Inspection on 25/07/06 for Grovelands Farmhouse

This inspection was carried out on 25th July 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Grovelands Farmhouse 26/01/10

Grovelands Farmhouse 07/03/08

Grovelands Farmhouse 24/11/05

Grovelands Farmhouse 16/06/05

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 Inspection 25th July 2006 10:00 Grovelands Farmhouse DS0000013661.V302175.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 Grovelands Farmhouse DS0000013661.V302175.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. Grovelands Farmhouse DS0000013661.V302175.R01.S.doc Version 5.2 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 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) THF Care Estates Limited Mrs Diana Hayes Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Grovelands Farmhouse DS0000013661.V302175.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The age/age range of the persons to be accommodated will be: 18-50 YEARS Only one service user between the age of 18 and 20 years may be admitted, within the total of six service users. 24th November 2005 Date of last inspection Brief Description of the Service: Groveland’s 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 single-track 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 DS0000013661.V302175.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection to be undertaken in the Commission for Social Care Inspection year April 2006 to March 2007. Mr Kenneth Dunn, Regulation inspector carried out this unannounced inspection, which took place over one day. The registered manager was present for the duration of the inspection process. The process of inspection included sampling service users care plans; discussions with staff and service users; the sampling of written records; audit of staff files, staff training records and policies and procedures were all sampled: and a tour of the service. Care staff spoken to on the day of inspection stated that they were happy with the running of the home and they said they felt supported in their role. 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. Grovelands Farmhouse DS0000013661.V302175.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Grovelands Farmhouse DS0000013661.V302175.R01.S.doc Version 5.2 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 the following standard(s): 1, 2 & 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes statement of purpose and service user guide provide the current service users and prospective service users with the details of the services the home provides enabling an informed choice to be made about admission to the home. The arrangements for assessing needs are strong ensuring service users need are assessed and identified prior to admission to the home. EVIDENCE: The service user Guide and statement of purpose are well designed and have been developed with the specific needs of the service users and it appears to fully meet their individual and joint needs. It is essential that the manager update both documents with the full details of the new registered provider. There has been no new service users admitted into the home since the previous inspection by the CSCI. The policy in operation for potential service users fully reflects the prescribes procedures established by the National Minimum Standards, which requires all of the individuals needs to be assessed by a trained member of staff to ensure that the home can meet their individual needs and aspirations. The service operates a very robust set of procedures governing potential service users they must be given the opportunity to test-drive the home; to ensure that they are suitable for the home and that the home is suitable for Grovelands Farmhouse DS0000013661.V302175.R01.S.doc Version 5.2 Page 8 them. The policy, procedures and guidance to the manager and staff are fully compliant. The inspector was informed that the service offers a degree of flexibility within its admissions policies depending upon the individual. If a potential service users could not cope with the test drive and it was deemed appropriate by the multidisciplinary placing team that the person would be better served by moving straight into the home then special arrangements can be made to accommodate this move. The staff stressed that this was not the preferred route but because of the challenging behaviour demonstrated by the service users it has been necessary to facilitate this method in the past. Grovelands Farmhouse DS0000013661.V302175.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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for care planning at the home are good ensuring service users assessed needs are reflected in their care plans. The systems for decision making at the home are very robust ensuring service users are supported to make decisions about their lives. Risk taking policies are good and risk assessments are carried out on all activities. EVIDENCE: The home has care plans drawn up with the involvement of service users together with their relatives, care staff and other professionals. The care plans are reassessed monthly, risk assessments 3 monthly, full review 6 monthly, this is flexible this can be brought forward if a change is detected. All service users have one full review of their needs annually. The home has a key worker system, which is regularly reviewed. The inspector noted a service user have had a specialist behavioural assessment to enable staff to support the service users consistently and safely. Grovelands Farmhouse DS0000013661.V302175.R01.S.doc Version 5.2 Page 10 The home involves service users in decision making, which is reflected in the care plans. The service users are encouraged to make their own decisions the inspector was informed that staff would only assist if they were asked directly or if the member of staff knows a service user is struggling they will offer to help. The inspector was informed that the staff were undertaking Person Centred Planning (PCP). The staff group are completing their PCP training by accessing external trainers. The members of staff on duty explained that PCP’s would give the reader a more accurate picture of the service user and be more able to offer appropriate assistance to the individual The home has a policy of risk taking and risk assessments are in place for all service users. The service users are actively encouraged to be as independent as possible risk assessments are completed by the individual key workers and agreed by the manager. Observations confirmed staff provided service users with information to enable the service users to make decisions that affect their daily lives. Grovelands Farmhouse DS0000013661.V302175.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): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home supports service users to take part in valued and fulfilling activities. The arrangements at the home enable service users to be part of the local community. The policies and routines at the home promote personal relationships with families and the rights of service users. Meals at the home are good offering both variety and choice EVIDENCE: Service users at the home have opportunities for education and occupation and some service users attend local colleges. The home has its own transport to enable service users to access community facilities shops, pubs, cinema and other places of interest. Staff stated that they actively encourage and support the service users to be independent, to make their own choices and to live their lives as they wish, as far as they are able. Grovelands Farmhouse DS0000013661.V302175.R01.S.doc Version 5.2 Page 12 Household routines are kept to a minimum and are only in place to enable service users to share their home’s facilities and to work together as a team. The service has maintains good records of the support offered to the service users to maintain family links and friendships outside of the home. Observations confirmed service users had unrestricted access in the home and staff supported service users in maintaining their independence. The home has a written 5 weekly rolling seasonal menu plan and a record of meals. The service users are involved with the cooking and preparation of the meals with staff support. Grovelands Farmhouse DS0000013661.V302175.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for personal support are good ensuring service users are supported in the way they prefer. The arrangements in place for meeting the health care needs of service users living at the home are appropriate. Medication management at the home is good and promotes the health of service users. EVIDENCE: The service users are supported by the staff in a way that promotes their privacy and dignity and the inspector noted a care staff knock on doors before entering service users bedrooms. Service users preferences about personal support are recorded on their individual care plans and observations confirmed staff supported service users to maintain their independence in choosing clothing, meals and activities. The home operates a health action planning and service users have access to a GP, dentist, optician and chiropodist to maintain good health. In addition the service users all attend either a Well Woman’s or a Well Mans clinic for annual screens and tests, these are based at their GP’s surgery. The home has a good policy on safe storage and handling of medications, which was undergoing a full review to ensure that it accurately reflects current good practises. The manager is enrolling 10 members of staff at NESCOT Grovelands Farmhouse DS0000013661.V302175.R01.S.doc Version 5.2 Page 14 (Further education Collage based in Epsom Surrey) for further training. The medication awareness training offered by NESCOT is based on long distance learning and is spread over 3 to 4 months. The medication recording sheets were sampled they had been dated and signed by staff and had a recent photograph of the service user. Medications are stored in a locked metal cabinet secured to the wall in the staff office. Grovelands Farmhouse DS0000013661.V302175.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All required policies, procedures and practices are in place to ensure that residents are safeguarded, as far as reasonably possible, from harm or abuse. EVIDENCE: The home has a robust complaints policy, which fully complies with the National Minimum Standards. The inspector was informed that there has been no complaints made since the last inspection, however this was not substantiated because the manager could not produce the complaints log. The manager must ensure that the complaints policy and log are always available for future reviews. The home has a policy on abuse and a whistle blowing policy dated August 2005 and staff had training in protection of vulnerable adults. A member of care staff stated that any allegations of abuse would be taken seriously recorded and be handled by the manager. The inspector noted the Crisis Prevention Intervention training is provided to all staff an annual update will take placing 16th of Aug 2006. This is to enable staff to deal with verbal and physical aggression and had introduced a de-briefing policy to support staff involved in serious incidents if the member of staff requires it. The home has a copy of the local authority (Surrey County Council) procedure on safeguarding vulnerable adults. Grovelands Farmhouse DS0000013661.V302175.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 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The location and layout of the home is suitable for it’s stated purpose. It is accessible, safe and well maintained. The home was found to meet residents’ individual and collective needs in a comfortable and homely way. EVIDENCE: On the day of the inspection the home was clean, well presented and free from mal odour. The standard of décor was generally good throughout the home. Bedrooms were nicely decorated, well presented and personalised. Furnishings and fittings were of good quality. Staff had training in infection control and observations confirmed staff practised infection control measures by washing their hands regularly and using disposable gloves. The manager should keep a record of repairs and maintenance to the home noting the dates the work was requested and the dates they are completed. It was disappointing once again to see the garden was very over grown and could not be considered user friendly and accessible. The inspector found stinging nettles and very invasive shrubs encroaching onto the fire escape and in general the garden is not safe place for the service users to access freely. The manager must ensure that the provider takes urgent action and introduces regular garden maintaince and clearance of all areas around the house with Grovelands Farmhouse DS0000013661.V302175.R01.S.doc Version 5.2 Page 17 immediate effect. Failure to comply with these may result in CSCI seeking legal advice, if these continue to remain unmet. Grovelands Farmhouse DS0000013661.V302175.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): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All interactions observed between staff and residents evidenced a high degree of respect and skill in working with the individual residents at the home. Staffing is kept under review and provided to meet the needs of the residents at all times. EVIDENCE: It was evident for direct observation that the staff have a good understanding of the service users needs, are respectful and have a good rapport with them. Staff recruitment files are up dated and contain all the relevant documents as detailed in Schedule 2 of The Care Homes Regulations 2001. All staff has had a criminal record bureau (CRB) check and Protection of Vulnerable Adult (POVA) check prior to starting work in the home. The registered manager to ensure all staff has a copy of the General Social Council & Care, code of conduct document. The inspector was informed that the service is working towards 100 NVQ trained staff. A number of courses have been undertaken by staff and they are up to date with all other mandatory training. The home had a training plan for staff for the financial year 2006/2007 and a dedicated budget for staff training, which controlled by the provider. Staff had training in a number of areas, which included autism, preventing and responding to challenging Grovelands Farmhouse DS0000013661.V302175.R01.S.doc Version 5.2 Page 19 behaviour and sign language to equip them with the skills necessary for working with this service user group. Staff supervision was seen to be undertaken on a regular basis, and staff are provided with a copy. The manager stated that staff are always offered additional supervision if they feel that it will benefit them. Grovelands Farmhouse DS0000013661.V302175.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, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management approach in the home provides an open, positive and inclusive atmosphere. The home has a quality assurance and monitoring system in place that is based on seeking the views of the residents. EVIDENCE: The manager has several years experience of supporting people with a learning disability and challenging behaviour, in addition she has just completed The Registered Managers Award (RMA) the inspector reviewed the award certificate. The home had a good policy for quality assurance and used questionnaires to obtain feedback about the home. The inspector reviewed the results and they indicated a very positive outcome from all those how took part in the survey. The inspector noted a Regulation 26 (record of monthly monitoring visits) are undertaken and stored appropriately. The home has a policy on health and safety dated August 2005 and the manager stated that all staff have had full training in health and safety issues. Grovelands Farmhouse DS0000013661.V302175.R01.S.doc Version 5.2 Page 21 Staff have mandatory training in fire, food hygiene, moving and handling, and first aid. Grovelands Farmhouse DS0000013661.V302175.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 2 2 3 3 3 4 X 5 X 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 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Grovelands Farmhouse DS0000013661.V302175.R01.S.doc Version 5.2 Page 23 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 YA1 Regulation 4, 5 & 6 Schedules 1, 4.1 & .2 Requirement It is essential that the manager update both the statement of purpose and the service users guide with the full details of the new registered provider. The manager must ensure that the complaints policy and log are always available for future reviews. The manager must ensure that the provider takes urgent action and introduces regular garden maintaince and clearance of all areas around the house with immediate effect. Timescale for action 30/10/06 2 YA22 22 (1, 3 & 4) Schedule 4.11 30/09/06 3 YA28 16(1), 23(1a, 2a & n) 25/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Grovelands Farmhouse DS0000013661.V302175.R01.S.doc Version 5.2 Page 24 No. 1 2 Refer to Standard YA24 YA31 Good Practice Recommendations The manager should keep a record of repairs and maintenance to the home noting the dates the work was requested and the dates they are completed. The registered manager to ensure all staff has a copy of the General Social Council & Care, code of conduct document. 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