Inspection on 13/12/06 for Miller Farm

This inspection was carried out on 13th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Miller Farm 30/01/06

Miller Farm 03/11/05

Miller Farm 10/03/05

Miller Farm 23/06/04

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 HOME ADULTS 18-65 Miller Farm 66 High Street Worle Weston Super Mare North Somerset BS22 6EJ Lead Inspector Catherine Hill Unannounced Inspection 13th December 2006 10:45 Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 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 Miller Farm DS0000043599.V319152.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Miller Farm Address 66 High Street Worle Weston Super Mare North Somerset BS22 6EJ 01934 521288 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) Freeways Trust Ltd Mrs Deon Davis Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30/01/06 Brief Description of the Service: Miller Farm is a small community home for younger adults with learning disabilities. Some of the residents display behaviour which challenges carers or have severe communication difficulties. The home is on the main street of a suburban area, with easy access to the local shops and services. This is a main bus route for the local town and for Bristol, but the home also has its own minibus. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was done by visiting the home unannounced on one day and by later contacting a resident’s social worker to get their views on the service. The visit to the home started in mid-morning and went on until the early evening. The inspector looked at a number of records relating to residents care and to the running of the home, spoke with the staff on duty, and spent time with the residents when they came home from their day placements. She also met the family of one of the residents. The requirements from the last inspection had all been met. No requirements were made at todays inspection. A recommendation was made at the last inspection that the admission procedure should be amended. This had not been done, so the inspector repeated the recommendation today. What the service does well: The home has a culture in which people’s rights and individuality is respected. Residents are encouraged to express their views and take charge of their own lives as far as practicable. They are treated as valued individuals, and each person is supported to follow the sort of lifestyle that they prefer. Residents friends and families are made welcome in the home, and the staff team actively supports these relationships. Staff are carefully chosen and get very good support to do their jobs well. The staff the inspector met were confident in their roles, and happy to be working at Miller Farm. The manager is very experienced and qualified, and promotes an atmosphere in which people feel valued and empowered. The wider organisation also actively supports the development of good practice: there are a number of projects going on within Freeways Trust in which service users are highly involved, senior managers regularly visit the home to carry out their own inspections and offer support, and the Trust provides an excellent range of training opportunities to staff. The environment is well-suited to the residents needs. It is homely but also practical. Residents bedrooms are decorated and furnished according to their individual needs and preferences. There are different seating and dining areas so that people can get away from each other if they wish. Records were generally very clear and the information in them was easy to find. Miller Farm DS0000043599.V319152.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. The summary of this inspection report can be made available in other formats on request. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4,5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives get plenty of information before deciding to move into the home, and the home gathers enough information on the person to be reasonably sure that it is able to offer them a service. Admissions are planned in a flexible way to suit individual needs. EVIDENCE: The homes Statement of Purpose is reviewed and updated every year, and gives useful information about the service and the people providing it. Residents are given a welcome pack soon after they move in, which was revised in September this year. The persons key worker goes through this pack with them to introduce them to the home’s facilities and services. The most recently admitted residents file was sampled. This showed that his needs were thoroughly assessed before admission, and that he was able to visit Miller Farm as often as he wished before making the decision to move in for a trial period. His family and Social Worker were also closely involved in this process. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 9 The inspector commented in the last inspection report that admission procedures say it is the Trusts chief executive who has the final say in who moves into the home. However, is the homes manager who must be responsible for this decision, because they hold the responsibility under the Care Standards Act 2000 as the person registered in day-to-day control of the home. It was recommended at that inspection that admission procedures should be amended. The manager had made amendments and returned the procedures to headquarters for action, but the admission procedures seen at todays visit were the same as at last inspection, so the recommendation was repeated. Each resident has been issued with an updated copy of their contract, which is in a service-user-friendly format, with symbols and plain language. Those people who wanted their own copy were given one to keep in their rooms. Staff went through this procedure with those residents they felt would benefit from it. No information was submitted to CSCI regarding fee levels. An additional charge is made for services such as chiropody, hairdressing, toiletries and magazines. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents care plans give clear, up-to-date information on their needs and what staff should be doing to meet these. Residents are fully involved in planning their care and, as far as possible, in their daily lives at the home. EVIDENCE: The care plans sampled contained clear, up-to-date information. Residents care records gave a clear picture of the person, their interests, their wishes, and their needs. Supporting documentation, such as risk assessments and response strategies, gave useful extra information. The manager said that the team intends to start clearly cross-referencing these documents with each other. Many of these care records have been rewritten as person-centred documents, and their emphasis is much more upon what the person themselves wants from the service and how staff can help them achieve this. Residents own Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 11 input was evident, and staff have made every effort to find out the preferences of residents who are not easily able to express themselves. Staff have also been quite creative in devising strategies to manage inappropriate behaviour. For example, one persons bedroom walls have been stencilled and some posters have been placed around the room, so that the person can look at something interesting in bed rather than becoming bored and destructive. Where there is an element of risk in some aspect of the persons life, this is clearly documented, along with a note of the actions to be taken to reduce the risk to a reasonable level. Freedom is not unnecessarily restricted, and where some restriction is unavoidable, this is openly negotiated with the person themselves as well as with external carers. Information on residents files was much easier to find at todays visit, since their files have been reorganized, and a list of contents placed at the front. Documents were generally signed and dated, making it easier to see which ones were current. Confidential information about residents is normally kept locked away, and staff are evidently in the habit of discussing sensitive issues in a discreet manner. Residents are encouraged to be as involved as possible with creating their records and can see their files if they wish. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Each person is offered a good range of interesting activities and opportunities for development. EVIDENCE: Most of the residents have four days each week at the Freeways Trust Day Centre. Each person also has one life skills day at home, when they have a lot of one-to-one time with the staff on duty. These days are used to carry out Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 13 basic chores such as laundry and room cleaning, but also to go out and enjoy community-based activities. Two residents only have one or two days a week at an external activity, due to their individual needs. Each of these people has a lot of one-to-one support from staff in suitably structured activities while they are at home. There is an evening activities list on the back of the staff rota, so that staff have an idea of what sort of social or leisure activities to arrange. This is not too rigid, and takes account of individual staff interests and abilities, as well as what the residents feel like doing that night. Evening activities include the local pub, karaoke, chill-out sessions with massage, watching a DVD, going out in the homes minibus, and cookery sessions. The conservatory is being used as an arts and crafts room, and residents have been making some very attractive Christmas decorations in there. Residents are supported to regularly use community facilities, such as the library, shops, cinema and theatre. The Worle Lions group are donating a large sum to the home to buy equipment for the Snoozelan room. Two of the staff have also worked hard to raise funds towards this. All the residents who wanted a holiday have had one. There have also been plenty of local trips out. Residents are actively supported to maintain significant relationships. Social events are organized that include their friends and families, and residents sometimes have friends over for tea. Visiting families are made welcome. The residents noticeboard is by the front door, and had a variety of current information that might be of interest to them. The day centre’s Christmas activities timetable was posted, along with information about other local events. The home is also hosting some social and leisure events to celebrate the festive season. Freeways Trust is now publishing a magazine called The Leigh Courterly, written by service users for service users, and a copy of this was in the office. There is another noticeboard in the conservatory, which included a poster for the Leigh Court pop group, the Residenz, who have recently brought out their CD and are playing at a local disco in early January. The trust also has a web site run by and for people with learning disabilities: www.choiceandvoice.com. House meetings are held, and staff use a variety of communication methods in an effort to ensure that each persons views are taken into account. The minutes of the last residents meeting - at the end of October - were also posted on the conservatory noticeboard, and showed that menus had been discussed, residents were asked for their ideas on Christmas activities, the Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 14 recent fire drill was discussed, and staff went through the recently revised, service-user-friendly complaint procedure with the residents. These minutes showed that each resident was given room and support to voice their views, and that the staff facilitating the meeting treated these seriously. Residents daily records confirmed the practice seen during this visit: staff try to offer residents a meaningful choice where possible. Staff allowed the person plenty of time to think about the choice, and repeated the choices on offer if this seemed necessary. Menus are based on residents known preferences, and provide a good balance of nutritious meals that are likely to suit the tastes of this age group. The Community Team for People with a Learning Disability has visited to offer the staff team guidance on healthy eating. The manager and two staff recently did a certificated course in Nutrition and Health. Menus are regularly discussed at residents meetings. Alternatives are offered if a resident seems to not be keen on eating a meal at that particular time. Residents are able to use the kitchen to make their own hot drinks, with staff support if needed. Residents may also help the staff in the kitchen, if they like. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents care needs are clearly documented in increasingly person-centred formats. Health Action Plans - which document peoples routine healthcare needs as well as their specialist ones - are well underway. Medications practice has become safer. EVIDENCE: Care plans include detailed guidance on each individuals preferred means of receiving support. The staff the inspector spoke with were well-informed about these individual preferences, and the practice seen during this inspection confirmed this. The Action for Health Co-ordinator from North Somerset Social Services has given advice to the home on the drawing up Health Action Plans for each resident. The manager created a sample plan to give key workers ideas on what sort of issue should be included in residents plans. Some residents now have really thorough and informative Health Action Plans in place; for other Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 16 residents, the outline of a plan has been set up, and their key workers will be expanding this with the person’s own involvement. Since last inspection, the manager has asked the residents’ GP to review their medications on a regular basis. She has also requested that each person has a yearly health check. There had been an unusually high number of medication errors at the time of the last inspection, and the manager had been looking at ways of improving practice to stop this occurring. The number of errors has dramatically reduced since then. Medications records are very clear, and a second staff member signs each record as evidence that they have checked the correct medicines are being given to the right person. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents evidently feel comfortable to express negative opinions about the staff and the service, and staff respond to this positively. There are highly effective arrangements in place for supporting people to complain and for protecting residents from abuse. EVIDENCE: Freeways Trust operates a straightforward complaints procedure. The procedure has been reviewed since the last inspection, and now contains the contact details of CSCI. Only one of the residents’ files seen had a serviceuser-friendly copy of the complaints procedure on it, and this was very out-ofdate. The manager said that the home’s updated copy of this procedure was taken to the residents meeting in October, for staff to go through with the residents to remind them of how they can complain, and may not have been returned to the policy file afterwards. She has requested another copy from headquarters. In practice, it was evident that residents feel very confident about airing their views and criticizing staff. The one complaint from a resident that has been recorded in the past year indicates that residents concerns are taken seriously and followed up. No complaints have been received by CSCI. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 18 Freeways Trust operates a clear and thorough prevention of abuse procedure, and all staff receive yearly refresher training in abuse awareness. Conversations with staff revealed that they have a high awareness of residents rights and a strong commitment to upholding these. Staff described a number of ways in which the homes culture of respect for residents is promoted, including the manager leading by example, regular open discussions within the team, and any less-than-ideal practice being addressed promptly and positively. Staff were able to describe the whistle-blowing procedure to the inspector, and were confident about what sort of issues should be reported, and why. Senior management staff are still drafting the policy on sexuality and relationships, in close consultation with a group of Freeways Trust service users. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents benefit from a safe, pleasant, comfortable and well-maintained environment that is well suited to their needs. EVIDENCE: The home was completely refurbished a year ago, and the environment is well suited to the needs of this resident group. One of the staff has worked hard, with help from some of the residents, to turn the back garden into a pleasant space that is safe for residents to use alone. Staff are creative about tailoring the environment to meet individual needs. For example, one person will not tolerate curtains in their bedroom, so all but the very top of their windows have been covered in an opaque film. This lets the light in but preserves privacy. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 20 All the bedrooms are single and three have an ensuite toilet. Those bedrooms seen had been decorated and furnished to suit the occupant’s needs and preferences. There are five communal toilets around the home, three of which are in bathrooms. There is a wet room with a shower in one wing of the building, and an adapted bath in the nearby bathroom. Toilets and bathrooms are well spaced throughout the home so that all bedrooms are within easy reach of one. A ramp leads from the dining room up to the corridor leading to some of the bedrooms. There are a few comfy chairs and a TV to one side of the dining room, and there is a large lounge at the front of the house. There is also a small lounge upstairs. There is an office, and the attic can be used as a study space for staff. The kitchen is reasonably safe for residents supervised use, and the kitchen door has a keypad as well as a magnetic hold-open device. The front door also has a keypad, which releases automatically if the fire alarm sounds. All areas were clean, tidy and fresh smelling. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents benefit from safe staffing practices. Staffing levels are good, staff are effectively deployed, and staff support systems are excellent. EVIDENCE: Detailed job descriptions are available for each role within the staff team. The staff rota is well planned, and staff are on duty in sufficient numbers to meet residents needs at different times of day. There is always at least two staff in the home, usually more. Most shifts have at least three care staff on duty. The manager or her deputy works in addition to these staffing levels. An administrator also works in the office three days a week to help with paperwork that is not directly related to residents care. Two staff are on waking duty at night. Some of the residents have very high needs and it is written into their contracts that they will have set amounts of one-to-one support from staff. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 22 Each persons one-to-one time is clearly marked on the rota, and one-to-one staff are supplied additional to basic staffing levels. Staff comments showed that relevant training is arranged promptly to address any issues that arise. Staff felt that this training is very effective in increasing their confidence and skills. Individual staff training records showed that a wealth of training is on offer, and that staff are receiving in excess of the minimum training required. The manager drew up a training needs list for this financial year, based on statutory requirements, individual staff needs, and the needs of the resident group. She plans to do this again for the coming year to ensure that each person has refresher courses on all statutory training, in line with Freeways Trusts policy. Over the past year, training has included basic food hygiene, first aid, manual handling, fire, abuse awareness, positive communication, COSHH (Control Of Substances Hazardous to Health) and risk assessments, and care plan documentation. Nine staff hold NVQ 2, and a further five people are working towards this award. Four staff are doing NVQ 3, and two of the seniors recently did a Team Leader course. All staff undertake LDAF training when they start work. There has recently been an issue about staff pay, and Freeways Trust are developing a long-term plan to create a consistent pay structure for all staff. There has only been one new staff member in the past year. The home has an unusually low staff turnover. The new member of staffs records showed that good recruitment practice is still being followed, with all the necessary checks being satisfactorily completed before the person starts work. Staff told the inspector that they find their one-to-one supervision sessions with the manager very supportive. They feel encouraged to develop their individual skills, and valued as members of the team. Staff felt that they are treated fairly, are listened to, and that their individual needs are regarded as important. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42, 43 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents benefit from a well-run home with effective external support systems. EVIDENCE: Deon Davies, the manager, holds the Registered Managers Award, NVQ 4, the NVQ Assessors Award, City & Guilds Advanced Management of Care, the NVQ Training and Development Award, and is a Studio 3 trainer in the management of challenging behaviour. She has also developed strong links with North Somerset Social Services Community Team for People with a Learning Disability. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 24 Since taking over the home two years ago, Ms Davies has helped the team to become a more cohesive group, has created clear lines of accountability within the home and clear guidance about what is expected of each staff member, and has helped the team set up much more accessible care records for the residents. Individual staff have their own delegated areas of particular responsibility, and there is room within these to be creative. Checklists for each shift are in use, and staff initial each task on the list when they have completed it. This helps to ensure that all essential tasks are carried out. Staff felt that they are part of a good team with high morale and plenty of support from line managers. The home’s manager and Freeways Trust managers are seen as approachable and genuinely interested. Staff commented on the managers willingness to muck in with the less desirable aspects of their jobs. A quality assurance file has been set up which includes a copy of the Statement of Purpose, residents questionnaires that were completed in October this year, the record of complaints, a record of staff statutory training, and a copy of residents contracts. The inspector suggested that this file might also usefully include a note of the teams achievements over the past year, and a list of achievements the team is aiming for in the year ahead. This would provide not only a broad underpinning aim for all other developments, but also give the team a means of reflecting on how they are helping the service to develop. A group of Freeways Trust service users have been meeting over the past year to review the Trusts policies. The group has been working to ensure that service users interests are at the heart of policies and that they are produced in a format accessible to service users. A service users policy file is now kept in the office with copies of symbol-supported versions of all policies and procedures that are relevant to the residents. Some policies and procedures have been adapted to suit different individual needs. For example, one person has their own missing person procedure, which is kept on their file and is followed whenever this person goes missing. This is tailored to the persons own particular needs, and was drawn up in consultation with the person themselves, their family, their Social Worker, and the local police. All staff undertake the Appointed Person level of first aid training. Residents benefit books are still kept at Freeways Trust headquarters. For the past couple of years, Freeways Trust has been considering ways of handing this area of control over to residents where practicable. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 25 The inspector commented at the last inspection that residents assessments cover their ability to manage their finances, but care plans did not address this issue. The care plans sampled in depth today show that individual arrangements are set up with each resident. This helps to ensure that people are able to exercise more control over their own finances. Freeways Trust operates a very thorough system for managing residents money. One of the Responsible Individuals representatives who regularly visit the home unannounced has a particular expertise in financial systems, and checks this aspect of the home’s running. A representative from Freeways Trust visits the home unannounced at least once a month, and compiles a thorough and informative report on each visit. These visits are used to strengthen the links between the residents and staff of individual homes and the senior management team. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 4 32 4 33 3 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 4 4 3 3 4 Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 27 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. 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 YA2 Good Practice Recommendations The admission procedures should be amended to show that it is the decision of the homes manager whether to admit a resident. This recommendation was first made at the inspection of 30/01/06. Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Miller Farm DS0000043599.V319152.R01.S.doc Version 5.2 Page 29 - 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!