Inspection on 03/03/06 for Pound Farm

This inspection was carried out on 3rd March 2006.

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

Pound Farm 28/06/07

Pound Farm 10/10/05

Pound Farm 08/03/05

Pound Farm 31/08/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Pound Farm Gorsley Nr Ross-on-wye Herefordshire HR9 7SL Lead Inspector Jean Littler Unannounced Inspection 3rd March 2006 1 pm Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 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 Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 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. Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Pound Farm Address Gorsley Nr Ross-on-wye Herefordshire HR9 7SL 01989 720546 01989 720188 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) Salters Hill Charity Limited Mrs Gillian Hilary Sackett Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents may also have a mental disorder or a physical disability, or a sensory impairment associated with their learning disability. 10th October 2005 Date of last inspection Brief Description of the Service: Salters Hill Charity, a charity set up to provide residential care for adults with learning disabilities opened Pound Farm in 1988. Salters Hill Charity Ltd has another care home in Herefordshire and runs another service in Gloucestershire under the Supporting People arrangements. Pound Farm provides a service to 14 adults whose primary care needs arise from learning disabilities. Some people using the service also need care and support due to physical or sensory impairment or intermittent mental health needs. The emphasis at Pound Farm is on the people who live there playing an active role in the day-to-day life of the Home, ongoing learning and skill development and on enjoying a full and active life. The accommodation is provided in a farmhouse style house and adjoining barn. The buildings are linked by a covered walkway. The extensive grounds are used to grow vegetables and keep farm animals. Involvement in the care of the garden and the animals is an important element in the Homes statement of purpose which indicates that prospective service users need to have an interest in this type of lifestyle. A small day care service is also offered to people who live at another of the groups homes and in the local community. Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on a week day afternoon between 1pm and 4pm. The main purpose of the inspection was to see the final results of the major restructuring of the premises that has been taking place over the last year, and to assess how this is impacting on the quality of service users’ lives. Five service users were spoken with while they showed the inspector their bedrooms. Three of these service users now have bedrooms in different parts of the Home after all service users choose which of their peers they wanted to share with in the new small units. The service users were very proud and pleased with their new bedrooms and communal areas and had enjoyed choosing and purchasing their own décor, furniture and fixtures. The manager assisted with the inspection process and a new member of staff was spoken with in private. One service user showed the inspector their care plan, their money, and medication that they are now keeping in their bedroom. Information already known about the service, and communications between the service and the Commission since the last inspection were also considered as part of the inspection process. What the service does well: What has improved since the last inspection? The major internal building work has been completed. Accommodation is now arranged in units providing groups of two to four residents with their own kitchen, dining and lounge areas. The sizes of the smallest bedrooms have been increased, less people are using communal bathrooms and four en-suite facilities have been provided. A new larger laundry has been provided and staff office facilities have been improved and relocated. The changes have already allowed the service to be provided in a more personal manner and opportunities for service users to develop their independence skills have been greatly increased. The way care records are stored and managed has been improved. Two more staff have been appointed to allow support to be given in each flat to enable service users to develop their independence skills. Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 6 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. Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 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 Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 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 the following standard(s): EVIDENCE: These standards were not assessed. There have not been any changes in the resident group since the last inspection and there are no vacancies. Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 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 the following standard(s): 6, 7, 10. Appropriate arrangements are in place for planning and reviewing the support each service user wants and needs. Service users are being provided with the assistance they need to make decisions about their lives. Personal information is being kept confidential. EVIDENCE: The service users are now keeping their care plan folders in their bedrooms. They agree with staff each day what should be recorded in their dairies. Some records are being kept securely in the office including incident reports, as it is felt that keeping some information in the folders may have a negative affect on the service users’ self worth. Any changes to the support arrangements are now noted in the care plan straightaway e.g. after being discussed at a staff meeting and agreed with the service user. This means they are now accurate at all times. Care reviews are being arranged on a six monthly basis and efforts are continuing to make the care plan formats and the style of meeting more Person Centred so the service users feel empowered during the process. The service user who showed the Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 10 inspector his care plan had had a review meeting recently, which his social worker and family had attended. He is also being supported to keep a communication book that he takes to show his family when he visits them. His family also record in it what he wants to communicate back to the staff about his stay. The new member of staff spoken with had been made aware of the policy and the need to kept service users’ personal information confidential. Records that are not held by the service users themselves are kept securely. Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 16, 17 The opportunities for service users to develop their independence and life skills have been further improved. Their rights are being respected and they are being empowered to make decisions. Service users are supported to have a healthy diet and enjoy their meals, further improvements in the way meals are managed are planned. EVIDENCE: There was a relaxed and happy atmosphere in the home. All those spoken with were pleased with the recent developments and changes to the environment. There was some excitement about a planned coffee morning taking place the next day in the log cabin. This was to raise funds and good quality woodwork pieces made by the service users were already on display and for sale. The feedback from service users indicated that their quality of life had improved greatly now they were settling into their small group living areas. They had more control over their immediate environment and who comes into it. They are now more independent e.g. preparing personal snacks, holding their own money and medication. Staff are only eating with the service users if they are invited. Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 12 A new worker had attended a ‘Flat’ meeting where service users from that flat were making decisions about things that affected them. She had observed that it had been a genuine process of consultation where the service users had talked about things such as holiday plans for the summer. The staff did not direct their thoughts and those that needed it were given time to think before deciding. The flats have been named and post boxes have been put in place for each area so service users can receive their post directly. One service user was seen to check all the post and she recognised her own letter from the bank and confidently took this. She agreed with the manager to show it to her keyworker later and keep it in her folder. Information is provided around the Home in pictorial form to support service users e.g. rotas for tasks like looking after the chickens. Preferred individual communication methods are also in place. The service users are getting used to making their own breakfast and snack meals in the kitchenettes and shopping for their group’s provisions. This responsibility is due to be expanded, as all meal preparation will eventually take place in each flat. A provisions budget will be delegated to each flat, which will allow even greater choice of meals. The current menu includes a high level of fresh produce and a healthy life style is promoted. While the building work was going on these high standards had to be compromised at times while the main kitchen was out of action, however the Food, Fitness and Fun educational programme is due to be re-launched to get everyone back on track. Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 13 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 the following standard(s): 20 Medication is being safely managed and staff are due to attend accredited training. EVIDENCE: It is positive that after extensive negotiations the manager has arranged for the service users to be offered annual health checks at their GP surgery. These will be focused on targeted areas that are identified in a personalised health assessment that will be completed first. The service users are now storing their medication in their bedrooms. A risk assessment has been completed for each person and a variety of arrangements are in place to provide suitable assistance. One service user demonstrated how he is managing his tablets and where he is signing his own records. Staff are currently supporting him quite closely to do this but the need for this level of support will be kept under review. Central records and storage for medication coming in and out of the building have been relocated from a kitchen area to an office, which is more suitable. The manager has arranged accredited medication training in April. This will then become part of the normal training programme. Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 14 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 the following standard(s): 22, 23. Appropriate arrangements are in place to ensure service users’ views are listened to and they are offered protection. EVIDENCE: Whistle Blowing, Abuse and Complaints procedures are in place and staff have received training in these areas. No complaints or adult protection concerns have been reported to the manager or the Commission since that last inspection. A worker spoken with felt she and other staff would raise any concerns promptly. All service users have the capacity to inform staff or their representatives if there is something upsetting them. Systems are in place to allow service users to opportunity to raise any concerns with their key-worker or in their regular meetings. Some service users did become disturbed at times with the noise and disruption caused by the building work and changes. Staff offered sensitive support to these service users and where possible took steps to reduce anxiety levels. Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 15 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 the following standard(s): 24, 25, 26, 27, 28, 30. The layout of the Home has been significantly changed to make it much more suited to its purpose. EVIDENCE: Through major structural changes the Home has been separated into small group living areas each with a kitchen, lounge and dining area. The sizes of the smallest bedrooms have been increased. Those in each flat are now the only people using the communal bathrooms in this area. Four en-suite facilities have also been created. Each flat is being shared by between two and four service users, all of whom have chosen to live together following significant involvement of an independent advocate. Some of the service users showed the inspector around their new flats and newly decorated bedrooms. They have been fully involved in choosing fixtures and furnishings. The effect is that each area is homely with its own distinct character. The laundry has been relocated into a larger area. This has been well equipped and is being used by each flat on certain days. An Environmental Health inspection had recently been carried out and approval had been given to these and the catering arrangements. The Fire Authority has been asked to inspect the new layout of the building and the fire precautions, but this visit had not Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 16 yet taken place. Until fire safety approval has been obtained the manager had taken the decision that only snacks will be prepared in these areas and main meals would still be prepared in the main kitchen. Hall carpets were being laid during the inspection, and some snagging work is needed before the work is formally finished. A party is planned for when the builders leave, even though some have developed positive relationships with the service users. There is a plan to add a covered walkway between the house and the laundry to provide some protection from bad weather. A new parking area will also be constructed, however this work will not disrupted life inside the Home. The logistical arrangements needed to get this level of internal alterations completed whilst still providing good quality support to the service users has been very complex and the manager and staff team must be highly commended for achieving this. Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35, 36. The service users are benefiting from a well managed staff team who are suitably trained and supported to understand their role. EVIDENCE: No staff have left since the last inspection but two others have been taken on to enable workers to be based in the flats. The rota showed suitable staffing levels were being maintained despite some sickness. The minimum staffing level is three, however there can be up to seven on at times to enable service users to attend planned activities, health appointments etc. New senior positions of ‘Unit Coordinator’ have been created and these staff are responsible for ensuring good practice is maintained in each flat and the service users are consulted regularly. The other staff will work across all flats but will continue to have keywork duties. A new support worker was spoken with. She reported that all staff were approachable and had helped her learn her role. She had been on core training courses including adult protection, medication, food hygiene, and basic first aid. Other courses were planned. She had worked alongside other staff to learn the routines and each service users preferred way of being supported. She was now going to start the LDAF induction award and was aware that in the future NVQ awards would be offered. She had received one-to-one supervision and support sessions from the manager, which had been helpful. She felt team Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 18 morale was good, the service was very positive and the service users had a good quality of life. Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: The manager was aware of the pending changes to the way the Home is regulated. These will impact on her and the providers’ legal responsibility for monitoring the quality of the service. Systems are already in place for periodic audits to gain feedback from service users. The manager planned to work with the providers to further develop quality monitoring systems that will produce evidence of outcomes for service users. This information can then be shared with the Commission through the providers’ monthly visits. Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 20 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 X 2 X 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 4 26 4 27 3 28 4 29 X 30 3 STAFFING Standard No Score 31 3 32 X 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X X 3 LIFESTYLES Standard No Score 11 4 12 X 13 X 14 X 15 X 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 x X X X X X X x Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 21 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. Refer to Standard Good Practice Recommendations Pound Farm DS0000024729.V285644.R02.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN 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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