Inspection on 16/06/05 for Grovelands Farmhouse

This inspection was carried out on 16th 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 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

Grovelands Farmhouse 26/01/10

Grovelands Farmhouse 07/03/08

Grovelands Farmhouse 25/07/06

Grovelands Farmhouse 24/11/05

Grovelands Farmhouse 22/09/04

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

CARE HOME ADULTS 18-65 Grovelands Farmhouse Grovelands Tandridge Hill Lane Godstone, Surrey RH9 8DD Lead Inspector Kenneth Dunn Unannounced 16 June 2005 10:00 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. Grovelands Farmhouse Version 1.10 Page 3 SERVICE INFORMATION Name of service Grovelands Farmhouse Address Grovelands Tandridge Hill Lane Godstone Surrey RH9 8DD 01883 744128 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) THF Care Estates Ltd Mrs Diana Hayes Care Home 6 Category(ies) of LD - Learning Disability (6) registration, with number of places Grovelands Farmhouse Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accomodated will be : 18-50 years 3. Only one server user between the age of 18 and 20 years may be admitted, within the total of six service users. Date of last inspection 22 Sep 2004 Brief Description of the Service: Grovelands Farmhouse is a care home providing personal care and accommodation for six adults with learning disabilities between the ages of 18 and 65 years. The home provides for service users with complex needs, particularly those of a psychological nature. The home is owned by THF Care Estates Limited. The company operates other care homes, in Sussex and Surrey. The company also owns a working farm next door to the home. A range of daytime services for people with learning disabilities operate from the farm and service users living at the farmhouse attend for individually planned sessions.The farmhouse is in a remote country location, accessible via a singletrack road. There is no public transport route nearby so visitors to the home use their own private car or taxi service. The home is situated close to the junction of the M23 and M25 motorways. The towns of Oxted and Godstone are easily accessible by car, and the home has its own minibus. Grovelands Farmhouse Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5 hours and was the first inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. This inspection was carried out by Mr Kenneth Dunn Inspector for the service, Mrs Diana Hayes, Registered Manager, was present as the representative for the establishment. All of the service users have complex needs and they can become unsettled and uncomfortable with people they do not know. In order to minimise any distress, the inspectors did not feel it appropriate to carry out in depth interviews with the service users. Instead, observations of interactions and service user responses have been recorded in this report. A full tour of the premises took place, care plans and staff files were inspected. The inspectors would like to thank the manager, staff and service users for their time, assistance and hospitality during this inspection. What the service does well: What has improved since the last inspection? The training and development of staff continues to improve, with formal and informal supervision being undertaken by the manager on a regular basis. The home’s statement of purpose and service user guide have been revised and adapted after recommendations from a previous inspection report, to make them easier for residents to understand. Grovelands Farmhouse Version 1.10 Page 6 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. Grovelands Farmhouse Version 1.10 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 Grovelands Farmhouse Version 1.10 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 Information is available about the home, but due to the nature of their disabilities, service users cannot understand the document. All assessment are carried out by trained and qualified staff. There are clear policies and procedures for the admission of new service users but they are not always fully complied with. EVIDENCE: The home’s Statement of purpose and service user guide are written in clear plain English and are easy to read and understand. The manager stated that it is questionable as to how much of these documents if any, the service users could understand. Each Resident had a comprehensive assessment of needs carried out by the manager at the home. The manager explained that in some cases the opportunities of a long introduction to the service is not always possible due to the nature of the individual service users disabilities. It is recommended that when an admission does not follow the homes own policies and procedures. A full report must be made, to ensure that there is clarity, in what actually happened especially in the event of a break down in the ability of the home to care for the individual and their placement being terminated. Grovelands Farmhouse Version 1.10 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, 9 & 10 The service users’ individual plans are clear and comprehensive including details of needs and goals. They also incorporate known or indicated preferences with in depth risk assessments. EVIDENCE: Care plans inspected were comprehensive and clearly set out actions which need to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the service users are met. During this inspection the service users were seen to be making clear choices about their daily lives and to be supported by staff as necessary. Service users were seen to be choosing where they went and what they did in the home with confidence. Grovelands Farmhouse Version 1.10 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, 15 & 16 The service users have opportunities for personal development, to take part in appropriate activities within the home and in the local community. They are supported and enabled to maintain and develop appropriate personal and family relationships. Systems are in place to ensure that service users’ rights are respected. EVIDENCE: The care plans sampled detail each service users known and previous preferences for leisure activities. The staff are gradually introducing new activities and experiences, both inside and outside the home and are monitoring and documenting the individual service users reactions and indicated preferences. The home has their own mini-bus for outside activities. The inspector was informed that all service users are expected to assist in helping with domestic chores and they have each have one at home day a week to help the staff. Grovelands Farmhouse Version 1.10 Page 11 Other activities enjoyed by the service users included arts and crafts at the local college. On the day of the inspection two service users went with staff one to complete a project and the other to enjoy the social outing. Grovelands Farmhouse Version 1.10 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) 19, 20 & 21 Personal care and healthcare support and assistance is fully detailed in the service users individual files. Where assistance was needed, it was in a respectful and sensitive manner. Sound policies and practices are in place for the administration and management of medications. However aspects of Standard 21 did not meet the National Minimum Standards. EVIDENCE: The inspector was informed that the service users were mainly self caring and required the minimal of assistance and their role was mainly prompting and occasionally offering help. Detailed information and guidance was seen in the individual service users care plans. All medication is handled and administered by staff and they are maintained in a safe storage unit. The manager has based the policies and procedures for medication handling upon a previous CSCI pharmacy inspection. The homes policy for ageing, illness and death requires to be reviewed. Upon auditing the policy it was evident that, there was very detailed information concerning the death of a service users but little or no information covering ageing or potential illnesses. Grovelands Farmhouse Version 1.10 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 There have been no complaints since the last inspection. The home has a complaints procedure in place in line with Community Integrated Care policies and procedures. The home was able to demonstrate that residents were being appropriately protected and that their views were important and acted upon. EVIDENCE: Policies and procedures are in place to ensure that service users are safeguarded from harm or abuse. A log is kept of all complaints and compliments received into the home. There have been no complaints since the last inspection. Regular residents meetings are held so that views are listened to and acted upon. Grovelands Farmhouse Version 1.10 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 & 30 The environment is generally appropriate to the needs of the service users. it currently meets the collective and individual needs of the residents, providing an attractive and homely place to live. On the whole the home is well maintained, however there are areas that do not reflect this and they are detailed below. EVIDENCE: The location of the home is suitable for its stated purpose; it is accessible, safe and on the whole well maintained. The home meets the service users’ individual and collective needs in a comfortable and homely way. The home’s communal areas are spacious and are decorated and furnished to a good standard. However the carpets in the sitting rooms were heavily stained. The manager explained that the carpets were relatively new but what ever had been dropped and spilt on them would not lift even with industrial cleaning. It is recommended that an alternative floor covering be investigated which will offer a more long-term solution. Standards of cleanliness and hygiene were nevertheless good throughout the home. In one bedroom malodours were evident due to the service user Grovelands Farmhouse Version 1.10 Page 15 collecting and hiding damp towels and flannels. The staff were fully aware of this and they do check the room regularly however this has not prevented the room retaining a damp odour. Toilet and bathing facilities were of a good standard and afforded adequate privacy for the service users. It was discussed with the manager that the broken tiles in the ground floor bathroom must be replaced immediately to ensure service users safety. Service Users bedrooms were very spacious, individual and decorated and furnished to a very good standard and had been personalised by the service users. A gardener handyman has recently been employed by the organisation in an effort to get on top of the very over grown garden, which was full of weeds and thistles. It is recognised that the service users have the facilities of the working farm/Day care centre to enjoy the outdoor life but the garden would greatly enhance the home. Grovelands Farmhouse Version 1.10 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 34 & 36 All interactions observed between staff and service users evidenced a high degree of respect and skill in working with the individual service users at the home. Staffing is kept under review and provided to meet the needs of the service users at all times. EVIDENCE: There are arrangements in place for all staff to have regular access to training and a commitment from the organisation to provide staff with NVQ training. Three members of staff have NVQ Level 2 and one has a certificate in Health and Social Care, which the manager stated was equal to an NVQ level 3 in care. There are currently sufficient staff employed to meet the needs of the service user group, who are all of high dependency. Staff are able to work on a one to one basis with Service Users. Two written references are required for all staff and Criminal Records Bureau checks will be carried out on all staff. The manager is involved in all aspects of staff recruitment and equally importantly staff induction programmes. All staff receive a minimum of six formal supervision sessions a year but the manager regularly hold informal sessions with staff. It is important that the manager ensures that all supervision sessions even informal meeting be recorded to provide evidence that they have taken place. Grovelands Farmhouse Version 1.10 Page 17 Grovelands Farmhouse Version 1.10 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 40 & 42 Service users benefit from the management approach at the home, providing an open, positive and inclusive atmosphere. EVIDENCE: All interactions observed between the manager, staff and service users at this inspection evidenced an open, positive and inclusive atmosphere. Various systems are in place to ensure that the staff are able to obtain the service users’ views on all issues concerning their life at the home. The main method used is by skilful and careful monitoring and observation of the individual service user’s reactions and actions in all situations. All required written policies and procedures are in place at the home but it is a recommendation that the manger reviews there content on a regular bases. All necessary health and safety checks are carried out by the staff at the home, with documentary evidence inspected of routine fire practices and evacuations, fire, gas and electrical safety certificates. Grovelands Farmhouse Version 1.10 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. 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 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 2 2 x 3 Standard No 11 12 3 3 Standard No 31 32 33 34 Score 3 3 x 3 Page 20 Grovelands Farmhouse Version 1.10 13 14 15 16 17 3 x 3 3 x 35 36 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x 3 x Grovelands Farmhouse Version 1.10 Page 21 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 YA 27 Regulation 16 (1), 23(2)(j) Requirement The broken and missing tiles in the ground floor bathroom must be replaced. Timescale for action 16/07/05 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. 2 3 4 5 Refer to Standard YA2 & 4 YA21 YA28 YA28 YA30 Good Practice Recommendations The manager should record all aspects of the admission procedure, specifically where they deviate from the homes written policies. The manager should ensure that the homes policy for ageing, illness and death follow the National Minimum Standards. The manager should make alternative arrangements for the floor coverings used in the communal areas of the home. The manager should ensure that the garden area is maintained and kept at an appropriate level. An appropriate source of ventilation should be fitted to the service users bedroom identified during the inspection as having a strong damp odour. Grovelands Farmhouse Version 1.10 Page 22 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Grovelands Farmhouse Version 1.10 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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