Inspection on 03/11/05 for Miller Farm

This inspection was carried out on 3rd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Miller Farm 13/12/06

Miller Farm 30/01/06

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 BS22 6EJ Lead Inspector Catherine Hill Unannounced 3 November 2005 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. Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Miller Farm Address 66 High Street Worle Weston Super Mare BS22 6EJ 01934 521288 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) Freeways Trust Ltd Mrs Deon Davies Care Home - Personal Care Only 10 Category(ies) of Learning Disability - (10) registration, with number of places Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10 March 2005 Brief Description of the Service: Miller Farm is a small community home for younger adults with learning disabilities. Some of the residents display behaviour patterns that are challenging to carers. 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 D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted during the late afternoon. It focused on spending time with residents, and talking to staff. The inspector talked with two of the residents individually and spend time with five other residents in the communal rooms. She spoke to four of the staff on duty individually, one of whom was from an agency. The inspector sampled some of the records relating to residents personal care, medications administration, fire precautions testing and training, and residents and staff meetings. These records were generally well maintained and gave a useful amount of information. One of the staff on duty gave the inspector a tour of the premises. The major renovations that were being made to the premises, inside and out, have now been completed. The environment is greatly improved as a result, and is better suited to the needs of the people who live there. The staff team is organising its work far more effectively, and the staff on duty were clear about their roles and were able to focus their attention where it was needed. At the time of the previous few inspections, the home was accommodating several people who were outside the range of service it is geared to provide, and despite good intentions the staff team was not able to meet everyones needs. Since then, however, new placements have been found for these people and the home is only accommodating people whose needs fall within its remit. Probably as a result of these factors, residents seemed much more settled than on previous visits. What the service does well: What has improved since the last inspection? Deon Davis, the homes manager, has been registered since the last inspection. She and the team have evidently worked really hard to improve communication, allocate work more clearly, and delegate tasks more Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 Page 6 effectively. Staff morale had been very low for a considerable time, but was improving at the time of the last inspection and has improved further still since then. New placements are being given more careful consideration to ensure that the home is likely to be able to meet peoples needs once they are admitted. The group of residents in situ now have more compatible needs which the home is geared to cater for, and both residents and staff seemed calmer and happier than previously. Major changes have been made to the environment, and it is far more comfortable, attractive, and suited to residents needs. 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. Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 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 Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 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) These standards were not assessed at this inspection. EVIDENCE: Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 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 Residents needs are clearly recorded. EVIDENCE: The inspector noted at the last couple of inspections that residents records need to be expanded to give more guidance on how staff should address individual needs, particularly the reactive strategies. These have now been expanded to give wider guidance, and are being reviewed regularly, both formally and at staff meetings. As a result, the written information on residents needs is much more explicit. Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 Page 10 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) These standards were not assessed at this inspection. EVIDENCE: Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 Page 11 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) 18-20 Residents needs are well met. EVIDENCE: Residents who were able to express their opinion to the inspector felt that they are treated with respect. One person said that they used to behave aggressively but do not feel the need at Miller Farm because they feel better in themselves and are not bored. Discussion with staff and observation of practice showed that staff are responsive to all sorts of cues from residents, in line with the agreed reacted strategies, and treat people as respected individuals. Medications and the associated records were kept in good order. The home has a particularly effective system of checking medications and records at the end of each shift. Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 Page 12 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 Residents views are taken seriously. EVIDENCE: Residents expressed their views freely and fearlessly, and are evidently accustomed to being listened to and having adult-to-adult discussion with staff. Only one complaint has been recorded in the homes record since the last inspection, and this concerned another service rather than the home itself. However, the home had taken appropriate action on the persons behalf and this was recorded in the complaints log. No complaints have been received by the CSCI. Staff offered support discreetly, and were patient with residents, going at their pace and with their flow. Staff offered a variety of alternatives and choices to people wherever possible. Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 Page 13 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) 24-30 Extensive improvements have been made and the environment is now far more comfortable, attractive, and suited to residents needs. EVIDENCE: The driver-handyman has made a real difference to the back garden by creating a lawn and flower beds, and he plans further improvements before next summer. Several bedrooms have been redecorated, and two extra en-suite toilets have been created. The upstairs bathroom has been made bigger and fitted with a new suite, the downstairs bathroom nearest the kitchen has been completely refurbished, and a new walk-in shower with seat has been created at the other end of the building. The corridor by this latter bathroom has had sky lights installed so that it is much lighter. A new boiler has been installed, and staff reported that the hot water and central heating is much more efficient and reliable now. The dining room has been completely refurbished and a ramp built from this room up to the corridor leading to the bedrooms. Access throughout the home Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 Page 14 for people with mobility problems has been improved. The front lounge has been redecorated and has new furniture that is much better suited to the residents needs. The old office is now a residents downstairs bedroom, and a new office has been created at the top of the stairs. The kitchen has been completely refitted, and the kitchen door has been fitted with a keypad as well as a magnetic hold-open device. The new laundry is a great improvement, and has room for two washing machines. The home has been recarpeted throughout. Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 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) These standards were not assessed at this inspection. EVIDENCE: Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 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) 37-39, 42-43 The home is well run, and residents views underpin all aspects of the service. EVIDENCE: The manager has set up systems of task allocation, in consultation with the staff team, that are clear and effective. Staff described a supportive team whose individual members are now able to function far more effectively because of this clear framework, and staff felt that they are achieving meaningful outcomes for the residents. As a consequence, team morale is much better. The Freeways manager with particular responsibility for Miller Farm has also been giving good support to the home, making regular visits and spending time with residents and staff, and also providing training and advice in the management of challenging behaviour. Staff get regular one-to-one supervision from either the manager or her deputy, and find this supportive and useful. Communication has greatly improved, with regard to both written systems and team relationships. Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 Page 17 Regular residents meetings are being held, and the minutes showed that people are being well supported to think about what they want from the service and to express their views. Regular staff meetings are also being held, and these showed that the team is being much more involved in decisionmaking, and that good use is being made of the skills within the team. Fire precautions equipment testing and training records showed that the Fire Officers recommendations are being met, but emergency lights and fire extinguishers are not been checked by the home on a monthly basis. Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 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 x x x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Miller Farm Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 2 3 D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 Page 19 Yes 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 YA1 Regulation 6 Requirement The Statement of Purpose needs to be re-written to give explicit detail on the range of needs that the home can cater for. this requirement was made on 24/6/04 but was carried forward while the home went through a period of rapid change. Emergency lighting and fire extinguishers must be checked on a monthly basis. Timescale for action 10/9/05 2. YA42 23 3/11/05 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 YA6 Good Practice Recommendations All significant records relating to residents care should be signed and dated. Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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 Miller Farm D53-D02 S43599 Miller Farm V242044 031105 Stage 4.doc Version 1.30 Page 21 - 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. 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