Inspection on 09/11/06 for Little Eastbrook Farm

This inspection was carried out on 9th November 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

Little Eastbrook Farm 02/05/07

Little Eastbrook Farm 24/01/06

Little Eastbrook Farm 08/04/05

Little Eastbrook Farm 30/11/04

Little Eastbrook Farm 13/07/04

Little Eastbrook Farm 05/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOMES FOR OLDER PEOPLE Little Eastbrook Farm Little Eastbrook Farm Burlescombe Tiverton Devon EX16 7JT Lead Inspector Andy Towse Unannounced Inspection 10:00 9 November 2006 th 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 Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 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. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Little Eastbrook Farm Address Little Eastbrook Farm Burlescombe Tiverton Devon EX16 7JT 01823 672373 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) Mrs Sandra Christine Gold Mr Ronald Herbert Gold Care Home 3 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (3) of places Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users over the age of 40 Date of last inspection 24th January 2006 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 owners sister. There is a large garden area that is easily accessible for service users. A terraced area of the garden is accessible via handrails and steps. 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. Fees charged range from £393.98 --£475.02 with additional charges being levied for clothes, hairdressing, chiropody, holidays and specialist activities such as horse riding. Copies of previous inspection reports are available at the home. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which took place over a period of seven hours. Prior to the inspection information was obtained from the registered manager who completed a questionnaire about the service and had a brief telephone discussion with the inspector when further information about the residents and the running of the home was obtained. During the inspection further information was sought from discussion with a member of staff and the registered owners and residents, inspection of records and files, observation and a tour of the premises. The residents have limited communicative abilities, although one is more able than the other. Information was obtained through verbal discussion, use of pictures, gestures and observation with, at times, assistance from the manager and her partner. What the service does well: This is a small family run home. It offers its residents a close, family type living environment. Residents are clearly very happy with the environment of Little Eastbrook Farm and it suits their needs. The registered manager is very knowledgeable about the residents. She keeps records which are well maintained and easily accessible. She has attained her NVQ 2 qualification and uses skills from this course in running her home. Residents are treated like family members and the owners encourage relatives to maintain contact with the residents. Residents have single occupancy rooms in a house which has a good standard of hygiene and cleanliness. Residents enjoy a family lifestyle, going shopping with the owners and having trips out, as well as being involved, to a limited degree with aspects of the farm. Residents enjoy various activities and the arrangement of staffing allows for 1:1 interaction between the manager and staff and residents. There is a friendly relaxed atmosphere in the home, which is complemented by various domestic pets. Residents can access all communal areas of the home and adaptations have been made both in the house and the garden to facilitate this. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 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. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 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 Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 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): 3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are only admitted if the home can meet their needs. The policy of residents visiting the home enables them to make an informed choice about moving there. EVIDENCE: There has been no recent admission to Little Eastbrook Farm. Records for existing residents showed that they had lived at the home for six or more years. At the time of their admissions they arrived with various pieces of information relating to their assessed needs. These included a nursing assessment and an assessment carried out by a staff member from a previous place of residence. This gave details of the resident’s ability in daily activities such as communication, personal hygiene and mobility. The residents however did not then, as part of their admission, visit the home prior to being admitted. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 9 The registered manager has now developed an admissions programme. Should any new residents be admitted, they will be able to make visits to the home and have overnight stays to ensure that they can make an informed choice about moving there This will also enable the registered person to assess whether the person’s needs can be met and that they are compatible with existing residents. This home does not offer intermediate care. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 10 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, 8, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents needs are met by well written care plans. Residents receive good healthcare and are safeguarded by safe medication procedures. Residents’ privacy and dignity are protected. EVIDENCE: Both residents’ files contained care plans. They also contained ‘My Plan’ documents. These were written in a word and pictorial format thereby making them more easily understood by the residents. These were discussed with the residents who showed that they understood what was on them and in discussion they were shown to be accurate in their appraisal of the individual resident’s needs. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 11 The regular reviewing of care plans ensures that any changing needs of residents are met. This was carried out by the registered manager. Residents’ files showed reference to ongoing access to appropriate healthcare. Residents were regularly weighed and were seen to have the same access to the same doctors and dentists as the registered manager and her family. There was evidence on files to input from appropriate professionals such as physiotherapists. In discussion the registered manager showed that she was very aware of the right of residents to privacy. Examples were given of this regarding assistance with residents with personal care, and reference was also made to this in job descriptions. The manager and her partner were also observed to speak respectfully to residents, and the manager herself. The manager also mentioned that the issue of respect and dignity had been an integral part of her NVQ training. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 12 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, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents experience a domestic lifestyle which meets their expectations Residents are encouraged to maintain contact with family and friends. Residents are enabled to exercise choice in their daily lives. Residents enjoy a varied diet which reflects their choices. EVIDENCE: A daily record is kept. This showed that residents have access to a varied social life. This includes the 1:1 activities which occur each week and which involve the resident choosing what to do. One resident goes horse riding. They also accompany the registered manager or her husband on shopping trips or just choose to accompany them on trips out. One resident receives regular visits by family members and there are frequent social visits to Little Eastbrook Farm by members of the owner’s family, which Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 13 residents are involved with. Residents are involved in social event with the owners’ family. Residents are also part of the local community. For two hours a week both of the residents are taken out individually by a support worker. This gives them 1:1 attention and they also have a choice of where to go and what to do. They are often assisted in making these choices through the use of flash cards. The residents often go out for lunch, visit garden centres and go shopping. Records showed shopping trips to Taunton and Tiverton, often combined with lunches out. Locally, the residents are involved in activities such as those held at the local village hall. Within the house residents have access to several televisions, cd players and a large assortment of games. These include lego, and others with educational and developmental attributes. On the day of the inspection one resident was going out with a support worker for two hours of 1:1 involvement to destinations of her choice. The other resident was contentedly making things with beads. Residents have also gone on holiday to various destinations. Residents referred positively to these. In addition they have attended specialist clubs for people with a learning disability. The relatives of residents are made welcome and records show that some are regular visitors. The registered manager also showed that she and her husband were pro-active in seeking and encouraging relatives to make contact with residents. Residents, through responses to questions and use of pictures confirmed both involvement with relatives and also their inclusion in family events involving the owners’ family. Residents have a varied and nutritious diet. The manager said that she sat down with residents and discussed and agreed what should be on the menu. To engage the residents in this discussion a book containing pictures of various foods was used which enabled them to refer to what foods they preferred. Residents also enjoy lunches out in the community. One resident by pointing showed that she was familiar with the book which was used for deciding menus. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s complaints procedure, the knowledge of the staff and the confidence the residents themselves have in the management of the home. EVIDENCE: The home has it’s own ‘Complaints, Comments and Compliments’ Policy. This is clearly written and includes timescales relating to response to the initial complaint being raised, to a 28 day period for the completion of an investigation. It does however need amending to let any potential complainant be aware that at any time during the complaints process they can approach the Commission for Social Care Inspection. When talking with one resident, she was able to indicate that should she have a complaint or a problem she would have confidence in approaching the registered manager. In conversation one of the supply workers was able to give examples of what constituted abuse and what action would be taken should it be seen to be occurring. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 15 Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, safe environment which meets their needs. EVIDENCE: Little Eastbrook farm is a detached farmhouse situated in a rural community. Internally it is well maintained family house. The owners share their home totally with the residents. Adaptations have been made to the home to ensure it meets the needs of those who reside there. Outside there is a secure, terraced garden area to the rear of the property, which through handrails and steps is easily accessed by residents and, in summer months provides a private recreation area for them. Both residents are accommodated in well decorated, clean bedrooms, which they were proud to show off. Bedrooms were personalised. There is an upstairs combined shower and wc room and downstairs another wc, all of which have been suitably adapted to meet the needs of the residents. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 17 There are spacious communal areas, which include a lounge, dining room, a former conservatory and a utility room. Residents were seen to have complete freedom to go anywhere in the home. The premises are well maintained in accordance with a written schedule. Decoration and furnishings are domestic in style and size. There is a separate laundry. This is clean and well maintained. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 18 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): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by competent and experienced carers. Support workers have the experience necessary to competently care for residents at the home. Residents are protected by the home’s robust procedure for employing support workers. EVIDENCE: The registered manager and her husband live on the premises. They provide the bulk of the care offered. A support worker takes residents out on a 1:1 basis for two hours twice a week. At times when the owners are not working on the premises, their daughter and her partner, who live in premises adjacent the farmhouse, will support the residents. When they are not available, another couple will work at the home. In discussion residents referred to the registered manager’s daughter, her partner and the other couple in a positive manner. Records showed that the home protects its residents by having a thorough recruitment system. This was demonstrated by all the above people, including Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 19 family members, have files which contained police clearance, two references, identification details and application forms. These confirmed that staff had no records which would make them unsuitable to work with vulnerable adults. The registered manager does the majority of the administrative work. It was seen to be well maintained. She also does hands on care. The supporting workers have between them considerable and varied experiences. This includes working in education, running specialist support groups and working within social services. Records of supporting workers showed that most had received training in mandatory subjects such as the protection of vulnerable adults and moving and handling either at the home or whilst in other, or existing employment. The support worker spoken to was able to demonstrate a knowledge of what constituted abuse and what would be the appropriate action to take if it was suspected of occurring. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 20 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): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager has the experience and competencies to run Little Eastbrook Farm. She has undertaken some NVQ training which she has put to use both in improving her administrative and recording work whilst also analysing her care practices to produce a care home which focuses on the needs of it’s residents. A Quality Audit has been put into place, which has sought the views of staff and stakeholders and which has the capacity to be expanded to take into account the views of residents. The audit enables the manager to evaluate the service she is offering and wherever possible, use the views of residents and stakeholders to develop it in a way which meets their perceived needs. Residents financial interests are safeguarded by the home’s financial recording procedures. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 21 The health and welfare of residents is protected. EVIDENCE: The registered manager has had the managerial experience of running the home for many years. She has complemented this by completing her NVQ 2 training. She does not have her Registered Manager’s Award however, throughout the inspection she demonstrated competency in maintaining appropriate records, being aware of safeguarding residents, ensuring that they received adequate privacy and being aware of the duties of a registered manager. At the previous inspection it was required that the registered manager implement a Quality Assurance system, whereby the view of residents and other stakeholders could be sought and used to develop the service. The registered manager has now developed a system. This comprises a questionnaire which asks about how people find the staff, what the accommodation is like in respect of bedrooms and other facilities, the experience of visiting relatives, choice and quality of meals, the complaints procedure and equality and diversity when asking whether personal issues such as culture, race and religion had been taken into account during a stay. Currently, due to communication difficulties the manager has yet not sought the views of residents, but will be doing so. This questionnaire has been submitted to relatives and those visiting the home but has yet to be responded to by residents and care managers. The registered manager keeps a record of all monies held for or on behalf of the two residents. There are facilities in the home for the safe keeping of all monies. Both residents have bank accounts and there is a record of all expenditure which, wherever possible is confirmed by the retention of receipts. On the day of the inspection a check was made relating to the monies held for residents and the amounts recorded. This showed that the records were correct. The response by the registered manager to the pre-inspection questionnaire forwarded by the C.S.C.I showed that the home safeguards the residents by having appropriate policies and procedures. On the day of the inspection, evidence such as the testing of water within the home, certificates confirming the safety of electrical installations and a recent satisfactory report by the fire officer showed that the health and safety of residents was ensured. Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 22 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 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 x Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 23 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. Refer to Standard OP33 Good Practice Recommendations 1 Effective quality assurance and quality monitoring systems, based on seeking the views of service users, are in place to measure success in meeting aims, objectives and statement of purpose of the home. (This refers to the inclusion of residents’ own perspectives in the quality audit and quality monitoring systems put into place in the home) Little Eastbrook Farm DS0000021968.V306194.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Devon Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 DS0000021968.V306194.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!