Inspection on 07/03/08 for Grovelands Farmhouse

This inspection was carried out on 7th March 2008.

CSCI found this care home to be providing an Good service.

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 4 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 25/07/06

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 Andrea Leverett Unannounced Inspection 7th March 2008 10:30 Grovelands Farmhouse DS0000013661.V359346.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.V359346.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.V359346.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) farmhouse@grovelandhouse.wanadoo.co.uk THF Care Estates Limited Mrs Diana Hayes Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Grovelands Farmhouse DS0000013661.V359346.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th July 2006 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. The scale of charges range from £1,200 to £1,700 per week. Grovelands Farmhouse DS0000013661.V359346.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that CSCI has received about the service since the last inspection. This unannounced Key inspection took place on the 7th of March 2008. 2 people who use the service were spoken with as well as 3 staff members and the manager. A tour of the premises was undertaken during the site visit and 3 people who use the services files and staff files were inspected. Judgements about quality of life and choices were taken from direct conversations with and observations of people who use the service, followed by discussion with support staff and evidencing records held at the home. The inspector concluded that people are given a good service at Grovelands Farmhouse. A good standard of support and access to health services is provided as well as a range of community-based activities. 1 requirement remains outstanding from the previous inspection regarding garden maintenance and 1 further requirement has been made regarding the homes heating and hot water maintenance. What the service does well: Risk assessments covered all key areas and gave good detailed information in order to support service users safely and in keeping with their needs. People who use the service benefit from a good standard of assessment and individual care planning, which is well thought out and aims to promote independence. Service users benefit from having the opportunity to take part in annual holidays that meet their needs. Grovelands Farmhouse DS0000013661.V359346.R01.S.doc Version 5.2 Page 6 The Home has its own transport, which helps service users access day services and the community. Service users continue to benefit from sensitive and appropriate support and have good access to health services including specialist health services as needed. Staff have a good understanding of the emotional and psychological needs of people who use the service and are encouraged to live their lives as it suits them. Freedoms and choice are only limited after careful thought, discussion, and agreement based on their best interests. The ethos’s of the service is to promote independence and support people to integrate into the community. It was clear that staff supported people in this by encouraging and facilitating them to access a range of activities and community resources. People are encouraged to maintain their own home and personalise their rooms to suit their tastes and interests. 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. The summary of this inspection report can be made available in other formats on request. Grovelands Farmhouse DS0000013661.V359346.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 Grovelands Farmhouse DS0000013661.V359346.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use this service receive good quality outcomes in this area. People who use this service can be confident that their needs and aspirations will be fully assessed before they move in to Grovelands Farmhouse and the Home will meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no new admissions into the home since the previous inspection by the CSCI. The policy in operation for people considering moving into the home 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 admissions 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 them. The service offers a degree of flexibility within its admissions policies depending upon the individual. If a person 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. Grovelands Farmhouse DS0000013661.V359346.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use this service receive good quality outcomes in this area. People who use this service can be confident that their assessed and changing needs and personal goals are reflected in their individual plan and that these enable people to exercise choice and control over their lives. People who live at Grovelands Farmhouse know that they will be supported to develop independent living skills and will be enabled to take risks as part of an independent life style. People who use this service know that they will be consulted and encouraged to take part in all aspects of life at the Home and that decisions are taken in their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Grovelands Farmhouse DS0000013661.V359346.R01.S.doc Version 5.2 Page 10 3 peoples assessments and care plans were inspected. Assessments are detailed and include risk, general care, relevant life history and health assessments. Care plans seen reflect peoples needs as detailed in their assessments and records showed that both these documents are regularly reviewed. Risk assessments are in place to promote independence whilst keeping people safe and discussions with people who use the service and observation during the site visit evidenced this approach. Regular meetings are held with people who use the service to plan menus and explore their needs and wishes in terms of the day-to-day running of the Home. Grovelands Farmhouse DS0000013661.V359346.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use the service experience good quality outcomes in this area. People who use the service take part in a range of activities including community activities and their rights are respected and responsibilities recognised in their daily lives. Time is taken to encourage and support people to maintain personal and family relationships. People are encouraged and supported to maintain a healthy diet and their needs and wishes are sort and respected in this regard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Grovelands Farmhouse DS0000013661.V359346.R01.S.doc Version 5.2 Page 12 Care plans; daily activity records and feedback from people on the day of the site visit showed that people who live at Grovelands have access to a broad range of activities that are in keeping with their therapeutic needs and wishes. People who live at the Home work at the adjoining farm as well as attending adult education classes. In addition they undertake a range of leisure activities including trampoline, swimming, shopping trips and annual holidays. Daily records showed that activities are consistently provided and regularly reviewed to ensure they are in keeping with people’s needs and wishes. Discussions with staff and observation on the day of the site visit showed that staff actively encourage and support people who use the service to be independent, to make their own choices and to live their lives as they wish. Household routines are kept to a minimum and feedback from people who use the service showed that they were happy with the range of activities provided and day to day living arrangements. The Home also has its own transport for the benefit of people who use the service. Records seen and discussions with people who use the service and the manager showed that relationships with families and friends are valued by the Home and communication was good. A range of nutritious food is provided which people help shop and cook for. Regular meetings are held to explore peoples wishes in terms of food provided and information from these meetings are used to plan menus. Records also showed that peoples special dietary needs are accommodated. Grovelands Farmhouse DS0000013661.V359346.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience good quality outcomes in this area. People receive a good standard of support to maintain their personal care in the way they prefer and require. People can be confident that their physical and emotional health needs will also be met. People are protected by the homes policies and procedures for dealing with medicines. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans and health records seen and observation on the day of the site visit showed that the Home met people’s health and personal care needs. Details of individual needs were recorded clearly in care plans and reviewed regularly. Staff were seen interacting and supporting people who use the service in a Grovelands Farmhouse DS0000013661.V359346.R01.S.doc Version 5.2 Page 14 respectful and sensitive manner and discussions with staff showed that care plans are followed. Health records and discussions with the manager showed that people have access to routine and specialist health services including Doctors, consultants, physiotherapists, speech therapists and chiropodists. A sample of medication and medication recording sheets were inspected, these showed that medication was being administered and stored appropriately. Medications are stored in a locked metal cabinet secured to the wall in the staff office. Subject to risk assessments, people are encouraged to manage their own medication with support from staff and discussions with staff evidenced that medication administration training is provided. Grovelands Farmhouse DS0000013661.V359346.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good quality outcomes in this area. People know that their concerns will be listened to and acted upon and they will be protected from abuse, neglect and self-harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information taken from the homes own annual assessment and discussions with the manager showed that no complaints have been made since the last inspection and copy’s of the complaints procedure was seen in each persons file. The home has a policy on abuse and a whistle blowing policy and staff had training in protection of vulnerable adults. Discussions with staff showed that they had a good understanding of adult protection issues and training was provided. Grovelands Farmhouse DS0000013661.V359346.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 and 30 People who use the service experience adequate quality outcomes in this area. People live in a clean environment, which is decorated and furnished to a good standard but more could be done to ensure the homes heating and hot water facilities and the homes grounds and gardens are maintained appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the site visit the home was clean, well presented and free from offensive odours. The standard of décor was generally good throughout the Home and 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. Although some improvements have been made to the homes garden, more work is needed in order to meet the requirement made at the last inspection. Grovelands Farmhouse DS0000013661.V359346.R01.S.doc Version 5.2 Page 17 Further improvements are needed regarding garden maintaince and clearance of all areas around the house. On the day of the site visit the homes hot water and heating had broken and discussions with staff and records seen showed that this has been problematic over the past month. It was also noted that the maintenance contract does not cover emergency call out, consequently issues with the homes heating have not been addressed in a timely manner. A requirement has been made that the Home reviews its maintenance arrangements for the homes heating and ensure these are appropriate. Although the inspector was informed that the organisation does have a supply of electric heaters, which could be used in emergencies, these were not being used in the Home on the day of the site visit and it was noticeably cold. Daily notes evidenced that one service user had complained that they were cold during the previous evening and one service user told staff that they were cold during the site visit. A further requirement has been made that the Home ensures that its procedures and practices for replacement emergency heating are reviewed and followed. Information taken from the homes own annual assessment and observation on the day of the site visit showed that in other areas equipment and facilities are being maintained appropriately. Grovelands Farmhouse DS0000013661.V359346.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 People who use the service experience good quality outcomes in this area. People who live at Grovelands farmhouse are supported by a sufficient number of staff that are competent and qualified and are supervised appropriately. People can be confident that they will be protected by the homes recruitment practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Observation on the day of the site visit, records seen and discussions with staff showed that the Home maintains good staffing levels at all times. The Home has at least 3 to 4 staff on duty at all times. Good staff ratios are clearly benefiting people who live at the Home. Staff support people to access community and adult education facilities consistently and support people in the Home in a sensitive, dignified and considered manner. Staff were observed Grovelands Farmhouse DS0000013661.V359346.R01.S.doc Version 5.2 Page 19 having the time to talk with people and explore their wishes regarding daily activities and day-to-day living tasks. Discussions with staff and training records seen showed that staff have undertaken a range of training, including Moving and Handling, First Aid, Fire safety, Infection Control, Safe Guarding Adults, and approved Challenging Behaviour training, including de escalation techniques. Records seen and observation on the day showed that staff had the skills and expertise to meet the specialist needs of people who live at the Home. No new staff have been employed in the Home since the last inspection and information taken from the last inspection report showed that staff recruitment files are up dated and contain all the relevant documents. All staff have had a criminal record bureau check and Protection of Vulnerable Adult check prior to starting work in the home. The inspector was informed that the service is working towards 100 NVQ trained staff. Staff supervision is being undertaken on a regular basis, and records are kept to evidence this. Grovelands Farmhouse DS0000013661.V359346.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use the service experience good quality outcomes in this area. A staff team that is led by a competent and experienced manager, who ensures that the home is run well, enhances the support of people who live at Grovelands Farm. People can be confident that their views underpin all self-monitoring, review and development by the Home and their health, safety and welfare are promoted and protected. This judgement has been made using available evidence including a visit to this service. Grovelands Farmhouse DS0000013661.V359346.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager has several years experience of supporting people with a learning disability and challenging behaviour, in addition she has completed The Registered Managers Award. The home has continued to have good practices for quality assurance and uses questionnaires to obtain feedback about the home. The manager informed the inspector that the Home will survey people who live there and the organisation take on the role of surveying relatives and other professionals involved in providing care and support. The Home continues to receive very positive feedback from all parties. Monthly-unannounced monitoring visits are undertaken to assess the standard of care and support provided and records are kept to evidence that this is being done. The home has a policy on health and safety and records seen showed that appropriate risk assessments are in place for people who live at the Home and the general environment. Staff have mandatory training in fire, food hygiene, moving and handling, and first aid. Grovelands Farmhouse DS0000013661.V359346.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 X 2 3 3 X 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 2 25 X 26 X 27 2 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 4 14 4 15 3 16 X 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.V359346.R01.S.doc Version 5.2 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 YA27 Regulation 23(2) (J)&(p) Requirement The registered person must ensure that the Home reviews its maintenance arrangements for the homes heating and ensure these are appropriate. Timescale for action 20/04/08 2. YA24 23.(2) (p) The registered person must ensure that the Home ensures that its procedures and practices for replacement emergency heating are reviewed and followed. 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. Original time scale 25/07/06 20/04/08 3. YA28 16(1), 23(1a, 2a & n) 20/04/08 Grovelands Farmhouse DS0000013661.V359346.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Grovelands Farmhouse DS0000013661.V359346.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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