Inspection on 27/02/06 for Home Farm

This inspection was carried out on 27th February 2006.

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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Home Farm 07/01/10

Home Farm 10/01/07

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 Gordon Chivers Unannounced Inspection 27th February 2006 09:45 Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 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.V280081.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 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). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 19th July 2005 Date of last inspection 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 DS0000022561.V280081.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, commencing at 09.45 and lasting six and a half hours. The inspection took place in the presence of the Manager, Rodney Casson, and included a discussion with one member of staff. Four of the service users were in the home for various periods of the inspection. The inspection focused upon those standards which drew forth a requirement or a recommendation, and some of the standards which were not assessed, by the last inspection. The inspection involved looking at case files and other documents, a tour of the home, and observing the service users and staff. The manager made notes of issues as they arose through the course of the 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? Some improvements have been made to the care plans and they are now reviewed regularly. The home has made important improvements in the way it consults with the service users. Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 6 Staff have been trained to ensure service users are protected from abuse and neglect. The manager has developed a form to help him decide what training the staff need. The home has produced an Annual Development plan. 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. Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home makes full assessments of the service users’ needs and aspirations. It is still in the process of clearly linking the support staff provide to these needs and aspirations. EVIDENCE: All the service users have full assessments of need, risk assessments, care plans and person-centred plans. 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 plans contain a great deal of information about the service users. The home maintains periodic records of service users’ behaviours and activities. The staff provide the service users with a lot of support but not all of the key work is recorded in the case files or clearly linked to particular needs or goals. The home is gradually improving the coordination of the main parts of the Care Plans, i.e. assessed needs, goals, actions and reviews, but still has more work to do to achieve this. Westhouse is developing a new care management format and the manager intends to test it out at Home Farm. Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,8 The assessed needs and personal goals of the service users are the main parts of the care plans. Changes in these needs are also identified, but changing or new personal goals are not always reflected in the plans. The review process still needs further improvement. The home has made important improvements in the way it consults with the service users. EVIDENCE: The care plans for the service users’ care needs are now better coordinated with the plans to meet their health needs, and the manager intends to bring the person-centred planning process more into line with these. Care plans are reviewed on a three-monthly basis. Reviews tend to focus on the assessed needs in the care plan. There is little focus on the effectiveness of actions to meet those needs. There is little service user involvement in the reviews, although they all have had some input into their person centred plans. Service users and their families who are able and wish to participate in reviews will be invited to do so. The manager will also attempt to find independent advocates to support some of the service users in reviews. The home has always made great efforts to inform and involve the families of the service users depending upon their personal circumstances. The manager Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 10 has introduced monthly house meetings which involve all of the service users, one of whom chairs the meeting with support. These have an agenda and are recorded. The issues are mainly domestic (e.g. decoration). but also include holidays and activities. The service users are also involved in weekly menu planning. Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 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 the following standard(s): 12,13,15 The service users engage in a wide range of activities. These include focused activities to improve their personal skills as well as leisure and social activities and interests. They are well accepted by and very much involved in the local community. All of them are supported to have contact with their families to differing degrees. EVIDENCE: The service users are involved in a wide range of activities according to their interests and abilities. Some of them have a full weekly programme of focused work, learning new skills or personal development courses. In one case this is so meaningful and effective that it has become the core part of the care plan and person centred plan. The service users with greater support needs also have a weekly activities programme. Not all the activities are reflected in the care plans or reviews as a means of meeting assessed needs or personal goals. As well as doing things which improve or maintain their skills and abilities, all the service users have personal leisure and social pursuits in the evenings and weekends, and they all have at least one holiday each year. One support worker is also a part-time activities organiser who seeks out activity and leisure opportunities for the service users. Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 12 The home and the service users are well accepted by the local villagers. Some of them have personal friendships and frequent, regular contact with people in the village. Others are involved in other ways in the wider community around Workington such as assisting in a charity shop or with an animal refuge, all on a voluntary basis. All of the service users have some contact with their families to varying degrees. Some have a great deal of personal contact, including visiting and staying with them on occasions, whilst others have only extended families who they see once a year at Christmas. The home has been successful in supporting one service user and her cousins to develop a closer relationship in recent years. Some of the families are not aware that the inspection reports are available to them and the manager will provide them with a copy if they want one. Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 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 the following standard(s): 19,20 The staff work hard at ensuring that the service users’ health needs are identified and met. The home administers the service users’ medication for them. EVIDENCE: The home makes every effort to identify the health needs of the service users and to work with the medical profession and others to meet those needs. For some, their emotional health needs are met partly through sensitive and appropriate contact with their families or friends. The home keeps good records of their physical health needs and monitors them closely. Staff are very pro-active in consulting with GPs, community nurses and consultants, and in developing full health records and health action plans. Advice and support is being sought from the local Alzheimer’s Association in respect of one service user. All of the service users require support with the administration of their medication. The home stores all the medication in an appropriate metal cabinet in a locked cupboard off the main corridor on the ground floor. The medication is dispensed from this point. The MAR sheets record when the medication is administered, as well when medication is received from the pharmacy and disposed of. The pharmacist and the surgery’s medicines manager provide helpful advice and guidance. The staff will be receiving Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 14 accredited training through distance learning provided by ‘Stancliffe’ in the near future. Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Staff are trained to ensure service users are protected from abuse and neglect. EVIDENCE: All the staff except two have undertaken recent training in the protection of vulnerable adults. The two outstanding are scheduled to receive this training in June 2006. Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The home is comfortable, well appointed, clean and hygienic. EVIDENCE: Home Farm is homely and comfortable. The furnishings and decoration are generally of a good standard. The manager has a budget for this and operates a three-year rolling programme of improvements. The two bathrooms and the single toilet are due to be redecorated, followed by three of the bedrooms. The manager is in discussion with the landlord, Impact Housing Association, to replace the kitchen units. This is not an immediate necessity but will become so within the next year. The electric shower cannot be ‘locked’ to the required maximum temperature of 43 degrees because the water comes straight from the cold water tank, but the manager has rigged up a home made guard which so far has prevented any of the service users from interfering with the controls. Neither the manager nor the landlord have been able to find a shower unit which can be thermostatically controlled. A risk assessment is in place and the matter has been referred to the Environmental Health department of Allerdale district council. The manager has also referred the issue of the hot water cylinder and the risk of legionella to the landlord. The home has sufficient fire extinguishers, smoke alarms and all the radiators have guards around them. Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 17 All cleaning materials are kept in a locked cupboard in the utility room. The home is clean and there are no obnoxious odours. The carpet in the bedroom of a service user who has continence problems has been replaced by washable wooden flooring. Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 The service users are supported by staff who are properly recruited and well trained. EVIDENCE: All of the staff are qualified to NVQ 2 or above except the three new members of staff. These staff have undertaken the LDAF induction and foundation course. The home has acquired a copy of Westhouse’s recruitment and retention policy and procedure, including the equal opportunities policy. The manager has developed an ‘at-a-glance’ training record of all the staff in the home. From this he can identify which staff have not had up-to-date training in particular aspects of the work. The manager discusses staff’s training needs with them in individual supervision sessions and refers them for specific training courses to Westhouse’s training manager. Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39,42,43 The home has produced an Annual Development plan but it is not based upon the views of the service users. The health and safety of the service users is promoted and protected by the home’s procedures and how they are put into practice. Service users finances are properly audited. EVIDENCE: The manager has produced an Annual Development Plan which is a good first attempt. Some of the goals may be a little difficult to measure and future plans might benefit from having more ‘lower’ level, tangible goals. This Development Plan has not been based in any part upon consultation with the service users or their representatives. Westhouse has undertaken an environmental risk assessment on the safety of Home Farm in the last year. The manager and staff undertake a weekly check of health and safety issues, including water temperatures, legionella and fire alarms. The staff undertake fire drills and fire procedures training four times a year. Equipment in the home is tested, serviced, and repaired/replaced if necessary by the contractors. The issues regarding the safety of the hot water system have been recorded elsewhere in this report. The landlord has cut Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 20 down several old trees which presented a hazard from the banking directly behind the home. The regular audit by Westhouse of the service users’ personal income and expenditure records is now recorded. The manager will give further consideration to supporting those service users with very large savings to benefit directly from them, although it is recognised that this is not always easy to do. Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 2 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X 3 X X LIFESTYLES Standard No Score 11 x 12 3 13 3 14 X 15 3 16 X 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 2 X X X 2 X X 3 3 Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 22 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 YA6 Regulation 15 Requirement Timescale for action 01/03/06 2 YA20 18 3 YA39 24 The manager must give the service users and their families or representatives an opportunity to participate in the reviews of their care plans if they wish to. All staff who administer 30/06/06 medication to the service users must undertake accredited training. The Annual Development Plan 30/09/06 must take the views of the service users into account. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA3 YA6 YA24 Good Practice Recommendations Actions undertaken to meet the goals of the personcentred and care plans should be recorded. The manager should attempt to arrange for all of the service users to have some independent support. The registered person should continue to look for a thermostatically controlled shower unit which can be DS0000022561.V280081.R01.S.doc Version 5.1 Page 23 Home Farm installed in the shower room. Home Farm DS0000022561.V280081.R01.S.doc Version 5.1 Page 24 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. 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