Inspection on 18/04/07 for Stallcombe House

This inspection was carried out on 18th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Stallcombe House 02/02/06

Stallcombe House 16/08/05

Stallcombe House 09/11/04

Stallcombe House 15/06/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Stallcombe House Sanctuary Lane Woodbury Salterton Exeter Devon EX5 1EX Lead Inspector Vivien Stephens Key Unannounced Inspection 18th April 2007 9:30 Stallcombe House Farm DS0000022040.V327405.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 Stallcombe House Farm DS0000022040.V327405.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. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stallcombe House Address Sanctuary Lane Woodbury Salterton Exeter Devon EX5 1EX 01395 232373 01395 233351 stallfarm@eclipse.co.uk 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) Stallcombe House Farm Trust Mr Christopher Robert Thistle Care Home 26 Category(ies) of Learning disability (26), Learning disability over registration, with number 65 years of age (26), Mental disorder, excluding of places learning disability or dementia (26), Mental Disorder, excluding learning disability or dementia - over 65 years of age (26), Physical disability (9) Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd February 2006 Brief Description of the Service: Stallcombe House Farm is home to 26 adults with learning disabilities. The home provides personal, educational and supportive care. All residents living at Stallcombe House Farm have single bedrooms. The house sits in 55 acres of land on the outskirts of Woodbury. The property consists of a main house and cottage, which are the main living areas for the residents. There are a variety of out buildings, which are used for such things as woodwork and chicken farming. There is a large working garden, which is kept attractive and well tended. Stallcombe House Farm is a registered charity. The home has achieved The Investors in Peoples Award. The home offers a wide range of educational and leisure activities. Arts and crafts, weaving, woodwork, cookery, music, drama, dance and horse riding are some of the therapeutic activities that can be enjoyed daily. The residents help with the maintenance of the homes organic garden and the hen houses, egg collection and delivery. At the time of this inspection the lowest fees for a new resident start from £850 per week. A copy of this inspection report can be seen at Stallcombe Farm on request. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Several weeks before this visit took place a pre-inspection questionnaire was sent to the home. When the completed form was received back by the Commission survey forms were sent to residents, staff and those professionals who visit the home regularly. 25 completed questionnaires were received from residents, and 22 completed questionnaires from staff. One relative contacted the Commission by telephone and also completed the survey form on behalf of their son. Some of the residents completed their own survey forms, while others received varying levels of help from either a friend, a member of their family, or from an advocate, and in these cases the person helping them has recorded their actual responses to the questions. This inspection took place over 1½ days. The first day started at 9.30am and finished at 5pm. The second day began at 10.30 am and finished at 2pm. During the visit time was spent talking to the manager, five residents, and six staff. Shorter conversations also took place with other staff and residents. A tour of the home and grounds took place and records relating to the care of residents and the recruitment, training and supervision of staff were checked. What the service does well: Throughout this inspection the enthusiasm and happiness of the residents and staff was very clear to see. Comments from residents who completed survey forms were overwhelmingly positive – the following are some examples - “I like living and working here,” “It’s a nice place”, “They are good”, “They treat me very well”, “I am very happy here”. All of the staff who completed survey forms clearly felt very proud to be a part of the home, and many wrote at length about the good things about Stallcombe House. The following statement sums up the many pages of positive comments from staff - “The home has a wonderful atmosphere and allows service users (and staff) to grow. I have never worker anywhere better!” Throughout the inspection staff and residents enthusiastically demonstrated the many good things about the home. The home has a variety of different ways of providing information for people who are interested in moving to Stallcombe House. These include a very good internet web site. They also offer lots of opportunities to visit and get to know the home. Good assessments are carried out and the home makes sure that they can provide the right support and facilities before people decide to move in permanently. Many of the residents who completed survey forms before this inspection talked about how they visited the home and were given information and support to help them decide if Stallcombe was the right place for them. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 6 The home has good care plans in place that give staff clear written instructions about how the person wants to be helped and supported by them. They include relevant information on health and personal care needs. They show that health and social care professionals have been consulted and treatment provided wherever necessary. During this inspection there were many examples of how the residents are supported to make choices and decisions in their everyday lives. Residents talked about how they meet with their keyworkers regularly to agree what they want to do. They also have regular Residents’ Meetings where they are consulted about the day-to-day running of the home. Residents are given excellent opportunities to lead interesting and fulfilling lives, both within the home and in the local community. They have opportunities to work on the farm, in the gardens, in the craft workshop, or help with tasks around the house including cooking. People were proud to demonstrate many of their achievements, including caring for the free-range chickens, rug making and weaving, pottery, music, drama, arts and crafts. Much of the food that is grown and produced on the farm is used in the daily meals. Residents talked about how they are consulted over the meals, and said they always enjoy the food they receive. Menus provided for this inspection showed that residents receive a healthy, wholesome and varied diet. There are safe systems in place for the storage and administration of medicines. Residents said they knew how to make a complaint, and said they felt safe to talk to someone if they were worried or concerned about anything. Staff have received good training on how to prevent abuse and the procedures they must follow if abuse is suspected. All parts of the home have been well maintained. All areas have been attractively decorated and comfortably furnished. Each resident has a bedroom of their own that has been decorated and furnished to their individual taste, and reflecting their interests and personality. All areas were found to be clean and safe. There are sufficient staff employed to ensure all residents receive the support they need. The staff have been well-trained and are positive and committed. Good recruitment procedures have been followed, with all required references and checks taken up before a new member of staff is confirmed in post. These procedures ensure that all residents are protected from harm or abuse. Staff, residents and relatives praised the way the home is managed. Good systems are in place to ensure the standard of care and facilities and services are constantly monitored and improved. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 7 A member of staff has been appointed as the Health and Safety Advisor, and he provided good evidence to show how he takes this responsibility very seriously. There are very good systems in place to ensure all procedures, equipment and the environment have been assessed, any possible risks identified, and steps taken to reduce or eliminate any possibility of harm. Staff have received good training on all health and safety topics. 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. Stallcombe House Farm DS0000022040.V327405.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 Stallcombe House Farm DS0000022040.V327405.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): 1, 2, 3, 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who are considering moving to Stallcombe House are provided with an excellent range of information and good opportunities to help them get to know the home and decide whether Stallcombe House is the right place for them. People can be reassured that they will get the help and support they need following the careful assessment procedures carried out by the home. EVIDENCE: Stallcombe House provides information for prospective new residents in a variety of ways. They have an excellent internet web site with lots of pictures and a wide range of information about all aspects of the home and the farm. This can be found at www.stallcombehouse.co.uk People who may be thinking about moving to Stallcombe can read this on the screen or print it off if they find this easier to read. The pictures are very helpful for anyone who has difficulty in reading. The information is clearly written and, if read to someone with reading difficulties, it gives a very clear idea what it is like to live there. There is also a printed brochure called ‘An Introduction to Stallcombe House’. This also gives good information about the home, but has no pictures and is more suitable for those people who are able to read. There is also a ‘Statement of Purpose’ that is written in a formal style. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 10 Other forms of information for prospective new residents are presented in visual format on a DVD, and also spoken information on a compact disc. They regularly look at the information they provide and consider how this can be improved. During this inspection a film crew were visiting the home and the manager said this had prompted ideas for even more ways of helping people find out about the home and decide if they want to move there. The manager and staff firmly believe that the best way of finding out if Stallcombe House is the right place for a person is to encourage them to visit, possibly to stay for a while, and for everyone to get to know each other. In the last year one new resident moved in. Written information seen during this inspection showed that the home gathers as much information as possible in order to make sure that they have the right level of skilled staff to be able to support and assist the person. They also check carefully to make sure that the accommodation is suitable, and that the person will benefit from the range of facilities provided. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 11 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): 6, 7, 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents can feel confident that their needs have been carefully considered through the care planning process and the staff have good written instructions to show how the person wants to be supported. Residents are well supported to make choices and decisions in all aspects of their daily lives. EVIDENCE: During the inspection four care plan files were seen, and in the afternoon the inspector met with the residents whose care plans had been read. The documents contained a good range of information and provided a very clear picture of each individual and the ways they want to be supported. They included instructions to staff on how to minimise any anticipated risks. The plans have been improved since the last inspection to show how aims have been achieved. The plans have been regularly reviewed with the residents and Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 12 with their families, care managers and other professionals involved in their care. Within each file there is a table showing their chosen weekly activities. All residents have been given a copy of this table. In some cases the tables have been drawn up in detail, showing the activities hour by hour for each day, and some have been laminated to minimise the chance of them becoming worn. These timetables were very helpful to many of the residents – several residents wanted to show them to the inspector to help them explain the things they like doing each day (although one person said he didn’t like them). The residents talked about how they chose the things they want to do each day, and it was clear that, as far as possible, they are able to choose exactly what they want to do. Where residents’ wishes conflict with the rights and wishes of other residents, or may place the individual at risk of harm, this has been carefully considered by the home in consultation with relevant health or social care professionals. In these case, clear guidelines for staff are set out in the care plans. Residents are consulted in a variety of ways about all aspects of daily life at the home. Regular Residents’ Meetings are held. During the inspection staff gave many examples of how they have consulted with the residents over such things as menus, activities, the farm, choice of clothing, and decoration of their rooms. There was an atmosphere of friendship and co-operation between everyone involved in the home, and constant discussion about all matters affecting the residents. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 13 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): 12, 13, 15, 16, 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Stallcombe Farm provides excellent opportunities for residents to lead interesting and fulfilling lives, both within the home and in the local community. Residents receive a healthy, wholesome and varied diet to suit their individual dietary needs and preferences. EVIDENCE: Within the grounds and buildings of Stallcombe Farm there are many opportunities for residents to learn, develop new skills, and to achieve meaningful and worthwhile employment. The farm has several flocks of freerange chickens supplying eggs both to the home and for sale in local shops. Some of the residents enjoy helping to look after the chickens and with the distribution to the shops. There are also large productive gardens providing organic fruit and vegetables. Many of the residents enjoy helping in the gardens. Several residents talked about how much they love to be working Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 14 outside, and how much they enjoy looking after the birds and seeing the wildlife around the farm. Staff and residents talked with great enthusiasm about their plans for a new garden area with an aviary and small animal area. Drawings have been made of the planned layout up and work has already begun on this project. A smaller aviary is already in the grounds, cared for by some of the residents, and the birds will be transferred to the new, much larger aviary when completed. Inside the home there is a modern and well-equipped weavery and craft room. Some of the residents proudly showed some of their work, including some beautiful woven rugs, tapestries, silk scarves, candles, felt slippers, pottery and paintings. The work is of a very high quality and is sold at their annual fete. Other opportunities for employment in the home include cooking and meal preparation. One resident talked about his work in the kitchens and how much he enjoys this. The home encourages residents to be as independent as possible. Several residents were seen doing their own laundry and hanging it outside on the washing lines during the inspection, with guidance and support from the staff where needed. There are plans to create a new computer suite in the home and to provide opportunities for residents to learn computer skills. The staff have helped residents to attend educational courses outside of the home wherever possible. Where courses have been stopped due to cuts in local authority funding the home has looked for ways of continuing this education, either through other external courses, or by bringing in trainers to continue to courses at Stallcombe. Some residents have funding to provide individual support during the day and this has enabled them to do many more of the things they enjoy. Some residents talked about how much they enjoy going swimming, attending music or drama classes, or going out to clubs and local events. Some of the residents talked about their love of music – one resident proudly showed the posters and pictures in his bedroom of his favourite group, while another resident was sat in a quiet area playing the guitar. Families and friends are encouraged to be fully involved in life at the home. They can visit whenever they want, and many are involved either as a Trustee, as volunteer, or by joining the Families and Friends Association. There is a regular newsletter keeping everyone up-to-date with news, events and future plans. Where residents agree, families are invited to attend care planning reviews. Residents talked about how much they enjoy visits to, or from, their families and friends. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 15 Wherever possible food produced on the farm is provided at mealtimes, ensuring that residents have fresh fruit, vegetables and eggs of the highest quality. Menus are discussed with the residents every fortnight and adjusted to ensure everyone has a good balanced diet with meals to suit their preferences and dietary needs. The staff support residents to eat a healthy diet, and specialist advice is sought where necessary. On the first day of this visit the inspector sat with a group of residents at lunchtime and enjoyed a meal of sausages and mashed potato. Several residents said this was one of their favourite meals! There is a self-service system enabling residents to choose what they want, but staff are on hand to provide discreet support where necessary. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 16 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): 18, 19, 20 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are well met. Residents are safeguarded through careful systems for storing and administering medicines. EVIDENCE: Documents seen on care plan files showed that the home has liaised very closely with all relevant health care specialist to ensure that all of the residents’ health needs are fully met. A letters from a specialist Occupational Therapist showed that mobility problems have been carefully assessed, specialist equipment provided, and staff have been given clear and detailed instructions on how to assist the resident. Where residents have clearly expressed distress or discomfort there was evidence to show how the home has sought guidance appropriately, and agreements have been reached on the best way to support the person. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 17 Documents showed that residents are registered with health practitioners of their choice in the local area, and are helped to attend regular check-ups and treatment. One person has been given the responsibility of overseeing the administration of medicines at the home. The home uses a monitored dosage system supplied by a local pharmacy. Although the pharmacy supplies administration charts the home has chosen to draw up their own. They have found that they wanted larger charts that are clearer for staff to read. The charts seen have been carefully completed and showed that medicine administration has been taken very seriously at the home. Staff have received good training on the safe administration of medicines and their competencies checked. Medicines are held securely in a locked cupboard. When new medicines are received into the home these have been checked and recorded on the pharmacy administration charts. Creams and lotions have been clearly marked to show the date they were opened and the date they must be discarded. The administration charts provide very clear instructions to staff on how and when all medicines and creams must be administered. Any medicines that need to be kept cool can be stored in the locked fridge in the dining room next to the medicines cupboard. Policies and procedures relating to the safe administration of medicines are in place – some areas of the policies may benefit from expansion and information has been forwarded to the home to help them when they next carry out a review of the policies. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 18 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): 22 and 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents can feel confident that their complaints and concerns will be listened to and addressed promptly and fairly. Residents are protected from potential abuse or neglect. EVIDENCE: Since the last inspection the Commission has received one complaint from a resident. The complaint was passed back to the provider to be dealt with through their own complaints procedure. The Commission was kept fully advised of the actions taken by the home. They looked closely at each issue, setting them out clearly in writing and then discussed each point with the resident. During this inspection the inspector discussed the complaint with the manager, and also with the resident concerned. While the resident remained dissatisfied, the home was able to demonstrate how they had looked at each issue carefully and had considered the health and welfare of the individual as well as that of the staff and other residents. They also liaised closely with other professionals and family where necessary. The Commission were fully satisfied that the home acted in the residents’ best interest. The majority of the residents who responded to this inspection by completing a questionnaire said they knew who to talk to if they were worried about anything, and knew how to make a complaint. A few responded that they were unsure – these were mainly people who have poor communication abilities. This was discussed with the manager, Chris Thistle, who gave Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 19 assurances that staff have a variety of methods of ensuring that those people with communication difficulties are safeguarded. This includes good communication with families, friends, professionals and independent advocates to ensure the resident is heard and understood. The inspector met with one person with limited speech. The person was clearly able to understand verbal communication, and was able to answer questions appropriately. The staff member working with them knew them well, was able to communicate well, and was able to explain how they would realise if the resident was upset or worried about anything. All staff have received training on how to recognise abuse, and how to protect vulnerable adults. Good policies and procedures are in place on all aspects of abuse and protection. The regular involvement in the home by the Trustees, relatives and friends also ensures that residents have plenty of opportunities to raise any concerns and to ensure that residents are safeguarded. Records of money held by the home on behalf of residents were checked. Each resident has their own personal savings account. In addition, the home has a bank account held in the name of all of the residents collectively. This account provides the day-to-day cash for residents. All transactions have been carefully recorded on computer, with receipts held to provide evidence of all items purchased. There are a number of checks and safeguards built-in to this system, including regular auditing, and all transactions double-checked by a second member of staff. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 20 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): 24, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, comfortable and safe home. EVIDENCE: A tour of the home and grounds took place during this inspection. Three bedrooms were seen at the invitation of residents, and most of the communal areas were also checked. All areas have been maintained to a high standard, and have been well decorated and furnished. Everywhere appeared bright, clean, comfortable and homely. Residents were proud of their bedrooms, which have been decorated and furnished to suit their individual tastes and interests. Each resident has their own, single bedroom. 15 bedrooms have en suite facilities. On the day of this inspection the weather outside was warm, and therefore no heating was on. One resident said at times he worried about being warm enough. This was discussed with Chris Thistle who gave assurance that any Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 21 individuals who need additional heating have had an extra heater provided in their room. Information provided by the home in the pre-inspection questionnaire showed that all equipment has been regularly maintained. One member of staff has been given the responsibility for the health and safety of staff and residents, and he was able to demonstrate very careful risk assessments have been carried out on all aspects of the environment. Regular checks have been carried out on electrical equipment and hot water systems in order to protect everyone at the home. Staff have received training on infection control. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 22 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): 32, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive all the support they need from sufficient numbers of competent, well-trained and committed staff. Careful procedures have been followed when recruiting new staff to ensure that residents are protected from harm or abuse. EVIDENCE: Sample staff rotas were forwarded to the Commission before this inspection took place. Records showed that there are five carers employed between 7.30am and 9.30am. After this, residents are out and about, either working on the farm or attending activities of their choice. Staff are employed on the farm to work with, and provide instruction to small groups of residents. Some residents have staff allocated to work with them on an individual basis. In the evenings there are a minimum of four care staff. Other staff employed include a chef, administrator, training co-ordinator, cleaning and maintenance staff. Residents and staff expressed satisfaction in the level of staff support provided. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 23 Files of four staff recruited since the last inspection were checked. These showed that careful recruitment procedures have been followed, ensuring that satisfactory references and checks have been received before staff have been confirmed in post. Training records were discussed with the training co-ordinator. These provided good evidence of thorough induction training when new staff begin. Records of on-going training were seen, and copies of certificates showed that staff have received a wide range of training on all relevant subjects. Training provision meets with the nationally recognised standards known as the ‘Learning Disability Award Framework’. All staff have been given a staff handbook setting out many of the key features of their employment, and explaining what is required of them. Staff have been given copies of all policies and procedures and have signed to say they have read them and understood them. All policies and procedures are held in the staff room to enable easy access if needed. At the time of this inspection the number of care staff who hold a nationally recognised qualification (either a National Vocational Qualification (NVQ) or equivalent) had fallen below the recommended 50 . However, six staff were in the process of obtaining qualification, and when these have been completed the number of qualified staff will once again be above 50 . The overall level of training in the last year has been good, and covered a wide range of subjects relevant to the needs of the residents. Training has been provided both internally by trained senior staff, or through external training specialists. Every member of staff was invited by the Commission to complete a questionnaire, and 22 forms were received. Their responses showed 100 confidence in the home to provide the highest standard of facilities and support for the residents. The staff had clearly spent a great deal of time and thought filling out the questionnaires, and wanted to explain the many excellent features in the home. Their responses confirmed that staff employed in recent years under the current management have been recruited following current good practice requirements, and have received all the training and support they need. While all of the staff praised the home highly, three staff said they felt communication could be improved. A few staff said they did not attend regular staff meetings or individual supervision. This was discussed with Chris Thistle who said that a very small number of staff either work nights, or work for just a few hours each week, possibly for specific tasks, and may find it difficult to attend staff meetings. While he accepted that these staff may feel less well supported he felt that systems have been put in place to try and involve and communicate with all staff, and to ensure they receive sufficient supervision to enable them to do their work effectively. However, he did agree to look again at this issue and to see if anything else can be done to improve communication and supervision of part-time staff. A Trustees report received by the Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 24 Commission recently showed that a Trustee visited the home on a number of nights during November and December 2006 specifically to provide a personal link with all of the night staff who, because of their shifts, may have less opportunity to meet the trustees, or to have access to key workers and management. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 25 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): 37, 39, 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well-run. A range of good systems are in place to ensure the standard of care and facilities and services are constantly monitored and improved. Residents are staff are protected from harm through excellent health and safety checks and procedures. EVIDENCE: Chris Thistle has over 15 years of experience in residential care, and has managed Stallcombe House for a number of years. He holds a nationally recognised qualification known as the Registered Managers’ Award and is currently working towards level 4 of a nationally recognised qualification known as National Vocational Qualification (NVQ). The home holds the Investors in Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 26 People Award (this has recently been renewed). Chris Thistle is supported by an experienced and competent Deputy Manager. Staff and residents contacted through this inspection expressed complete confidence in the management of the home. The following comments are typical of the many positive statements received from staff: “The home has a wonderful atmosphere and allows service users (and staff) to grow. I have never worker anywhere better!” “It is a wonderful community. The clients are enabled to do many activities and work in pleasant surroundings. Staff are encouraged to be creative and ideas are listened to. There is a great understanding of the needs of individuals and opportunities for staff to learn and develop. The ‘open door philosophy is productive.” “Staff are very well looked after, with training, personal issues out of work, promoting staff to do the best they can and progress to become more experienced members of the team. We also have regular supervision for problems to be aired and it isn’t spoken about any further. The management will also recognise hard work at difficult times and have given loyalty payments and rewards in the past. They have the best interests of the resident at all times and are open to suggestions if we feel that a particular issue can be improved.” “Training and supervision for staff – excellent!” The home has a range of methods of checking the quality of the service and ensuring that standards are constantly improved. Regular staff and residents’ meetings are held. Monthly visits are carried out by a representative of the trustees and their reports are forwarded to the Commission. The trustees also meet regularly. The home has an annual business plan. Exit interviews are carried out when staff leave in order to check that they have no concerns about the management of the home or care of the residents. Quality assurance surveys were carried out in 2003/4 – these were found to be useful at the time but have not been repeated since then. Chris Thistle said he intends to send out more surveys in the near future. Relatives and friends are encouraged to be involved in the home and to share their views, opinions and suggestions. There is a lively ‘Family and Friends’ group who run fundraising events and help to fund many improvements around the home. A member of staff has been given the responsibility of overseeing the health and safety within the home. He was able to provide clear evidence to show how seriously he takes this responsibility, with detailed assessments in place for every task, piece of equipment, and every aspect of the environment where a risk has been anticipated. He has received a range of training and qualifications in care, supervision and health and safety. All staff are asked to read any changes or updates to the risk assessments, and to sign to say they Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 27 have read and understood them. The fire log book has been well maintained and showed that all equipment has been regularly tested and serviced, and staff have received a variety of training in fire safety, and this has been updated regularly. All staff have received training and updates on all health and safety topics. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 28 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 4 2 4 3 4 4 X 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 4 ENVIRONMENT Standard No Score 24 4 25 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 4 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 x 4 x x 4 x Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? no 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 YA36 Good Practice Recommendations The home should review their methods of communicating, consulting and supervising staff to ensure that all staff feel well supported and informed. Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton Devon TQ13 7UP 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 Stallcombe House Farm DS0000022040.V327405.R01.S.doc Version 5.2 Page 31 - 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!