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Inspection on 08/04/05 for Little Eastbrook Farm

Also see our care home review for Little Eastbrook Farm for more information

This inspection was carried out on 8th April 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The residents are seen as part of the family and treated as such. The home has a comfortable feel and residents appeared relaxed and at ease. The provider ensures the provision of a variety of suitable and preferred activities for the residents to enhance their quality of life. The home is efficiently run and well maintained in every respect.

What has improved since the last inspection?

Since the last inspection the provider has worked hard to implement the requirements of the National Minimum Standards, which she has achieved. There was a noticeable difference in the atmosphere and all residents seemed very relaxed and happy. The interaction between the provider and the residents was of a gentle and encouraging nature and residents were seen enjoying varied activities within the home.

What the care home could do better:

The practice of writing prescriptions on medication records is a risk of making a mistake; so two signatures should be recorded. The spiritual wishes of the residents are not recorded and have not been explored with them.

CARE HOMES FOR OLDER PEOPLE Little Eastbrook Farm Burlescombe Tiverton Devon EX16 7JT Lead Inspector Patricia Hellier Announced 8 April 2005 th 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 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. Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Little Eastbrook Farm Address Burlescombe Tiverton EX16 7JT 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) 01823 672373 Mrs Sandra Gold CRH PC - Care Home providing Personal Care 3 Category(ies) of LD Learning Disability [3] registration, with number LD[E] Learning Disability over 65 [3] of places Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service users over the age of 40 Date of last inspection 30th November 2004 Brief Description of the Service: Little Eastbrook Farm is a rural care home set in the countryside below the Blackdown hills. The care home offers accommodation and 24 hour care to 2 service users with Learning Disabilities. The service users share facilities with the owners, the male owner’s sister and mother. There is a large garden area that is easily accessible for service users. A terraced area of the garden is not so accessible but pretty to sit and admire from the patio area. The home has a large 7-seater vehicle for taking service users on outings to the shops and seaside. If required holidays with the family can be arranged. Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over three and a half hours on 8 April 2005. The Registered Provider Sandra Gold was present during the inspection. Both residents and the National Vocational Assessor (NVQ) took part in the inspection. The residents told the inspector they were happy living at the home. During the inspection the residents were observed to be at ease moving around the home and happily occupied in their chosen way. The inspector looked around the home. A number of records were inspected, which included pre inspection questionnaire, comment cards from relatives and one from one of the residents. Telephone conversations with two professionals involved with the residents’ care. 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 contacting your local CSCI office. Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 7 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 standard(s) 3 The admission procedure appears robust ensuring that proper assessment is made prior to admission, thus assuring that care needs can be met. EVIDENCE: There have been no recent admissions to the home to assess this standard fully. The admission policy is robust. Both residents’ care files contained Social services’ assessments dated for the time of admission and there were also the home’s own assessment documents. Annual review and assessment records were seen. Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 8 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 standard(s) 7,8,9,10 The health needs of residents are well met with evidence of good multi disciplinary working taking place on a regular basis. Personal support is offered in such a way as to promote residents’ privacy, dignity and independence as able. EVIDENCE: Individual plans of care are available and each resident has a comprehensive file containing all information to meet health and social care needs. Good risk assessments have been included along with a social history. Residents’ likes and dislikes have been recorded in pictorial format to reflect their best form of communication. Spiritual wishes regarding death are not recorded and this should be addressed. The system for the administration of medicines is clear and comprehensive arrangements in place. Transcription of medicines provides potential for error. This practice should be reduced to a minimum and if used record 2 signatures. Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 9 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 standard(s) 12,15 Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. EVIDENCE: Both residents like routine and a plan of activities for the week is kept in the care records. Activities arranged include horse riding, gardening and manicures. Other activities are outings and holidays with the family are arranged. Both residents living at the home indicated through pictorial communication that they liked the food. A file of picture menus was seen and residents were seen being offered choice. Menus showed a varied, balanced and nutritious diet. Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 10 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 standard(s) 16,18 A robust complaints policy is well displayed and the provider is keen to get it right for her residents. Residents are well protected by informed staff. EVIDENCE: Given the communication difficulties of the residents it is difficult for them to complain however the provider has displayed a comprehensive complaints policy for all visitors to see. There have been no complaints. Five comment cards from relatives praised the service provided. For example one stated that their relative ‘is very happy here’ and she is ‘fortunate to live in such a comfortable home with pleasant caring people’. The provider attended an Adult protection training earlier this year. She demonstrated good knowledge and understanding of what constitutes abuse. Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 11 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 standard(s) 19,24,26 The standard of the environment within this home is good providing residents with an attractive and homely place to live. The cleanliness and standard of hygiene is good and provides a safe environment EVIDENCE: Since the last inspection the laundry has been resited and the conservatory made into a nice sitting area for residents. The bathroom has been refurbished with a new shower and the downstairs toilet has been completed. Residents’ bedrooms were personalised and safe. For example radiator guards were in place. Hand washing and clinical waste disposal systems reflect good practice, as observed and discussed with the provider. Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 12 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 As part of the family, residents’ needs are well met by the owners who are caring and competent EVIDENCE: The two residents are like part of the family and as such are cared for by the provider, her husband and daughter. There are no employed staff. The provider is recruiting volunteers to care for the residents when she and her husband have some time away. The provider is carrying out the appropriate checks. The personnel file for one volunteer was to contain all required documents. The provider has gained her NVQ level 2 qualification and is working towards her NVQ level 4 qualification in care. Certificates showing attendance at relevant training events to enhance the providers care provision were seen. Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 13 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 Residents receive care in a safe environment EVIDENCE: Personal and environmental risk assessments were seen, and appropriate actions taken to minimise risk. A satisfactory report from the Fire Safety Officer on 14/02/05 was seen. The provider has completed her First Aid training within the last 12 months. Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 14 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 3 Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 15 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 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. 2. 3. Refer to Standard OP9 OP11 Good Practice Recommendations When transcribing medication prescriptions to record the signatures of the person transcribing and the person checking. To ascertain and record the spiritual wishes of the residents regarding their death Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 16 Commission for Social Care Inspection Suite 1, 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. Extracts may not be used or reproduced without the express permission of CSCI Little Eastbrook Farm D54 D06 S21968 Little Eastbrook V211364 080405 OP Stage 4.doc Version 1.30 Page 17 - 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. 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