Inspection on 31/10/05 for Merrivale Farm

This inspection was carried out on 31st October 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Merrivale Farm 10/11/06

Merrivale Farm 28/02/06

Merrivale Farm 08/02/05

Merrivale Farm 07/10/04

Merrivale Farm 26/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Merrivale Farm Eastwood Tarrington Ledbury HR8 2RN Lead Inspector Jean Littler Announced Inspection. 31 October 2005 11:00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Merrivale farm Address Eastwood Tarrington Ledbury HR8 2RN 01531 670220 01531 670914 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) Alphagrange Limited Mrs J Armitage and Mrs T Loveridge. CRH Care Home 7 Category(ies) of LD Learning disability 7 registration, with number of places Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 One named resident has a mental disorder in addition to a learning disability. Date of last inspection 8 February 2005 Brief Description of the Service: Merrivale Farm is situated in a rural location, on the outskirts of Tarrington village, between Hereford and Ledbury. The home is set in 20 acres of land and comprises a traditional farmhouse that has an annexe and other outbuildings. It is the only service owned by Alphagrange Ltd. There are two managers, one of whom is also one of the two company directors. It is registered to accommodate up to 7 adults whose primary care needs must be due to learning disabilities. Some animals are kept and service users are encouraged to help with their care and other tasks in the garden. Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine announced inspection was carried out on a weekday between 11am and 2pm. The managers completed an inspection questionnaire prior to the visit to provide additional information. The residents and their representatives were provided with feedback questionnaires. Four relatives and all the residents returned these and they all contained positive comments. The providers monthly visit reports that are sent to the Commission, and other communication with the Home since the last inspection were considered as part of the assessment process. The inspector spent some time with four residents who were all positive about the service. One manager and one provider assisted with the inspection process. The staff on duty were out with some of the residents until the end of the inspection, doing the weekly shop, so no staff interviews took place during this visit. What the service does well: What has improved since the last inspection? What they could do better: Person Centred Planning is due to be introduced to assist the residents to develop their own ideas for their future. Staff training arrangements would be further improved by accessing adult protection training. Some areas of health and safety management need to be given more consideration including the level of First Aid training for staff. Methods of assessing the quality of the Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 6 service against the standards should be further developed as part of an increased emphasis on self-regulation. 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. Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 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 standard(s) 1, 5. Up to date information about the Home is available in a suitable format. EVIDENCE: The Statement of Purpose includes all the required information. The Service User’s Guide had been reviewed in September 05 and this now includes information on complaints, confidentiality, privacy, the Home’s values etc. This information has been clearly presented in a suitable format for the residents. Keyworkers have gone through the information with each resident and they have their own pack. There are no vacancies in the Home so the packs have not yet been used to provide information to a new resident. A Terms and Conditions document has been developed and this has been agreed with residents in conjunction with the Residency Agreement. The managers could consider asking the advocacy service to review this with the residents who do not have any family closely involved. Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 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 standard(s) 6. Suitable arrangements are in place for care planning and monitoring. These are due to be further improved with the introduction of the Person Centred planning approach. EVIDENCE: One resident’s care plan was sampled. This contained up to date and accurate information about his needs, his weekly activity plan, and the independence skills that he was being supported to develop. Daily records contained information about the resident’s general wellbeing, health issues, social contact and activities. The risk assessments for one resident had been reviewed in September. Physical intervention is very rarely needed but staff have been training in suitable techniques should low-level intervention be required to calm a situation. The managers agreed to report any such incident to the Commission under regulation 37. Care reviews are being planned on a six monthly basis, and it is positive that a review took place recently with one resident even though the social worker who arranged it cancelled. Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 10 It is positive that one member of staff is due to attend the Person Centred Planning training being held as part of the Governments ‘Valuing People’ initiative in the county. The worker is then going to help the residents develop their own support plan and aims for the future. Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 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 standard(s) 11, 12, 14. Residents are being provided with opportunities for personal development and are taking part in an increasing number of educational and leisure activities. EVIDENCE: The residents are becoming more confident in making suggestions about activities and holidays and are using the regular resident’s meetings to voice their ideas. Suggested ideas have been acted on promptly to reinforce the concept that their choices will be listened to e.g. some residents saw a poster while out and suggested a theatre trip to see ‘Night Fever’, which has now been arranged. As well as using the meetings to air their views the residents have access to advocacy services and some attend advocacy groups weekly. A newsletter has been launched and the first one included details of all the activities, trips, holidays and events that have been arranged. It is hoped that residents will get more involved and help publish the Christmas addition. The residents now all have their own bank accounts. These have taken a lot of effort to arrange over the last six months, but the results have been positive with residents enjoying taking on more responsibility for their money. Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 12 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 standard(s) 19. Suitable arrangements are in place to meet residents’ health needs. EVIDENCE: One resident’s medication had recently been changed, so close monitoring of his epilepsy was taking place. The medication system was not assessed, however some feedback was given on the Home’s medication procedure and the managers agreed to review and update this. The residents were being supported to access local health services and appropriate links were in place with health professionals for specific needs. Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 13 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 standard(s) 22, 23. Suitable arrangements are in place to manage complaints. Arrangements to help protect the residents from abuse would be strengthened if staff attended training in this area. EVIDENCE: A complaints procedure is in place that has been written in a clear format with some visual images to aid residents’ understanding. No complaints have been received by the Home or the Commission since the last inspection. A brief and clear ‘Abuse’ policy is in place. This makes clear reference to the local multi-agency procedure for dealing with ‘Vulnerable Adult’ concerns. A ‘Whistle Blowing’ policy is also in place that states staff will be protected if they report a concern. No adult protection issues have occurred since the last inspection. The managers attend a conference on Adult Protection in 2004 and are aware of the POVA guidance. Although the newer staff will have covered adult protection in their foundation it is advisable that all staff are provided with training from the Herefordshire Adult Protection Manager. Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 14 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 standard(s) - EVIDENCE: These standards were not fully assessed, however it is positive that the work on building the extension has started. This is not currently affecting the Home but will greatly improve the layout of the Home when completed. The roof has been repaired so the ongoing leak problem in one area has stopped and there are plans to make good the ceiling on the landing. Work continues in the garden and there are now raised beds that residents are being supported to use for growing vegetables. Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35. Appropriate staffing levels are being maintained and rotas arranged to meet residents’ health and activity needs. Staff training is now being well promoted and specific courses accessed in line with residents’ assessed needs. Appropriate recruitment arrangements are in place if needed, but the staff team is very stable. EVIDENCE: No new staff have been recruited and all current staff have clear CRB checks in place. One worker has retired since the last inspection, but he is staying on as a relief worker as he may cover staff holiday periods. The team is made up of eight workers including the responsible individual and both managers. There is usually two staff on at peak times but there is a good degree of flexibility to accommodate activities and outings. Staff training continues to be developed. The two newest staff have now completed the LDAF foundation units and are going on to start NVQ awards. The responsible individual is also starting an NVQ award and if all three gain a qualification the Home will meet the target of having at least 50 of the staff qualified. Two staff have attended epilepsy training and found this very useful. There are plans that the other staff will also attend. Autism training has been attended by some and core training updates have been provided e.g. Food Hygiene. Two staff are due to attend the Person Centred Planning training. Two staff are still waiting to attend accredited medication training. Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 40, 41, 42. The management arrangements remain stable and both managers are suitably experienced and qualified. Work is continuing to strengthen the management framework and improve the outcomes for the residents and staff team. Policies have been further developed and appropriate records are being maintained. Health and safety arrangements continue to be improved. Some areas for further consideration were identified. EVIDENCE: The management arrangements have not changed since the last inspection. Both managers have gained relevant qualifications including NVQ4 in Care. It is very positive that one manager has also recently completed her Registered Managers Award. All records requested were available and were being kept up to date e.g. training and fire safety records. The Responsible Individual has been completing monthly monitoring reports and forwarding these to the Commission. The content of these has been improved and a discussion took Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 17 place about the increasing emphasis that is being placed on providers to monitor the quality of their services. The management team have worked very hard over the last three years to develop a comprehensive policy set. The only ones outstanding against the list included in the National Minimum Standards are sexuality and personal relationships, aggression towards staff, referral and admissions. These should be developed along with a policy statement on how the quality of the service is going to be monitored. A fire safety risk assessment has been completed. This was detailed and included details about staff training and routine checks of the alarm system. Staff had all attended fire training and were taking part in periodic drills with the residents. As part of the fire safety arrangements all portable electrical appliances had been tested. The last wiring certificate is dated 1997 so consideration should be given to renewing this. It is recommended that wiring is checked every five years. The COSHH assessments were seen. Data sheets were in place for all substances used in the Home. An overall risk assessment should also be completed to show what arrangements for the residents are considered safe in regards to storage and use of cleaning chemicals. The current arrangements for First Aid training i.e. a one day course, fall below the National Minimum Standard. The manager and provider agreed to complete a risk assessment and provide any additional training identified as needed. There current building work is fenced off and is not affecting the inside of the Home. The manager and provider agreed to forward a risk assessment to the Commission at each phase of the building work, which will involve quite complex arrangements when it is the main areas of the Home that are affected. Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 3 x 3 x x x Standard No 31 32 33 34 35 36 Score x 3 3 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Merrivale Farm Score x 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x x 3 2 2 x E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 19 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 YA42 Regulation 13 Requirement Complete a risk assessment regarding the First Aid cover provided. A copy needs to be forwarded to the Commission. Any additional training identified as needed must be provided in a timely manner. Timescale for action 31/12/05 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 YA42 Good Practice Recommendations Complete a written risk assessment for each stage of the building work and forward these to the Commission. Have the electrical wiring checked and obtain a new safety certificate. Arrange these checks at least every five years as part of safety and fire prevention arrangements. Arrange for all staff to attend adult protection training with the local Adult Protection manager. Further develop arrangements for quality assurance. 2. 3. YA23 YA39 Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 178 Widemarsh Street Hereford HR4 9HN Address 4 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 Merrivale Farm E52 E02 S24724 Merrivale Farm V246917 311005 Stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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