Inspection on 01/05/07 for Street Farm

This inspection was carried out on 1st May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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

CARE HOME ADULTS 18-65 Street Farm Street Farm Draycott Cheddar Somerset BS27 3TH Lead Inspector Pippa Greed Unannounced Inspection 1st May 2007 09:10 Street Farm DS0000068806.V337846.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 Street Farm DS0000068806.V337846.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. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Street Farm Address Street Farm Draycott Cheddar Somerset BS27 3TH 01934 744930 01934 744930 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) Mr Neil Bradbury t/a Bradbury House Organisation Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May accommodate up to 11 persons aged 18-65 years with a learning disability (LD). One room is to be used exclusively for short-term assessment and transitions for residents moving into more independent accommodation. New Service Date of last inspection Brief Description of the Service: Street Farm is owned by Mr Neil Bradbury of Bradbury House Organisation. Mr Neil Bradbury is the registered provider. The acting manager is Ms Tina Dewey. Ms Tina Dewey is currently applying to register with the Commission for Social Care Inspection. Street Farm is situated in the village of Draycott. The village has a church, two pubs, village hall and a shop/ post office, all within easy walking distance of Street Farm. The village is on a direct bus route between Cheddar, Wells and Weston-super-Mare. There are ten permanent and one assessment room at Street Farm. The main farmhouse has three en-suite bedrooms, one staff sleep in room, office, two communal lounges, dining area and a large kitchen. In addition to this, there is an annex with two bedrooms both of which have their own bathrooms and an assessment room with en-suite facilities. Five service users live in the main house and annex. There are four cottages, which have been built around a large garden that contains ornamental ponds and patio area. These cottages cater for five service users. The cottages have a range of facilities to increase each service user’s independence. The current scale of charges is £699.00 to £750.00 per week. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Key inspection was conducted over one day (8hrs) by CSCI Regulation Inspector Pippa Greed. On the morning of the inspection, two support workers and the acting manager were on duty. During the afternoon there were two support workers. There was one sleep in staff rostered for that evening. The acting manager Tina Dewey was available to assist the inspector during the unannounced visit. On the day of the inspection five service users were at home initially and five service users left early morning to attend Badgworth Riding School. One service user was away on holiday with parents. The remaining five service users left mid morning to attend Yoga at Cheddar (10am-11.30am). At lunchtime, two service users returned from Badgworth. During the afternoon, two service users went to Badgworth after Yoga and lunch. Six service users were at home participating in textile session (needlecraft and knitting). The atmosphere was relaxed and informal. Staff were seen to work professionally and demonstrated good rapport with the service users. The inspector viewed all communal areas. The inspector was also shown by four service users respectively their bedrooms with permission. The inspector met and spoke with six service users. The inspector sat and had lunch with the service users and staff and also observed daily routines within the home. Four service users described to the inspector their experience of living at Street Farm, which were very positive. The inspector spoke with three staff members, day care manager and area manager. A selection of records was examined. These included four service users care plans and three staff recruitment files. CSCI sent out feedback cards for three relatives, eight staff, one social worker and one General Practitioner. One relative comment card was received. It reflected overall positive comments. The relative wrote ‘Staff have good relationships with clients and communicate well with us.’ They also stated ‘Addition of new day care provision by Bradbury House Organisation will be added value brought in by new owners – will be good when made fully available to (service user).’ Eight care staff comment cards confirmed that they receive regular supervision and training updates. One staff wrote ‘Management extremely supportive. Staff and clients are a pleasure to work with.’ Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 6 Social worker confirmed that the home communicates effectively with funding authority. One GP comment card has been received and this confirmed that the service provides good care. The GP wrote ‘Most patients come to us accompanied by member of staff. Staff member is well informed regarding problem and I am very happy with communication between home and surgery.’ The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. What the service does well: What has improved since the last inspection? This is Street Farm’s first inspection under new owners – Bradbury House. The home has arranged for two service users shower facilities to be refurbished. Also, the hallway and dining floor area has been fully tiled. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 7 The management of medication now includes two staff signatures when medication is received into the home. This also includes two staff signatures when non-medidose medication is administered. 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. Street Farm DS0000068806.V337846.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 Street Farm DS0000068806.V337846.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, 4, 5 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 statement of purpose, and service user guide that clearly sets out the objectives and philosophy of the service. Prospective service users are given the opportunity to spend time in the home prior to admission. EVIDENCE: The service user is provided with a Statement of Purpose and a Service User’s Guide. The Service User’s Guide is provided with easy to follow description, photograph and pictorial symbols. The symbols are easy to understand and the guide explains what the prospective service user can expect from Street Farm. This enables the service user and their family to make an informed choice. The Statement of Purpose outline criteria for admission. Initial referrals may come from either a parent/ carer or from a social worker. The home will then send out an introductory brochure. The home will then make arrangements to invite all interested parties to visit so that they can look at the facilities and meet other service users. A further visit is arranged for a longer duration, which includes lunch and activity session. Overnight stay is offered which then progresses to long weekend assessment and an assessment week. Throughout Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 10 the process, the manager would be carrying out assessments and collating details. The potential service users family and social worker would also make an application for the appropriate funding from their placing authority. There is no set timescale as each case is judged on the service user’s needs. One service user spoken with stated that her parents enquired about the home and that they had visited a range of services before deciding on Street Farm. The service user also confirmed that she and her family were provided with enough information about the home. Another service user spoken with was on the waiting list for a place at this home. Some service user have lived in the main house for a number of years building up their independence skills and making the transition to life in the cottages in the grounds of Street Farm to further enhance their independence. One pre-admission assessment was sampled in one care plan. This was written by Bristol County Council and provided the home with very clear and detailed plan of care. Service users contract were kept in a separate admission file. This was sampled and evidenced terms and condition of service from the home. There is no vacancy at present. Street Farm DS0000068806.V337846.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, 8, 9, 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has a detailed and well-written care plan for each service user. Service users are encouraged to exercise choice and participate in all aspects of life within the home. Service users are supported in taking risks. Records relating to service users are stored securely and appropriately maintained. EVIDENCE: The inspector sampled four service users care plans. Care plans are well maintained for each service user. Care plans provided information regarding service users needs, daily routines and preferences. The care plans also included records of visits to health care professionals, activities undertaken, and service user’s feedback on day care. Individual risk assessments had been completed for each service user. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 12 Assessment of needs cover a range of topics which includes health, personal care, life skills, accommodation, day care, leisure and social, relationships, communication, culture and religion and general comments. Written care plans have been updated and care planning review meetings have been arranged in recent months. Bradbury House is planning to update all care plans in line with their care planning approach. An example file was seen and this is considered much more structured. This format will include behaviour management guidance and clearer accident recording. Service users are encouraged to exercise choice. There is a board in the kitchen, which is used to provide timetables for all service users. These have been designed with service user’s input and ensure duties are shared equally in the home. These cover a range of duties such as laundry, cooking, changing bedclothes, food menu and shopping list. Quality assurance tools are used and one example is a questionnaire, which seeks service users opinion on life at Street Farm. These questionnaire evidences consultation as well as opportunity to address and improve the service. One service user explained to the inspector how she wishes to live in her own flat near her family one day. She aspires to develop her independence skills, have her own place and look after two cats. The home keeps individual day to day records that detail the activities and choices that have been made by service users. Service users meetings take place every few weeks. These are recorded. A newsletter is issued on a monthly basis outlining planned events and optional activities. The newsletter for May was sampled and listed a broad range of options and ideas all of which were agreed with the service users in advance. These are some of the examples listed: - pampering evening, pub visit, barbecue, computer award ceremony, cinema trip, DVD and nibbles night, and shopping trip. Financial records were seen for two service users. One staff initial supported all entries as well as service user’s signature. The entries were correct for expenditures and tallied with the balance. Benefits are paid directly into service user’s bank account. All service users handle their own financial affairs with key worker’s support. All records relating to service users are stored securely. Street Farm DS0000068806.V337846.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): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home supports the service user with personal development. The home offers service users opportunities to engage with peers, access appropriate leisure activities, and exercise choice. Service users are supported with friendship and family contact. Service users rights and responsibilities are respected. Service users are offered a choice of menu, and the options are developed around their preferences and dietary needs. EVIDENCE: On the day of the inspection, service users were accessing a range of activities, some of which were daily living skills, horseriding and animal care, lunchtime preparation, yoga and textile (needlework and knitting). Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 14 A timetable for the week listed the following activities: swimming, yoga, budgeting, health and well being, computer studies, work placement, gym, home skills, working towards independence, trampolining, cooking, textiles, and Badgworth Riding School (horseriding and animal care). Service users also access the local community, shopping, visit local pubs, and go out for meals. They are able to pursue their personal hobbies and interest in the home, such as social evenings, Gateway Club, amateur dramatics, caring for pets, singing and crafts. In-House activities includes cookery, daily living skills and social evenings covering a range of topics such as film night, women pampering evening and theme cooking. Two service users spoken with described participating in Race for Life fundraiser for Breast Cancer. One service user described to the inspector how she flew to USA independently to visit a close family friend. Two service users described to the inspector how they travel by bus independently and work for a few hours each week in a charity shop or healthy eating café. These examples demonstrate excellent outcomes for the service users. All service users are in frequent contact with their families and friends and any closer relationships, i.e. boyfriends, are supported. The home is brightly decorated throughout in cheerful colours, which lends to a welcoming atmosphere. Service users were observed carrying out a craft activity. Through the interaction and communication, it was evident that the staff were well motivated and clearly understood the service users needs. Staff spoke to the service users in a kind and respectful manner. Service users were supported with decision-making and encouraged to do so. Service users were also empowered to walk around freely and access local shop if so wished. The inspector had lunch and chatted with the service users. The inspector noted that the lunchtime routine was relaxed and the atmosphere was convivial. Service users have a love of animals and this is nurtured in the home. They have their own pets and also communal pets. Service users are fully involved in decision-making regarding pet care and make contributions voluntarily. Service users meet with staff on a weekly basis and discuss their mealtime preferences for the upcoming three weeks. A cooking rota and mealtime menu is planned with service user’s agreement. This also forms part of budget management skills. Menus sampled appeared well balanced and appetising. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 15 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, 21 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are provided with appropriate support to meet their personal care needs. The home supports service users in accessing healthcare services. The home has a medication policy, which provide staff with clear guidance. Medication records are managed safely. EVIDENCE: It was evident from the care plans through regular monitoring that any changes in the service users wellbeing or behaviour would be identified. The manager and staff team would then take pro-active steps to address and meet changing needs. Care reviews were seen to be regular and up-to-date. The care plans that were sampled contained documentation of the visits made to health care professionals. Records are kept of all visits and consultations. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 16 All service users keep and manage their own medication with assistance from staff as appropriate. Service users have lockable rooms. Service users respect each other’s private space and do not enter without agreement or invitation. Service users are encouraged to store their medication in the locked areas available. The home’s procedures for the management and administration of medication were examined at this inspection. Two files were sampled: – a ‘collection and distribution’ folder and also another file for recording non-medidose medication. These were found to be detailed including two staff signatures and service users initials. No gaps were seen on the Medication Administration Records. Medications were considered to be handled and stored appropriately. The home has a detailed medication policy file, which was updated in March 2007. Photographs of service users are stored on their medication care profile. At present the care plan does not contain details relating standard 21 in the care plans. The home has a policy in place in respect of standard 21. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 17 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, 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place for the protection of vulnerable adults from abuse. It is recommended that staff receive Protection of Vulnerable Adult (POVA) training as good practice. The home has a complaints procedure and policy relating to the Protection of Vulnerable Adults. EVIDENCE: The home has appropriate policies relating to the Protection of Vulnerable Adults, Whistle Blowing, Complaints policy, and Grievance policy. The home’s complaint policy demonstrates clearly that complainants can contact the Commission for Social Care Inspection at any stage of a complaint. The inspector met with three staff members and asked about their understanding of Safeguarding Adult procedures. Whilst staff knew of the policy and who to report to, it would be beneficial to introduce POVA training for all staff. Staff recruitment files were seen to be robust and contained records required in Schedule 2, Care Homes Regulations. POVA1st checks have been carried out on newly recruited staff appropriately. The inspector was informed that there have been no complaints since the last inspection and no complaints/concerns have been raised directly with the Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 18 CSCI. It is recognised that no complaint has been made. However, it would be good practice to implement a ‘Concerns, Complaint and Compliment’ file. One service user spoken with stated that she felt able to talk to the manager if she had any worries or concern. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 19 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, 25, 26, 27, 28, 29, 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has been decorated and furnished to a high standard. Appropriate adaptations have been provided. The home has sufficient communal areas and bathrooms to meet service users’ needs. The home was found to have a high standard of cleanliness. EVIDENCE: On the day of the inspection the home was warm and homely in appearance and appeared to maintain high standards of cleanliness and hygiene. The inspector conducted a tour of the premise. Street Farm is a large detached farmhouse situated in a small village within walking distance from local amenities. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 20 The main farmhouse has three en-suite bedrooms, one staff sleep in room, office, two communal lounges, dining area and a large kitchen. In addition to this, there is an annex with two bedrooms both of which have their own bathrooms and an assessment room with en-suite facilities. Five service users live in the main house and annex. There are four cottages, which cater for five service users. These have been built in the grounds to the rear of the farmhouse. There is also a paved patio area with patio table and chairs and a large garden that contains ornamental ponds. It was noted that Forget-me-not Cottage vestibule window has a crack in it. It does not appear to pose any immediate risk as the crack is formed as part of the double-glazing. However, this would need to be repaired or replaced. Four service users showed the inspector their bedrooms with their permission. Each service users bedroom was specifically decorated to their taste and interest. One service user is planning to update her bedroom, paint a new colour scheme and purchase new curtains. The bedrooms were filled with a range of décor such as collectibles, photographs of families and friends, comfortable armchair or sofa, television, DVD player, music system, fairy lights and personal memorabilia. The en-suite facilities were also personalised in a bright and cheerful manner. A buzzer system is in place should any of the service users wish to seek staff support at night time. Communal areas are situated on the ground floor and consist of two lounges, a large dining room and spacious kitchen. There are sufficient communal spaces for the service users to access and choose from. A private hallway area allows service users to make personal phone calls in comfort and privacy. Outside to the rear of the house is a good-sized laundry area, which houses two washing machines and two tumble driers. It was found to be clean and well organised. Cleaning schedules were sampled and detailed what task has been completed, when and who by. Service users are fully involved with daily living management such as laundry, cooking and changing bed linen. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 21 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): 31, 32, 33, 34, 35, 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are experienced and provide a good standard of care. Staffing levels are appropriate to meet service users’ needs. Training updates in Adult Protection for the staff is recommended. Staff receive appropriate support and supervision. EVIDENCE: Duty rotas are well maintained. On the day of the inspection, there were two staff on duty during the morning, one manager during the day, three staff during the afternoon and one sleep in duty at night. Since the last inspection, three staff has joined the team at Street Farm. There is one staff vacancy at present. The inspector spoke with three staff members. Staff spoken with confirmed that they had received appropriate support and supervision. Staff meetings are also provided regularly. Staff comments were positive and confirmed good communication and support network. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 22 Observation of care provided throughout the inspection process showed that the staff team are caring and demonstrated rapport with the service users. The manager has maintained a record of staff training needs to ensure that all staff are provided with appropriate training to undertake their role. Newly employed staff have completed a thorough Induction programme. Bradbury House Organisation has it’s own training manager who will be assessing and planning all staff training. It is anticipated that all staff will undertake NVQ 2 in Care training. Also, further mandatory training refresher is planned for 2007. Staff are provided with regular opportunities to receive training, and have attended courses on Health and Safety, Food Hygiene, First Aid, Fire Safety, Manual Handling, Behaviour and Down’s syndrome. Out of the eight staff employed, three have obtained the NVQ level 2 qualification in care. Three staff recruitment files were examined. These were maintained appropriately. Each was found to contain the documentation required within Schedule 2 of the Care Home Regulations 2001. The inspector viewed the records in relation to staff supervisions and appraisals. The manager has an overview of all staff supervisions that have been conducted. Senior staff also provides supervision in order to maintain good frequency. The inspector noted that staff has been supervised recently. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 23 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, 38, 39, 40, 41, 42, 43 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is well run and benefits from a competent manager. There is a relaxed and inclusive atmosphere within the home. Health and Safety checks are well maintained and the service users welfare is protected. EVIDENCE: Ms Tina Dewey is the acting manager for the home. She has many years experience of providing care to service users with learning disability. Tina has worked at Street Farm for two years in a deputy role. Tina has background experience working with vulnerable adults and coordinating care in the community. Tina is currently applying to register with the Commission for Social Care Inspection to become registered manager. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 24 Tina is planning to enrol and work towards her NVQ level four in Care and Registered Managers Award (RMA). An assistant manager and a senior member of staff support her. Staff at the home seek service users’ views on an individual basis. There is a strong person centred focus and this was evident throughout the inspection process. Staff spoken with confirmed that the manager was approachable and that they would be able to raise any concerns. The staff spoken with commented that they felt well supported. The home operates a comprehensive system of health and safety audits. Records relating to the health and safety of service users and staff were examined at this inspection and the findings were as follows: Portable appliance testing was up to date. The last test was carried out on 15.12.06. Detailed records are maintained. Records are maintained for all hot water outlets. Records show that temperatures exceeded HSE recommended limits. Risk assessments are in place to take this into account. However, it is recommended that all hot water outlets be thermostatically controlled. It is also recommended that the home consider contracting an external agency to test presence of Legionella microorganisms in the water supply and a strategy for the prevention of this disease be developed. The home records weekly checks for fire detection systems and emergency lighting. Regular in-house drills are conducted by the home. A fire policy is in place. Fire checks were carried out on 26.4.07. Staff fire training took place on 21.12.06. The home does not appear to have an appropriate electrical hard wiring certificate available. The manager has since informed the inspector that there is no electrical wiring certificate in place previously. The new owners will make arrangements for electrical testing. The home has an up to date Landlords Gas Safety Certificate dated 23.10.06 Risk assessments have been completed for service users relating to life skills, road safety, money management, fire, food and nutrition, social skills, medication and leisure. These were up to date. The accident book was sampled and demonstrated clear records kept. Accident levels are deemed low with three minor incidences over a three-month period. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 25 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 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 1 3 Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 26 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. 1. Standard YA42 Regulation 23 (2b) Requirement It is required that an Electrical Wiring test (5yrs) and certificate be arranged and a copy sent to the CSCI. Timescale for action 15/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard YA22 YA24 YA35 YA42 Good Practice Recommendations It is recommended as good practice to set up a file to record in the eventuality of any concerns, complaint and compliments received by the home. It is recommended that the vestibule window of Forgetme-not Cottage be repaired or replaced. It is recommended that Protection of Vulnerable Adult (POVA) training be provided for all staff. It is recommended that the water system in the home be tested at least annually by external agency for the presence of Legionella microorganisms in the water supply and a strategy for the prevention of this disease be developed. It is also recommended that all hot water outlets be thermostatically controlled to below 43 degrees in line with Health and Safety Executive guidance. Street Farm DS0000068806.V337846.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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. 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