Inspection on 16/02/06 for Homeleigh Farm

This inspection was carried out on 16th 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 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

Homeleigh Farm 18/07/06

Homeleigh Farm 02/08/05

Homeleigh Farm 03/02/05

Homeleigh Farm 10/08/04

Homeleigh Farm 25/02/04

Homeleigh Farm 08/05/02

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

CARE HOME ADULTS 18-65 Homeleigh Farm Dungeness Road Lydd-on-sea Kent TN29 9PS Lead Inspector Lisbeth Scoones Unannounced Inspection 16th February 2006 13:45 Homeleigh Farm DS0000023452.V281627.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 Homeleigh Farm DS0000023452.V281627.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. Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Homeleigh Farm Address Dungeness Road Lydd-on-sea Kent TN29 9PS 01797 321506 01797 322134 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) Parkcare Homes Limited Mr Michael Christopher Britton Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd August 2005 Brief Description of the Service: Homeleigh Farm is owned by Creagmoor Healthcare and provides residential care for 6 male residents with learning difficulties some of whom may present with behaviours that challenge. The home comprises a domestic style extended bungalow, situated on the South Kent coast, approximately one mile from the small town of Lydd. It has extensive gardens on all sides, a large part of which is used for growing vegetables and housing chickens and geese as well as a greenhouse and outhouses. Residents are very much involved in gardening tasks and looking after the chickens and geese. The home produces all its own vegetables, some fruit and eggs, the surplus of which is for sale. Car parking is provided. There are local shops, churches and pubs. Other amenities such as swimming pools, cinemas and colleges are within half an hours drive. All but one of the residents currently living at the home have needs requiring one to one staff support. The home has no other facilities on site but residents are accompanied if they wish to make use of facilities elsewhere. The home has the use of two new vehicles. Residents have access to general and specialist medical services either through the local primary care team or through consultants employed by the company. Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place in the afternoon over about 3 hours. It comprised discussions with all six residents, the deputy manager, three other members of staff on duty, a visiting relative, a partial tour of the premises and examination of records. The manager Michael Britton was on holiday at the time of the inspection but was provided with verbal feedback on his return. The home continues to provide a pleasant, relaxed, homely, well-maintained and safe living and working environment for the residents. What the service does well: What has improved since the last inspection? What they could do better: The manager is very aware of improvements that could be made to the environment and these are addressed in the home’s action plan. A recommendation was made in respect of formal company visits. Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 Page 6 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. Homeleigh Farm DS0000023452.V281627.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 Homeleigh Farm DS0000023452.V281627.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): 1, 2, 3 Prospective residents’ individual aspiration and needs are assessed and they have the information they need to make a decision about moving into the home. Residents move into the home knowing that their needs can be met and their independence maximised and promoted. EVIDENCE: The registration certificate was seen on display and the recent inspection report freely available. Since the previous inspection, a new resident has been admitted to the home. From documentation seen, discussions with the resident, deputy manager and staff on duty, it is evident that the pre-admission process involved careful and comprehensive assessments. The purpose of this process is to ascertain whether the prospective resident would be suitable bearing in mind his particular needs, staff competencies, compatibility with residents already living at the home and the facilities and services on offer. Homeleigh Farm DS0000023452.V281627.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, 7, 8, 9 The care planning system is clear and provides staff with the information they need to meet the residents’ needs. Residents are provided with the information and support they need to make decisions about their life. They are consulted on and participate in all aspects of life in the home. Residents are enabled to take responsible risks taking into account their safety, that of other residents and staff. EVIDENCE: Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 Page 10 The care documentation of the recently admitted resident was examined and provides much information including the views of the resident. There was evidence that the resident’s participation and involvement in/with activities are included in the care plan. Care plans are evaluated monthly by key workers and achievable goals identified at individual’s planning meeting. Regular reviews take place both formally which would include the care manager and residents’ relatives and informally as needs change. Very detailed risk assessments are included, care needs identified and goals set. Daily records, maintained at each shift, are an integral part of the care documentation. The deputy manager said that residents are involved in their plan of care for as much as their disability would allow. Included in the care plan are charts of achievement. Such achievements relate to jobs carried out confirmed in a job description and financially rewarded. It was observed that staff involve and include the residents in discussions and the events and routines of the day. The care records incorporate a comprehensive selection of individualised, regularly reviewed risk assessments. Homeleigh Farm DS0000023452.V281627.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): 11, 12, 14, 17 Residents are provided with opportunities for personal growth and are enabled to take part in appropriate activities. They are offered and enjoy appropriate leisure facilities. Residents enjoy a healthy and varied diet. EVIDENCE: Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 Page 12 Residents are encouraged to take part in the daily domestic chores as e.g. ironing, cleaning and hovering. They are encouraged to assist with growing vegetables, gardening and caring for the chickens and geese within the grounds of the home for which therapeutic earnings are paid. Residents are encouraged to attend courses provided by a local college. Within a risk assessment framework, staff accompany residents to any suitable event or activity of their choice on a one to one basis. Residents said that they have access to a wide range of leisure activities. These include food and clothes shopping, cycling, walking, swimming, trips to the cinema and pubs, fishing, bowling and holidays. A resident said how much he had enjoyed a recent holiday at Centre Parcs. All residents and 8 members of staff attended. Plans for another holiday in September are underway. The home has Karaoke equipment and a large fish tank was seen in one of the lounges. Other in-house activities on offer include: basketball, model making and board games. On the day of the inspection, a resident had a visited from his family who were pleased with their relative’s progress. The home provides a quiet lounge where residents may meet their visitors in private. Relatives are invited to take part in service users’ care reviews. The cook provides the meals from Monday to Friday. Some residents assist care staff with the meal preparation at weekends. Menus show that the food is varied, wholesome and provide a choice. Individual preferences are catered for. The home uses its own vegetables, fruit and eggs. Residents are involved in collecting eggs and assist in growing and picking fruit and vegetables. Drinks and snacks are available as needed and meals are offered three times a day. The hot meal is usually provided in the evening. Mealtimes are relaxed and unhurried and staff and residents eat together, outside when the weather is fine. Nutritional assessments are undertaken including the risks of under or over weight and records of food are maintained. Residents are weighed monthly. The kitchen looked well equipped. Homeleigh Farm DS0000023452.V281627.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): 18, 19, 20 Residents receive personal support in the way they prefer and need. Residents physical, and emotional health needs are met. Good medication administration systems are in place. EVIDENCE: Residents are well dressed in clothes chosen by them. Staff provide support in an unobtrusive manner with due regard for residents’ life style, privacy, dignity, independence and control of their lives. On the day of the inspection, the chiropodist, who visits monthly, was in the home. From documentation seen and discussions with staff on duty, it is evident that residents’ physical, emotional and mental health needs are met. All residents have a medical consultant. There was recorded evidence of regular input from GP’s, weekly visits from or to community psychiatric nurse and annual visits from the optician and dental appointment as required. Consultations are held in private with the discreet presence of the staff. Records of such visits were seen in the care plan on medical contact sheets. There is monthly input from a clinical psychologist/cognitive behaviour therapist following an assessment. Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 Page 14 As identified on the training matrix, all staff have access to Safe Handling of Medication training from a college trainer as part of a six weeks course. The deputy manager is responsible for all medication issues. Residents have well maintained individual medication files. In addition to the MAR chart, the files contain other relevant information including a pictorial medication procedure, risk assessments and side effects. The manager ensures that medication is regularly reviewed. The recent reduction in medication for one resident was discussed. Medication administration requires two staff signatures. Currently none of the service users self medicate. The home’s medication policy is based on the Royal Pharmaceutical Society guidelines the Administration of Medication in Care Homes. Homeleigh Farm DS0000023452.V281627.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): 22, 23 Residents know that their views are listened to and acted upon. Residents are protected from abuse. EVIDENCE: The home has a formal complaint procedure, which makes reference to the CSCI as well as a pictorial one devised for residents with communication difficulties. It was evident from observations that residents feel comfortable to express their views and staff respond in a supportive, problem-solving manner. The home maintains comprehensive records of incidents. Where appropriate, the CSCI is informed of these as per Regulation 37. See also standard 42. The home has a staff training programme and policies in place to protect vulnerable adults in respect of whistle-blowing and adult protection. The company is registered with the Criminal Records Bureau and all staff are (enhanced) CRB and POVA checked prior to being offered employment. See also standard 34. Staff demonstrated a very good awareness of those issues, which constitute abuse and know what to do if this was ever witnessed or suspected. Team leaders deal with financial issues. Financial records examined were well maintained. All residents have their own accounts and individual financial files, which are checked every two days. Homeleigh Farm DS0000023452.V281627.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, 28, 30 Residents live in a homely, comfortable, well-maintained, clean and safe environment, which include suitable and comfortable shared spaces. EVIDENCE: The home is well maintained and furniture and carpets regularly replaced according to need and residents’ choices. A handyman is employed one day a week. A resident’s bedroom floor has recently been replaced. Staff and residents have been involved in a sort out of the greenhouse, which is now more user friendly. Regulation 26 reports comment on the quality of the environment both in-house and externally relating to safety and repairs. A resident showed his room, which was spacious and well equipped with his favourite possessions. None of the residents’ single rooms have en-suite accommodation or washbasin following risk assessment. The home has two toilets, a bathroom and a shower room all fitted with appropriate locks. All of these are of an acceptable but not high standard. The maintenance plan identifies a new bathroom to be installed in May 2006. The home has a large garden with furnished patio area. There is a family size kitchen, used by residents and staff for shared meals, lounge, dining area and Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 Page 17 quiet lounge. Smoking is permitted under staff supervision in the conservatory. The home provides a clean and odour free environment. The night staff are involved with cleaning duties and during the day, residents are encouraged to take part in cleaning chores. All staff receive training in health and safety, infection control, food hygiene and COSHH. Separate hand wash facilities are available in the garage for staff and residents involved with gardening and caring for the chickens. Homeleigh Farm DS0000023452.V281627.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): 31, 32, 34, 35, 36 Residents know that their needs will be met by staff who are competent, qualified and aware of their role and responsibilities. Residents are supported by adequate numbers of staff who are well trained. Residents are protected by the home’s recruitment procedures and are cared for by staff who are well supported and supervised. EVIDENCE: Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 Page 19 Senior staff comprise a manager, deputy manager, three team leaders and a senior night care worker. All staff are issued with job descriptions. A newly appointed support worker showed a good awareness of his role and responsibilities. Every resident has been assigned to two key workers. It is evident that staff know the residents very well and develop relationships with the residents they support. Through training and staff meetings, the home’s aims and values and their own skills and knowledge are constantly reenforced. Apart from one, all residents require one to one care and support during the day. There are two members of staff at night; one awake and one does sleep in duties. These staffing numbers seem to be adequate for the varied needs of the residents. The duty rota is comprehensive and clearly maintained. During every shift there is at least one team leader. The manager’s hours are supernumerary. Two staff files were examined, were well maintained with appropriate checks made. At the previous inspection, a discussion took place around the company’s view on vaccinations e.g. for Hepatitis B. The manager said that risk assessments would determine whether staff would be required to be thus immunised. All support workers are encouraged and supported to undertake training at NVQ level 2 and all team leaders at level 3. The home has access to divisional training managers who are contacted when training needs are identified. The deputy manager said that, in that respect, schizophrenia training has been requested. New induction and foundation training has recently been introduced, which include the relevant LDAF (Learning Disability Award Framework) modules. The current training matrix identifies all statutory training, medication and adult protection training. Monthly training statistics are maintained. The deputy manager said that the recently introduced Personal Performance Agreement, which incorporates performance management, training and career development, is an effective tool. Each member of staff has an individual annual performance record in which 6 supervision sessions are recorded. The format would allow for different levels of supervision. Staff said they are well supervised and the newly appointed support worker confirmed that there is a high level of support from management. As confirmed on a schedule on display, all staff receive regular recorded supervision as part of their contract of employment. All new staff receive monthly supervision for the first three months. Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 Residents live in a well managed home and benefit from the ethos and leadership approach. The quality assurance systems in place include the residents’ views and evidence that these are acted upon. The health safety and welfare of residents and staff are promoted and protected. EVIDENCE: Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 Page 21 On the day of the inspection, Mr Britton, the registered manager, was on holiday. He has an NVQ level 4 in management and many years of experience in the care of people with a disability. The deputy manager has recently been promoted and said he enjoyed the new role, which is supported by a job description. Staff said that they feel well supported by the manager and senior staff. Residents feel free to talk to the manager or his deputy when it suits them and this evidences the open door policy. The deputy manager knows the residents and staff very well and interacts with them in a friendly and constructive manner. Residents’ meetings are held monthly and are minutes kept. Residents choose the items for discussion. Favourite topics are foods and outings. The manager confirmed that a representative of the company visits the home monthly and produces a report in accordance with Regulation 26. Whilst previously, the CSCI would be sent copies, these have recently not been received. The report would include the residents’ views on the service provided. The deputy manager said that relatives are always invited to take part in care reviews to enable them to be fully aware of their relative’s care needs and progress made. A twice-yearly quality assurance survey, involving residents’ relatives, is due. The manager is a trained auditor and undertakes monthly audits in respect of accidents and care planning. Training records and care documentation are regularly reviewed. The manager and deputy manager have recently attended health and safety training. The deputy manager said that he particularly benefited from the training around risk assessments. Accidents or incidents are reported to the CSCI in accordance with the requirements of Regulation 37. In-house incident reporting is of a good standard. The home undertakes environmental risk assessments as already referred to elsewhere in the report. Staff have regular fire training. Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 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 3 25 x 26 x 27 x 28 3 29 x 30 3 STAFFING Standard No Score 31 3 32 3 33 x 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 4 x LIFESTYLES Standard No Score 11 3 12 4 13 x 14 4 15 x 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 2 x x 3 x Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 Page 23 N/A 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. 1 Refer to Standard YA39 Good Practice Recommendations That copies of Regulation 26 reports be sent to the CSCI. Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Homeleigh Farm DS0000023452.V281627.R01.S.doc Version 5.1 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. 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