Inspection on 01/09/05 for Higher Morris Farm

This inspection was carried out on 1st September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Higher Morris Farm 10/11/09

Higher Morris Farm 28/11/08

Higher Morris Farm 04/07/07

Higher Morris Farm 06/09/06

Higher Morris Farm 23/01/06

Higher Morris Farm 15/02/05

Higher Morris Farm 15/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Higher Morris Farm 595 Preston Road Clayton le Woods Lancashire PR6 7EB Lead Inspector Val Turley Unannounced 01 September 2005 10:00 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. Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Higher Morris Farm Address 595 Preston Road Clayton-le-Woods Lancashire PR6 7EB 01772 324515 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) Progress Adult Services Limited Care Home 5 Category(ies) of LD Learning Disability registration, with number of places Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for a maximum of up to 5 service users to include : 1 Up to 5 service users in the category LD (Learning Disability) 2 The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 3 Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines, which may be issued through the Commission for Social Care Inspection. Date of last inspection 15 February 2005 Brief Description of the Service: Higher Morris Farm is one of the two homes operated by Progress Adult Services Ltd, which is a company caring for young adults whose severe learning disabilities are compounded by severe challenging behaviour. The service aims to provide an individualised, integrated service within which, communication therapy and high quality care, combine to reduce challenging behaviour and reinforce and maintain positive changes. The home is a detached property with a large enclosed secure garden to the rear, and parking area to the front and side of the property. The home offers accommodation to five young adults who each have their own bedroom. There are two bedrooms located on the ground floor, which are adjacent to a bathroom. On the first floor there are three bedrooms with one service user having sole use of an adjacent bathroom. The remaining two rooms having access to a second bathroom also on the first floor. In addition, the home has three lounges over the two floors, a dining room, kitchen, and two staff offices/sleeping accommodation and bath/toilet facilities. The outbuildings provide an activity room for the use of one of the young adults and a laundry in another. Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over one day in September 2005 by one regulation inspector. The inspection involved discussion with and observation of the young adults who lived at the home and also discussion with and observation of the staff working there, an examination of records, policies and procedures and a tour of the premises. As part of the inspection, the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allowed the inspector to focus on one of the young adults living at the home. All records relating to that individual are inspected along with the room occupied at the home. The young adult was invited to discuss his experiences of the home with the inspector, however this was not to the exclusion of other people living at the home. What the service does well: What has improved since the last inspection? The home had introduced a number of daily checks to ensure that medication was being administered as required. The home had made progress in terms of involving outside agencies in the decision–making processes in the home. This had helped to ensure that the care and support provided for the young adults is the most appropriate. Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 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. Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 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 Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 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) 2 The pre-admission process is in sufficient detail to ensure that prospective service users supports needs are fully assessed before admission. EVIDENCE: One young adult had been admitted to the home since the previous inspection. His file was examined in detail to ‘track’ the admission process that had been followed. The file contained a great deal of information which had been collected from his previous placement, involved professionals and a family member. An assessment had also been undertaken by the home. The information on file covered all of the service user’s identified support needs and recognised that a very structured timetable should be provided to enable the young man to settle into the home. Discussion with staff indicated that they had been fully involved in the admission process and they had a good working knowledge of the young adults needs. A telephone conversation with the parent of the young adult confirmed that she was very happy with the admission process. She stated that staff had visited the young adult at the family home on a number of occasions and had supported him there. She said that she felt that staff ‘really care and understand my son’s needs.’ Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 and 9 Care plans for young adults living at the home were very detailed outlining individual support needs. They ensured that staff were able to provide a safe and structured environment, and also work towards extending the young adults range of experiences and options for the future. EVIDENCE: The care plan examined contained details of the young mans identified support needs. The plan was based on information drawn from a variety of sources and gave staff clear guidance as to how they should work with him in specific situations with a view to helping him to feel confident and comfortable in his new environment. Strategies were included in the plan to enable staff to manage any challenging behaviour presented by the young adult effectively. Staff were observed supporting the young adult when they explained to him the plans for the day and reassured him regarding any concerns that he had. Discussion with the young adults mother confirmed that she had been involved in developing her sons care plan and that the home always discussed any changes to the plan with her and asked her advice. She stated that she felt confident in contacting the home if she had any concerns or was in need of advice regarding the support of her son. The young adult stated ‘I like living here, I can do what I like’. Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 10 Risk assessments were in place for all activities the young adult was involved in and discussion with staff and the young adults mother confirmed that these had been discussed prior to admission, ensuring as far as possible that a safe environment was maintained at all times. Staff had been given clear guidance as to how the young adult should be supported to make decisions and choices safely. Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15, The support staff at the home recognised the importance of family links and friendships and supported the young adults to maintain these. EVIDENCE: It was clear from discussion with staff, a young adult and his mother and from documentation that the young adults were supported to maintain contact with their family and friends. On the day of the inspection staff were observed to support a young adult to contact his mother by telephone to give her some good news. The young adults were supported to attend local colleges and become involved in the local community and develop friendships and relationship through these contacts. Policies and procedures in the home underpinned the support provided to the young adults in respect of relationships. Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 12 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) 19 and 20 The home had procedures in place to assess the health needs of the young adults they supported and worked appropriately and sensitively to ensure that their health needs were met. Some additional work needs to be undertaken by the home to ensure that the management of medication meets the required standard and so protects both service user and support staff. EVIDENCE: The file examined indicated that the health needs of the young adult were still in the process of being assessed, although GP and dental appointments had already been made. The young adult and the support staff confirmed this. The young adults mother was particularly pleased that her son had been supported to attend the dentist. The staff stated that the GP’s surgery would provide an annual health check for the young adult. The medication records relating to the same young adult were examined. These had been completed appropriately and included a record of the medication that he took with him on home visits. The service users consent to medication had not been recorded on the file, possibly placing the service user and support staff in a position of risk. The management were aware of this omission but had discussed the difficulties around the issues of obtaining informed consent from service users. It was recommended that further advice be sought. A number of daily checks were in place to ensure that medication was administered as required. The organisations training in the administration of medication was not accredited Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 13 and this should be addressed to ensure that procedures within the home are as safe as possible. Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 14 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) 23 The home had made some progress in terms of involving outside agencies in the decision-making processes in the home. This had helped to ensure that the care and support provided for the young adults is the most appropriate. Some additional work must be undertaken to continue with this ensuring that a balanced approach is adopted as far as possible at all times. EVIDENCE: The homes policies and procedures in relation to the protection of vulnerable adults contained all the necessary detail, ensuring as far as possible the safety of the young adults at the home. At the previous inspection it had been required that the home involve professionals from other organisations in order to ensure that the care and support provided for the young adults is the most appropriate and by doing this avoid any potential abusive situations. As a result of this the home had involved the local advocacy service and a representative of the service had attended each of the young adults reviews and had also made their services available to families. Two of the senior managers of the organisation had joined the local Care Consortium and planned to attend the next meeting. They hoped that this membership would give them an overview of care services in the area and an awareness of any developments in care services in general. Some additional work should be undertaken to involve other health professionals in the home especially were specific challenges may need to be addressed. Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 15 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 The home was clean and comfortable and provided a pleasant and safe environment for both the young adults and support staff. EVIDENCE: The home provided a clean, pleasant and comfortable environment for both the young adults and the staff. The furnishings and fittings were of good quality and had been chosen carefully with safety in mind. The home was situated close to local amenities and young adults accessed these with staff support, making use of the homes minibus, staff cars, minibuses and taxis. The home was fully accessible to all of the young adults who were resident at the home on the day of the inspection. Some redecoration and repairs were required, and these had been planned to take place. Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 16 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 Appropriate training and support is provided for staff to help ensure that the needs of the young adults are being met. EVIDENCE: The file of a recently appointed member of staff was examined and discussion took place with her regarding the training she had received and expected to receive within the organisation. She confirmed that she had spent the first two weeks of her employment on an induction course and that she was aware of other training opportunities that would be made available. The acting manager confirmed this. The member of staff stated that the training was specific to the needs of the young adults and that she felt able to ask for assistance if she did not feel confident about undertaking a specific duty. Daily support from the management team allowed the progress of staff to be monitored and ensure that the needs of the young adults were being met appropriately. The managers were observed to support staff and offer them advice. The member of staff stated that she felt well supported in her role. Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 17 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) 42 The home takes its health and safety responsibilities seriously and was in the process of reviewing some of its policies and procedures in a specific areas with a view to ensuring the safety of the young adults and staff as far as possible. EVIDENCE: The home was able to provide evidence that a variety of checks were undertaken to ensure the health and safety of both the young adults and the staff. Electrical appliances had been PAT tested on an annual basis and the electrical system had a valid certificate in place. The gas boiler was serviced by the housing association and so records were not available. Training was undertaken by staff in moving and handling, first aid, food hygiene and infection control. Staff also received induction and foundation training. Training records in the home confirmed that this training had taken place, as did discussion with staff. Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 18 The home kept records of any accidents, injuries or incidents occurring within the home. The home was in the process of reviewing its fire training and associated procedures. All staff had signed to say they had read the guidance regarding fire procedures in the home. Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 19 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x x x x 3 x x Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Higher Morris Farm Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 20 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 YA23 Regulation 13(1)(b) Timescale for action The registered person shall make 31/12/05 arrangements for service users to receive treatment, advice and other services from any health care professional where necessary. Requirement 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 YA20 Good Practice Recommendations All staff authorised to administer medication should receive accredited medicine management training. Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 21 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Chorley PR7 1NW 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 Higher Morris Farm F57 F08 S5967 Higher Morris Farm V247474 010905 Stage 4 .doc Version 1.40 Page 22 - 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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