Inspection on 19/07/05 for Home Farm

This inspection was carried out on 19th July 2005.

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

Home Farm 07/01/10

Home Farm 10/01/07

Home Farm 27/02/06

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 Gordon Chivers Unannounced 19 July 2005 09:30 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 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 Stationary 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 F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Home Farm Address Camerton Workington Cumbria CA14 1LS 01900 606913 Telephone number Fax number Email 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 Rodney James Casson Care Home 6 Category(ies) of LD - Learning Disability registration, with number of places Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 6 service users to include: up to 6 service users in the category of LD (Learning Disability under 65 years of age) 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection.. Date of last inspection 04 March 2005 Brief Description of the Service: Home Farm is staffed by West House and provides care and services for six people with a learning disability. The home, which is a large detached house, is situated in the village of Camerton off the main road between Seaton and Great Broughton. Home transport facilitates access to local amenities and facilities for service users. Car parking is available to the sides of the home. Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, commencing at 09.30 and lasting seven hours. The inspection took place in the presence of the manager, Rodney Casson, and included interviews with one of the service users and one member of staff. The inspection focused upon those standards which were not assessed by the last inspection. The inspector would like to thank the service users and staff of Home Farm for their welcome and cooperation during this inspection. What the service does well: 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 Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 6 contacting your local CSCI office. Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 The home provides comprehensive information and written contracts for service users. It accepts admissions only on the basis of full assessments and after a suitable process of introduction. Plans are put in place to meet service users’ needs and aspirations and the home undertakes some good work in this respect, although its systems for administering and managing these processes could be better coordinated. EVIDENCE: The home has a Statement of Purpose and a Service User Guide, both of which contain useful and comprehensive information about the home and Westhouse for prospective (and current) service users. This information includes the facilities in the home, the services provided, the staff team, the values and aims of the service, and other issues such as personal belongings and contact with relatives and friends. All the service users have had full assessments of need, risk assessments and person-centred plans completed with and for them. These are all reviewed periodically. The person-centred plans identify service users’ aspirations and how they might be met; and the care plans identify how to meet the assessed needs. These are developed with reference to the strategies and measures to manage and control the assessed risks and about which the service users have given their agreement. The home maintains daily and periodic records of service users’ behaviours and activities. The manager gave some examples of Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 9 innovative and effective work undertaken by staff in managing challenging behaviours and in supporting the service users towards achieving the goals of their person-centred and care plans. In one particular example, the manager resisted plans to move one of the service users to an alternative living arrangement because they had been based upon inadequate and incorrect risk and needs assessments. Unfortunately, not all of this work is recorded in the case files. The goals of the person-centred plans are reviewed on an apparent ad-hoc basis. Reviews of the care plans are not always undertaken every six months as prescribed by Westhouse’s procedures, and the review format actually focuses back upon the assessed need rather than upon the effectiveness of actions identified to meet those needs. All of these assessments, plans and reviews appear to be in operation in parallel with each other, and there is little coordination between all these various elements of the overall care management process. The manager is currently transferring the contents of the case files into another format which he hopes will better rationalise the process and make it more user friendly. Each service user has a contract or terms and conditions of residency in their case files. These are signed by or on behalf of the service user, and by a representative of Westhouse. The manager will ensure that those families who maintain contact with service users have a copy of these. Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 8 Service users have chosen to be consulted on everyday issues on an individual basis rather than as a group. They are not always directly involved or represented in care planning or reviews. EVIDENCE: The service users have declined the offer to have regular, formal meetings of their own or to sit-in on staff meetings. Consultation therefore takes place on a one to one basis, although some service users may take it upon themselves to consult with the others and to make representation to the manager or staff on behalf of the whole group. Domestic and leisure issues tend to get dealt with as and when they arise. Service users are not always involved directly in care plan reviews, and for those without any active family support the home has experienced difficulty in arranging advocacy support or representation. Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17 Staff support service users to make their own choices and decisions and encourage them to take responsibility for their own actions. Service users have a varied and balanced diet and meals which they are able to eat and enjoy eating. EVIDENCE: Service users are afforded the right to make their own decisions over a range of everyday living issues such as bedtimes, clothes to be worn, daytime and leisure activities. Staff were observed to be respectful to and of service users and were there to support them in their decisions. Staff also actively encourage service users to take responsibility for their own actions. For example service users sign their agreement to strategies to restrain them from unacceptable behaviours, and they are involved directly in rewriting their person-centred and care plans into the new format. The weekly menu sheets reveal a varied and balanced range of meals, including vegetables and fruit. Staff attempt to dissuade them from an excess of chips and other fatty foods. The menus are informed by any service users’ dietary prescriptions as well as their likes and dislikes. Service users can Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 12 always select an alternative to the day’s menu. Some of the service users participate in the shopping for food and cooking of meals. Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,21 Support techniques and intervention is based upon experience as to what is required and what is most effective for each service user. Health issues are attended to in detail and monitored by the manager. EVIDENCE: The person-centred plans identify in detail how the service users like to receive various types of support, as well as their corresponding aversions. Similarly, management strategies and restraint measures are based upon the types of intervention to which the service users will react positively and are therefore likely to be effective. . One service user has a range of health problems, and his case file contains clear plans in respect of each problem, full records of actions in place to address those problems, and specific guidelines for staff developed by the manager on how to manage these health issues. The home has/is addressing the sensitive issue of service user desired funeral arrangements. Staff have achieved more with some than with others, especially if there is family actively involved. Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Service users are listened to and staff act upon their wishes and desires if appropriate/possible. EVIDENCE: The service users spoken to, and especially the one service user interviewed in private, confirmed that staff help them to express their feelings, opinions and wishes, and support them in making appropriate decisions and taking appropriate actions. Clearly this is based upon a sense of mutual trust and respect. Discussions with the manager and staff, and evidence from the case files further confirmed this to be an underlying principle of practice in the home. Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 The home has installed and ensures the maintenance of any specialist equipment required. EVIDENCE: The only specialist equipment in the home are a bath hoist which was installed when the home first opened but is not currently needed, and a mattress elevator used by a service user with asthma problems. The maintenance record for this is in place. Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34, The roles and responsibilities of staff are clearly defined. The staff team is sufficiently qualified and operates effectively. The recruitment procedures are implemented effectively to ensure the protection of the service users. EVIDENCE: There is a clear structure of authority and responsibility within the staff team. The member of staff interviewed was clear about her job description and role. Of the thirteen support staff, eight have qualified to NVQ level 2 or above, another one has just completed this course and three are currently undertaking it. All staff undertake mandatory annual refresher training on a range of health and safety topics. Each member of staff has a Personal Development Plan and has an Annual Appraisal. Training needs are discussed in formal supervision, and records of all training undertaken are kept. The staff team are not carrying any current vacancies. The service users are supported by 372 support/care hours per week, including a ten-hour waking night shift complimented by a ten-hour sleep-in shift. There is no dedicated Activities Coordinator, but one of the support workers takes on this role on an informal yet effective basis. Team meetings take place on a regular basis. Staff interviewed considered the team to be cohesive and morale to be good. All the staff have had CRB checks returned and the dates are recorded. New staff are not allowed to work unsupervised until the CRB check is received. The home’s manager was unable to produce Westhouse’s recruitment Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 17 procedure. Westhouse has a comprehensive recruitment policy and procedure which includes a policy statement on equal opportunities and diversity. It undertakes a rolling recruitment programme; candidates are interviewed firstly by Service Managers of Westhouse and, if successful, they are then interviewed by the manager and one or two service users from the home(s) with vacancies for which the Service Managers consider the applicants to be appropriate. All the documentation relating to the recruitment of staff is stored at Westhouse’s central office in Workington. This documentation was inspected in-situ on July.22. The personnel files contain records of Application forms with personal details and employment history, personal references including previous employer, health assessments and screening , the interview and assessment against the person specification, a CRB check and POVA check if required, signed contracts and terms and conditions, and a summary of the probationary period of at least six months. Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,41,43 The home is well managed and the core values and principles underpin care/support practices. Service users’ views are taken into account in when developments are planned, although this process could be more robust. Confidential information is stored securely and there is a good system in place to administer and safeguard service users’ monies. EVIDENCE: The manager, Rodney Casson, has worked with people with learning disabilities for thirty-seven years. He has been the manager of Home Farm for ten months, and has had several short term experiences as acting manager in other similar homes. He has a NVQ level 4 in care and is undertaking the Registered Managers Award. He is supported by a Senior Support worker. Staff interviewed considered the manager to be approachable, inclusive and fair. It is evident that the manager has established a culture which is consistent with the values and principles of Westhouse, namely promoting the independence of service users, treating them with dignity and respect, and undertaking a duty of care. Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 19 The home does not have an Annual Development Plan. It does have a threeyear rolling refurbishment programme to which service users contribute views and ideas, and they are consulted on other domestic and leisure issues. The home experiences problems in arranging for independent support/advocacy for service users. Confidential information about service users and staff is kept locked away in the office. The manager and senior support worker have a key to this, and a back-up key is held at Westhouse central office in Workington. Case files are kept in a locked cabinet on the ground floor. All the service users have a bank account, and their spending money is kept in separate locked tins inside a locked desk in the manager’s office. The money in these tins is checked every evening and the balance recorded. The manager maintains a thorough system of monthly record sheets in respect of each service user, noting all income and expenditure and receipts for the latter. These records are audited by staff in Westhouse central office every two months. Some of the service users with low expenditure patterns have considerable savings in their bank accounts and there is no strategy to ensure that they derive maximum benefit from this. Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 2 x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x 3 x Standard No 11 12 13 14 15 16 17 x x x x x 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Home Farm Score 3 x x 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 x 3 x 3 F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 21 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 3 Regulation 15 Requirement The home must ensure that care plans are reviewed at least every six months, and that the effectiveness of the actions designed to meet the goals of the care plan are the focus of the reviews. Timescale for action Immediate RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard 3 3 8 8 32 39 Good Practice Recommendations Actions undertaken to meet the goals of the personcentred and care plans should be recorded. Reviews of the various assessments and plans should be coordinated so that they fit together and provide a clear picture and direction of and for the service user. The home should adopt a more pro-active approach to consultation with the service users en-bloc. The home should seek ways to involve service users in care plan reviews. The manager should develop a training matrix so as to facilitate the management of training of the home as a whole. The home should produce an Annual Development Plan to ensure continuous improvement across al aspects of the F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 22 Home Farm 7. 8. 9. 43 43 34 home and its service. Westhouse should record the auditing of service users expenditure monthly records. Westhouse should consider a strategy to ensure that service users without independent support derive full benefit from their savings. The manager should ensure that there is a copy of Westhouses recuitment policy and procedure in the home. Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP 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 Home Farm F58 F10 s22561 home farm v238654 190705 ui stage 4.doc Version 1.40 Page 24 - 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!