Inspection on 07/03/06 for Hill Farm

This inspection was carried out on 7th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hill Farm 17/07/09

Hill Farm 23/07/08

Hill Farm 16/10/06

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 09/07/2008.

CARE HOME ADULTS 18-65 Hill Farm Hill Farm 15 Keycol Hill Sittingbourne Kent ME9 8LZ Lead Inspector Ruth Burnham Announced Inspection 7th March 2006 10:00 Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 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.V281681.R01.S.doc Version 5.1 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.V281681.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hill Farm Address Hill Farm 15 Keycol Hill Sittingbourne Kent ME9 8LZ 01795 841220 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 Gary Greening Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd June 2005 Brief Description of the Service: The Home offers services for people with learning disabilities who have challenging behaviour/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 & assistance. The Home is a detached property with accommodation on two floors. Accommodation is provided in 9 single bedrooms, some of which are located on the ground floor, all of which have call bell points & T.V points. There is a shaft lift providing wheelchair access to the first floor. Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on 7 March 2006 from 09:00 to 13:00hrs. The inspector was helped with this inspection by the deputy manager, the manager and the administrator, other staff and people who live in the home were spoken to and observed during the inspection. It was found that many of the National Minimum Standards had been met or partially met and that the overall quality of care provided was good. In some instances the judgment of compliance was based solely on verbal responses given by those spoken with. Not all the standards were assessed at this inspection, but these standards were met during the last inspections. What the service does well: What has improved since the last inspection? What they could do better: A detailed record of all food provided shall be maintained and the kitchen must be kept clean. Criminal record Bureau checks and references must be obtained prior to appointment of staff and the manager should have a suitable management qualification and must set up an effective quality assurance system which produces a report for people who live in the home and the Commission in line with the regulations. All staff should be trained in infection control and have training in respect of the specialist conditions of people who live in the home, they should receive formal supervision at least 6 times a year. Safe working practice should be based on individual assessments rather than the imposition of blanket policies. Views from bedroom windows should not be obscured Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 Page 6 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. Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 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 the following standard(s): 5 The rights and security of people who live in the home are protected. EVIDENCE: People who live in the home have their rights and security safeguarded through the provision of individual contracts which include details of the room which they occupy and the level of fees which are charged, these documents are gradually being signed by all parties as reviews are carried out. Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 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 the following standard(s): 10 The confidentiality of people who live in the home is respected. EVIDENCE: People who live in the home can be confident that information about them is handled appropriately, records are stored securely when not in use and are available solely to authorised and appropriate people. There are clear policies about confidentiality and staff induction training includes this. Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 17 People who live in the home are offered choice at mealtimes from a varied menu however blanket policies do not promote the dignity of residents. EVIDENCE: Menus have been planned to ensure that people in the home are offered a choice of nutritious food. A record of meals provided is recorded each day, advice was given that his record should be expanded to include more detail and should include any snacks which are provided throughout the day and in the evening. Morning teas and coffees were served to residents in coloured plastic beakers whilst staff drank from china mugs, the manager explained that this was because of risk of injury through throwing or chewing when china crockery was provided, it was agreed that individual risk assessments should be drawn up rather than a blanket policy being imposed and that more appropriate drinking vessels would be provided which were safe, age appropriate and promoted the dignity of people who live in the home. Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 Page 11 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 the following standard(s): EVIDENCE: Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 Page 12 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 the following standard(s): These standards were examined at the previous inspection and were found to have been met. EVIDENCE: Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 26 & 30 People who live in the home benefit from the large single bedrooms however views from some windows have been obscured. The residents are at risk from poor hygiene standards in the kitchen. EVIDENCE: People who live in the home benefit from the provision of single bedrooms which are large and personalised, each room has a wash hand basin and the type and amount of furniture in service users’ rooms was suitable for them. In two of the bedrooms located at the back of the house views have been obscured by frosting lower panes, this has been done to protect the dignity of the occupants, whilst the reasons are understood an alternative solution should be found which does not prevent the occupants from enjoying the view from their bedroom windows. People who live in the home are being placed at risk through the poor hygiene standards in the kitchen, the oven and microwave were dirty, tiling was damaged and the edges of the floor were also dirty, out of date food was found in the fridge. Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 - 36 People who live in the home benefit from the support of a qualified staff team however they may be at risk through inadequate recruitment practices and some of their needs may not be fully understood due to lack of specialist training. EVIDENCE: People who live in the home benefit from the care provided by a staff team who are clear about their roles and responsibilities, clear job descriptions are provided for support staff, seniors and managers and observation on the day of the inspection showed that the residents benefit from the way that the team work together. Residents can be confident in the commitment of the company to increase the skills of staff through National Vocational Qualifications and foundation training in line with national guidelines. Staffing levels are determined by the needs of people who live in the home and are reviewed regularly. There are clear recruitment policies and procedures to protect residents however the company has not caught up with recent guidance from the Criminal Records Bureau in that some staff are still working on checks carried out by previous employers, it was agreed that criminal record checks and references would be taken up immediately for all newly appointed staff to ensure that residents continue to be protected. Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 Page 15 Staff files which were examined were well maintained and up to date with 2 written reference and copies of documentation required under the regulations. People who live in the home benefit from the variety of training which is provided for staff to enhance their skills and understanding however residents who are experiencing mental health difficulties or other specialist conditions such as autism in addition to their learning disability may not be adequately supported as the majority of staff have not received training in these areas. It was of further concern that formal supervision in the home has not been provided for staff as often as the standard recommends however the manager said that he is addressing this issue through training more senior staff to take on a supervisory role. All staff receive annual appraisal when performance is assessed and training needs are identified. Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 People who live in the home benefit from a generally well run service however there is no effective quality assurance system and there may be some risk to their safety through lack of training and risk management. EVIDENCE: People who live in the home benefit from a generally well run service, the registered manager who is also a partner in the company, has many years experience and has a relevant nursing qualification however he does not have the Registered Manager Award and intends to recruit a qualified manager to take over the role. There is no clear quality assurance system which is based on action planning and review to demonstrate continuous improvement in the service for people who live in the home which takes account of their views and the views of others who are involved in their care. A report of any quality review is not being provided to the commission in line with the regulations. The safety of people who live in the home is promoted through the implementation of safe working practices in that staff receive training in health and safety, moving and handling, first aid , fire safety and basic food hygiene Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 Page 17 however some risks in relation to infection control were identified during the inspection and the majority of staff have not received training in this area. There may be further risk to the safety of people who live in the home due to the very hot water temperatures at some outlets which were checked during the inspection, the manager explained that work was being carried out to the systems and that a risk assessment will be carried out and temperatures monitored to ensure the safety of service users whilst the problems are being sorted out. Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 Page 18 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 4 5 CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x x x 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x x 3 ENVIRONMENT Standard No Score 24 x 25 x 26 2 27 x 28 x 29 x 30 1 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x 2 x 2 x x 2 x Version 5.1 Page 19 Hill Farm DS0000063115.V281681.R01.S.doc 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 YA17 Regulation Sched. 4 Requirement The registered person shall maintain in the care home records of the food provided for service users in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. Timescale for action 30/04/06 2 YA30 16(2)(j) The registered person shall, after 30/04/06 consultation with the environmental health authority, make suitable arrangements for maintaining satisfactory standards of hygiene in the care home; specifically the kitchen must be maintained to a satisfactory standard of cleanliness The registered person shall not employ a person to work at the care home unless he has obtained in respect of that person the information and documents specified in Schedule 2, specifically a current CRB DS0000063115.V281681.R01.S.doc 3 YA34 19. Sched. 2 30/04/06 Hill Farm Version 5.1 Page 20 check and 2 written references. 4 YA35 19(5)(b) The registered person shall ensure that all staff have qualifications suitable to the work that he is to perform, and the skills and experience necessary for such work; specifically training in mental health needs and other specialist needs such as autism. A person is not fit to manage a care home unless he has the qualifications, skills and experience necessary for managing the care home. 30/04/06 5 YA37 9(2) 30/04/06 6 YA39 24 The registered person shall establish and maintain a system for reviewing at appropriate intervals and improving the quality of care provided at the care home. The registered person shall supply to the Commission a report in respect of any review conducted by him and make a copy of the report available to service users. The system shall provide for consultation with service users and their representatives. 30/04/06 7 YA42 13(3) & (4) The registered person shall make 30/04/06 suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home through training and satisfactory standards of hygiene. The registered person shall ensure that all parts of the home DS0000063115.V281681.R01.S.doc Version 5.1 Page 21 Hill Farm to which service users have access are so far as reasonably practicable free from hazards to their safety and unnecessary risks to the health or safety of service users are identified and so far as possible eliminated, 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. 2 3 Refer to Standard YA26 YA36 YA17 Good Practice Recommendations Views from bedroom windows should not be obscured All care staff should receive formal supervision at least 6 times a year Blanket policies such as the use of coloured plastic beakers for all service users should be reviewed and individual risk assessments used as a basis for future practice which should always promote dignity and be age appropriate. Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Hill Farm DS0000063115.V281681.R01.S.doc Version 5.1 Page 23 - 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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