Inspection on 04/10/06 for Penrose Farm

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

What the care home does well

Most of the service users and relatives who were interviewed said that they like the home and it meets their needs well. One relative said that service users appear to be well matched with each other and the staff team reflects their ages and genders, which they appreciated. There is detailed written background information on each service user so that people working with them have enough information to support them effectively. Service users` needs are clearly set out in individual care plans, which are regularly reviewed with them and their representatives so that they are aware of the purpose of their placements in the home. They are encouraged to make choices about things that are important to them such as what activities they do during the day, meals and what time to get up in the morning, which was observed during the inspection. Staff support them to take managed risks so that they improve their skills and develop increased independence. A relative of one service user said that they had noticed significant progress in this respect over the time of their admission to the home.Service users described the various activities they take part in, both in and out of the home. All said they are able to do things they enjoy and some were very enthusiastic about it. At least two said that it was the best home they had ever lived in and their relatives said that they were always happy to go back there after home visits. Activities include going to local colleges, attending voluntary work placements and social clubs. Service users access shops, entertainment and sporting facilities in the local community and there are certificates of their achievements on their individual files. The home has a very large garden for barbecues and social events in the summer and satellite television, which one service user was enjoying at the time of the inspection. Service users are actively supported and encouraged to maintain and develop relationships with their families and appropriate friendships with people in and out of the home. There are facilities for them to make telephone calls in private, so they are not isolated in the home. Service users are informed of their rights and responsibilities, which are set out clearly in their service users` guides, with the exception of their fees, which are in the process of being included. Where necessary, they are supported to access local advocacy services, which can act independently of the home to protect their rights and best interests. Most of the service users said they are satisfied with the meals provided. They were observed accessing the kitchens independently to prepare breakfasts and snacks for themselves at various times during the day. Service users are encouraged to eat healthy, home cooked meals, which they help to plan and prepare, so that they stay well and enjoy their food. Service users looked smart and well cared for and there are good systems in place to ensure their healthcare needs are properly attended to, so that they can remain in a community setting. Where service users expressed dissatisfaction with their healthcare during the inspection, the manager was able to provide reasonable explanations of what was being done to address their problems. Some aspects of management of service users` medicines are safe and sound, particularly with regard to storage and instructions to guide staff on how to manage them safely. Most of the service users said that they feel safe in the home and there are systems in place to protect them from harm and abuse. Where they expressed specific concerns, the manager was aware of the circumstances and able to describe the actions she had taken to protect their best interests. The home provides service users with an exceptionally homely and comfortable environment in which to develop their skills and independence. Most of them, and their relatives expressed their appreciation of this, and one relative said that it gave the service user an opportunity to live a "normal life" in a noninstitutional setting. The home is conveniently situated for public transport and the local community, but also provides service users with privacy, as it is Penrose Farm DS0000041536.V315867.R01.S.doc Version 5.2 Page 7slightly off the main road. There is a very large garden and ample communal space in addition to service user`s private rooms, which are spacious and personalised. It was clean and tidy throughout at the time of the unannounced inspection. Most of the service users and all of the representatives who were interviewed in the course of the inspection expressed satisfaction with the staff team working in the home. They all already have or are working towards achieving formal qualifications in care and are recruited on the basis that they are suitable to work with vulnerable adults in a care setting. Most of the service users and all of their relatives and representatives said that they are satisfied with the way the home is managed. A staff member who was interviewed said that it feels like a safe place to work in and that there is adequate support and back up in place to cope effectively with emergency situations.

What has improved since the last inspection?

There was improved evidence of service user participation in developing their care plans at this inspection and all the care plans reviewed were clearly signed and dated. Service users and their representatives stated that they are fully involved in the process. The home`s written procedures to guide staff on what to do if they suspect abuse of a service user have been updated and improved so that they have clearer instructions on what action they should take to protect service users. Service users were observed accessing all parts of the communal areas of the building and the door of the utility room was not locked. The manager said that they were able to access the room if they needed to, so a written risk assessment was not necessary. There was improved evidence that staff have access to ongoing training to update their knowledge and skills so that they can work safely and effectively with service users. The new manager has developed improved systems to ensure that they are appropriately supervised, so that they are able to reflect on and improve their working practises for the benefit of service users. There was improved evidence at this inspection that service users` views are taken into account in the day-to-day and ongoing management and development of the home. This includes regular visits by Spectrum`s senior managers to make checks on how the home is running, for example.

What the care home could do better:

Service users` individual contracts did not clearly set out their fees, or how their individual contributions are calculated. This meant they could not make fully informed decisions about their placements in the home. The manager said that she is updating all the contracts, during a telephone conversation held shortly after the inspection, so a formal requirement to do this has not been issued in this report. Service users would benefit from more detailed and specific goals in their care plans so that they can readily monitor their own progress towards independence over time and be clear about what they can realistically achieve. Some expressed frustration about restrictions due to living in a registered care environment, even though there were clearly stated and documented reasons for this. Improvements are needed to the way service users` medicines are managed in the home so that they are better protected from medication errors, including appropriate training for all staff handling medicines, and ensuring clear lines of communication between the home, prescribing doctors and the local pharmacy so that the correct medicines are supplied, when they are needed. Improvements are needed to the ways in which service users` concerns and complaints are acknowledged and managed so that they can have confidence that the written procedures given to them are followed. Records relating to a complaint made by a service user during the summer were missing from the home and the new manager was not aware of what their concerns had been, so could not take appropriate action to prevent them from arising again. Another service user was under the impression that they had made a formal complaint about a specific issue and whilst the manager was aware of it, the matter had not been formally acknowledged and dealt with in accordance with the home`s written procedures.