Inspection on 30/06/05 for Place Farm House

This inspection was carried out on 30th June 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 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

Place Farm House 04/11/08

Place Farm House 25/01/07

Place Farm House 15/12/05

Place Farm House 18/01/05

Place Farm House 17/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Place Farm House Ladies Mile Road Patcham Brighton East Sussex, BN1 8QE Lead Inspector Elizabeth Dudley Unannounced 30 June 2005 10:00 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Place Farm House Address Ladies Mile Road Patcham Brighton East Sussex BN1 8QE 01273 563902 01273 508911 placefarmhouse@yahoo.co.uk Mrs Margaret Tomlinson 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) Mrs Margaret Tomlinson Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (OP), 20 of places Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of service users accommodated must not exceed twenty (20). 2. The service users accommodated will be aged sixty-five (65) years or over on admission. Date of last inspection 18 January 2005 Brief Description of the Service: Place Farm House is a family run home registered to provide personal care for 20 older people, the registered provider and manager is Mrs Margaret Tomlinson who has owned and managed the home for 20 years. The home is situated in a residential part of Brighton within easy reach of local transport and amenities. There is unrestricted on road car parking in the roads around the home. The home is on two floors both served by a shaft lift and accomodation is provided in eighteen single and one shared room. All rooms have en-suite bathroom facilities. There is a good range of communal space which includes a lounge and dining room, with level access to samll well-maintained garden areas. Many of the rooms provide views of the Downs and surrounding area. Mrs Tomlinsons daughter, Miss Webb is the deputy manager and her son works as the administrator. Her other daughter, Mrs Dale, provides administrative and managerial consultancy services within the home. Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 30th June 2005 over a period of 7 hours and was assisted by the manager, Mrs J Tomlinson. This forms part of the annual inspection programme for this home. During the inspection 18 residents and six staff were spoken with. Documentation, which included personnel files, care plans, medication records, policies and procedures and health and safety records were examined, and a tour of the home took place. Thanks are extended to the residents, staff and management for their help and courtesy during this inspection. What the service does well: The home is exceptionally clean and well decorated, the manager changing the décor of a room and buying new curtains and bedlinen every time a new resident comes into the home. The lounge is furnished in domestic style and accesses a well maintained garden with a pleasant seating area for residents to use. Video recorders are now being provided in all rooms so that residents can watch films in their rooms, the home has a supply of films and books for residents use. A good range of activities is provided including a craft workshop and an artist, and musical evenings and residents are encouraged to pursue their interests. A resident stated that ‘ There is always something to do here, and if you don’t want to do it you don’t have to- I never want to do it, so I don’t’. Food is well cooked and appetising and served in a very pleasant dining room, although it can be served in the residents own rooms. There is a good atmosphere within the home, residents are happy and say that moving to Place Farm House was ‘ The best thing I could have done’ and ‘ How could you not be happy here?’. Staff and residents appear to get along well, and the manager takes a great interest in all the residents, visiting them in hospital several times during their stays, or ensuring that their birthdays are recognised with presents and a party. The home is well managed, all the paperwork that is required is in place and all health and safety requirements are in order. The home is an example of how good a care home can be and provides a good standard of care and quality of life for the residents living there. Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 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. Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5.The home provides sufficient documentation, and encourages visits to the home by prospective residents, to ensure that they have all the information necessary prior to deciding whether to make Place Farm House their home, EVIDENCE: The home provides a statement of purpose and service users guide in one document, the information within this meets both the requirements of Schedule 1 and National Minimum Standard 1. This document is well presented and easy to read and includes a section on what to look for in a care home. This is sent or given to all people who look around the home or make an enquiry regarding accommodation at the home. Two residents stated that they felt that they were given sufficient information before they came to look around the home, and were able to come and meet other residents before they made the decision to move in. The home provides a statement of its terms and conditions, which meets this standard, to all residents either prior to or on their admission to the home. Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 9 All prospective residents are assessed by either the manager or the deputy manager to ensure that the home can meet their needs and residents are encouraged to visit the home prior to admission. Information gained at assessment is used to provide the basis of the initial care plan. The home is able to accommodate residents from ethnic backgrounds and meet most cultural and dietary needs following consultation with the resident. The home is able to meet the needs of the residents within its registration category, and when the home can no longer meet these needs, the resident is assisted to find a suitable home that can provide for these. Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10,11 Care plans show the care to be given to each resident to enable staff to give the care appropriate to each residents needs. The present medication administration system ensures the safety of residents. Some staff training needs to be in place to ensure that residents are treated with the dignity that reflects their age and status within the home. EVIDENCE: The care plans identified the social and physical needs of the residents, these are set out clearly allowing care needs to be identified and a daily care diary is included in each care plan. 25 of the care plans were examined and these showed that all care plans had been reviewed monthly, that the residents or their representatives had been involved in the formation of the plan of care and its review, and all care plans addressed the care needs of each resident including details of doctors and hospital visits. Ten residents spoken with, stated that they knew what was said in their care plans and had been able to include their own wishes in this. If any nursing care is needed, this is undertaken by community nurses who also come into renew dressings and give advice. Pressure care aids are provided by the district nurses. Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 11 Residents who are very ill, receive care from the staff in the home in their own rooms, with instructions and help from the community nurses. The home reviews its policy on caring for the dying resident following a resident’s death, and amends the policy to include any improvements that they feel may be necessary. The home has recently changed its medication administration practice to a monitored dosage system and staff are receiving training in this. A medicine trolley, controlled drug cupboard and drug fridge have now been purchased. There are some residents who self medicate and the self medication risk assessment must be in more detail than at present, showing assessment of the residents capability, number of medication taken and number supplied and the name of the care staff responsible for checking this. This must be reviewed at least monthly, and there should be space on the risk assessment to record any changes and decisions in detail. Residents said the staff treat them with respect although one member of staff was seen to be addressing a resident using an endearment which she stated was the residents preferred form of address, but this was not in the care plan. This was discussed with the manager as this is not considered good practice although accepted that residents sometimes prefer this. Where this is happening it should be put in the care plan, but in general this must not be encouraged. Another resident stated that staff do not always knock his door and stating that when the door was open that they should do this and wait for him to answer before they entered because this is ‘his front door and his home’. Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15. Residents are able to make choices regarding their lifestyle and the food offered, a good range of activities ensures that residents have plenty to occupy them within the home. EVIDENCE: Care plans detail the choices made by residents regarding their preferred times of rising and retiring and their choices of lifestyle. The home has a full programme of activities which includes a visiting artist, craft sessions, musical evenings, ‘Music for Health’ and visiting entertainers. A birthday party was held recently in the garden, and several residents talked about this and also showed presents that the manager had given them for their birthdays. Residents said ‘There is always plenty to do’ and ‘ There’s plenty going on all the time, but I don’t join in because I prefer not to’. There appeared to be good interaction between staff and residents. The home has open visiting times although visitors are asked to wait until after 0930 to ensure residents dignity and privacy is respected, there were no visitors in the home on this day. Residents can bring their own possessions into the home. A varied menu is in place and residents are able to choose different meals to that offered on the day if they wish. Care staff take the menu around and Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 13 indicate resident’s choices. Most cakes and puddings are homemade, and service users said that the food was good, although one said that ‘ like everywhere some days the food is better than others’. The kitchen was clean with food and fridge temperatures and alternative choices made by residents recorded, and food was stored appropriately. All staff dealing with the food have their food hygiene courses and staff helping in the kitchen have the food handlers course. The meal of the day was roast beef, roast potatoes, vegetables and Yorkshire pudding with peaches and ice cream to follow. An alternative meal of roast turkey was served to those not wishing to have the beef. Vegetarian meals can be produced if required. Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18 Residents are protected through both the homes complaints policies and through staff knowledge of their responsibilities towards residents in their care. EVIDENCE: The home has a complaints procedure, which is included in the service users guide and meets this standard. The home has had no written complaints as the manager talks to residents and deals with concerns as they arise, minor complaints or concerns are recorded. The deputy manager plans to attend formal training on adult protection and staff receive ongoing in-house training on this. Staff appeared to be aware of their role in the protection of those in their care. However the manager should continue to give further training, which incorporates the latest protocols relating to this. Residents can vote using postal votes or can attend the local polling station Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26,Place Farm House is a very clean, well decorated and maintained environment which gives residents a lovely home in which to live. EVIDENCE: Place Farm House provides accommodation in 18 single rooms and 1 double room, which are served by a shaft lift. All rooms have en-suite facilities. There is a large lounge area and an attractive dining area with easy access to a well-maintained garden. The lounge is decorated in light colours and has access to the garden. Fresh flowers are always provided in the lounge and residents stated that these were always provided and changed. Individual accommodation is attractive and comfortable, each room being provided with a lockable drawer or similar facility and a lockable door, for those residents that wish to have this. Radiator guards and window restrictors are in place and the water temperatures are monitored and recorded regularly, all are within recommended parameters. New bed linen and curtains are bought and the room redecorated when a resident is expected into the home, Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 16 and furniture bought specifically to suit the room. Video recorders have recently been provided in all rooms so that residents can watch films of their choice in their rooms. There are two further assisted baths within the home and grab rails are fitted around the wc and baths. The home has recently been assessed by an occupational therapist, and her recommendations followed. Residents commented on how lovely their rooms were, how beautifully clean the home was kept and that they had their individual bed linen. One resident said ‘ When I moved into the home I could not believe how lovely and clean it was, the room felt as if no-one else had been in it and as if it was decorated with my tastes in mind’. All areas are exceptionally clean and well maintained, and the home has a good range of infection control policies. There are ample supplies of vinyl gloves and aprons and all care assistants wear tabards when entering the kitchen. Following latest infection control guidelines, block soap should be removed from communal bathrooms and soap and towel dispensers supplied. Place Farm House is to be commended on the environment it provides for the older person, and provides an excellent example of how good a care home can be. Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30,The residents are protected by a robust recruitment practice and the staff receive sufficient training to enable them to meet the needs of the residents in their care. EVIDENCE: There is a good staff to resident ratio, which is required to maintain the quality of life and care currently enjoyed by the residents. There is one waking night staff and the manager or members of her family, who live close by, are ‘on call’, should they be required during the night. Residents stated that there were always plenty of staff on duty and that they never have to wait very long for their needs to be attended to. Six members of the fifteen care staff now have NVQ2 , with 3 further members of staff studying for this qualification. Four members of staff have shown an interest in undertaking this. Staff receive mandatory training and some staff members have undertaken medication training. Staff undertake further training applicable to the care of the residents, most of which takes place ‘in-house.’ The home has an induction programme, which meets the NTO guidelines, and all staff have taken part in this on commencing work at the home. A total of five personnel files were examined, including some relevant to recently recruited staff. These contained all documentation as required by Reg 19 and Schedule 2. All staff have received copies of the GSCC code of conduct. Details of the individual’s further training are kept in the personnel files. Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 18 Staff confirmed that they have attended mandatory training and receive other training relating to the care of the residents and meeting their assessed needs. Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36,37,38.The home is run in a manner which ensures a comfortable, happy home for residents whilst ensuring that their safety is a primary concern. EVIDENCE: The registered provider and manager, Mrs Margaret Tomlinson, has managed the home for 22 years and ensures the home meets its stated objectives. Her daughter, Ms Dawn Webb, who at present works as deputy manager is studying for the registered managers award and will eventually take over from Mrs Tomlinson who will remain as registered provider. The ethos and atmosphere within the home is inclusive and happy. Staff turnover is low and residents stated that the care given and attitude of the staff as ‘excellent’, they confirmed that Mrs Tomlinson talks to them every day and visits them when in hospital. The CSCI has received reports from Mrs Tomlinson when she has visited residents who are hospitalised and Mrs Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 20 Tomlinson will also visit other care homes when the residents needs can no longer be met by the home, to ensure that the new home can meet these needs. The home reviews its polices on a yearly basis and has a quality monitoring policy. Staff have to sign to show they have read and understood the reviewed policies. The home has tried to extend their quality monitoring system by sending quality questionnaires to visiting health professionals but received no response. Staff receive formal supervision six times a year and the planning programme for this was seen, staff confirmed that they receive regular supervision, and that staff meetings are held four monthly with minutes taken. The manager does not act as appointee for any of the residents and does not take care of any of the residents monies. Financial details for the home have been seen in the past year and these appeared satisfactory. Evidence of appropriate insurance was seen. All certificates relating to the servicing of utilities and equipment were in place and in date and all staff have received mandatory training including manual handling, fire training, ‘heart guard’, food hygiene and food handlers courses. Risk assessments, including fire risk assessments are done on a regular basis and all doors have automatic closures to prevent risk of fire spreading. Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 4 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 4 4 4 3 3 4 3 4 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 22 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 10 Regulation Reg 4(a) & 5(b) Requirement Timescale for action 30th July 2005 2. 18 Reg 13(6) That staff will address service users using their preferred name.Staff knock on all service users doors and wait for a response prior to entering. That updated training on the Nov 30th protection of the vulnerable adult 2005 takes place within the timescale planned. 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. 2. 3. Refer to Standard 9 18 26 Good Practice Recommendations The risk assessment for service users who self medicate is expanded to include the details in the main body of the report. That the deputy manager gives staff further training on adult protection in line with the latest protocols and procedures. That block soap in the communal bathrooms is replaced by soap dispensers, and disposable towels provided. Place Farm House H59-H10 S14225 Place Farm House V222778 090605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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