Inspection on 01/08/07 for Holme Farm Care Home

This inspection was carried out on 1st August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 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

Holme Farm Care Home 04/08/06

Holme Farm Care Home 28/02/06

Holme Farm Care Home 15/11/05

Holme Farm Care Home 20/01/05

Holme Farm Care Home 10/08/04

Holme Farm Care Home 30/03/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Holme Farm Care Home 9 Church Street Elsham Brigg North Lincolnshire DN20 0RG Lead Inspector Stephen Robertshaw Key Unannounced Inspection 1st August 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holme Farm Care Home Address 9 Church Street Elsham Brigg North Lincolnshire DN20 0RG 01652 688755 01652 681709 residential-home.elsham@fsmail.net 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) Mr Anthony John Steeper Mrs Janet Steeper Mr Anthony John Steeper Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th August 2006 Brief Description of the Service: Holme Farm is situated in the small village of Elsham. The home has open views across fields and fishing ponds and very pleasant accessible gardens. The home is registered for 20 male/female service users over the age of 65 years. The home is well maintained and provides a very homely environment. The service users accommodation is on one level and bedrooms are all single occupancy. Three of the bedrooms have ensuite facilities. The home has two lounges and a dining room. The home does not offer nursing care. Service users health needs are met with the assistance of other health care professionals for example general practitioners and district nurses. Information about the home and its services can be found in the statement of purpose and residents’ guide, both these documents are available from the manager of the home. Information detailed in the pre inspection questionnaire indicates the home charges between £337 and £345 per week. Service users that are private funded also have the following supplements to pay: £80 for ensuite and £60 for a bed-sit per month. The home charges third party top-up fees for bed-sit and ensuite rooms for local authority funded service users. In addition residents are expected to pay for hairdressing, private chiropody treatment, toiletries and newspapers/magazines. Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit was unannounced and took place on the 01st August 2007. The inspector was in the home for approximately six hours. The Commission gathered other information used for this inspection report from a variety of different sources since the time of the last inspection. This included an Annual Quality Assurance Assessment that was returned to the Commission by the homes management before the site visit took place. Surveys were also sent out to service users and staff and the inspector also contacted social workers for some of the service users that were case tracked. The inspector also spoke with nine of the service users, four visitors, three care staff and the manager of the home. The inspector would like to thank everyone who completed a questionnaire and/or took the time to talk to him during this inspection. Their comments and input have been a valuable source of information, which has helped provide the information included in this report. What the service does well: What has improved since the last inspection? The staff receive more of the training that they need to make sure that they understand how to look after the service users properly and safely. Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 6 All of the staff had received moving and handling training to make sure that they knew how to safely move service users. There are more activities for the service users this means that they can now choose from whether or not to join in a wide range of activities at the home and in the community. 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. Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that the service users have a full assessment of their needs completed before they are admitted to the home to make sure that they can be appropriately looked after there. EVIDENCE: The inspector case tracked three of the service users that were living at the home. All of their care files included a copy of their terms and agreements for the services that are provided at the home. However some of these only included the funding authorities terms and conditions and should also include the homes terms and conditions of residency. The manager of the service stated that on the file concerned this had been a oversight and would be amended immediately. Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 9 The costs for the services to be provided by the home are clear and service users or their representatives understood the additional costs that would be incurred for service users personal toiletries, chiropody services and newspapers and magazines. All of the care files seen by the inspector included a full assessment of their needs that had been completed before the service users had been admitted in to the home. The assessments were a combination of the homes pre-admission information and where appropriate a care management care assessment of need. The home can meet the assessed needs of the service users living there. A variety of evidence was provided to support this standard. This included the inspector’s direct observation of staff interactions with the service users, a tour of the premises, discussions with service users and interviews with management and staff. One service user stated to the inspector ‘I get everything that I need here, I am well looked after and so is everybody else’. On the day of the site visit evidence was provided that supported that service users are provided with trial visits at the home to make sure that it will meet their individual needs. A lady was visiting the service for her lunch the inspector was informed that this happens on a daily basis. She stated to the inspector that she was ‘visiting the home’ to see her friends as she had already met them on a period of respite care at the home. The lady also stated that she was also invited to attend any activities that were being provided at the home. The service users said that these opportunities were good as she was ‘not as good’ at doing things for herself now and accepted that at some stage she may have to move in to residential care on a more permanent basis. They stated that these opportunities helped to get her used to the other service users and the staff. Other service users also stated to the inspector that they had been given the opportunity to visit the home before they made a decision to move there to live. One stated ‘they let me stay here for a week before I decided to stay here’ and another said ‘I was allowed to come here for two weeks before I made a decision to stay’. The home does not provide intermediate care to service users. Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that the personal and healthcare needs of the service users are met through the home and its partners. EVIDENCE: The home does not provide nursing care to the service users, however, the records in the home showed that the healthcare needs of the service users are met through healthcare professionals that are based in the community. This included contact with GP’s, dentists, chiropodists and district nurses. The inspector observed the care files for three of the service users living at the home. All of these files included care plans that had been developed from the identified needs in the service users assessments. There were care plans provided through the placing agencies and also care plans that had been Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 11 developed by the care staff at the home. The care plans had also been evaluated on a regular basis to make sure that they were still appropriate to the individual service users needs. However, the content of some of the care plans was very basic and would be difficult for anyone new to follow or understand what care individual service users needed. One service user stated to the inspector that the care staff made sure that they were always physically and mentally well and that the support that they required was ‘marvellous, I can’t talk too highly of them, they really care for the people here’. A visitor to the service commented on the personal health of their relative since they arrived at the home and stated that they ‘looked a lot better since she came here’. Outside professionals spoken with by the inspector also confirmed that the staff at the home make sure that all of the service users healthcare needs are met and inform them of any changes in the service users daily health. The care file records seen by the inspector clearly indicated when service users had received any contact with outside professionals. Some of these records, however, did not include any outcomes from the appointments. The medication records in the home were appropriately stored and signed. Good administration records were also observed. Individual service users care files included information in relation to the medication that they were prescribed. The prescribed medication is provided through a local GP practice and is not put into monitored dosage cassettes. All of the medication in supplied in either bottles or boxes. Two staff sign to dispense the medication and then two staff also sign the administration of the medication. This method is used to maintain the safest practices for administering this type of medication to the service users. Interviews with care staff and observation of staff training records supported the evidence that all staff that administer medication to service users have received accredited medication training. All of the medication records were up to date and had been accurately recorded. There were no controlled drugs prescribed to any of the service users at the time of the inspection, however, the home had the appropriate storage and recording facilities for controlled drugs. Direct observation supported the evidence that service users privacy, dignity and respect are upheld at all times in the home. Service users confirmed to the inspector that they are free to make decisions for themselves at the home. The care files seen by the inspector all included the last wishes in the event of the deaths of the service users. Some of these were very detailed included the type of service to be held and what hymns to be sung. Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that the service users are supported to maintain the interests and hobbies that they had before they were admitted in to the home. EVIDENCE: Service users spoken with by the inspector and direct observations supported the evidence that daily routines in the home were flexible. The service users stated that that they were able to choose how they wanted to spend their day. Individuals spoken with confirmed that their wishes were kept in relation to the times of rising from and retiring to bed, preferences with bathing, personalising their bedrooms and how they could generally choose their meals and where to eat them. One service user commented ‘we also have large print library books that are changed regularly’. Another service user said ‘If I use my bell, someone will always come’. Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 13 The inspectors direct observations also supported the positive interactions between staff and service users and it was clear that staff worked towards building positive relationships and communication with them. Religious needs of individual service users were identified on their admission to the home. Service users spoken to by the inspector stated that if they wished to follow their religious practices then the care staff would support them to continue with this. This included access to local churches or to attend other religious services held in the community. The only religions identified for the service users in the home were Christian religions the care staff and manager were confident that service users admitted with other religions would have their needs met through the services provided to them at the home. The manager of the home stated that this would be appropriate in relation to the home ‘personal centred planning for individual service users’. Service users are encouraged to maintain contact with their families and friends. The daily record for activities identified any contact that they had with their families and friends. Service users spoken to by the inspector stated that their families are free to visit the home at any reasonable time. A visitor to the home confirmed that they are always made to feel welcome at the home and stated that ‘its always nice when we come here. It is always clean and tidy’. The service does not employ an activity co-ordinator, however, care workers are responsible for organising activities for a group or on a one to one basis with individual service users. This has improved the quality of the activities made available to the service users and provided greater opportunities for the service users to access the wider community. Staff confirmed to the inspector that the activities provided in the home included, bingo, quizzes, sing-a-longs, visiting entertainers and trips out. On the day of the inspection a singer was performing to the service users in the afternoon. The entertainer spoke with the inspector and stated that their experience of the home was that it was ‘one of the friendlier and better homes’ that they visited. The inspector observed the care staff casually reminding service users that the activity was due to begin in the lounge of the home. The singer also stated that ‘the owner is very hands on ‘in the home and supports any of the activities that are taking place’. Meals provided in the home are good. Weekly menus are provided, which demonstrated that a choice of meals was provided. Service users spoken to by the inspector were very positive in relation to the quality and variety of the meals provided in the home. One service user commented ‘there are two good cooks’, and another stated that the meals provided were ‘marvellous’. The inspector ate lunch with several of the service users. The meal was well presented and was full of taste. Service users that required support to complete their meals were seen to be offered support from the care staff that was provided in a professional manner that upheld the dignity and respect of the service users throughout the mealtime. The inspector observed choices being provided to service users who did not want the main meal that had been Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 14 prepared. Discussion between the inspector and the cook supported the evidence that demonstrated good knowledge of the service users food preferences and their food dislikes. The home was not catering for any specific diets, although the cook said the home would be able to accommodate any specific religious or cultural dietary requirements of residents. The cook was aware of where to access information and guidance about diets if this information was required. Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that the service users are safeguarded from possible abusive situations at the home and the complaints procedure is open and available to them. EVIDENCE: The home had an up to date complaints procedure available to the service users at the front of the home. Service users and visitors spoken to by the inspector were all confident that they knew how to make a complaint in relation to the services being provided at the home and they were very confident that any concerns or complaints raised would be appropriately dealt with by the management of the service. The Annual Quality Assurance assessment returned to the Commission showed that since the last inspection there had been no complaints made in relation to the care provided at the home. The complaints records in the home also reflected that there had been no complaints made in the last twelve months. There had been no safeguarding adults issues raised at the home since the last inspection. Records held with the home and with the Commission also supported this evidence. Staff training records and interviews with Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 16 management and care staff confirmed that the staff receive protection of vulnerable adult training to make sure that they can protect the service users form abuse at the home. Staff personnel files seen by the inspector all included appropriate safety vetting before they are employed to have any contact or work with the service users. This included appropriate references and Criminal Record Bureau checks. Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that the environment of the home is suitable to meet the needs of the service users. EVIDENCE: The inspector made a tour of the premises and found it to be very clean and tidy and it was free from any offensive odours. The home is currently being extended and the building works are safely guarded from the service users. There is a choice of communal areas for the service users to choose from to either spend time on their own, or with their peers, families or friends. All areas of the home seen by the inspector were decorated and were furbished to Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 18 a good standard. There was a clear maintenance programme in place and several of the rooms had been decorated since the last inspection. All of the toilets and bathrooms were spaced between the communal and bedroom areas. Four service users invited the inspector to look at their personal rooms. These rooms were observed to be furnished and decorated to their personal tastes and preferences. The service users spoken to by the inspector stated that they were very happy with their rooms. Care staff confirmed to the inspector that they are provided with all of the equipment that they require to safely transfer and care for the service users. This included a good supply of disposable gloves and aprons. The only difficulty the inspector observed with the environment was in the unlevelled floor between the older and newer parts of the home. This could cause a trip hazard to service users and should either be levelled, or a small incline to be introduced or appropriate signage to indicate the unlevelled floor. The manager of the home stated that they were aware of this and only fully mobile service users currently access this area, however, he added that appropriate actions would be taken to make the area safe for service users. The home has sluice facilities that are separate from the laundry facilities in the home. As the hot water temperatures are higher in this area to the remainder of the home it would be safer for the service users if the door to the sluice was secured when not in use to stop any unauthorised access. The homes washing machines are programmable to disinfection and sluicing standards. Service users confirmed to the inspector that they ‘always’ receive their own clothes back from the laundry. Visitors to the home also confirmed to the inspector that when they visit the service users are always in clean clothes that belong to them. All of the hot water outlets in the home have the temperature of them regulated, however there was no current process in the home to monitor the temperature of the hot water systems to make sure that service users were safe from scalds or burns from contact with hot water or pipes. Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that the care staff have the necessary skills and knowledge to care for the service users in the home. EVIDENCE: The inspector observed the staff personnel and training files for three of the staff that worked in the home. The staff rotas were also observed and these suggested that there are always appropriate numbers of care staff available to care for the needs of the service users. The staff records showed that there were no staff working at the home that were under eighteen years of age, and no staff under twenty-one were ever left responsible for the running of the service. Twelve out of the eighteen care staff had completed National Vocational Qualification 2 (NVQ 2) in care. This equates to approximately sixty-seven percent of the staff that have completed the award. A further three of the care staff are enrolled on the award and are working towards it. Seven of the care staff have also completed NVQ 3 in care. The manager stated that they have recently experienced some difficulties with the homes NVQ training and Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 20 therefore are looking for another provider for the training. One service users spoken to by the inspector stated that the staff ‘are marvellous, I cant talk too highly of them, they really care for the people here’, another service user supported this by saying ‘they are ever so good to you, I could never speak too highly of them’. The staff personnel files supported the evidence that they are employed following equal opportunity policies and procedures and in the best interests of protecting the service users from harm and abuse. This included two written references and Criminal Records Bureau (CRB) safety checks before they are employed to have any contact with the service users. Since the last inspection the care staff have been provided with more individual time with the service users to enable them to engage in more regular and more diverse activities. The new activities now include trips out to the coast and to local markets and places of interest. The home has its own transport and the care staff are assessed before they are allowed to transport the service users on the minibus. The staff are also now recording when service users refuse to take part in the homes activities this is so that the activities that are offered are appropriate to all of the service users. Interviews with management and staff and observation of staff training records showed that the mandatory training for the care staff had all been either completed or had been planned to take place in the next few months. The home also employs three domestic staff, and one laundry worker. These all work very hard to maintain the upkeep of the home and to ensure that the service users have clean clothes to wear at all times. Two cooks are employed at the home and there are also two kitchen assistants. The kitchen was very clean and the service users were very positive in relation to the meals that they receive at the home. The doors leading in to the kitchen do not lock and the sharp kitchen knives are kept in a drawer. The inspector informed the manager of the home that these knives needed to be secured to make sure that nobody could access the knives if they did not have the correct authorisation. Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. This means that the management of the home supports the care of the service users and the safe working practices of the service. EVIDENCE: The proprietor of the home is also the registered manager. He has completed the work for the Registered Managers Award and is waiting for this to be verified. As previously identified the home have had difficulty with the company that was providing their NVQ training and is no longer trading. An alternative training agency is being sought to verify the completed work. Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 22 The senior care supervisor in the home has completed the NVQ 4 in care. The inspectors direct observations supports the evidence that the management approach of the home is open, positive and inclusive. Interviews with staff and discussions with service users also supported that the management of the home is open ands supportive. One service user commented that the manager of the home was ‘very hands on’ and involved in the care being provided to the service users. Although the personal finances for the majority of the service users are the responsibility of their families the manager of the home is the Department of Working Pensions (DWP) appointee for one of the service users. The service user also has access to an advocate to make sure that their finances are being dealt with appropriately. The financial records for this service user were observed by the inspector and were up to date and had been accurately recorded. The home has previously had an effective quality assurance and monitoring system, however this had not been updated since March 2006. The inspector informed the manager that this was an important system for the home to identify how other people viewed the services that they provide and stated that this must be reintroduced within a short time scale. The service user and staff meetings records showed that they are not held on a regular basis. These meetings should be held more regularly and the information gained through them could help to support the homes quality assurance and monitoring systems. The staff supervision records and interviews with management and staff suggested that the care staff do not receive the recommended minimum of six formal recorded supervision periods per year and their annual appraisals were not up to date. The majority of the homes records that are required by regulation were in position, however not all documents completed by staff had been signed by the person completing them, and the care plans and medical appointment records needed to include greater detail to recognise the needs of the service users and how they should be met. The home had the appropriate maintenance certificates for the fire system and fire fighting equipment. Record showed that maintenance and servicing had been carried out on the fixed bath hoist. The accident books were filled in appropriately and where appropriate regulation 37 reports had been submitted to the Commission. Guidance issued by the Medical Devices Agency were available to the care staff in relation to when bed rails are used for individual service users. Only one Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 23 service user has bed rails in use and a risk assessment was in position to support this practice. Staff training records and discussion with staff and management evidenced that although some staff had not completed all of their mandatory training most had been completed and the remainder had been planned. Holme Farm Care Home DS0000002905.V347839.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 2 3 3 3 3 3 STAFFING Standard No Score 27 2 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 2 2 3 Holme Farm Care Home DS0000002905.V347839.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. 1. Standard OP7 OP37 Regulation 15.1 Requirement The responsible individual must make sure that the individual service users care plans are developed to include more detail of how their needs must be met at the home. For example if the care plan recognises that a service user requires support to have a bath or shower, the plan should also identify how that needs to be met for example either encouragement or hands on support. The registered person must make sure that the hot water temperatures in the home are regularly monitored to ensure the health and safety of the service users. The registered person must make sure that the home has an effective quality assurance and monitoring system. This will allow the management to gather information from other people to see how they view the services that are being provided at Holme Farm. DS0000002905.V347839.R01.S.doc Timescale for action 30/09/07 2. OP21 23.1b 30/12/07 3. OP33 24 28/02/08 Holme Farm Care Home Version 5.2 Page 26 4. OP36 18.2 The registered person must make sure that the care staff receive the recommended minimum of six formal recorded supervision periods per year (pro-rata) and this also includes an annual appraisal of their performances. This will support the staff in their roles and identify any training that they may require. 30/03/08 Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 27 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. Refer to Standard OP2 OP8 Good Practice Recommendations The registered person should make sure that all of the service users have a contact for their terms and conditions of residency at the home. The registered person should make sure that service users contact with outside healthcare professionals is fully recorded including any expected outcomes or identifying any new care plans that need to be implemented due to the information recorded. The registered person should make sure that all of the care staff understand the policies and procedures for the local authorities safeguarding adult team. This will help to put in to context the protection for Vulnerable Adult training that they already receive. The registered person should make safe the un-level floor in the corridor to ensure the health and safety of the service users. The registered person should make sure that the kitchen knives are safely stored to ensure the safety of all of the people in the home. The registered person should make sure that a lock is fitted to the sluice room door so that unauthorised entry to the room cannot be accessed due to the hot water temperatures in this area and to protect the health and safety of the service users. The registered person should continue with the staff mandatory and specialist training programme to provide the staff with the necessary knowledge and skills to be able to care for the service users. The registered person should make sure that all documents completed by the staff have been signed by the person that has made them so that they are identifiable at a later date if required. 3. OP18 4. 5. 6. OP19 OP19 OP21 7. OP27 8. OP37 Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Holme Farm Care Home DS0000002905.V347839.R01.S.doc Version 5.2 Page 29 - 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. 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