Inspection on 27/02/08 for Higher Keason Farm

This inspection was carried out on 27th February 2008.

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

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

Higher Keason Farm 19/05/06

Higher Keason Farm 30/11/05

Higher Keason Farm 14/10/04

Higher Keason Farm 20/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Higher Keason Farm St Ive Liskeard Cornwall PL14 3NE Lead Inspector Mandy Norton Unannounced Inspection 27th February 2008 10:55 X10015.doc Version 1.40 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 Higher Keason Farm DS0000009038.V360270.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 Older People. 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. Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Higher Keason Farm Address St Ive Liskeard Cornwall PL14 3NE 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) 01579 383137 01579 383137 linda.olver@ssmail.net Mr Andrew Charles Hambly Mrs Linda Rose Olver ****Post Vacant**** Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability (Code LD) The maximum number of service users who can be accommodated is 3. 19th May 2006 Date of last inspection Brief Description of the Service: Higher Keason Farm is registered for 3 Adults with learning disabilities. The home is run as a family home with all the care and services delivered by the two registered persons. Each service user has their own single bedroom, with bathing facilities on the same floor as their bedroom. Communal space includes a lounge/dining room and a spacious conservatory. Access to the house is via a long drive where car parking is available. The home is situated in a rural position with pleasant views over the open countryside. The home is close to public transport routes for access to the facilities of Liskeard and Callington. Higher Keason Farm DS0000009038.V360270.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. This unannounced inspection took place from 10.55 am until 1.30 pm on the 27th February 2008. The inspection was conducted with the provider/care giver. A tour of the home was carried out and 2 of the 3 people who live at the home were spoken to. This report also contains information taken from the completed annual quality assurance assessment (a document that is completed annually detailing ongoing improvements and achievements). What the service does well: What has improved since the last inspection? What they could do better: Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 6 The provider/care-giver should ensure that peoples care plans are up to date and reviewed regularly so that they reflect an up to date view of the residents welfare. The provider/care-giver should continue with her plans to enrol on a ‘registered managers award’ course. 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. Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have access to good information about the home in order to make an informed decision about whether the service is right for them. A personalised needs assessment means that people’s diverse needs are identified and planned for before they move to the home. The home is not registered to provide intermediate care. EVIDENCE: Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 9 The provider has not taken an admission for a number of years but is clear about the assessment process she would use if a vacancy arises. Contracts with terms and conditions of occupancy were seen in the 2 care plans seen. The Service Users Guide & Statement of Purpose are up to date explaining the ethos of the service and what the service has to offer. The manager explained that when residents are unable to read then the content of any document is explained to them in a way that they understand. Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The practice regarding the delivery of care means that people can be sure that their health and personal care needs will be met. The care plans need to be reviewed more regularly and statements about peoples welfare needs to be recorded more regularly so that others who may be called upon to look after the residents have up to date written information about them. EVIDENCE: The 2 care plans examined had a lot of information about the individual and their abilities and lifestyle choices. They had not been regularly evaluated and updated and whilst the provider/care giver was very aware of peoples needs and daily routines she was reminded that unless this was clearly recorded Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 11 other people that may be called on to look after the residents may not have such knowledge and the care plan is a document that they should be able to refer to. She said that all appointments for the residents are recorded in a general diary as they occur. She states in the Annual quality assurance assessment that risk assessments are ‘written up for each Service User’. The people spoken to were clearly able to express themselves and are actively involved in decisions about how they spend their time. Medication is via a blister pack system and is delivered to the home weekly by a local pharmacist. None of the current residents are able to self medicate and the provider/ care - giver ensures medicines are given at the appropriate time and that the day centre knows of any special instructions about medications if required (this was evidenced by a letter of instruction about a particular medication that was prepared for the day centre staff by the provider/caregiver). People spoken to and the provider said that there is freedom to make choices and spend time in their own rooms if they wish. Residents do not go into each others rooms unless invited. Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of activities within the home and community meaning the people have a range of opportunities to participate in stimulating and motivating activities. Meals and mealtimes are not rushed making them an enjoyable, social occasion for people. EVIDENCE: The 2 residents spoken to were able to say how they spend their time in the house, weekly outings they go on (2 of the residents go out together most of the time) and what they like to do. All of the residents are now over 65 so do not attend education or have an occupation but do have local links and are included in the local community as they are all out and about independently. The Annual Quality Assurance Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 13 assessment states that each person attends a day centre one of which is in the village where one resident is able to take their dog. The communal lounge had a TV, which they all like to watch, books and games and the 2 residents rooms seen had TV’s, CD players and personal collections of music. The provider/care - giver talks with the residents about what they like to do, visitors are welcomed and there is access to all areas of the house and gardens. Breakfast and evening meals are taken together but the residents are often out during the day and will choose what they want to eat and where. The provider states in the Annual Quality Assurance assessment that peoples ‘dietary needs are met by good home cooked, balanced meals’. She goes on to say that likes and dislikes are taken into account. Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Formal complaints and reporting of abuse policies and procedures are in place. They are available to all people looking after the residents and people visiting the home at all times. People feel their concerns are listened to and acted upon meaning that they raise concerns or make complaints when they should. EVIDENCE: The provider/care giver said that there have been no formal complaints since the last inspection, although she has got a complaints procedure and method for recording the complaint and outcomes. The Commission have received no concerns or complaints about this service. During discussion it was clear that the provider/care giver was aware of adult protection/safeguarding procedures and would know who to contact if necessary. The residents visit day centres and have contact with outside agencies to whom they are able to talk if they have any concerns that cannot be shared with the provider/care giver. Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 15 Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment means that people have a homely, comfortable and safe home in which to live. EVIDENCE: Higher Keason Farm is run as a family home with the two providers living on the premises. It is near to a local bus route that is used regularly by the residents. On the day of the inspection the home was clean, tidy and homely. The 2 individual rooms seen were decorated appropriately, had personal possessions and ornamentation chosen by the residents themselves. There is one Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 17 communal bathroom/toilet on the first floor. There is a communal lounge on the ground floor that is used by all the residents. No adaptations are required for the current residents, although the staircase has a hand - rail on each side. Electrical appliances seen had up to date ‘portable appliance test’ (PAT) stickers on them. Washing is done in a domestic machine and the cleaning and household chores are done by the provider/ care - giver and the residents. Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The provider/care - giver show a responsible attitude and implements changes and improvements in order to keep improving quality and outcomes for people living in the home. The provider/care - giver provides most of the care and support and is on site 24 hours a day. She is experienced and trained to look after the current residents meaning they get the care they require. EVIDENCE: The provider/care - giver has many years of experience of looking after people with a learning disability. She looks after the needs of the service and the residents on a day – to - day basis. She achieved a National Vocational Qualification level 2 in care whilst working for the local trust and is planning to enrol on a registered managers course in the near future. She has access to training via the local learning disability service and is soon to attend a study day on care planning and risk assessment. Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 19 The other registered provider and three other people look after the residents from time to time and also have many years of experience in this field. These people all have criminal records bureau (CRB) checks on file. The interaction seen with the 2 residents and the provider/care - giver was respectful and appropriate. Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The provider/care - giver improves and adapts the service the home offers to meet the needs of the people that live there EVIDENCE: The provider/care - giver is intending to enrol for a registered managers award in the near future. She has many years of experience in the field of learning disability. There is no formal quality assurance system but with 3 residents that she sees on a daily basis there is plenty of opportunity to discuss concerns, changes, Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 21 improvements and day to day activities during that time. The annual ‘quality assurance assessment’ required to be completed for the Commission will act as a self assessment document and can be used as a working tool towards positive outcomes for the residents. Each person has access to their own money but are not able to manage their finances independently. The provider/care giver demonstrated the system she has in place to manage their money this includes recording expenditure and keeping receipts, which the residents are asked to give her when they return from being out. Fire detectors and smoke alarms throughout the home were in full working order on the day of the inspection. PAT stickers were seen on plugs in resident’s rooms. Hazardous substances were not freely available to the residents and are used under supervision when carrying out household tasks. Up to date public liability insurance is in place. The accident book was seen and has had no recorded incidences for sometime. The home has a policy about confidentiality and despite ongoing building work and disruption to storage space peoples records are being kept safely. Higher Keason Farm DS0000009038.V360270.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 Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Higher Keason Farm DS0000009038.V360270.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. Refer to Standard OP7 Good Practice Recommendations The registered person should ensure that care plans are reviewed regularly and statements as to the residents welfare should be recorded at least weekly. The registered person should undertake a Registered Managers Award in the near future. (Carried over from previous report) 2. OP32 Higher Keason Farm DS0000009038.V360270.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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. Extracts may not be used or reproduced without the express permission of CSCI Higher Keason Farm DS0000009038.V360270.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. 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