Inspection on 15/11/05 for Holme Farm Care Home

This inspection was carried out on 15th November 2005.

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

The inspector 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 01/08/07

Holme Farm Care Home 04/08/06

Holme Farm Care Home 28/02/06

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 ORG Lead Inspector Ms Matun Wawryk Unannounced Inspection 15th November 2005 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.V260735.R01.S.doc Version 5.0 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.V260735.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Holme Farm Care Home Address 9 Church Street Elsham Brigg North Lincolnshire DN20 ORG 01652 688755 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) residential_home.elsham@fsmail.net 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.V260735.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the Registered Manager commences the Registered Managers Award and NVQ level 4 in Care before 31st October 2005. 20th January 2005 Date of last inspection 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. Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on the 9th November 2005. The Inspector spoke to the manager and three care workers who were on duty at the time of the inspection. Throughout the day the Inspector spoke individually to five people who lived in home and had lunch with a small group of service users. In addition the inspector also looked at a range of paperwork and records including staff recruitment, induction, supervision and training records, the staff rota and a sample of care plans. The inspector completed a partial tour of the building. What the service does well: The home appeared clean and tidy and had a welcoming and homely feel. Information provided to prospective service users and their carers is detailed thereby enabling them to make informed decisions about whether the home can meet their needs. There was a core group of staff that had worked at the home for several years and knew the service users well. Service users spoken to say the care workers were caring and kind, although busy. Service users stated the staff respected their privacy and dignity. Service users spoken to stated that the meals were very good. All the service users said the quality of the food was excellent and that they had plenty to eat and drink. If they didn’t like the choices on offer they could have an alternative. Staff reported that relatives are made to feel welcome when visiting the home; records and discussions with service users confirmed this, thereby helping service users to maintain family contacts. Staff commented that access to training was very good. This means staff are provided with relevant training to enable them to meet the changing needs of service users. Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 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.V260735.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 Information provided to prospective service users and their carers is detailed thereby enabling them to make informed decisions about whether the home can meet their needs. Not all service users had their needs assessed prior to admission to the home. This is needed to ensure the home is able to provide the necessary care and support. EVIDENCE: The home had a statement of purpose and service user guide. Both these documents include information set out in National Minimum Standard 1, Regulation 5 and Schedule 1 of the Care Homes Care Regulations. The inspector saw evidence that the guide was routinely issued to new service users and/or their carers. Both documents required updating to reflect recent management changes. This is needed to meet legal requirements and must now happen. Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 Page 9 The inspector examined the care records for one service user who had been recently admitted to the home. The service user was self-funding. There was no evidence to show the registered person had completed a needs assessment for this person. In the absence of a local authority needs assessment the registered person must ensure needs assessment are completed prior to a service user being admitted to the home. Where necessary assessment reports must be updated to reflect changes in the service users circumstances and needs. Without this there is no assurance that the home is able to provide necessary care and support. From records seen there was no evidence to indicate the manager formally wrote to potential service users following the assessment stating that the home was able to meet their needs. This must now happen. This is needed to meet legal requirements. Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Some care plans did not include all the information staff need to meet the service users assessed needs. The absence of important information potentially puts service users at risk and means their care and health needs may not be met. Personal support is offered in such a way as to promote and protect the service users right to privacy and dignity EVIDENCE: The Inspector examined four care plans and the quality and quantity of information varied. Two care plans were comprehensive with all areas of assessed needs covered. The care plan for one service user did not reflect all areas of identified needs. For example the local authority assessment record and care plan for this person, identified concerns about psychological health and manual handling issues related to the service users medical condition. Similarly the care plan for another service user was very basic and although the service user had significant memory impairment the care plans and risk assessments did not fully detail the service users needs in this area. The registered person must ensure care plans set out all the service users care needs including psychological health needs and that they contain sufficient Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 Page 11 detail to ensure staff have necessary information to deliver all the care that’s needed. Individual plans and discussions with staff and service users showed that the health care needs of the service users were generally being met and that service users had access to health care services as required. A record of health screening and visits to and from health care professionals was kept for each service user. The home had a range of risk assessment tools for example, manual handling, water low and nutritional screening. In some cases information was brief for example, the needs assessment provided by a the local authority for one service identified manual handling issues associated with the persons medical condition. This matter was not fully addressed in the manual handling risk assessment. Similarly for those service users at risk of developing pressure areas, general guidance was noted in the files examined. This standard format does not reflect, nor promote a personalised approach to care delivery. The inspector advises that for those service users at risk of developing pressure areas, individual care plans are developed. These must contain sufficient information to guide staff practice for example, they should set out in detail tasks staff are expected to carryout for that individual e.g. where ‘regular’ positional changes are advised care plans must be more specific in terms frequency, manovovours and monitoring arrangements etc. Training records and discussions with staff did not evidence that staff with responsibility for completing service user risk assessments for example, manual-handling assessments had been provided with relevant training. The registered person must ensure staff that complete risk assessments are provided with training. Training must be linked to the areas of risk being assessed. This is needed to ensure staff have necessary skills and knowledge to carryout out this role safely and competently. Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 15 Service users are encouraged and supported to maintain family links and friendships. The meals in the home are good offering choice and variety. EVIDENCE: Staff reported that service user’s visitors are made welcome at any reasonable time. Visitors are required to sign in and out when entering and leaving the home for health and safety reasons. The home does not provide a separate visitor’s room. However the home provides a variety of communal space, which visitors can use; in addition service users entertain visitors in their own rooms. Key workers helped service users to maintain family contacts by sending cards at significant occasions such as birthdays and Christmas where this was needed. This means service users are enabled and supported to maintain family contacts. This was confirmed in discussions with service users. The home provides service users with three meals a day and a light supper. Staff advised the inspector that hot drinks are available at set times and or on request. This was confirmed in discussions with service users. All of the service users spoken to said the meals were good and that choice of meals was provided. Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The home had a satisfactory complaints procedure. Service users, their relatives and staff can be assured their complaints will be listened to and acted upon. The arrangements for handling allegations or suspicions of abuse must be improved through the provision of staff training. EVIDENCE: The complaints procedure is clearly set out in the service user guide and timescales for resolution and contact details are provided. Feedback from discussions with service users and staff evidenced they would feel confident in making a complaint if this was necessary. This means complainants feel assured their complaints and concerns will be listened too and acted upon. The home had an adult protection and whistle blowing procedure. Examination of staff training records and discussions with the manager, highlighted staff had not had specific adult abuse training. This is needed to ensure staff fully understand and are able recognise potential abusive practices and to ensure staff are fully aware of their responsibilities and reporting arrangements. Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 & 26 The home was clean and was free from mal-odours. Service users bedrooms were found to be safe, homely and furnished with their own possessions to varying degrees. EVIDENCE: The inspector carried out a partial tour of the home. A full tour of the premises will be carried out at the next inspection. The home appeared clean and tidy and had a welcoming and homely feel. The home met the requirements of local environmental health and fire departments. There is ample car parking facilities and CCTV is not used in the home or grounds. Service user bedrooms see were personalised according to individual preferences. All of the service users spoken to stated they were very happy with their rooms. All commented that they had everything they needed. Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30 Staffing levels are sufficient to meet the needs of service users. The arrangements for vetting staff before they start working in the home do not ensure the safety and protection of service users. Staff training arrangements are generally satisfactory, however staff must be provided with training in manual handling. This is needed to ensure the health, welfare and safety of service users and staff. EVIDENCE: Staff interviewed were very clear about their roles and responsibilities and understood the management and reporting structures for the home. Feedback from staff and examination of the rota indicates staffing levels are generally satisfactory. The inspector examined a sample of staff personnel records. Records showed recruitment practice was not in line with regulation 19 of the Care Homes Regulations. For example, one staff member had had her Criminal Records Bureau (CRB) check completed by a previous employer. The manager had allowed the worker to commence working in the home without carrying out a Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 Page 16 POVA 1st check. An updated CRB check had been sought but again had not been obtained prior to the worker starting in the home. Similarly records for three other workers showed inconsistent vetting practice. Two workers had commenced working in the home prior to a POVA 1st check. CRB checks had been obtained after they commenced employment. Records for one worker showed a POVA 1st check had not been carried out, a CRB check had been requested but at the time of the inspection had not received. Records for one worker showed one written reference had been obtained after they commenced working in the home. This practice potentially puts service users at risk and must cease. The registered person must ensure staff do not commence working in the home unless a POVA 1st check has carried out or a satisfactory CRB check and two written references have been obtained. Records and discussions with staff evidenced that the home was committed to the provision of training. The manager reported that induction training was provided to Skills for Care (formerly TOPPS) standards, but documents to evidence that this training was provided were not available as the staff kept their own books. The home had implemented an NVQ training programme for staff. Records examined did not evidence staff were fully up to date with all areas of mandatory training particularly manual handling. This potentially put service users and staff at risk and training must now be provided. Records for one of the cooks indicated their food hygiene certificate was just out of date. The registered person must ensure the cook completes a recognised training course. This is needed to meet legal requirements. Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 36 The management arrangements for the home are satisfactory. However the manager must obtain a relevant management qualification. A Condition of Registration for the manager to complete NVQ 4 has not been met within the required timescale. EVIDENCE: The owner of the home is also the registered manager for the home. The manager had enrolled to complete the Registered Managers Award. This was needed to meet legal requirements. In interviews staff demonstrated a clear understanding of their roles and responsibilities, management and reporting structures. Staff reported that the manager and senior carers were efficient and approachable. Systems were in Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 Page 18 place for the manager to brief staff and to receive feedback from staff for example staff meetings, supervision and handovers. The manager had implemented a staff supervision programme and examination of a sample of supervision records showed supervision was provided on a regular basis. Staff appraisals had been completed. This means staff receive necessary guidance and support to carry out their duties. Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 Page 19 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 2 X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 X 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 3 X X Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No 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 OP1 Regulation 4&5 Requirement The registered person must update the statement of purpose and service users guide to reflect the management changes. Timescale of 31st March 2005 not met The registered person must ensure that all service users are assessed prior to admission to establish if the home can meet the service users needs and a full assessment must be completed on admission to ensure that all the service users needs, including health needs, and associated risks are identified. Timescale of 20.1.05 not met The registered manager must complete NVQ 4 in management and care. The registered person must ensure care plans reflect all areas of identified need including social, emotional, health and psychological health needs. The registered person must ensure staff are provided with adult abuse training DS0000002905.V260735.R01.S.doc Timescale for action 31/12/05 2 OP8OP3 14, 13 30/11/05 3 4 OP31 OP8OP7 9 15 31/12/05 31/12/05 5 OP18 13 31/01/06 Holme Farm Care Home Version 5.0 Page 21 6 OP29 19(1)(b) 7 OP29 19(1)(b) 8 OP3 14(1)(d) 9 OP38OP30 OP8 13 The registered person must ensure staff do not commence working in the home unless POVA 1st checks have been completed or a satisfactory CRB check has been obtained The registered person must ensure staff do not commence working in the home until two satisfactory references have been obtained The registered person must write to potential service users or their representatives following the assessment stating the home is able to meet their needs. The registered person must ensure staff responsible for completing service users risk assessments are provided with relevant training. Training must be linked to the areas of risk being assessed The registered person must ensure the cook obtains a current food hygiene certificate The registered person must ensure staff are provided with manual handling training 30/11/05 30/11/05 30/11/05 28/02/06 10 11 OP30 OP3 18 18(1)(a) 28/02/06 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP26 Good Practice Recommendations The proprietor should consider the purchase of a washing machine with a sluicing facility for the future. Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Holme Farm Care Home DS0000002905.V260735.R01.S.doc Version 5.0 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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