Inspection on 10/01/07 for Home Farm

This inspection was carried out on 10th January 2007.

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

Home Farm 07/01/10

Home Farm 27/02/06

Home Farm 19/07/05

Home Farm 04/03/05

Home Farm 19/08/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Griffin Lodge

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

CARE HOME ADULTS 18-65 Home Farm Camerton Workington Cumbria CA14 1LS Lead Inspector Liz Kelley Unannounced Inspection 10 January 2007 11:00 th Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Home Farm Address Camerton Workington Cumbria CA14 1LS 01900 606913 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) West House Mr Rodney James Casson Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 6 Residents to include: up to 6 Residents in the category of LD (Learning Disability under 65 years of age). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 27th February 2006 Date of last inspection Brief Description of the Service: Home Farm is operated by West House, a non-profit making organisation who run other similar homes in the area. The Home provides accommodation and care for six adults who have a learning disability. The home is a large detached house, situated in the village of Camerton off the main road between Seaton and Great Broughton. The communal areas, which are all on the ground floor, consist of kitchendining room, laundry room, and lounge. Two bedrooms are on the ground floor, with a further four on the first. There is a staff office and separate bedroom. A shower room is on the ground floor and a bathroom on the first floor, both have equipment to assist with mobility. There is a parking area to the sides of the Home, a private garden area and patio to the rear and sides. The home has a wheelchair accessible vehicle for Residents use. The current scale for charging is £1036.80 per week. A Handbook is available for prospective residents, the latest Commission for Social Care Inspection report is made available on request. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 4 hours. All six residents were at home across the day and spoken to. The manager and three members of staff were on duty and assisted with the inspection. Feedback cards had been received from residents, relatives and professionals. A full tour of the premises was carried out. Staff, resident’s records and administration files were examined. To help the inspector to write this report the home provided a self-assessment report/questionnaire. Information was also used on past information CSCI had about the home. This was all used to plan the inspection and to make judgements about the quality of care provided to residents. The overall picture gained by the Inspector was that residents were being offered an individually tailored service that promotes choice and quality of life for people living in the home. All residents, relative and professional survey cards were positive about their experience of the home. What the service does well: What has improved since the last inspection? After recent staff training residents are encouraged to be even more involved in their plan of care and to take stock of what they have achieved and what they would like for the future. Those people that had done this exercise had really enjoyed it and had suggestions that had surprised staff. For example one person had a wish to be picked up for a night out in a limousine, and they were supported to arrange this and invited other housemates to join in. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 6 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. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 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 Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good procedures and paperwork in place to ensure approriate refferals and that they accept only people who’s needs they can met. EVIDENCE: The homes Statement of Purpose and Service Users Guide contained relevant details to assist residents, relatives and professionals in making an informed choice on the appropriateness of the home. The Service Users Guide is available in different formats and is user friendly having symbols and pictures to illustrate and promote understanding. One service users described their introduction to the home which included a series of tea-time and over-night stays. These were carefully recorded and included input from family and social workers. This ensured that all relevant information and assessments were available to increase the likelihood of a successful of placement. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff work hard to encourage residents to take control and make informed choices which is carefully monitored through a well-developed system of care planning. EVIDENCE: The key principles of the home for delivering a quality service are based on the belief that residents should be able to take control of their lives. Staff are strongly committed to supporting all residents including those with limited communication to make informed decisions, understand the range of options which are available to them and that they have the right to take responsible risks. The resident plan is developed in partnership with the resident, based on an efficient assessment. The plan clearly sets out how specialist requirements will be met through positive and planned interventions. Residents are well supported through individually tailored support plans that promote positive interactions and experiences. The emphasis of these plans is to focus on the positives and what a person can achieve and build upon these achievements. This has proved very successful with a number of residents Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 10 making steps towards independence and choosing individuals hobbies and interests. Individual care plan files were well organised and laid out in a format that clearly identifies needs and how they were to be met. These are supported by additional information such as profiles and pen pictures to aid greater understanding and knowledge of the individual. Innovative methods are used to enable residents to participate and communicate their views to the development of their care plan and the review process. The plan focuses on current needs, development of skills, and future aspirations of the individual. This follows the principles of person centred planning. Staff have the necessary training and skills to support and encourage the individual to be fully involved. A key worker system provides additional support enabling one to one involvement. Staff have recently received training on using a Person Centred Approach and this was already benefiting Residents by increasing their involvement leading to increase in opportunities to try out new experiences. For example this had recently led to one resident being supported to hire a limousine for a night out which fulfilled one of her dreams. Risk assessments examined demonstrate that they under pin these activities and they are of a good quality and had clear instructions to inform staff. Risk assessments included details of restrictions imposed on residents for example limiting cigarettes. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Personal development and making informed decisions is a key feature for individuals and the staff team are skilled at enabling residents to make these choices. EVIDENCE: Care plans examined contained in-depth instructions for staff to enable and promote positive relationships with relatives and friends. Residents were observed interacting in a positive manner with staff and other residents. There was lively conversation and an interest in the welfare of others in the home. Good relationships had been built with neighbours and supportive friendships had been formed. Residents are enabled to make informed choices through one-to-one keyworker support and many examples were found and identified as good practice in this field. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 12 Family have expressed their satisfaction with the contact with the home and have said that communication has been good. Menus are planned with residents and a communal evening meal is encouraged. Although there is a weekly big shop for the house where residents choose to take part, individual shopping is also encouraged to develop independence and daily living skills. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Good systems have been developed to monitor individual’s health and medication, including established links with local health care professionals to ensure residents receive effective and timely health care. EVIDENCE: Staff have a good understanding of the support needs of residents. and work positively with local health care professionals to offer a responsive and supportive approach in assisting people to maintain their health. Staff have also developed good working relationships with these health care professionals and behaviour specialist, which have benefited Residents by the approach and strategies used. MAR sheets, which record medication given were examined and were in good order. Medications are kept in a secure locked cupboard, All staff are currently undertaking a Managing and Safe Handling of Medications through a local College, to Level 2 as reccommeded by CSCI guidance, and Level 1 for new staff as part of Induction. Health and personal care issues are well managed and residents are supported to make informed decisions. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 14 The home has sensitively handled the ageing process, as appropriate for some people, and offered support to minimise any impact on independence, including training and equipment. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents, and their families, know action will be taken to resolve any concerns and that their well being is safeguarded by the open approach of the home. EVIDENCE: The home has a satisfactory complaints system with residents being able to express their views on the home, and these are acted upon. Residents were observed freely expressing opinions to the manager, they said that they would feel able to speak to the manager, or staff about issues they had. The open atmosphere created within the home ensures that residents feel free to express their opinions and are confident that they will be listened to and concerns acted upon. Residents had been given a brochure with ways to make complaints in it and was in various formats to aid understanding. All six residents have regular contact with other people outside the home with whom they can discuss any problems, for example each person has a link with a day centre or work placement. Financial transactions on behalf of the residents were all documented and receipts and signatures gained to approve authorisation. The manager demonstrated a good awareness of different forms of abuse and the rights of the individual. The Home has induction training that covers adult protection issues and the various forms of adult abuse. These areas, and training in Adult Protection safeguarded residents from abuse. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a well kept and safely maintained home that is regularly up-graded to ensure a high standards. EVIDENCE: The home is a large converted farm house and has been adapted to suit the needs of residents. There is a large lounge with patio doors leading onto a patio, and residents chose between this room, their own bedrooms, all of which have easy chairs and televisions, and the dining kitchen. Residents also like to spend time in the staff office which also has easy chairs, and this creates an open friendly atmosphere with no barriers. This gives ample communal space and choice of for residents. The home has now been running for over 10 years and over this time the relationship with neighbours and the local community has steadily strengthened, with residents now very much part of the local community. Residents individuals bedrooms where of a good size and individualised to each persons tastes and interests. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 17 A programme of planned maintaince and renewal was available and areas recently up-graded were dining room floor and carpets to the lounge. Staff and residents work together to keep the home tidy and clean. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The staff recruitment, training and staffing practices of the home are well developed which ensures that residents’ well-being is promoted, by staff that have the qualities, aptitudes and skills to work in social care. EVIDENCE: has a stable workforce with a good mix of skills, experience, age, and gender, which reflects the profile of the residents. All staff are clear regarding their role and what is expected of them. Residents comment cards stated that staff working with them know what they are meant to do, and that they are able to meet their needs. This leads to good levels of confidence and satisfaction from residents, relatives and professionals with the care that is delivered. The Home follows the recruitment procedures of West House. Staff files are held in the home, and contained all the relevant documentation being clearly sectioned and well-organised. The selection procedure includes obtaining two written references, a formal interview and an informal interview involving residents, wherever possible. All staff had CRB disclosure checks and applications are subject to equal Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 19 opportunities monitoring. Upon appointment staff were issued with a handbook, which includes job descriptions and terms and conditions. Appointments are subject to a six-month probationary period. West House has a code of conduct and all members of staff have a statement of terms and conditions. A member of staff interviewed confirmed these practices. These are all good practices and ensure that residents are supported by a carefully selected and vetted staff team. The home has a framework for supervisions and appraisals, and these have been carried out to good standards; staff reported that these are helpful and they feel well supported by the manager and the organisation. Staff training continues to have a high profile in the home and staff are keen to gain new knowledge and skills that will assist them in supporting residents. For example all staff have recently completed a Safe Handling of Medication training course. The majority of staff, over 84 , now have a qualification in care, either NVQ 2/3 and the manager has the Registered managers award and NVQ 4 in care. Staff also receive varied training to equip them with skills and knowledge to support residents. A rolling programme of training includes first aid, abuse and neglect, fire wardens, moving and handling, health and safety and physical intervention training. Staff had been particularly vocal about the recent person centred planning training which they were keen to put into practice. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed by an experienced and competent manager who in turn is supported by a committed staff team who together run the home in the best interests of residents. EVIDENCE: The manager promotes an open, positive and inclusive atmosphere in the home through a variety of ways: regular staff meetings; regular supervision; and by inclusion of residents in the use of feedback and encouraging participation in users groups. There is strong evidence that the ethos of the Home is open and transparent. The views of both residents and staff are listened to, and valued. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 21 Staff had received all of the required training to ensure the health and safety of residents and themselves. Advice is taken from the local environmental health and fire officers regarding maintaining a safe environment. All the working practices in the home are safe and there are no preventable accidents. The home has a full range of policies and procedures to promote and protect residents’ health and safety. Staff consistently follows these. There is full and clearly written recording of all safety checks and there is no evidence of a failure to comply with other legislation. The home proactively consults other experts and agencies about health and safety issues. There is a good understanding of risk assessment and this is taken into account in all aspects of the running of the home. The quality assurance system confirms that the findings from risk assessments have been actioned and the home continuously improves its systems for health and safety. The Home has a comprehensive set of policy documents and procedures to guide and instruct staff on good practice. The manager ensures that staff follows the policies and procedures. Staff have practice handbooks and easy access to all documents, which are discussed during supervision, staff training and team meetings. Spot checks and quality monitoring systems provide management evidence that practice reflects the homes policies and procedures. The provider, West House, appoints an operations manager to carry out Quality Assurance checks (regulation 26). These are sent into the Commission for Social Care Inspection on a monthly basis. The registered persons have extensive knowledge and are highly confident in both strategic/ financial planning and review and have developed a detailed business and financial plan which gives a clear indicator of the success and efficiency of the business arrangements. The manager, in turn, has sound knowledge of both strategic and financial planning and review, and provides value for money through effective management. The administration systems within the home were found to be up-to-date and in good order, ensuring the home was run in an efficient and effective manner. Record keeping is of a consistently high standard. Records are kept securely and staff are aware of the requirements of the Data Protection Act. Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 22 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 3 2 3 3 3 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 4 33 x 34 4 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 4 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 x 4 x x 4 x Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 23 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Home Farm DS0000022561.V310069.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!