CARE HOME ADULTS 18-65
Higher Morris Farm 595 Preston Road Clayton Le Woods Lancashire PR6 7EB Lead Inspector
Val Turley Unannounced Inspection 4th July 2007 10:00 Higher Morris Farm DS0000005967.V337118.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 Higher Morris Farm DS0000005967.V337118.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. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 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 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) Progress Adult Services Limited Michael Sharples Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for a maximum of 5 service users to include: *Up to 5 service users in the category of LD (Learning disability). 6th September 2006 Date of last inspection Brief Description of the Service: Higher Morris Farm is one of the three 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 for up 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 young adult 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. Fees for the home range from £126,165 to £163,611 per year with additional charges for any extra staffing, some activities and personal shopping. At the time of the site visit there were four young adults living at the home. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an inspection that took place over a ten-month period and culminated in a site visit to the home over one day in July 2007 by one regulatory inspector. The inspection involved discussion with people living at the home where this was possible, discussion with staff, observation of staff supporting residents and an examination of records, policies and procedures. Information was also provided through a pre-inspection questionnaire completed by the manager, through surveys completed and returned by 1 young person living at the home, 2 by relatives and 1 by a health professional. As part of the inspection, the inspector used ‘case tracking’ as a means of assessing some of the National Minimum Standards. This process enabled the inspector to focus on one of the people living at the home. Records relating to that individual were inspected and discussion took place with people who were present in the home on the day of the site visit. What the service does well:
Higher Morris Farm provides clean, comfortable and well-maintained accommodation for the young adults who live there and a pleasant working environment for the support staff. The home has a thorough and detailed pre-admission process that ensures as far as possible that the home is able to provide appropriate support to a prospective resident and also, whenever possible, encourages and supports the prospective resident to make a decision themselves as to whether they wish to live at the home. The home has a history of being person centred in its approach and places an emphasis on the abilities, interests and hobbies of the young adults with the intention of supporting them to enjoy a fulfilling life. The home involves the young adult, people who know the young adult best, (including family members involved health and social care professionals and the staff working at the home); in the process of deciding how best to provide the necessary support. The care plans are detailed and include details of the young adults preferred routines and preferences and also includes details of how to implement strategies to ensure that the young person and other people are
Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 6 kept safe. Care plans are reviewed and updated as often as necessary but at least every six weeks. The young adults are supported to make choices and decisions as far as they are able and the home has developed links with the local advocacy agency, which is able to provide independent support if this is needed. One young adult said he liked living at the home and liked the staff who supported him. Each of the young adults living at the home has their own activity timetable that enables them to follow their own interests and hobbies and participate in the local community as far as possible. They enjoy a number of activities including shopping trips, pub lunches, visits to leisure centres, the cinema, fishing, baking, college and holidays. Flexible staffing arrangements enables the young adults to take part in activities outside of the home and also spend time alone if they wish. The home enjoys good links with families who are made to feel welcome at the home. One of the young adults was able to explain how he is supported by staff to stay in contact with his family. Meals are planned to meet the specific needs of the young adults with dietary, religious needs and individual preferences being taken into consideration. Each young adult has a health care plan in place and these outline what steps need to be taken to help ensure that the young adults continue to enjoy good health. A number of health and social care professionals are involved in the home, providing additional support for the young adults and the staff support the young adults to attend any out patient and routine health appointments. The home has good policies and procedures in place to protect the young people living at the home and has also provided staff with training in this area. Staff are carefully recruited with all of the necessary checks being undertaken before a new member of staff starts work in the home. One member of staff said she felt very positive about her job and well supported by the management and staff team. The young adults living at the home appeared to be relaxed in the company of the staff and the staff themselves spoke sensitively to and about the young adults and respected their privacy and dignity. The staff team have a good mix of skills having attended a range of appropriate training courses. The home does not use agency staff and this approach helps ensure that the young adults receive a continuity of care by staff who are familiar with the young adults and the working practices of both the home and the parent company. The home is well managed and provides a safe and relevant service for the young adults living there. The registered manager is continuing to work towards his registered mangers award and has undertaken other training to keep his skills and knowledge up to date. The home also receives good support
Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 7 and guidance from the senior management team including the responsible individual who visits the home regularly. There are a number of internal quality assurance audits undertaken to ensure that the home is run safely and the home has also achieved the Investors in People Award, a quality assurance award accredited by an external agency. The health, safety and welfare of the young adults and staff are promoted and protected with appropriate training being provided and systems and equipment in the home being maintained and serviced. What has improved since the last inspection?
Since the last inspection the acting manger has become the registered manager of the home. The home has changed the format of the young adults files and has used person centred planning as a method of providing information about the individual young adults in a more positive way. The care plans are as a result of this more positive in their approach although these are backed up by strategies that should be adopted to keep both them and other people safe. The home has actively investigated the possibility of one of the young adults becoming involved in an independent self-advocacy group. Since the last inspection the home had continued to work with a psychology service and they are involved in the home on a regular basis to advise and provide input where it is seen to be appropriate. Additional training has been provided in the management of medication in the home. The home has been working with the fire service to ensure that their risk assessments and fire training are adequate for the home. The home had sought the views of involved health professionals as part of their quality assurance audit. Manual handling training is now included as part of the induction training. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 8 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 9 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 Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 10 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The pre-admission process is in sufficient detail to ensure that prospective residents support needs are fully assessed before admission. EVIDENCE: Four young adults were resident at the home at the time of the site visit. There had been no new admissions since the last inspection. However there was documentary evidence to show that the home works hard to assess any prospective residents and ensure that they are able to meet their needs before admission is considered. As part of the assessment process, staff visit the prospective resident in their existing placement and work with family and involved health and social care professionals to make sure they have all the information they need before they make any decisions. One of the young adults in the home said that he had been given information about the home and had decided himself that he wanted to live there. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 11 To further improve the assessment and admission process, the home is in the process of developing an information pack about the home that will be more accessible for prospective residents. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at the home are supported appropriately in their daily lives enabling them to work towards a more independent lifestyle. EVIDENCE: The care of one of the young adults living at the home was tracked during the course of the site visit. The home has a history of being person centred in its approach and works with the young adults to help them achieve greater independence within a secure environment. The format of the young persons files has been changed since the last inspection and the information and guidance provided is presented in a more person centred format. This means that staff are provided with more positive information about the young person and their individual support needs. The young persons family, the staff team and as far as possible the young person had been involved in providing this
Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 13 information. In addition to this, guidance was provided as to how to implement strategies to ensure that the young person and other people were kept safe. The members of staff spoken to had an interest in and an understanding of the support needs of the young adult and a willingness to help the young adult live a fulfilling lifestyle. The young person’s care plans are reviewed and updated at every six to twelve weeks and are reviewed formally on a six monthly basis when other professionals are invited to be involved in this process. As the care plan is updated, staff sign to say they have read it and understood it, helping to ensure that there is a continuity of care and care approaches within the home. The care plans include information of the strategies that should be used to enable the young adults to make choices and decisions. Staff were heard to ask the young adults what they would like to do and offer appropriate choices. Support staff were aware of the individual likes and dislikes of the young adults and these were recorded within the care plans. The home has links with the local advocacy agency and they had been approached with a view to one of the young adults joining a local self-advocacy group. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 14 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The daily routines in the home promote the independence of the people living at the home, encouraging and supporting them to make safe choices and decisions and become involved in valued and worthwhile activities. EVIDENCE: Each of the young adults living at the home has their own activity timetable which enables them to follow their own interests and hobbies as well as giving them opportunities to make decisions themselves about what they would like to do. The young adults are supported to participate in the local community as far as possible and this includes shopping, visits to leisure centres, the cinema, pub lunches etc. The young adults enjoy and benefit from the input of a music therapist and the service has recently employed a dance and movement teacher and it is planned that she will have some input into the home. Flexible
Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 15 and extra staffing enables the young adults to take part in activities outside of the home but there is also the recognition that routine and familiarity are important to the young adults. On the day of the site visit the staff were observed to spend time with the young adults but also give them opportunities to spend time alone if they wished to. The young adults are free to move around the communal areas of the home as they wish and are supervised appropriately by the staff team. There was evidence that the home had good links and support from the families of the young adults. It was acknowledged contact with families could be improved on occasions but the relatives who completed and returned questionnaires stated that they are on the whole satisfied with the relationship that they have with the home and that they are confident that they would be contacted if there were any concerns of a serious nature. It was clear from the questionnaires returned that the home makes families feel welcome when they visit. One of the young adults explained how he is supported by the staff to stay in contact with his family. Meals are planned to meet the specific needs of each of the young adults, with dietary requirement and religious needs and individual preferences being taken into consideration. One young adult is supported to shop for his own food helping to ensure that his needs are met. Information is provided for staff to enable them to have an understanding of the young adults individual dietary needs. The weights of the young adults were monitored to give staff an indication as to their well being. The psychology service employed by the home is involved if there is a need to introduce a weight loss programme. Mealtimes are arranged to enable the young adult to feel relaxed and unhurried. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The support staff have a good knowledge of individual residents preferences and personal and health care needs and provide support sensitively and in accordance with their wishes. EVIDENCE: The person centred planning recently introduced for the young adults provides information for the support staff, including the young adults preferred routines. The care plans also include information for the support staff regarding the guidance and support the individual young adults need with their personal care. This guidance also includes how best to give the young adults choices over which clothes they should wear each day. The home has key worker system in place and this gives them the responsibility of co-ordinating the health care needs of the young adults they
Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 17 are key worker to. There was evidence on the files examined that a number of health professionals are involved in providing support to the young adults who use the service. These include a speech and language therapist, a behavioural specialist and a psychological service. In addition to this the young adults are supported to attend outpatient appointments and routine health appointments such as the dentists and opticians. There is a health care plan in place for each of the young adults and these outline any steps that need to be taken by staff in order to ensure their continuing good health. There was evidence of staff working with GP’s and other health professionals to help ensure that the health needs of the young adults are met as far as possible. One GP returned a completed comment card that stated that he thought that the care provided is very good. The management of medication including the controlled drugs kept at the home was looked at during the site visit. The medication was well managed with records being appropriately maintained. The home makes sure that any medication taken by the young adults is agreed by the GP, helping to keep the young adults safe and healthy. Training in the management of medication was provided in house and in addition to this staff were undertaking additional training provided by an external training company. It was recommended that the home clarify how often training in the administration of rectal diazepam should be provided. The aim should be to ensure that the support staff receive refresher training on a regular basis to ensure that their skills and knowledge are kept up to date. It was also recommended that the home should develop some guidance as to when as required (PRN) medication should be administered to those young adults who it is prescribed for. This would help ensure that support staff administer this medication in response to certain signs and symptoms and will enable the staff and health professionals determine how appropriate or effective these medications may be. It was required that the practice of sending medication administration records (MAR sheets) with the young adults on home visits must stop as these must be kept at the home as a legal record. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good policies and procedures in place in order to protect the people living at the home. EVIDENCE: The home has good policies and procedures in place to help ensure that the young adults are kept safe and that any concerns can be raised openly. A chart was displayed in the office of the home that outlined the steps the staff must follow if they are concerned that a young adult is being mistreated in any way. The majority of the staff team had also received training in adult protection. The surveys returned by those relatives who completed them indicated that they were aware of who to speak to should they have any concerns about the way the home is being run. One of the young adults at the home said that they would speak to either a member of staff or their social worker if they were unhappy or worried about anything. The manager said that they received good support from the psychology service that it had access to in terms of being involved in any decisions regarding the management of challenging behaviour. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 19 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean and comfortable and provided a pleasant and safe environment for both the people living at the home and their support staff. EVIDENCE: The home was clean and in a good state of repair and decoration. The manager said that repairs are generally attended to quickly and although there was some work outstanding, this had been requested and it is expected to be completed in the near future. Bedrooms had been furnished and personalised to suit the needs of the individual young adults and this had been done very much with their safety in mind. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 20 The laundry is situated in an outbuilding separate from the main body of the home. It was equipped to meet the needs of the home. The staff spoken to were aware of the health and safety policies in relation to the laundry. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 21 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home selects and trains staff appropriately to ensure that the people living at the home receive the support that they need. EVIDENCE: During the site visit, the files of three staff who had been appointed since the last inspection were examined. Records showed that all of the necessary checks had been made and references had been taken up before they had started to work at the home. One of these staff members was spoken to during the course of the site visit and she said she felt very positive about her job and well supported by the management and staff team. The records showed that these three members of staff had completed induction courses at the start of their employment in the home. Since the last inspection the induction programme had been changed and new employees are now given an opportunity to work in one of the homes during the induction period itself. The staff spoken to said that they felt that this was an
Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 22 improvement as it enabled them to apply some of the theory that they had learned to practical situations and get a better overview of the service provided. They also said that they were able to discuss their training needs in supervision with the manager or senior staff in the home. The home has a training matrix in place, which showed that the manager has a good overview of the training needs of his staff team. The staff team had attended a variety of courses giving them a range of knowledge and skills. The home was still working towards 50 of the staff team achieve a nationally recognised qualification in care. The manger said that there had been a good take up of the training and this should bring the numbers up to over 50 when completed. Staff were observed to speak to the young adults sensitively and to respect their privacy and dignity. They have a good knowledge of the way that each young person communicates and are able to respond to them appropriately. They are enthusiastic in their approach, knowledgeable about the needs of the individual young adults living at the home and are pleased when progress is made and maintained. The young adults were seen to be comfortable and relaxed in their presence. Staffing in the home is flexible enabling young adults to participate in activities with adequate staff support. Staff are encouraged to discuss new ideas and plans with the senior team that they feel may benefit the young adult at the home. The home does not use agency staff and this approach helps ensure that the young adults receive a continuity of care by staff who have a good understanding of both the young adults, the working practices of the home and the parent company. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, providing a safe and relevant service for the young adults. EVIDENCE: Since the last inspection the acting manager has become the registered manager of the home. He is continuing to work towards his registered managers award as well as undertake other training to keep his skills and knowledge updated. The members of staff spoken to appreciated his support and guidance and it was felt by them that this helped the team work well together and be supportive of each other.
Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 24 A recent survey of the views of involved health and social care professionals had been undertaken. It was reported that the response to this was generally poor although the feedback that was received was positive. The home continues to have ongoing discussions with the families of the young adults it provides a service to and works with them to improve the service. Since the last inspection the fire service have visited the home, which is in the process of acting on the recommendations that have been made by them. Fire training is being organised for all staff. It was recommended that the home consult with the fire service to determine how often training should be provided. Moving and handling, first aid and food hygiene training is included in the induction training that the home provides giving all staff the necessary skills and knowledge that they need in these areas. The home reviewed its policies and procedures on an annual basis and updated team. There were a range of checks and audits undertaken around the home to help ensure that the home was run safely and in the best interests of the young adults. The home has also achieved the Investors in People Award which is a quality assurance award accredited by an external agency. Information provided by the manager in the completed questionnaire indicated that the systems and equipment at the home were serviced and maintained appropriately. The home receives good support from the senior management team including the responsible individual who visits the home on a very regular basis and is fully aware of the day-to-day challenges that the home manages. It is however required that the responsible individual ensures that the home receives a monthly monitoring visit to ensure that the needs of the young adults are being recognised and met and that the home is being run for their benefit. A report must be prepared following this visit outlining any concerns recognised. A copy of the report should be provided for the manager who will then be able to act on any concerns. A copy of the report should be kept at the home. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 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 Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 26 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 YA20 Regulation 17(1) Schedule 3 Requirement Timescale for action 31/08/07 2 YA39 26 The registered person shall maintain and keep securely in the care home a record of all medicines kept in the home for the young adults and the date on which they were administered. The registered provider must, as 31/08/07 part of the quality assurance audits, visit the care home on a monthly, unannounced basis and prepare a written report on the conduct of the care home which must be given to the registered manager. 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 The home should clarify how often training in the administration of rectal diazepam should be provided and aim to ensure that the knowledge and skills of the staff are kept up to date. Guidance regarding the administration of as required
DS0000005967.V337118.R01.S.doc Version 5.2 Page 27 2 YA20 Higher Morris Farm 3 YA32 (PRN) medication should be developed to help ensure that all staff administers it in response to the same signs and symptoms. The home should continue to work towards 50 of its staff achieve a relevant qualification in care. Higher Morris Farm DS0000005967.V337118.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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
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