Inspection on 11/05/05 for Harkstead Barn Residential Home

This inspection was carried out on 11th May 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

Harkstead Barn Residential Home 19/04/07

Harkstead Barn Residential Home 28/04/06

Harkstead Barn Residential Home 22/11/05

Harkstead Barn Residential Home 15/03/05

Harkstead Barn Residential Home 28/10/04

Harkstead Barn Residential Home 09/03/04

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 Harkstead Barn Residential Home Brick Kiln Lane Harkstead, Ipswich Suffolk IP9 1DF Lead Inspector Joe Staines Announced 11 May 2005 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. Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Harkstead Barn Residential Home Address Brick Kiln Lane, Harkstead, Ipswich, IP9 1DF 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) 01473 327380 01473 327380 United Response Leonard Edward Pritchard Care Home 5 Category(ies) of Learning Disability (5) registration, with number of places Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15/3/05 Brief Description of the Service: Harkstead Barn offers accommodation and care for up to five adults with learning disabilities and challenging behaviour. The home was converted from farm buildings into residential accommodation in 1992 and is situated in a very rural position outside the village of Harkstead and seven miles from the capital town of Ipswich. Whilst the building is rather isolated in its location, it enables service users to have maximum space and freedom and offers spacious accommodation to a relatively small service user group. The property is owned by Orwell Housing Association but the business is run by United Response (Registered charity number 265429) who have many years experience in providing care for people with learning disabilities. The service user group had undergone little change since the home was opened and accommodates five young men at present. An additional resource, an activities centre, was completed in late 2003, and now provides activities for service users as part of planned day programmes of activities, or as/when required. Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was undertaken by Joe Staines, Regulation Inspector, between 10:30 am and 3:30 pm. The Inspection was facilitated by Mr Len Pritchard who has been Manager of the home since June 2002 and was registered with the National Care Standards Commission in October 2003. During the course of the inspection, the Inspector examined required records, staffing rotas, personnel files, and records maintained in relation to fire safety. On the day of the inspection all service users were receiving a day service, some accessing external resources and others engaged in activities such as shopping. The Inspector had the opportunity to talk to two service users during the course of the inspection. It was difficult to gain feedback from others due to communication difficulties but one service user was able to report positively on the service. The Inspector also carried out an environmental tour of the home. Below is a summary of findings identified during this Unannounced Inspection. More detailed information is available under each standard within the main body of this report. What the service does well: What has improved since the last inspection? Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 Page 6 The home has piloted a new filing system that is designed to make service users’ files more user friendly, both for staff and service users. Minor adjustments to the way files are stored had enhanced the safety of these important documents. 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. Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 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 Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 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 & 5 Prospective service users are provided with information about the service, in a format designed to be understandable to people of varying levels of comprehension. The needs of service users are assessed prior to admission, and on an ongoing basis throughout residency. Prospective service users and their representatives can be assured that the home is equipped to meet their needs, and this is supported by clear statements of residency providing terms and conditions. EVIDENCE: The home has an up to date statement of purpose and service user guide, providing detailed information regarding the services provided at the home, complaints information and a copy of the service users charter. A recent development is a new service agreement, with space for service users to sign, confirming their involvement in the process. Full assessments were in place for the service users at the home. New pre admission forms had been designed for future admissions. The examination of files and care plans confirmed that specialist services had been sought and used for service users whose needs required this, including speech and language therapists and community health teams. The training records confirmed that staff training is geared towards providing carers with Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 Page 9 the skills and tools to work with service users, whose needs fall within the home’s category of registration. Each service user had a service agreement. These documents were pleasantly personalised with photos and included a contract. Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 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 standard(s) 6, 7, 8, 9 & 10 Service users are involved in the creation of a detailed set of plans and assessments, designed to maximise the independence of service users and enable them to take reasonable risks and be involved in decision making about their lives and the running of the home. Some improvement is needed in relation to the keeping of up to date records of review of these plans. Information about service users is handled sensitively and securely. EVIDENCE: Each service user had a comprehensive individual plan containing detailed information, presented in a user friendly and personalised format. The plans had several sections, based on the activities of daily living. The manager reported that all service users needs and progress were monitored via reviews, which were held at no more than six monthly intervals, with copies of the minutes and decisions held on each service user’s file. However these records could not be identified in respect of two service users. The individual plans of service users included financial records. These could be enhanced by including details of the reasons for, and manner of support identified as necessary in relation to service users money management. Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 Page 11 Records confirmed that service users attended a variety of clubs and groups, where peer support was available. Feedback from staff and one service user, plus the examination of individual plans confirmed that the day to day activities in the home were undertaken with the involvement of service users, with specific tasks identified in plans, according to ability. There were records confirming that one service user had been actively involved in the recruitment of members of staff, not only to the home, but also in relation to senior appointments within the organisation responsible for the home, United Response. The home had a dedicated risk assessment folder, containing guidance and checklists on individual service users’ activities, group activities and the building and grounds. Many of the risk assessments were geared towards supporting service users in pursuing their own interests, and referred to the benefit of the activity as “enabling independence”. Risk assessments included timescales for review, all of which were met, and details of how the decision had been communicated to the service user concerned. The home had responded to a previous recommendation and moved the files to the far side of the office, to prevent any accidental damage being caused by service users who were interacting with staff in the doorway of the office. The files contained accurate information, within a safe environment. Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 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 standard(s) 11, 12, 13, 14, 15, 16 & 17 Service users are provided with support from the home to undertake a wide range of activities, both for recreational and personal development purposes. Engagement with the local community is facilitated, friendships are encouraged and routines within the home promote the rights and responsibilities of individuals. Personal preferences are sought, and met wherever possible, including in relation to activities, personal care and diet. EVIDENCE: Each of the care plans examined contained information about the communication needs of the individual, enabling them to express their views and desires about their daily lives. Active support folders contained plans in relation to a number of specific areas of choice and independent living. The home has it’s own activity centre on site, and has individualised plans for daily routines in relation to each service user. These plans include planned day services, either based at the home, at day centres in Ipswich and Claydon, or a gardening centre near to the home. Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 Page 13 The active support folders also contained evidence of service users being supported to engage in local and community activities, such as attendance of clubs, invites to functions associated with a local boxing club, classic car club, and plans for service users holidays in Norfolk. The manager reported that all service users enjoy regular contact with their family, at intervals ranging from twice a week on average to every three weeks. Contact included both visits by relatives to the home, and overnight stays by service users at their familial home. Service users plans included details of any restrictions, including latches on gates to deter absconding. Active support folders contained detailed descriptions of household tasks and support for service users to undertake as many activities as they could. One service user spoke with the inspector and confirmed they had their own key to their room. The induction material provided to staff included a reference to the issue of privacy, and instructions on the home’s ‘knock & wait’ policy. Each service user had an individual menu book, containing their likes, dislikes and favourite dishes. One service user confirmed their favourite choice, which was on the menu for the week of the inspection. Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 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 standard(s) 18, 19 & 21 Service users and their representatives can be assured that staff at the home and the policies and procedures in place ensure that personal care is provided in accordance with the expressed preferences of the individual concerned. The home has been rightly complimented for the way it meets the physical and emotional health needs of service users. The policies and procedures of the home ensure that ageing, illness and death are handled with respect, and in accordance with service users’ wishes. EVIDENCE: Service users’ files each contained an intimate and personal support assessment, detailing the needs of the individual, along with their choices and preferences’ regarding the way personal care was provided. The manager gave examples of the kinds of signals used in relation to specific service users concerned. Service user’s records included confirmation that routine healthcare appointments were made and attended with opticians, dentists, doctors and specialist healthcare providers. A number of compliments were received by the home in relation to a specific episode, in which the home undertook a series of pre planning and preparation exercises in relation to hospital and surgical appointments for three service users, all of whom had a great deal of anxiety about the procedures involved. The outcome of the work undertaken with the Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 Page 15 service users and professionals involved had led to all three appointments being managed in the best interests of the service users involved. The compliments included bonus payments from the organisation, one from the county sensory team and one from the chief executive of the proprietors, United Response. This standard was exceeded by the home. The home had a clear policy on death and bereavement. Service users were all at least 20 years away from retirement age and ageing was not an issue required to be included on service users’ plans. However, the manager reported that ongoing assessment and review of service users’ needs would include reference to this issue when appropriate. Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 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 standard(s) 22 The home provides service users’ with support and practical means of expressing their own views about the service, including any complaints. EVIDENCE: The home had a corporate complaints policy, on behalf of the proprietors, with a leaflet on display in the entrance area of the home explaining how people could access the procedure if they wished. The leaflet incorporated pictures and symbols to assist service users in understanding the information. The procedure contained all the information identified in the National Minimum Standards. The comment card returned by relatives prior to the inspection included the answer “yes” to the question, “Are you aware of the home’s complaints procedure?” and “no” to the question, “Have you ever had to make a complaint?” Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 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 standard(s) 24 & 30 The home provides accommodation within a homely and comfortable environment, which is routinely kept in good condition and state of repair. EVIDENCE: The home is situated in a rural part of Suffolk, although still close to the county town of Ipswich. The location is suitable for enabling service users to partake in country walks, identified by the manager as routinely enjoyed by service users. The building itself is a horseshoe shape, with a courtyard style garden, landscaped to provide attractive seating areas. There is ample car parking and additional garden areas. The service provides single room accommodation, a large communal lounge and a kitchen/dining room. The home is well maintained, both internally and externally, with homely, domestic style decorations and furnishings. The garden is surrounded by fencing, with a lockable gate, and trellising to deter vulnerable service users from leaving the home without staff knowledge. The building is accessible by all service users, all of whom are fully ambulant. Health and safety records showed that routine safety checks were undertaken. The home was clean fresh on the day of the inspection. The home has purchased a new washing machine since the last inspection, for use with items Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 Page 18 not requiring sluicing, and retained the old one for sluicing laundry when required. There was adequate space in the laundry for folding and ironing clothes. Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 Page 19 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) 35 Staff at the home are provided with a range of training opportunities, from an overall package based on supporting service users, whose needs fall within this home’s category of registration. EVIDENCE: The records of training confirmed that all new staff receive induction and foundation training accredited by the Learning Disability Award Framework. Ongoing training is provided by the proprietors, with courses planned in advance and identified with management on an individual basis. Training in the last 12 months had included food hygiene, total communication, mental health awareness, epilepsy, fire, 1st Aid, challenging behaviour, manual handling, supervising and appraising, prevention of harm and equality & diversity. Staff have individual training records with records of previous courses attended. Future training needs were addressed at supervision. Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 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 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 & 39 The home is well managed, by staff holding appropriate qualifications. The proprietors have an effective system for monitoring the care provided at the home, however, the reports produced by them in relation to this could be enhanced to provide more detail. EVIDENCE: The registered manager’s training records confirmed that they had achieved National Vocational Qualification (NVQ) level 4 in management, and were undertaking NVQ level 4 in care, and the Registered Managers Award. Monthly visits on behalf of the proprietor were taking place, evidenced by the report produced following such visits. Examination of the reports did not routinely contain evidence of any service user interviews taking place and the overall content of the reports provided little in the way of evidencing the way in which decisions about the standards of practice had been reached. Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 4 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Harkstead Barn Residential Home Score 3 4 x 3 Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x x x I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 Page 22 no 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 6 Regulation 15 (2) Requirement The registered persons must ensure that each service users file contains a copy of the minutes and decisions from the most recent review. The registered persons must ensure that reports produced following monitoring visits made under Regulation 26 include details of what records were examined, and evidence of interviews with such of the service users, their representatives and persons working at the home as appears necessary to form an opinion of the standard of care provided at the home. Timescale for action 15/7/05 2. 39 26 1/8/05 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. Refer to Standard 6 Good Practice Recommendations The registered persons should consider including a section on reviewing the placement plan of each service user on its agenda for internal reviews. I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 Page 23 Harkstead Barn Residential Home Harkstead Barn Residential Home I54-I04 S24402 Harkstead Barn V217987 050511 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 5th Floor, St Vincent House Cutler Street Ipswich IP1 1UQ 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. 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