Inspection on 02/08/06 for The Barn Heath Farm

This inspection was carried out on 2nd August 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

The Barn Heath Farm 25/07/08

The Barn Heath Farm 08/12/05

The Barn Heath Farm 20/06/05

The Barn Heath Farm 18/11/04

The Barn Heath Farm 14/06/04

The Barn Heath Farm 04/03/04

The Barn Heath Farm 24/09/03

The Barn Heath Farm 04/12/02

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

CARE HOME ADULTS 18-65 Heath Farm Heath Road Scopwick Lincoln Lincs LN4 3JD Lead Inspector Mick Walklin Unannounced Inspection 2nd August 2006 11:00 Heath Farm DS0000002370.V306318.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 Heath Farm DS0000002370.V306318.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. Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heath Farm Address Heath Road Scopwick Lincoln Lincs LN4 3JD 01526 320312 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) cathpartington@autismcare.co.uk autismcareuk.com Autism Care (UK) Limited Mrs Maggie Sykes Care Home 39 Category(ies) of Learning disability (39) registration, with number of places Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th December 2005 Brief Description of the Service: Heath Farm is situated near the village of Scopwick, 10 miles from Sleaford, and 15 miles from Lincoln. Scopwick has a pub and a village shop, and Lincoln and Sleaford have a full range of amenities and shops. It is owned by Autism Care UK, who have recently been purchased by another company, but continue to trade under the same name. Heath Farm is at present registered for 39 people with a learning disability, although the home specialises in the care of people with Autistic Spectrum Disorder. Accommodation is arranged in four units - The Farm House, The Barn, The Lodge and The Cottage. There is also an administration block. There are currently plans to register the four units as separate care homes. The main objective is To ensure Heath Farm provides the highest quality of care to those individuals with Autistic Spectrum Disorder enabling them to develop the skills needed to cope with everyday life in a knowledgeable and supportive environment. Pre-Inspection questionnaires provided details that the fees charged are between £1545 - £4000 per week. Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken using a review of all the information available to the inspector regarding the service history of Heath Farm, and through visiting the home. The visit took place over 7 hours, and concentrated on the Farmhouse and The Barn. The other two houses were not inspected. The main method of inspection used was called case tracking. This involved selecting three people who were living in The Farmhouse or The Barn, and tracking the care they receive through the checking of their records, discussion with them and care staff, and observation of care practices and interactions. A tour of both houses was conducted. Documents connected with the running of the The Barn and The Farmhouse were also inspected. The home managers each completed a pre-inspection questionnaire, and twelve ‘Have Your Say’ leaflets were returned, some of which had been completed by service users, and some by relatives on behalf of service users. What the service does well: What has improved since the last inspection? Heath Farm has continued to provide very good support for service users since the last inspection. Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 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 Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 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): 2. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Each new service user is thoroughly assessed before admission to ensure that their needs can be met. There are good systems to introduce people to the home. EVIDENCE: Staff at Heath Farm use a detailed pre-admission assessment, which is specific to the needs of people with autistic spectrum disorder. One service user has been admitted to The Barn since the last inspection. His parents said that he had visited The Barn with them twice before moving in, and he was currently in a transitional period, getting to know the other service users. The service user said that he was settling in well, and said, “I like living at The Barn – it’s better than where I was before”. Before admission, a home manager and an assistant psychologist from Heath Farm had assessed him. Staff also visited him at the care home he was living in at the time. A health action plan was completed by his parents, which outlined any health needs. Heath Farm makes extensive use of TEACCH (Treatment and Education of Autistic and related Communication Handicapped Children and Adults). This is a system which uses visual methods, such as pictures, to help service users communicate, and break tasks down into simple steps. This enables them to have a greater degree of independence. All prospective service users have a TEACCH assessment as part of their pre-admission assessment. Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans accurately reflect residents support needs, but some risk assessments did not have a corresponding care plan. Staff are skilled in communication with residents to ascertain their wishes. Staff support residents to gain independence skills safely. EVIDENCE: The care plans inspected contained very detailed assessments and information about the service users, which clearly describe their support needs. Because of the volume of information that they contain, they would benefit from indexing and cross-referencing. It is not possible to fully involve service users in The Farmhouse in the care planning process, but service users in The Barn said that they are fully involved, and attend their reviews. Residents have a ‘person centred plan’, which outlines their goals and hopes for the future. Service users in The Farmhouse have pictorial displays in their bedrooms, which explain their person centred plan. There are good daily records, which record all day-to-day events. Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 10 As previously mentioned, the TEACCH system is used extensively throughout Heath Farm. This enables service users who do not have verbal communication to better understand how their day is structured, and to communicate their needs and wishes. Staff have an excellent knowledge of the way individual service users communicate, which enables them to ascertain service users choices. A parent said “Our son’s key workers are both excellent, and able to communicate and understand him in the vast majority of situations”. Service users are encouraged to be as independent as possible, and care plans outline potential risks, and steps to minimise those risks. However, not all risks identified had a corresponding care plan. Staff have an excellent awareness of the need for service users to develop skills, whilst maintaining their safety. Service users in The Barn are invited to attend a forum each evening to discuss any household issues, and there are separate service user meetings, which are usually at service users request, and which they are encouraged to take the lead in. A service user in The Barn said, “The staff are very helpful and kind – they always listen and help me”. However, another said, “Staff listen sometimes, but not always”. He said that he gets angry about this. Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good variety of leisure activities and outings are provided to ensure that service users have an enjoyable timetable. The food served caters for service users choices and preferences. EVIDENCE: Service users have busy activity timetables, which combine educational and leisure activities. Each service user has a timetable from 7:30 in the morning to 9:30 at night. Heath Farm has an off-site day centre in Sleaford, but no service users from The Farmhouse or The Barn attend this. Service users in The Farmhouse have a timetable which includes swimming, horticulture, aromatherapy, financial skills, TEACCH and outings. Staff were observed to be offering 1-1 support for activities in the house. A service user in The Barn said that there were enough activities to keep him interested, and outlined his timetable for tomorrow, which he said that he was looking forward to. However, another said, “Sometimes it’s downright boring”. When asked ‘ Do Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 12 you make decisions about what you do each day’ he said, “I don’t always get the option”. Heath Farm previously used a curriculum called ASDAN (Award Scheme Development and Accreditation Network Towards Independence), which enables residents to work towards specific goals and awards. However, they have now decided to develop their own curriculum. This will use information in service users person centred plans to identify areas of interest that work can be developed around. One idea that has been put forward is to run a photography module. This project is in its early stages, but it is hoped to get the course recognised by the Open College Network. Contact with parents and friend is encouraged. Parents said, “The staff are always willing to oblige when we visit or phone”. Service users are encouraged to help with meal preparation according to their abilities. A service user in The Barn explained how he was making garlic bread as part of tonight’s meal, and said that he usually does his own menu planning and meal preparation. Service users had said that they would like more choice of meals, so a choice of two meals is now available. A whiteboard in the kitchen identifies the menu, and service users tick their preferred options. Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users receive good support, and their health needs are catered for. There are safe procedures for the administration of medications. EVIDENCE: Because of the nature of the service, providing for people with autistic spectrum disorder, many service users at Heath Farm require a structured timetable, and would find it more difficult to cope with flexible routines. Service users choices are respected, and care plans contain good information about preferences. Person centred plans have also assisted service users in identifying their future plans and wishes. Parents commented “Our son needs his routines, and he has a say in his structured routine. However, weekends are sometimes difficult as there is less structure, and there are sometimes agency or other house staff on duty”. Service users are registered with one of two local GP surgeries. Each service user has a Health Action Plan, which clearly identifies any health needs, and specialist services such as psychiatry and psychology are available. Service users with epilepsy, have excellent care plans explaining what steps to take in the event of a seizure. Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 14 Medication storage and administration records were inspected in three of the four houses, and were found to be satisfactory. Staff have received safe handling of medication training. There are clear guidelines for the administration of homely remedies, which are only given under GP guidance. One service user had not received his morning medication, but on further enquiries, it was found that he had been unwell, and staff were discussing not giving the medication. Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 15 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems in place to ensure that residents are protected, and that their complaints and concerns are taken seriously. EVIDENCE: The complaints procedure is available in symbols format, but service users would benefit from a shorter version. There have been no concerns since the last inspection. Five concerns have been raised by staff and service users since the last inspection, and records showed that they had all been dealt with satisfactorily. A parent commented, “Our relationship with our son’s carers is first class, and comments are always acted upon”. There had been one adult protection allegation in January. No further action had been taken by Social Services or the commission, but an internal investigation had resulted in appropriate action being taken by the manager. Staff interviewed showed a thorough knowledge of the procedure to follow, should they suspect that abuse was happening. Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Barn and The Farmhouse provide a comfortable environment for residents to enjoy. EVIDENCE: The Barn had been refurbished at the time of the last inspection, but further improvements have been made. The entrance hallway is now a transition area, with each service users individual timetable portrayed on a whiteboard. Service users said that they enjoy the additional space that the upstairs lounge provides, and that the kitchen area is much nicer now. The Farmhouse continues to maintain a good standard of furnishings and décor. Residents were enjoying the range of communal space, and the enclosed garden provides a safe open area for them. Both houses were clean and pleasant smelling at the time of the visit. Service users in The Barn are more independent than those in The Farmhouse, and are responsible for cleaning their rooms. A service user in The Barn commented that toilets and bathrooms were not always clean, and two parents also raised this issue, but it was not clear which houses this referred to. Another parent Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 17 commented, “Because of the client group, we accept that it cannot always be immaculate”. Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 18 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, 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 well trained, and supported, but some are overdue mandatory training updates. Current recruitment processes are robust to protect residents. EVIDENCE: Following the purchase of Autism Care UK, the company is currently being restructured. The training manager has left, and the person who is currently responsible for co-ordinating training explained that records were disorganised, following a recent office move, and they were awaiting the installation of new computer systems. It was difficult to assess staff training provision because of this. The most recent records for The Farmhouse were from January 2006. The Barn had more up to date records, but both showed that some mandatory training was overdue. Dates for forthcoming training were available on the training plan. The manager explained that Heath Farm was investing heavily in more specialist training, and this may have affected the provision of other training. The records of three newly recruited staff were inspected, and all contained the documentation necessary for the protection of service users. A member of staff who, had started at Heath Farm two weeks ago, said the recruitment process Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 19 had been thorough, and she had received good induction training. She said that her initial overall impression of Heath Farm was “excellent”. There are high staffing levels in The Barn and The Farmhouse, but these reflect the needs of the service users. Those in The Barn said that they receive good levels of support. The previous inspection identified that staff supervision was not occurring as often as it should. Records showed that this is still a problem, with several staff that had not received supervision due in May. Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 20 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): 37, 39 & 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Heath Farm is well organised and managed. There are excellent systems in place to monitor the quality of care, and staff promote a safe environment for service users. EVIDENCE: Due to the recent purchase of Autism Care UK, the current registered manager is applying to become the responsible individual for the company. There is also an application to register the four houses as individual care homes, each with its own registered manager, and to possibly register a fifth home on the site. Heath Farm underwent a full annual assessment by Autism Accreditation over two days in November last year, and are preparing for this years assessment. There is also a system of ‘Quality Circles’ where quality issues are discussed in each house, and fed back to the management quality circle to improve practice. The home is assessed by outside assessors, and holds the Investor in People Award for staff training and organisation, and the ISO 9001 award for Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 21 the systems in place to improve and measure quality. Service users in The Barn completed a satisfaction survey in the spring, and parents and placing authorities are asked to complete a questionnaire after the six monthly reviews. Servicing and maintenance records were not inspected in detail, but records in The Farmhouse showed that staff conduct regular checks to ensure the house is safe. A cupboard containing hazardous substances was found unlocked in the kitchen of The Farmhouse, but the manager took prompt action on this. Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 22 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 4 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 x 4 x x 3 x Heath Farm DS0000002370.V306318.R01.S.doc Version 5.2 Page 23 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 YA9 Good Practice Recommendations It is recommended that all risk assessments contain information about where the relevant care plan can be found. It is recommended that staff receive periodic training updates for mandatory training. It is recommended that staff receive formal supervision six times per year. 2. 3. 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