details of physical and mental health care and treatments. Because of the nature of their conditions, none of the students manage their own medication. No-one has died at the home. There were policies and procedures informing what action to be taken in the event of the death of a student. Staff understood the policies. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 13 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 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 all their self respect through their addictive behaviour. EVIDENCE: The students felt that their views are 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. They knew how and to whom to make a complaint. There was a complaints procedure included in the Service User guide. There were policies and procedures for the protection of the students and others living in the community. There was a whistle blowing policy for staff, and the allerter’s guide that informs staff about the recognition of different forms of abuse. Staff have not received any formal training in the Protection of Vulnerable Adults. Students’ money may be held in a separate account and valuables placed for safe keeping with a senior manager. Receipts have not been given for personal documents held on file. Some financial transactions with students have not been recorded. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 14 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) 24,25,26,27,28,29,30 The living accommodation in static caravans is not suitable or safe for long term care. EVIDENCE: People 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 has a small single bedroom. Cleanliness in the caravans was generally poor: carpets, sinks and wc’s. Fire protection was inadequate in three of the caravans in that the smoke detectors were either not working, missing or wrongly sited to be of use. There are shower/baths/toilets in all the caravans. There are two bath/shower rooms in the farmhouse. There is a living room in each of the caravans. There is a large lounge in the farmhouse. 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 toilets and a shower room in the Centre. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 15 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. The kitchen linen is washed separately in its own designated machine. However, the freshly laundered tea towels etc were in a linen basket sitting on the flooded laundry floor. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 16 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, 32, 33, 34, 35, 36 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. Students 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. The homes’ recruitment process has been taken over by a consultancy. Some staff records were incomplete in that there was insufficient employment and personal information, references were not seen on many files and there was no proof of identity on some files. Students spoke highly of the care and attention that staff gave them when they were admitted. They said they felt confidant in the staff team. There is no structured induction training programme for new staff and volunteers that meets the specifications of the Sector Skills Council. All staff are undertaking NVQ training at levels 2/3/4. Other ongoing training includes first aid, food hygiene, counselling. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 17 Staff are supervised individually and in groups by senior staff. These sessions have not been recorded there is no evidence to show whether staff have received planned supervision at least six times a year. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 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) 37, 38, 39,40,41, 42, 43 The care home and farm are generally well run by a team of qualified and experienced managers and senior support workers. Safety is of importance on the farm but may have been overlooked in parts of the living accommodation. EVIDENCE: The registered Manager works as part of the senior team in running the home.. She is nearing the end of the Registered Managers’ Award. The home is run on Christian principles which promotes family values and respect for each other. Evidence of this was seen over the two days of the inspection 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 but there was no formal Quality Assurance system in place that gathers the views of the students, their relatives or representatives in relation to how well the home is meeting its aims and objectives. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 19 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 and a fire drill. However, fire alarm call points in the farmhouse have not been tested weekly as recommended by Devon Fire and Rescue services. Gas and electrical equipment and appliances have been tested with certificates held on file. Some systems have not been risk assessed and tested ie hot water and legionella. First floor window openings in the farmhouse have not been restricted. The laundry room was flooded on the first day of the inspection. Control of infection, cleanliness and hygiene has not been a priority in the living accommodation. The homes accounts and business systems were very well managed in the accounts department. Audited accounts, the business plan, and financial records were readily available and produced for the inspection Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 1 2 3 3 N/A 2 Standard No 11 12 13 14 15 16 17 3 4 3 3 3 3 4 Standard No 31 32 33 34 35 36 Score 3 3 3 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Risdon Farm Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 1 3 3 2 3 D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 21 n/a 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. 2. 3. 4. Standard 1 20 23 24,25,26 Regulation 4,5,6 13 10 16,23 Requirement The statement of purpose must be updated as discussed and agreed Medication must be securely stored All staff must undertake Protection of Vulnerable Adult training Permanent accommodation must be provided for students in one of the completed bungalows; single bedrooms must be 10sq mts; furniture and fittings must be provided as listed; All parts of the home must be kept clean and hygienic with systems in place to control the spread of infection. A dedicated washing machine must be installed in the kitchen area for the sole use of kitchen cloths and towels. All the records required to be kept in a home as listed regarding persons employed must be held in staffs files as discussed and agreed. An induction training programme must be implemented for staff and volunteers. Specific training that addresses drug and alcohol Timescale for action 1st June 2005 1st May 2005 1st September 2005 1st October 2005 5. 30 13,16,23, 1st June 2005 6. 34 17,19 Schedules 2 and 4 18 1st June 2005 7. 35 1st July 2005 Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 22 8. 36 18 9. 39 24 10. 42 13,23 dependency must be provided for all staff and volunteers. A formal system must be introduced for the regular supervision of staff with plans and records kept on staff files. A formal Quality Assurance system must be implemented that will gather the views of students, relatives, representatives and professionals as to whether the home is meeting its objectives Fire safety systems must be tested and recorded as per the guidelines issued by the Fire Authority. COSHH hazard data sheets must be obtained and made available to people working on the farm and elsewhere.Regulation of water temperatures and design solutions to control the risk of Legionella must be implemented;Window openings on the 1st floor of the farmhouse must be restricted; all staff must receive training in Safe Working Practices and as part of an induction training programme. 1st July 2005 1st August 2005 1st August 2005 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 23 Good Practice Recommendations Any students valuables handed in for safekeeping must be recorded and a receipt given. Risdon Farm D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton, Devon 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 D54-D07 S61096 Risdon Farm V211178 050405 Stage 4.doc Version 1.20 Page 24 - 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!