Inspection on 19/07/06 for Hall Farm Cottage

This inspection was carried out on 19th 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 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

Hall Farm Cottage 05/01/06

Hall Farm Cottage 14/07/05

Hall Farm Cottage 02/12/04

Hall Farm Cottage 24/06/04

Hall Farm Cottage 27/11/03

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Hall Farm Cottage Church Road Bacton Norwich Norfolk NR12 0JP Lead Inspector Mrs Judith Huggins Unannounced Inspection 19th July 2006 03:00 Hall Farm Cottage DS0000027619.V305362.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 Hall Farm Cottage DS0000027619.V305362.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. Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hall Farm Cottage Address Church Road Bacton Norwich Norfolk NR12 0JP 01692 650707 01692 650330 janithhomes.com@internet.com 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) Janith Homes Limited Mr Alfred Finlay Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 People, of either sex, who have a learning disability may be accommodated 5th January 2006 Date of last inspection Brief Description of the Service: Hall Farm Cottages is a care home providing personal care and accommodation to 3 adults with a learning disability. A company operates the service and users attend day services at the companies main home The Rookery. Hall Farm Cottages stands on the outskirts of the Norfolk seaside village of Bacton The home has its own transport. The home is located in a country cottage and all users have their own bedroom. The home has enclosed rear gardens, with a patio, lawns, flowerbeds and a vegetable garden. Fees are from £2720 to £5492 per month according to need, with extra charges for transport and personal spending. The manager says that residents are made aware that the Reports regarding Hall Farm Cottage can be looked at any time. Other parties are made aware that the reports can be viewed when they visit and they are also made aware of the CSCI website facility should anyone request the report in a different format. He says this would be followed up by the organisation and made clear in the Quality Assurance Questionnaire and information. Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit to the home was unannounced, and the inspector first visited the manager’s base at the Rookery to look at some records to do with safety and staffing, as well as to talk about the service. The inspector spoke to the manager, the staff member on duty and both residents present in the home, as well as checking records and seeing parts of the home. There were three written comment cards from residents, and one from a visitor to the home. Comments are included in this report where needed. What the service does well: What has improved since the last inspection? The information that the home can provide to people who might like to move in if a vacancy arises is being looked at, as is the way that people’s care needs are set out when they first come and visit. The two staff covering most of the shifts are making good progress towards completing their National Vocational Qualifications (NVQ). Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hall Farm Cottage DS0000027619.V305362.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 Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The outcomes in this area would be excellent given completion of the proposed developments. Prospective residents would have the information they need to make a choice about moving into the home, would have their needs assessed and would have the opportunity to “test drive” the home. EVIDENCE: The manager says that work has started to develop a website for Janith Homes, which will include information about Hall Farm Cottage. Some information is already available on a CD rom (seen). This includes the statement of purpose, service users guide and the sort of contract that might be put in place. There are also printed copies. The manager says that, where rules on smoking had previously been included, additional information will be put into documentation about the use of alcohol or illicit drugs. The manager says that there are plans to make videos of a “day” in each home, so that prospective residents would have a better idea about what was on offer and what the home might be like. This will need the permission and participation of existing residents but would represent an additional and welcome method of providing information to prospective residents in a way that is easier to understand. Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 9 A new assessment form has been devised, collecting a good range of relevant information. If fully and thoroughly completed it would provide useful information from which to devise a care plan. There is a “short term” care plan form which the manager says has been devised to provide a more structured approach to care when prospective residents have completed a programme of tea visits and then progressed to stays of two or three days. A questionnaire (currently in print but the introduction from the manager says this can be made available in other formats or staff will ask the questions “in sign”) has been devised to check what prospective residents think of their early experiences of the home. (See quality assurance standard). Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 10 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is some room for improvement in underpinning records so that these do justice to practice and better reflect current personal goals. EVIDENCE: Records for residents are contained in two files for each person. One contains some general information, risk assessments, previous daily records, incident reports, financial records etc. One is described as the care plan. This contains a range of assessment information. Two out of three of the assessments of strengths and needs were updated in February. Relatives of one person say that they are always involved in reviews and consulted about care. Another contained information completed over two years ago, with a risk assessment showing the intended review date last year, but with no update since 2004. However, staff employed at the home know residents well and discuss with them what they would like to do or achieve. A recommendation has been made in this report, and before completion of the draft the manager said that the person’s care plan has been updated. Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 11 There are limited staff employed to work at the home, and the two staff covering the bulk of the hours have had many years to get to know the residents who live there. There is some guidance about keeping goals simple, and scope for residents to sign their records where they are able. Discussion with a resident shows that from time to time the person stays in the house without a staff member – an opportunity the person clearly enjoys. Discussion with the staff member on duty shows that this has been informally assessed as acceptable. The decision has not yet been documented – with clear guidance about duration, circumstances, the person’s ability to respond to an emergency, deal with a caller and so on. The inspector did note that where there had been concerns arising from a recorded incident, prompt action had been taken to complete a risk assessment. Staff meeting minutes show that staff have also recently considered the safety of cleaning materials and residents having access (bleach in this case). The manager says that storage and access is not considered to be a risk, but again, this has yet to be documented and made relevant to each individual. Careful consideration needs to be given about access to such products where there are issues of possible self-harm. A recommendation has been made. One person told the inspector they were planning to move into a place of their own. They said that the manager had done some work to help with managing money and shopping, and that the person had also done some cooking. However, the care plan does not fully reflect this goal and the steps needed to achieve it. Residents say that they are able to exercise choice in a range of areas, for example, clothes, colour of their rooms and décor, activities and food. Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 12 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, and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have opportunities to participate in a range of social, educational and recreational activities, participate in daily routines, and have a good diet. EVIDENCE: Both residents present say that they are happy at the home. One confirms attendance at college in the past (certificates seen). Other activities they told the inspector about were hammering and sawing, keep fit, work in the art barn, music sessions and holidays. Some of the things produced during daytime activities are displayed in residents’ rooms. All three of the residents completed comment cards and say that they have lots of things to do. One of the two people spoken to has a key for the front door of the home, but does not want a key for their bedroom door. The inspector was told that people always knock if they want to come in and the person concerned did not want a key. Residents make free use of their own rooms, based on discussion Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 13 with one person, who likes to use it to play music, enjoying the opportunity on occasions to have the house to himself. Rules on smoking are included in information for residents and the manager says this is being updated to include information about drugs and alcohol. Residents with family are able to keep in contact with them and make or receive visits based on records, discussion with the staff member and manager, and feedback from a relative in written comments. The issue of sexuality is addressed within care plans and risk assessments as appropriate. During the visit to the home, the staff member encouraged a resident to join in meal and drink preparation. The staff member says that residents discuss and plan menus together and these can be subject to change at short notice, according to preference. Residents were given the choice of whether they wanted to eat their meal inside or in the garden. Throughout the fieldwork visit the staff member talked to both residents and engaged them in conversation. Residents’ weights are monitored where this is necessary and one was aware of the importance of healthy eating from discussion. Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 14 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal and health care needs are met as they would wish, and their medication is managed appropriately. EVIDENCE: Residents spoken to say that they like the staff and all three comment cards received show that people feel well cared for. One received from a visitor to the home says that the person they visit is always very well cared for. There are forms for recording appointments with health care professionals and the outcomes of these. They show that residents access dentists, doctors, chiropody treatment, and opticians on a regular basis, and other professionals as needed. One person discussed the importance of healthy eating with the inspector, and was clearly aware of other aspects of a healthy lifestyle, such as not smoking. There is limited medication in use but this is stored appropriately. The cupboard was locked and the key secured. A member of staff at the main home orders medication on a regular basis. Transport between Hall Farm Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 15 Cottage and daytime activities at the Rookery is by a secure locked case. Compliance aides are only used when people go out for the day, according to the staff member on duty. The staff member on duty says that she has received training via distance learning and assessment (from Isle College). The way the medication was administered did not present any concerns, with the staff member explaining what they were doing, and encouraging the resident to get a glass of water to help swallow the medication. The training matrix confirms medication training for two of the three staff employed. A recommendation has been made. There is no documentation supporting that all of the residents need to have all of their medication managed and administered by staff. It was suggested to the staff member on duty that possibly one person could manage one of the medicines needed. She agreed this might be possible and the manager says this is being acted upon. A recommendation has been made. Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 16 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents or their representatives could be sure their concerns would be taken seriously, and they are protected from abuse. EVIDENCE: One relative responding knows what the complaints procedure is. Two residents completing comment cards know who to speak to and identify staff as being where they would go if they have concerns. One person spoken to confirms this. (One person did not understand the question but is supported by an independent advocate says the manager.) The manager says that the company recognise the importance of trying to make sure all residents know that they have the right to complain and how to do it. For this reason they are planning to include some sessions about complaints in the adult education programme offered at their day care provision. This is good practice. Training records show that all three staff have had training in Vulnerable Adults at Risk. There is whistleblowing guidance. The residents present were clearly very comfortable and relaxed in the company of the staff member on duty with no signs of anxiety or unease. Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 17 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, homely, safe and clean environment. EVIDENCE: The first of the key standards has been inspected on three consecutive occasions and deemed met. Nothing on this visit indicated any regression. The home was generally well maintained and very homely. Residents clearly enjoy their home and are proud of their rooms. There were no concerns about overall cleanliness. Hall Farm Cottage DS0000027619.V305362.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, 24 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel they are supported by staff who know how to help them, and who have been appropriately recruited. Some improvements in training could be made. EVIDENCE: The training matrix for the two staff working the bulk of the hours shows a good range of issues covered. One person has been at the home for just over a year and a half but works very few hours each week – at weekends. This presents some difficulties in arranging training. This person has covered basic training in fire safety, manual handling and basic first aid, as well as “vulnerable adults at risk”. However, other relevant training such as health and safety, medication, Makaton signing, care skills and challenging behaviour for example, have not yet been completed. One person is not shown as having received food safety training and one may have missed it. However, residents say they feel well cared for and records show that all staff have a good understanding of issues affecting their work. A recommendation has been made. Two staff are currently undertaking NVQ level 3 training and the person on duty felt she has clearly benefited from this. The organisation has achieved an award for “investors in people”. The induction process was discussed with the Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 19 manager and is currently under review but the organisation is clearly aware of the importance of this. None of the staff has recently been recruited, although discussion with the manager indicates an awareness of requirements for checks, and staff have had enhanced CRB checks. A consultancy company is currently reviewing some of the staffing policies to ensure changes in age discrimination rules are incorporated. Hall Farm Cottage DS0000027619.V305362.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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager runs the service appropriately, and with due regard to improving the quality of the service. The safety and welfare of residents and staff is promoted and upheld. EVIDENCE: The manager was considered at previous inspections, to be capable of fulfilling the required duties and running the home appropriately. The approach is proportionate with the size and nature of the service. Unannounced visits are being made on behalf of the registered provider. There is evidence from discussion, observation and records that suggestions made by residents and staff (for example for new garden furniture) are acted upon. There are only three people living at the home, so residents’ meetings are conducted informally. The manager sees staff on duty each day to pick up Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 21 any issue and problems. Detailed questionnaires (blanks seen) are used to survey people for their views although the manager says that response from other professionals have not been good. As mentioned in the first section of the report, the quality of short stay visits before people move into the homes in the group is assessed. The manager says that a consultancy has been employed to assist with developing systems and policies that will help with the monitoring of service quality. The premises is maintained in a good state of repair, and there is evidence in records that safety issues are assessed and addressed. This includes issues to do with the safety of cleaning products and maintenance of electrical systems. The electrical system was last tested as safe in November 2004. The manager says that the fire detection system has been “hard wired” and records show regular testing of the system with a fire drill on 9th June. Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 x 4 3 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 3 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 Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 YA6 YA7 YA9 YA20 YA20 YA35 Good Practice Recommendations The registered persons should make sure that all aspects of care are reviewed with each resident and the outcomes of these reviews written down. The registered persons should ensure that discussions regarding potential risks and the decisions arrived at are reflected within a risk assessment framework. The registered persons should ensure the remaining staff member without medication training, receives this to underpin practice. The registered persons should ensure residents are supported to manage as much of their medication as possible, within a risk management framework. The registered persons should ensure all staff cover training which contributes to the safety both themselves and residents. (food safety, health and safety etc.) Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Hall Farm Cottage DS0000027619.V305362.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!