Inspection on 30/11/05 for Kent Farm

This inspection was carried out on 30th November 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

Kent Farm 25/01/07

Kent Farm 13/07/05

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Kent Farm Kent Farm Mill Street Uffculme Cullompton Devon EX15 3AR Lead Inspector Louise Delacroix Unannounced Inspection 30th November 2005 12:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kent Farm Address Kent Farm Mill Street Uffculme Cullompton Devon EX15 3AR 01884 840144 01884 841486 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) Ms Pauleen Rachel Maitrise Ms Pauleen Rachel Maitrise Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15), Physical disability over 65 years of age of places (15) Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2005 Brief Description of the Service: Kent Farm is a residential care home, which provides a home for fifteen older people, who may have a physical disability. It is situated in the village of Uffculme and is close to the village square. It offers fifteen single rooms, ten of which have en-suite toilets. Fourteen of these rooms are situated on the first floor, and are accessed by a shaft lift. There is a homely lounge with a selection of armchairs and a bright dining room, with three tables. A visitors car park is available and rooms are styled to encourage the entertainment of visitors. The home is built on three sides of a courtyard, and residents and visitors use this in the summer. In May 2005, there was a change of ownership. The new owner, who is also the manager, has made many positive changes. Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over five and a half hours and was unannounced. On arrival, many residents were using the communal lounge and some had visitors. The shaft lift had just been fixed. The home had no vacancies. One resident was in hospital on the day of the inspection. Seven residents, three visitors, staff and the manager contributed to the inspection. Lunchtime had a friendly atmosphere with many residents chatting with each other and staff. Several people commented how much they had enjoyed the meal. During the afternoon, some residents chose to take part in a lively bingo session, while others chose to spend time in their rooms, either alone or with friends. A tour of the building took place and seven bedrooms were inspected. Records, including care plans, invoicing, some policies, communication book, medication records and night records were also looked at as part of the inspection. On the day of the inspection, there were three carers on duty in the morning, two in the afternoon and two in the evening, plus a cook in the morning and the manager. The staff on duty reflected the duty rota. This report should be read in conjunction with the home’s last inspection report on 13th July 2005 when the majority of the standards were inspected. What the service does well: Residents made comments such as ‘ it’s very good here’, it’s a ‘lovely place’ and the staff are ‘wonderful’. They spoke about the energy of the manager and a visitor commented that the atmosphere was relaxed and friendly. Residents feel involved with the life of the home. Care plans promote a rounded approach to residents’ care by including emotional and social needs, as well as health care needs. The manager promotes good communication between staff and residents, and emphasis is placed on maintaining peoples’ privacy and dignity. Medication practice in the home is safe and a resident praised the manager’s role as an advocate for their health needs. There is a developing activities programme, which includes external visits and visiting entertainment. The home is well cared for and attractively decorated. It is clean and odour free. There are good health and safety practices within the home. Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Standards 3,4 and 6 were inspected in July 2005 and met. No new residents have moved to the home since the last inspection. Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9,10 The home’s care planning system is being developed. However, already the emphasis on professional recording to ensure good communication between staff has created better outcomes for residents. The residents’ benefit from good medication practice by staff, and have their dignity respected. EVIDENCE: A number of care plans were looked at, particularly for people who were met during the inspection. The manager described how care planning is still work in progress as the care staff become more skilful in their recording skills. Care plans evidence that time has been spent with residents to portray their daily lives and care needs with monthly reviews. These are now in place for the majority of residents and residents have signed many of them. Residents’ social and emotional needs are now recorded with guidance given where appropriate, and the importance of friendships and relationships are recognised, which residents and visitors confirmed. Risk assessments were seen, including for bed rails. Day and night records and a communication book contain appropriate language and include health outcomes for residents. Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 10 A medication round was observed, which was unrushed and during which residents were asked about their pain with action taken if needed. Night records also evidenced residents’ pain control being monitored. Records showed that a frail resident’s pain levels were being monitored both by day and night staff. Good practice was observed i.e. ensuring residents had taken their medication before initialling the MARs sheets. Controlled drugs are appropriately stored and recorded with double signatures. The tally was checked and was correct. The manager explained that they are changing pharmaceutical dispensers because of administrative errors on the provided MARs sheets. The manager agreed that staff should record the dispensing of paracetamols in a consistent manner. Two members of staff spoke about their medication training, which has been via distance learning. Four members of staff currently administer medication. Four residents said that staff knew what they were doing and that their dignity was respected. This discussion was based around how personal care was given whilst being bathed. Care plans show sensitively worded bath plans, which recognise the individuality of residents and are signed by residents. The manager explained that staff could take these plans with them to ensure continuity of approach. A staff member was heard checking with a colleague about the preferences of a person they were to assist with bathing. A handover between staff also included information to maintain residents’ appearance and therefore their dignity. Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 The home has a regular activities programme, which residents can influence. The ethos of the home and atmosphere provides a welcoming environment with space to ensure privacy. EVIDENCE: A number of residents praised the introduction of a regular activities programme, which includes a weekly craft and music sessions. Several residents who have previously not gone on trips now participate and one spoke very positively about their experience. Photographs showed residents looking relaxed and happy, which was confirmed in discussion with individuals. Residents explained that trips and activities are discussed at residents’ meetings or individually for people who choose not to attend the meetings, which take place on a monthly basis. Care plans record the activities that residents become involved in. This can also include one to one conversations with staff. For example, a chat with a resident whilst helping them maintain their personal possessions i.e. polishing silver. Residents said that their visitors are made welcome, that they have the room to entertain them privately in their rooms, and visitors said they could visit when they like and one said they stayed for lunch on a regular basis. Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 12 Five residents talked about being able to create their own routines within the home environment. Night records and care plans show that people choose when to go to bed or get up, which residents said was the case. Residents spoke about being able to choose the level of their involvement in group activities i.e. residents’ meetings or communal meals. Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Steps are being taken to promote the staff’s awareness of the protection of vulnerable adults. EVIDENCE: A visitor said they had been able to discuss small problems with the manager, which had been resolved appropriately. This standard was discussed with residents at the last inspection, and was met. The manager has bought a policy system, which she will be adding local information to. There is information about recognising abuse and a list was seen of staff signatures to record when they have had read the home’s policies. The manager plans for individual policies to be discussed in supervision with staff. Her staff are currently on a waiting list for training on the protection of vulnerable adults. She is unhappy about the delay and said she has raised this with the local training company. Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,26 This is a well cared for home, which provides residents with an attractive, clean and homely place to live. The owner ensures residents are provided with equipment suitable to meet their individual physical health needs. EVIDENCE: The home was clean and odour free, apart from one room, which had an odour problem. The manager spoke about the steps that have been taken to address this problem in a sensitive manner. She explained that all the carpets and curtains had recently been cleaned. Residents and a visitor said that the home was always clean. Photographs showed the residents enjoying the use of the courtyard during the summer, which is easily accessible. There is a small porch with seating for smokers, which a resident and a visitor said they appreciated. The communal areas of the home are attractively decorated and homely in appearance with a range of suitable lighting and armchairs arranged in small groups. There is a clearly marked accessible toilet close to the lounge and the Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 15 dining room. The sluice is located separately from service users’ toilet and bathing facilities. The home has two bathrooms with assisted baths and two bedrooms with en-suite bathrooms. Eight other single rooms have en-suite toilets. The home has a four-person shaft lift between the two floors. There are grab rails throughout the building. The courtyard is accessible to all service users, including those people in wheelchairs. Hoists and assisted baths are installed. Portable call systems are available in every room. Equipment is well stored. A resident said that they appreciated the owner arranging for a safer and more comfortable sling for their hoist and spoke about new equipment provided to them to help with mobility. A tour of the building showed that pressure relieving-mattresses have been obtained for some residents, including one very frail resident, who has also been provided with an adapted bed to maintain their safety. A programme was seen of the home’s rolling maintenance programme, which includes fitting covers for radiators identified as high and medium risk. A tour of the building and the maintenance records show that further radiators have been covered since the last inspection and the manager said this would continue in early 2006. A resident said they felt involved a risk assessment i.e. the decision of fitting a cover on one radiator and not on another. Staff spoke about the home’s current infection control regime and gave examples. The home has an infection control policy, which the manager is currently reviewing. Throughout the home, there were plentiful amounts of gloves, aprons, liquid soap, hand gel and paper towels to help promote infection control. Staff confirmed these were always available. Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were inspected on 13th July 2005 and met. Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,35,36,38 The ethos of the home promotes residents’ involvement in the life of the home. Currently, the majority of care staff do not currently benefit from regular one to one supervision to support their personal development. EVIDENCE: The manager explained that the home does not ‘hold’ residents’ personal allowances. Instead, a comprehensive invoice is sent to the residents’ representatives on a monthly basis for extras i.e. chiropody and hairdressing. Examples of these were seen. As on the previous inspection, residents spoke positively about the manager’s style of running the home. Several people said they felt that she was approachable and they felt that their opinions were listened to. One person who said they chose not to attend residents’ meetings said that they still felt consulted about the life of the home as the manager took time to speak to Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 18 them individually. A visitor and residents said there were continued improvements in the running of the home. Two members of senior staff have received training in providing supervision but individual supervision sessions with all care staff have not yet started. The manager said that infection control would be an area of practice, which will be focussed on during supervision sessions when they begin. All staff have recently had training in food hygiene and they are up to date with their fire training. As part of a carer’s induction, they were observed by a senior to ensure safe practice. Fire extinguishers had an annual check in February 2005 and are also checked weekly by the home. Fridge and freezer temperatures are logged. Residents are provided with mobile call bells to enable them to call for help, if needed. Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 x x 3 2 x 3 Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 OP36 Good Practice Recommendations Staff should receive formal supervision at least six times a year. Kent Farm DS0000063659.V264624.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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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