Inspection on 23/07/08 for Hill Farm

This inspection was carried out on 23rd July 2008.

CSCI found this care home to be providing an Excellent 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

Hill Farm 17/07/09

Hill Farm 16/10/06

Hill Farm 07/03/06

Hill Farm 22/06/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Hill Farm 15 Keycol Hill Sittingbourne Kent ME9 8LZ Lead Inspector Elizabeth Baker Unannounced Inspection 23rd July 2008 09:10 Hill Farm DS0000063115.V367500.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 Hill Farm DS0000063115.V367500.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. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hill Farm Address 15 Keycol Hill Sittingbourne Kent ME9 8LZ 01795 841220 01795 841221 forwardcare@yahoo.co.uk 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) Forward Care (Residential) Ltd Mr Gary Greening Care Home 9 Category(ies) of Learning disability (0) registration, with number of places Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 9. Date of last inspection 16th October 2006 Brief Description of the Service: The Home offers services for people with learning disabilities who have challenging behaviours and or high dependency needs. Services are tailored to meet the needs of the individual aiming to offer opportunities, choice, to facilitate experience, enhancement of self-esteem and to enable service users to manage their lives with support and assistance. The Home is a detached property with accommodation on two floors. Accommodation is provided in nine single bedrooms, some of which are located on the ground floor. All bedrooms have call bell and television points. There is a shaft lift providing wheelchair access to the first floor. There is a small garden to the rear of the home and limited car parking to the side. The home is within easy access to the M2 motorway and about two miles from Sittingbourne town centre. The fees range from £1066.06 to £2875.91 per week depending on the individual assessed need. Additional costs are chargeable for horse riding, external sensory sessions and one to one trips out. Current internal activities and entertainment include listening to music, watching TV films, aromatherapy, beauty therapy, exercise programmes, movement to music and art and crafts. External trips include a week’s annual holiday, swimming, horse riding, shopping trips, church services and day trips to places such as theme parks and seaside resorts. A copy of the latest inspection report is available on request at the home. Hill Farm DS0000063115.V367500.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 3 stars. This means people who use this service experience excellent quality outcomes. Link inspector Elizabeth Baker carried out the key unannounced visit to the service on 23 July 2008. The visit lasted almost eight hours. As well as briefly touring the home, the visit consisted of talking with some service users and a number of staff. One service user, and two members of staff were interviewed in private. Verbal feedback of the visit was provided to the home manager during and at the end of the visit. The registered manager for this home is also the registered manager for an associated home but was not on site. One of the providers was on site for part of the visit and provided administrative information. At the time of compiling the report, in support of the visit, we (the Commission) received survey forms about the service from all the service users. Because of communication difficulties, these were completed with input from support workers. We have not received any survey responses from care managers and health care professionals. We have subsequently made telephone contact with three advocates and one care manager for their views on the service. At our request the home completed and returned the home’s Annual Quality Assurance Assessment (AQAA). Some of the information gathered from all these sources has been incorporated into the report. Eight service users were living at the home at the time of the visit. We have not received any complaints about the service. The AQAA records the home has not received any complaints. One support worker referral was made to the Protection of Vulnerable Adults List. What the service does well: The home manager was receptive to advice given and demonstrated an eagerness to put right any matters needing addressing to improve the service. Support workers are enthusiastic about their roles and enjoy working at the home. Any service user disruptions are handled in a calm and re-assuring way, quickly restoring the relaxed and open atmosphere of the home. The home manager is in the process of developing comprehensive guidance for hospital staff to support a service user during a planned hospital stay. A support worker will accompany the service user during the stay. The written guidance should assist hospital staff in minimising any potential anxieties the Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 6 service user, who has complex communication and behaviour difficulties, may have particularly during the post-operative stage. Returned service user surveys gave us information including that they were supported by family and care managers to choose the home, the home is always fresh and clean, they are happy with their lifestyle, they go out on regular trips and they like their bedrooms. Subsequent telephone survey responses told us “[The home] is very good at letting us know of any changes. [Relative] likes living there, always refers to it as “my home”. They do so many things, which are good – very attentive to [relative’s] needs and try to support them in accomplishing all they wish to do. We are all very pleased with the care. [Relative] has matured and is now really independent and is her own person”. “We are very happy with the home – it’s the right place for [relative]. Forward Care is away ahead of others. The home has done well in looking after [relative] as well as possible. We are very happy with all aspects of care. Would not wish [relative] to go anywhere else”. “We feel the home copes quite well with [relative’s] care. It’s a lovely family home but eight residents should be the limit”. “The home looks after clients as individuals. It supports people with complex and difficult needs well, providing the level of security needed but also treating them as individuals. All clients’ families are very happy with the care. Forward Care is a very good provider, particularly for difficult clients”. What has improved since the last inspection? What they could do better: Service users plans should continue to be developed and expanded so they contain more detail on the individual needs, wishes, support and encouragement in line with current good practice for the delivery of person centred care. The responsible individual must ensure a report is compiled following monthly checks of the quality of the service provided, as regulation requires. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 7 For service users’ protection, so that full employment histories are obtained on all staff, the application form should be amended requiring them to provide this information. Decisions made on service users’ behalf, restricting their civil rights and some choices, must be recorded and demonstrate the decisions have been made with input from the service user and other people involved in their care, including advocates, care managers and other health care professionals, as appropriate. There are no requirements, but a number of good practice recommendations have been made throughout the body of the report. 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. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 8 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 Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 9 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. Service users who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to this service. New service users move into the home knowing their assessed needs can be met. EVIDENCE: There have been no new admissions to the home since before the last visit in October 2006. The manager said prospective service users are referred to the home via care managers. The referral would be supported by a medical history and details of their current condition. If the manager thinks the referral might be appropriate a visit to the prospective service user would be undertaken. Either the manager or registered manager would undertake the visit. The prospective service users would then be invited to visit the home to meet current service users and staff. If the visit goes well then the prospective service user would be invited to stay at the home for a trial period. During the assessment process an admission file would be set up. The information would then be used to inform the service user plan. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Service users who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to this service. Service users are enabled and living an independent life as far as is possible. EVIDENCE: The two service user care records inspected contained care plans, risk assessments, monitoring charts and other supporting documents. Care reviews are undertaken with input from individual care managers. These are normally carried out on a six monthly basis. Service users and their advocates are invited to attend reviews. Service user care plans covered various needs and support with activities such as personal care, hygiene, dressing, communication, as well as medical conditions such as epilepsy. Charts are used to monitor service users’ weights and behaviours. Health and safety risk assessments are undertaken for medications, kitchen, sensory problems and aids, including a special mattress. Daily and night records are kept and provide a good picture of each service user’s quality and health experiences over 24 hour periods. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 11 The manager is keen to develop the service user plans so they provide more person centred care information and described how they will be expanded upon. Indeed the manager intends to incorporate the new learning she has just acquired after attending a two-day Mental Capacity Act training session. New documentation has just been obtained and the manager said it is her intention to transfer all service users’ plans to the new model. The new knowledge should help in the development of the new plans. Some service users have challenging and complex behaviours. Because of this action may be taken to protect service users from self-harm or harm to others. Where this is the case the decision for this would have been made jointly with other people involved in the service user’s care such as the care manager and specialist clinicians. To assist in the decision making for one service user without any next of kin, the home has arranged for independent advocates to act on their behalf, when there is a need. This is good practice. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17. Service users who use the service experience excellent outcomes. This judgement has been made using a range of evidence including a site visit to this service. Links with the community are good and support and enrich service users’ social, occupation and development opportunities. Service users benefit from a variety of lifestyle choices and with appropriate staff support where needed. EVIDENCE: Service users spoken with expressed their delight at having been on a recent holiday. Indeed so far this year six service users have had a week’s holiday. Arrangements are in hand for the two remaining service users to have a week’s holiday. Service users are supported in continuing or experiencing new activities such as swimming and horse riding. Currently no service user is in employment or education. However the home provides in house therapy sessions for service users to join in if that is their wish. Indeed this visit coincided with a beauty therapy session, which was followed by music and movement. The home has its own transport and this is used for trips to the seaside, theme parks, shopping centres, zoos, picnics, parks and boat trips. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 13 One service user has expressed a wish to do a sightseeing trip of London and this is being arranged. Each service user has a weekly therapy activity rota comprising of group and one to one activities. To maintain family and friend contacts, service users are supported in making home visits to see them on a regular basis, where this is appropriate. Families and friends also visit service users at the home and telephone contact is also maintained between them. One resident likes to attend church services and he is supported in doing this. Support workers were seen interacting with service users in a positive, reassuring and non-patronising manner, even in difficult situations. Meals seen during the visit were nicely presented and appetising. Special aids are available to assist service users with their meals where there is an assessed need. Choices are available at lunch and dinner times, and English Breakfasts are available at weekends. A decision has been made that service users are not able to exercise their right to vote. Bedroom doors are lockable, although service users do not hold their own keys. These decisions may well have been made with the service users’ best interests and safety in mind, but there is no recorded evidence how the decisions have been arrived at and or who was involved the decision process. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21. Service users who use the service experience excellent outcomes. This judgement has been made using a range of evidence including a site visit to this service. Service users receive personal and health care support in accordance with their needs, wishes and preferences. EVIDENCE: A service user spoken with said they get up and go to bed when they want to. Service users were seen appropriately dressed with attention to detail. A weekly beauty session takes place at the home, primarily, but not exclusively, for the two female service users and this was stated as being very important to them. Service users are encouraged and supported in buying new clothes and trying new styles. Where there is an assessed need, specialist support is sought and provided from health care professionals, including speech and language therapists, dermatologist, psychiatrist, psychologist, and the learning disability team. The home does not provide nursing care, so healthcare needs are provided by district nurses and GPs. Service users have regular eye, dental and health checks. The home is working hard on improving the sight of one of the service users. With support and input from the area’s learning disability team, arrangements Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 15 are in hand for the service user to have an operation, which should substantially improve his quality of life. However because of some behaviour problems, post-operative care may prove challenging. To minimise any problems the manager is in the process of compiling comprehensive care and support records specifically for this, including all known and potential risks, so hospital staff have a good understanding of the service user’s likely behaviours and preferences. This includes an easy to read “traffic light” assessment document. A support worker will accompany the service user during the hospital stay. The home manager should be commended on the preparation work. All service users take prescribed medicines and Medicine Administration Record (MAR) charts are kept as evidence of medicines administered. Some of the prescriber’s instructions on the MAR charts had been changed or added to by handwritten instructions. However it has not been the home’s practice to require signatures or counter signatures to the handwritten changes for identification purposes in the event of an investigation being carried out. Medicines are currently stored in the manager’s office. It has not been the home’s practice to monitor the temperature of the area in which medicines are stored. The manager is now going to monitor the area to ensure medicines are kept at temperatures stipulated by their manufacturers to maximise the efficacy of treatment plans. The manager said the home has acquired a copy of The handling of Medicines in Social Care published by the Royal Pharmaceutical Society of Great Britain, as well as our internet Professional Advice, all of which provide homes with information on medicine administration and storage. Service user plans did not contain information on service users’ cultural and spiritual wishes on death and dying. Although this is a sensitive subject, it is an important aspect of care and should be addressed. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Service users who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to this service. Service users and or their advocates can be sure any issues and concerns are listened and acted upon. EVIDENCE: Service users are provided with a pack, which includes the Statement of Purpose, Service User Guide and complaints procedure. A review of the procedure, identified complaints will be responded to within 30 days. However, 28 days is seen as good practice. The procedure includes our contact details. The documents provided were not in an easy to read format. Service users have access to care managers, relatives and advocates who are involved in all aspects of service users care and lifestyle. During the subsequent telephone surveys, respondents indicated they would speak to the manager or providers if they had a concern or problem. The provider completed the AQAA used in support of this visit in October 2007. The document records there had been no complaints received by the home in the last 12 months. However it was difficult to obtain an update, as there is currently no method of coordinating complaints. It was also established that it has not been the home’s practice to record details of any “niggles” received about the service. Recording centrally all types of complaints and niggles may provide the home with a more effective way of auditing numbers and trends for quality assurance purposes. We have not received any complaints about the service. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 17 Support workers spoken with described appropriately the action they would take if they suspected abuse had taken place. The training matrix provided at the visit identified support workers have received abuse of adults with learning disabilities training. The home has a safeguarding policy and procedure, which interlinks with those of the County’s. However the document does not include contact details of the County’s coordinator. Including this information should minimise any delays in reporting incidents to the appropriate agency. To safeguard service users of this home and other care services, the AQAA records one referral has been made to the Protection of Vulnerable Adults List. Some service users have their own interest bearing bank accounts into which their benefits and allowances are paid. For other service users, their next of kin or advocates handle their financial affairs and send the home regular cheques for the respective service users needs. This money is collectively kept in a separate client account, which is non-interest bearing. Because of this the balance held on behalf of each service user using this service is deliberately kept low. Each service user has a separate wallet in which cash is held on their behalf. Records and receipts are maintained and available for auditing. Next of kin and advocates are provided with expenditure details at care reviews or on request. The records are subject to auditing by the sponsoring authority’s client affairs officer. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 18 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, 25, 26 and 30. Service users who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to this service. Service users live in a homely and comfortable environment. EVIDENCE: Hill Farm is clean, fresh, tidy and homely. Each service user has their own bedroom and has been supported to choose the décor and personalise them with their belongings. One room has been equipped with special sensory aids and a special mattress to calm and reduce the behaviours the service user sometimes exhibits. The equipment was obtained after consultation and input with the area’s learning disability team. Bedrooms do not have en suite facilities but they all have their own hand washbasin so service users can attend to their personal hygiene needs in private. There are a number of bathrooms, separate toilets and a shower room, so service users have a choice. A number of bedrooms have good views across the adjoining countryside and one service user in particular likes to spend time taking in the views with his binoculars. The service users spoken with indicated they liked their rooms. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 19 An environmental health officer inspected the kitchen in January 2008 and recorded very good standards found. The kitchen was clean and tidy on this visit. For health and safety and quality assurance purposes, the manager has implemented the “safer food – better business” systems for recording, checking and reviewing practices. This is good practice. The home has a secluded back garden and patio area, with tables, chairs and benches. During this visit many of the service users were seen at one time or other sitting in the garden or enjoying ball games on the lawn. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 20 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): 31, 32, 33, 34 and 35. Service users who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to this service. Service users’ care, social and emotional needs are promoted by a stable workforce in such numbers that meet their needs. EVIDENCE: In addition to support workers, staff are employed for fulltime therapies and activities, cooking, maintenance, cleaning and administration. In addition, the services of a self-employed therapist are used three mornings a week, to supplement the in house provision. The home is staffed 24 hours a day, including awake night staff. A member of staff interviewed said they receive regular supervision from the home manager and attend staff meetings. Since the AQAA was completed in October 2007 the manager said all support workers are now trained to either NVQ level 2 or 3. This is good practice and should provide support workers with the skills and knowledge required to perform their roles. Two personnel files were inspected. These contained evidence that recruitment checks are carried out. This includes requiring prospective support workers to obtain Criminal Record Bureau check clearance and seeking appropriate references from former employments. Regulation 19(4) Schedule Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 21 2, paragraph 6 requires full employment history, together with satisfactory written explanations of any gaps in employment, is obtained. One of the two files provided a complete history. However the other did not. It was noted on this visit that the application form in use only requires applicants to state five year’s employment history. The regulation came into force in 2004. During 2006 we published guidance to assist providers and managers in the development of their recruitment procedures and practices. The publications in question are called Safe and sound? Checking the suitability of new care staff in regulated social care services and Better safe than sorry – Improving the system that safeguards adults living in care homes. Both publications are available on our website – www.csci.org.uk. The files also enclosed signed evidence the support workers had been provided with a copy of the General Social Care Council’s code of conduct. A support worker interviewed said since working at the home she has had “loads of training, the training is very good and is supported in a very good team”. The support worker said this training included a two-week’s induction, health and safety, medication administration, Mental Capacity Act and challenging behaviours. The training matrix supplied in support of this visit recorded support workers and other staff have received training on subjects including infection control, speech/communication, sensory impairment, Schizophrenia, food hygiene, first aid, Autism, Mental Health, handling medication, Non Abusive Psychological Physical Intervention (NAPPI) and adult protection. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 22 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, 38, 39, 40 and 42. Service users who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to this service. Service users have the benefit of living in a home, which is managed by an enthusiastic home manager. EVIDENCE: The registered manager for this home is also the registered manager for an associated home. Hill Farm is run by a home manager who is NVQ level 4 Health and Social Care qualified. The home manager intends to commence on a registered manager’s award course shortly and then to apply to become the home’s registered manager. To support the home manager, the two providers of the company visit the home a number of days each week. However despite this, monthly reports of the visits are not routinely done as required by Regulation 26. The home Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 23 manager accessed our website during this visit to obtain our guidance, including the report template, so that monthly reports can be completed and kept at the home for our inspection at future visits. The provider said the home undertakes annual satisfaction surveys to obtain the views of service users and or their advocates. Views are also sought from advocates during regular telephone calls. The returned AQAA indicated policies and procedures were last updated in 2007. The document was completed in October 2007. However there was clear evidence on this visit that the majority of policies and procedures have been subsequently reviewed. This is good practice as support workers and other staff should have access to up to date guidance on good practice and regulation. As stated previously the home manager has implemented new systems in the monitoring of safe food handling. And the home has successfully achieved Investors in People status. Although it was not possible to communicate with all the service users at the visit, the interaction seen between service users and home manager was open and friendly. A support worker interviewed said, “the manager carries everyone along, is easily accessible and approachable and is a good listener”. And a care manager commented on how approachable the manager and staff are and that families are very happy with the care and support provided. The home’s training matrix indicates support workers and other appropriate support workers have received training in health and safety subjects including first aid, food hygiene, moving and handling and fire safety. Records indicated safety checks on fire equipment are regularly carried out, fire alarm checks are done weekly and fire drills carried out every six months. Since the return of the AQAA, some of the home’s equipment has been serviced in accordance with manufacturer’s instructions. This includes the lift. The service document indicated some work was required. The provider said this has been completed. Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 24 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 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 4 32 4 33 3 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 4 13 3 14 4 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 2 4 4 2 3 X 3 X Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 25 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. 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. Refer to Standard Good Practice Recommendations Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Hill Farm DS0000063115.V367500.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!