Inspection on 02/02/06 for Stallcombe House

This inspection was carried out on 2nd February 2006.

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 18/04/07

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 Farm Sanctuary Lane Woodbury Salterton Exeter Devon EX5 1EX Lead Inspector Belinda Heginworth Unannounced Inspection 2nd February 2006 09:30 Stallcombe House Farm DS0000022040.V279980.R01.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 Stallcombe House Farm DS0000022040.V279980.R01.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. Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Stallcombe House Farm Address Sanctuary Lane Woodbury Salterton Exeter Devon EX5 1EX 01395 232373 01395 233351 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.V279980.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th August 2005 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. Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three hours with the manager being present. Some residents living at Stallcombe House Farm have limited verbal communication skills therefore they were unable to contribute fully to the inspection process. However observations were made throughout the inspection. About 15 residents were consulted and their views of the home and their experience of living there were discussed. Eight staff were spoken with and observed. Evidence of standards being met was also taken from reading some documentation. The Trustees of the Charity regularly inspect the home. Copies of the reports are sent to the Commission. What the service does well: Stallcombe House continues to be well run by a team of staff who follow the ethos of the home – promoting independence and person-centred care. The manager of the home has a clear commitment and vision for the home, which he communicates well to the staff team. The atmosphere throughout the home is friendly and caring. The home has a strong and well-developed ethos of person centred care. Each resident is treated as an individual who has rights and responsibilities and who should be supported to live the life they wish to live. Health needs are well met with evidence of good multi disciplinary working. Personal support is provided in a way that promotes privacy, dignity and independence. Residents appeared to be safe, happy and comfortable. Staff act in a caring and respectful manner towards residents. Staff are provided with good information and guidance to help meet residents’ needs safely. The home offers a lot of activities, ranging from horse riding, walks, shopping to swimming, night school, computer lesions, weaving pottery and many more. Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stallcombe House Farm DS0000022040.V279980.R01.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 Stallcombe House Farm DS0000022040.V279980.R01.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): 0 No standards were inspected in this section but key standard two was fully met during the last inspection. EVIDENCE: Stallcombe House Farm DS0000022040.V279980.R01.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 Staff are provided with good information to help meet residents’ needs safely. EVIDENCE: Residents have limited communication skills and have a limited understanding of care plans and are therefore many are unable to contribute to their formulation or reviews. Two care plans were read. These provide good information and guidance about residents’ assessed needs and set individual goals that encourage independent living skills. On the whole, staff use these documents daily, but in some cases, staff still need to be encouraged to use them more effectively. For example, it is not always clear when aims have been achieved. Relatives and the staff team advocate on behalf of the residents and work hard to identify any changes in their assessed needs. Staff demonstrated an excellent knowledge and understanding of the plans. Risks are carefully identified and minimised. These were not inspected on this occasion but were fully met during the last inspection. Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 10 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): 13, 15 & 16 Residents are respected and their rights recognised daily. Residents are encouraged to maintain relationships and use the local community. EVIDENCE: Residents are encouraged and supported to pursue their own interests and hobbies. Residents said they enjoyed the new evening activities that have been introduced, for example, bingo, music, games and many more. Trips out to pubs or events such as “gateway” club are supported. Weaving, pottery and papermaking are but a few of the craft activities that take place at Stallcombe House. On the day of the inspection there were two residents in the craft room undertaking some activities and about seven residents in the gardens and four in the chicken farm. All residents appeared very happy with the work they were doing. Residents said that staff support them to maintain contact with friends and relatives through visits and telephone calls. Residents said staff were kind, patient, caring and respectful. Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 11 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): 18, 19 & 20 Residents’ personal and health needs are well met. EVIDENCE: Care plans describe how residents prefer to receive support and personal care. Staff demonstrated a good knowledge and understanding of such needs. Residents said that staff are always respectful of their wishes. Residents said that staff support them to attend appointments to doctors, dentists and so on. Care plans provided further evidence that health needs are monitored well. Residents health & welfare is therefore well protected. It was recommended during the last inspection that topical creams should be dated when opened; and hand written prescription sheets should be checked and double signed. Although this has improved there was still a number of handwritten entires that had not been checked or signed for. It is important that this is completed consistantly to ensure no errors are made and therefore better protecting residents. Some creams and bottles had no date of opening. All creams and liquids have a shelf life, particularly after opening; because no date of opening was recorded, staff would be unaware of when the cream of liquid should be discarded. The manager said the supplying pharmacy said it was not necessary to do this. The inspector agreed to consult with the CSCI Pharmacy inspector for advice and would feedback the outcome. A bottle of Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 12 medication was found with a handwritten label. It did not provide the times the medication should have been given. The manager and staff did not know why this medicine had been dispensed from the “blister packs. Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 13 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 Residents are protected from potential abuse and neglect. EVIDENCE: Residents were aware of how to complain or raise concerns. Regular care plan reviews take place; residents attend and can raise any concerns. Regular residents’ meetings take place where issues of concern can be discussed. Residents are also consulted about the running of the home at these meetings. The home is also inspected by the Trustees of the Charity where residents are consulted. A report is written and a copy sent to the CSCI. The home has achieved the Investors in People Award and receives visits from The Investors in People; one is due in May 2006. To achieve the award the home has to meet certain standards. The home has an Adult Protection policy that includes the Department of Health’s guidance on “No Secrets”. This informs the staff on how to recognise abuse and what to do if they suspect any. All staff have received training on this topic and demonstrated a good awareness of it. Residents are therefore well protected. The home has a bank account called “Residents’ Fees and Personal Monies”. This account is separate from the business account. All benefits are paid into this account and personal monies are paid to residents when necessary, through an “imprest” system. Financial records are good providing a good audit trail of residents’ monies, with receipts kept. Residents are therefore protected well from financial abuse. Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 14 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): 0 No standards in this section were inspected on this occasion but key standards 24 and 30 were fully met during the last inspection. EVIDENCE: Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 15 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 & 34 Residents benefit from a competent team of staff and the home’s recruitment practices. EVIDENCE: The home aims to provide a minimum of five care staff from 7.30am until 9.30am where residents then go to their workshops and activities. Additional staff are employed to run the work projects during the hours of 9.30am until 5pm. Extra staff are employed to provide one to one support for some residents. In the evenings there are a minimum of four care staff. Residents benefit from a well staffed home that are able to meet their needs effectively and safely. Residents spoke highly of the staff team and some said they felt there was “plenty” of staff to take care of them. The home has a robust recruitment procedure that includes obtaining two references and a police check for all staff. Residents are therefore well protected. Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 16 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): 39 The home has excellent systems in place to monitor the quality of services provided. EVIDENCE: The home has many systems in place that monitors the quality of care delivered to residents. The management structure in the home ensures that the quality of these services is constantly monitored. For example, senior staff complete structured one to one supervision meetings with all staff. During these meetings residents’ care plans are checked to ensure they are being used properly and training issues are also highlighted. Residents are consulted about all aspects of their lives and about the running of the home through care plan reviews and resident meetings. An excellent standard of staff training ensures that residents’ needs are met appropriately and safely. Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 17 The financial controls in the home ensure residents are well protected from financial abuse. The Health & Safety Officer ensures that the home is run safely with measures in place to reduce any risk to residents or staff. The Trustees of the charity meet regularly and also inspect the home. They involve residents and relatives in their consultation process to ensure they are happy with the quality of services the home provides. A copy of the report made; and the business plan is supplied to the CSCI. These reports show that an excellent person centred standard of care is provided and show a continuous improvement programme that has taken into account the needs and wishes of residents. Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 18 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 4 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 4 14 X 15 4 16 4 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X X X 4 X X X X Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 19 N/A 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. 1. Refer to Standard YA20 Good Practice Recommendations Topical creams should be dated when opened. Hand written prescription sheets should be checked and double signed. (Repeated from last inspection. Some improvements were made but not consistently) Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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. Extracts may not be used or reproduced without the express permission of CSCI Stallcombe House Farm DS0000022040.V279980.R01.S.doc Version 5.1 Page 21 - 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. 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