Inspection on 18/02/08 for Rose Farm House

This inspection was carried out on 18th February 2008.

CSCI found this care home to be providing an Good service.

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

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Rose Farm House Haine Road Ramsgate Kent CT12 5EG Lead Inspector Julie Sumner Unannounced Inspection 18th February 2008 11:00 Rose Farm House DS0000070878.V358016.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 Rose Farm House DS0000070878.V358016.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. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rose Farm House Address Haine Road Ramsgate Kent CT12 5EG 01843 583380 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) High Quality Lifestyles Ltd Mr Michael Harrison Care Home 4 Category(ies) of Learning disability (0) registration, with number of places Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 4. Date of last inspection Not applicable as new service. Brief Description of the Service: Rose Farm House is a detached property located in a rural setting. It is close to seaside towns of Ramsgate and Margate and approximately 16 miles from Canterbury in Kent. This home is part of a group of homes owned by a private company: High Quality Lifestyles. The home is designed to accommodate up to 4 individuals who will have a learning disability, are on the autistic spectrum and who could present challenging behaviours. The current fees for the service at the time of the visit range from £3750.00 to £9000.00 per week. Information on the home’s services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. The e-mail address for the home is mikerf@hqls.org.uk. And for the company is www.hqls.org.uk. The house is set in spacious ground of approximately 3 acres with 2 formal gardens around the house. The accommodation is spacious, airy and decorated to a high standard. All bedrooms are single. The service provides transport to encourage community participation, but at the same time enable individuals to access public transport. On the ground floor there is a separate flat to be used for a person who wishes to be supported in a way that he can be completely separate or if he wishes can mix with other residents. This flat has all facilities including a separate Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 5 bathroom, kitchen, lounge, bedroom and garden. This flat also has its own front door. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This report is based on information received about Rose Farm House including an unannounced site visit to the home lasting around 5 hours. Information was gathered for this inspection in a variety of ways both prior to and during the visit to the home. Surveys have been sent out to the people living in the home, relatives and visiting professionals. Those returned have been taken into account in this report. The visit included talking with some of the people who live in the home, the manager and staff. General observations were made of how people are supported. There was a tour of the building and various records were inspected. As Rose Farm House has only been opened for six months the individuals that have moved into the service have only been living within the service for a few weeks or months. The people living in Rose Farm House were able to participate in the inspection by having conversations about their lifestyle. People with communication difficulties were supported by the staff and observations were made about what was being provided for them. It was not necessary to make any requirements at this time as the new home is functioning very well and plans are in place to develop the service around the needs of the people who now live there. One recommendation was made to develop the monitoring visits to the home by a representative of the company. What the service does well: Assessments are carried out thoroughly before a person moves in and then is reviewed and updated as individual needs change and skills develop. The home has been completely refurbished to suit all people living there. There is a good staff team who are motivated. There is a thorough recruitment procedure to make sure that the staff know what is expected and have had checks to make sure they are the right people for the job. Staff have a range of relevant training and all the essential training needed to support people was given before anyone moved in. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 7 The manager has a clear idea of what the home needs to provide and is responsive to the comments received about the service provided. 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. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 8 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 Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 9 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions to the home only take place if the service is confident that the staff have the skills and ability to meet the assessed needs of the prospective individual. EVIDENCE: Assessments are written prior to moving in with the specialist team based on information given from the previous placement. The individual support plan is based on the assessment information. The manager explained that the plan is reviewed as individual needs are re-assessed in the home and as individuals become settled and develop. One of the people living in the home talked about their experience moving in. They said they were able to see the home and were helped to decide about moving in. Rose Farm House DS0000070878.V358016.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual support plans are being developed following person centred planning principles. Management of risk is positive addressing safety issues whilst aiming for better quality of life. EVIDENCE: Individual support plans have been completed based on the assessed needs of each person. Staff said they are getting to know each person and their needs and wishes are changing as they are settling into the home and getting to know the staff. The individual support plans follow the company format. One of the people living in the home talked about his support plan and said that he had been involved in its contents. Where decisions have been made in how to support him he has signed to say he agrees. One of the staff said that at the next review he could probably write parts of it himself and they would look at developing a format in the way he wants it laid out. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 11 There are guidelines for how staff are to support individuals with communication difficulties and interpret responses and wishes. The people living in the home who were spoken to, said that staff listened to them and they were happy to express themselves. They said that they were able to make decisions. Staff were observed finding out what individuals wanted and responding to that. Longer term goals and aspirations are being decided and some action plans are included in the individual support plan. Risk assessments are in place for all relevant circumstances and have been designed to provide appropriate staff support when out in the community. Risk assessments are also completed prior to going out to make sure a person will be supported appropriately when out. One of these was viewed that had been completed on the day of the visit. Staff said that the guidelines were easy to follow and that they were listened to if they needed altering or reviewing. Rose Farm House DS0000070878.V358016.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service actively supports the people who live in the home to be independent and involved in all areas of daily living. People who use the service are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. EVIDENCE: Staff are getting to know each persons’ preferences and are experimenting with choices by offering different activities on a trial basis. Each person has a timetable of activities to give some structure. The staff explained that they are in the process of providing timetables in different styles to suit individuals and one is going to be put on the wall. Activities were planned for the day of the visit and one person was already out. One of the people living in the home spoke about their lifestyle. They discussed the activities and timings of what they do and what is important to them. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 13 The service provides transport to encourage community participation and one vehicle belongs to one of the people living in the home. The staff said they also use public transport or walk. Contact details of people who are important are contained in the individual support plan. Daily records indicate visits and outings with families and friends. There are no imposed restrictions to access around the home. People’s bedrooms are considered private. Access in and out of the home is restricted to make sure that individuals are safeguarded from the road at the front of the house. Risk assessments have been written for this. One of the people living in the home talked about the meals provided in the home. He showed the inspector the menu and shopping list for the week. He said he is going out food shopping in the afternoon. He said he likes cooking and prepares some of the meals with the staff. During the visit he and a member of staff cooked the dinner. Staff spoke about the importance of having a balanced diet and they use the local farm shop to buy fresh fruit and vegetables. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual personal and healthcare needs are met. The people who use the service are given the support they need to manage their medication. EVIDENCE: The manager spoke about how they support individuals’ personal and health care. Health action plans are being implemented for individuals. There was information and guidelines for staff on how each person likes to be supported with their personal care. Health care appointments are logged in individual log sheets and they each have a diary containing day to day information. The manager said that he intends to introduce health action plans as part of the development of person centred plans. Each person is registered with a local doctor. Specialist advice is sought when further support is needed to maintain individual health. Medication storage was viewed with the manager and all is kept securely. All medication was stored in clearly labelled containers and was well organised. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 15 Some of the medication was dispensed in the Boots monitored dosage system. Staff who give out medication have received training. A sample of training certificates were viewed. Risk assessments are completed to establish the level of support each person needs. One person is fairly independent. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an open culture that allows the people who live there to express their views in a safe and understanding environment. EVIDENCE: The home has a complaints procedure that is both displayed in the home and given individually with the service user guide. People spoken to said they were happy to talk to staff if they have a concern. There have been no complaints to the home since it has opened. All staff working at Rose Farm House have been checked against the Protection of Vulnerable Adults (POVA) list and they have had training for safeguarding adults. Some of the staff talked about their understanding of safeguarding adults. They said they felt confident about what they would do and the first action would be to report anything untoward to the manager. Staff have attended training in behaviour management which included deterring techniques, talking down and positive support. There are clear guidelines for staff to follow to support individuals. The staff explained the procedure if incidents occur outside the managers hours and additional support or advice is needed. Financial procedures were discussed with the manager and a sample of records viewed. One person manages his own money. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 17 Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 18 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. The home provides a physical environment that is appropriate to the specific needs of the people who live there. EVIDENCE: One of the people living in the home showed the inspector around and spoke about life in Rose Farm House. There are three bedrooms on the second floor. No bedrooms on this floor have en-suites however all have sinks. One person has recently moved in and the sink in that bedroom has been removed due to his assessed needs. This is included in the homes statement of purpose. The kitchen is large enough for people living in the home to help prepare meals if they wish to. The lounge dining area is large enough to accommodate four residents and staff required and if friends and family are invited to eat with them. There is also a smaller lounge in the front of the home, which could be used as a quiet room. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 19 The laundry runs off the kitchen and has washing and drying machines. The home has worked with the local EHO and they are happy with the facilities. The home was clean and fresh throughout on the day of the visit. Staff have attended infection control training. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are consistently enough staff available who are supported through training to meet the needs of the people living in the home. EVIDENCE: Some of the staff spoke about their role in the home and their experiences of the homes recruitment process. It was confirmed, with the manager and the documentation viewed in the staff files, that all checks for the protection of the people living in the home are carried out and documentation for identification is kept on file. Time was spent talking to the staff about the recruitment checks and their induction. Staff explained that the team is made up of a mixture of staff with experience working in care homes and others that are new to this. Most of the staff team were recruited and received induction and mandatory training, prior to the people moving into the home. A sample of 3 staff files were viewed and recruitment information including safety checks were viewed. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 21 There is a staff development and training plan. The rota was viewed and planned training was highlighted for staff attending at that time. Essential training for the health and safety of the people living in the home and staff working in the home has been completed before anyone moved in. Some have NVQ training and some are studying for this. The manager said that there is always a member of staff with first aid training on each shift. Senior staff spoke about their role in the home. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 22 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has a clear understanding of the aims and focus of the service. The manager promotes equal opportunities, has good people skills and understands the importance of person centred care and effective outcomes for people who use the service. EVIDENCE: The manager has been in post since the home opened and has been the registered manager for other properties in the company. He has several years experience of managing homes and supporting people with learning disabilities and challenging behaviour. He is currently studying the final year of a degree in positive behaviour support. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 23 The quality assurance monitoring system is being set up. The company have produced a business plan and development plan as part of the documentation for registration. There was a discussion about designing a development plan that is kept in the home. This could provide a framework that identifies the areas the manager has prioritised and gives other people an idea of how the manager intends to develop the home. Surveys have been designed and the manager said that these would be sent out when the home has been open around a year to give everyone a chance to move in and settle in. The visits to the home under regulation 26 need to be developed. These visits need to be unannounced and need to focus on crucial areas in the home that are either working well or need development. They should form a critical part of the quality assurance system. A recommendation has been made for this. Staff have received health and safety, moving and handling, hoist, first aid, food hygiene and COSSH training as part of their induction. There is a trained first aider on each shift. All staff and people who use the service have had fire training within the home and are aware of the evacuation procedure. All relevant health and safety checks were carried out during the registration of the home and have been maintained. The fire department have visited the home and made no requirements. The fire log was viewed. Staff have received fire training and this is being updated for all staff. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 24 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 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 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? N/a 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 YA39 Good Practice Recommendations Visits under regulation 26 need to be developed to form a part of the quality monitoring and assist with the development of the service. Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Rose Farm House DS0000070878.V358016.R01.S.doc Version 5.2 Page 27 - 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!