Inspection on 20/06/05 for The Barn Heath Farm

This inspection was carried out on 20th June 2005.

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 02/08/06

The Barn Heath Farm 08/12/05

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 LN4 3JD Lead Inspector Mick Walklin Unannounced 20 June 2005 10:30 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 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 Stationary 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 C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Heath Farm Address Heath Road Scopwick Lincoln LN4 3JD 01526 320312 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Autism Care (UK) Limited Mrs Maggie Sykes Care home only 39 Category(ies) of LD Learning disability (39) registration, with number of places Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24th November 2004 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.The home 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. An administration block adjoins The Lodge. 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”. Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 8 hours. All four living areas were visited, but only The Lodge and The Cottage were inspected in detail. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. Pre-inspection questionnaires were completed by the Home Managers, and 25 comment cards from relatives and social workers were received, together with 10 questionnaires from service users. Other documents were also inspected. What the service does well: 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 6 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 Standards Statutory Requirements Identified During the Inspection Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 7 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 standard(s) 2 & 4. The home has good admission procedures, including trial visits, to ensure that prospective service users needs and aspirations can be met. EVIDENCE: Three service users have been admitted since the last inspection, and all had detailed pre-admission assessments. Staff from Heath Farm had visited two of the prospective service users in their existing placement prior to admission, and spent two days working with them and their support staff. All three had trial visits to Heath Farm, which one service user said had been useful in helping him decide where he wanted to live. He said that he “loves this place – it is brilliant”. He had settled in quickly, and found the staff very helpful and supportive. Transition arrangements can vary according to individual assessed needs. New admissions are for a four-week trial period Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 8 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 standard(s) 6 & 9. There is excellent care planning and documentation, ensuring that resident’s needs are fully met, and that they can live as independently as possible with risks minimised. EVIDENCE: Care plans are of a high standard, with detailed information about service users daily living needs, ongoing support and assessments. There is a clear link between care plans and assessments, ensuring that identified needs are met. Key workers hold monthly meetings with service users to review the care plan to reflect any changes. Six monthly internal and external reviews, where service users or their representatives are asked to agree the care plan. If service users are unable to understand their care plan, or are unable to attend review meetings, the reason for this is documented. The home is introducing ‘Person Centred Planning’, where individual goals and aspirations are identified, and a number of facilitators have been trained to help service users with this process. Since the last inspection, a new daily recording sheet has been introduced, which gives detailed information about residents on a shift by shift basis, which enables staff to communicate more effectively between shifts. Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 9 Detailed risk assessments are in place, which enable service users to live as independently as possible, whilst ensuring that risks are minimised. There are excellent guidelines for staff in how to manage and defuse challenging behaviours that service users present. A number of comment cards received from relatives and social workers praised the standards of care within the home. Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 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 standard(s) 11, 12 & 13. There are a wide range of educational, occupational and leisure activities available, to ensure that service users have a varied and enjoyable timetable. EVIDENCE: A majority of service users attend day services either at Oak Park in Sleaford, the Social Education Centre on-site, or in-house activities. Service users in The Lodge and The Cottage have detailed weekly plans, which included a variety of educational, occupational and leisure activities. Service users have individual session plans, which have recently been introduced, and these give detailed guidelines for staff in facilitating activities. There are also individual activity boxes, with contain a variety of resources, and a portable schedule for the day. One service user explained how he had recently completed NVQ level 1, and was starting a new job as a kitchen assistant. Another talked about how he enjoyed his work with ‘The Clean Team’, a recycling project. One service user is attending a life skills course at Lincoln College. Heath Farm is committed to TEACCH (Treatment and Education of Autistic and related Communication Handicapped Children), a communication method Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 11 originally designed for children with autistic spectrum disorder, which uses photographs and symbols to provide structure and information in the service users day. Service users have portable schedules that travel with them. The home employs a TEACCH advisor, and four TEACCH assistants. There is widespread use of pictures, symbols and objects of reference, to enable service users to communicate and exercise choice. Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 12 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 standard(s) 19 & 20. There are good arrangements in place to ensure that the health needs of service users are met. EVIDENCE: An assessment called the ‘OK Health Check’ is use to identify health needs, and this links directly with care plans. Service users are registered with two local GP practices, and specialist services are available through referral through the Community Learning Disability Team, such as Speech and Language Therapy, and Occupational Therapy. Psychologists and Psychiatrists hold regular clinics at the home. Only senior carers administer medication, and administration, storage and stocktaking arrangements in The Cottage were satisfactory, ensuring that medication is administered safely. Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 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 standard(s) 22 & 23. There are robust systems for handling complaints and adult protection issues, ensuring that service users are listened to and protected from abuse. EVIDENCE: Complaints forms are available in each house for service users, and the complaints procedure is available in both written and symbols formats to ensure that it is accessible to service users. There have been four complaints since the last inspection, three of which had been from one service user, and these had been resolved. Adult protection is covered in induction, but some staff had not received training since 2001. The Training Manager confirmed that a programme of update sessions was planned. One of the home’s Senior Support Workers is a member of the Lincolnshire Adult Protection Committee, and is available for advice and training. Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 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 standard(s) 24 & 30. There have been continued improvements to the four houses, but there are still a number of maintenance issues outstanding, which need to be addressed in order to make some areas comfortable and homely for service users. EVIDENCE: A number of environmental improvements have been made since the last inspection, and the requirements from the previous inspection have been addressed. The Lodge has had new flooring installed in the bathrooms and showers, and sensory equipment was being installed in one of the lounges. An extractor has been installed in one of the shower rooms, to aid ventilation. The carpet in the hallway is showing signs of wear and tear, and requires replacing in the near future. The downstairs showers have been cleaned in The Farmhouse, and problems with the water pressure have been resolved. The opening on the staff toilet door has been changed, and it no longer presents a health and safety hazard. Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 15 The Lodge now has magnetic curtain fastenings so that curtains can be replaced quickly when they are pulled down. Privacy screening has been fitted to windows, and a new carpet has been fitted to the top lounge. One of the rooms has been converted to a soft play area. Despite continued environmental improvements in The Lodge, there are still a number of outstanding maintenance issues, and the Home Manager provided evidence of numerous maintenance requests, which she was following up. The Assistant Registered Manager identified 20 issues during a visit on 27th May. In view of the continued maintenance problems, it is required that a full environmental audit of The Lodge be conducted, and remedial work be undertaken. The Registered Manager agreed to replace the bench and table arrangement in one of the rooms with furniture of a more domestic appearance. A pedal bin for clinical waste is required in one of the bathrooms. The Barn was undergoing major building work, so an inspection was not conducted. Service users stated that although the building work was an inconvenience, this was being managed to ensure the minimum of disruption. One comment card received from a relative raised issues regarding the poor standards of hygiene in communal areas, but it was not clear which unit this referred to. One relative was concerned about the size of the room that her son occupies. Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 & 36. Staff are well trained and supported, and there are sufficient numbers to meet the needs of service users. Recruitment and selection procedures are robust, ensuring that service users are protected. EVIDENCE: Staffing levels in all four houses are high, but this reflects the complex needs of service users. The Personnel Manager explained that the overall establishment has been increased by 8 staff since the last inspection, and that the home was nearly fully established. Service users said that the staffing situation had improved, and one said that there are “lots of new staff”. Staff files contained evidence of thorough pre-employment checks. Staff described training opportunities as “excellent”. The Training Manager has compiled a data base of all training undertaken by staff, and is responsible for booking courses, which Home Managers nominate staff. Rotas have recently allowed staff have a dedicated training day every 3rd week, and they have access to a resource room for study. A large number of staff are undertaking NVQ training this year, and all Home Managers are undertaking the Registered Managers Award. The Training Manager has also updated the induction procedure, and has produced an excellent resource pack for new starters, who have a four-week induction period. The home holds the Investors in People Award. Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 17 Staff receive regular supervision, and there are excellent systems in place to support staff following violent incidents, including post-incident de-briefing, referral to occupational health services and external counselling if required. Staff said that the introduction of new physical intervention training had led to a significant reduction in violent incidents. Staff of all grades said that they are well supported by their managers. A number of comment cards received from relatives and social workers praised the attitude and commitment of staff, saying that they are dedicated and confident. Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39. There are good quality assurance procedures to ensure that the standards of care received by service users are monitored. EVIDENCE: The home is reviewed on an annual basis by Autism Accreditation, who last conducted an in-depth review over two days in December 2004. The Accreditation Panel congratulated the home on achieving the standards required to maintain Accredited status, and praised the progress that they have made over the past year in achieving the recommendations made, showing a real commitment to the Accreditation process and the development of autism specific practice. The home also holds the ISO 9001 Quality Award Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 Heath Farm 4 3 3 x x Standard No 31 32 33 34 35 36 Score x x 3 3 3 3 Version 1.20 Page 20 C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc 16 17 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 4 x x x x Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 21 NO 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. 1. Standard 24 Regulation 23 Requirement Timescale for action 30/8/05 2. 24 13 The registered person must ensure that a full environmental audit of The Lodge be conducted, and an action plan be submitted to the Commission, outlining timescales for the completion of all outstanding maintenance work. The registered person must 30/8/05 ensure that a clinical waste bin with a lid be provided in the bathroom in The Lodge. 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 Good Practice Recommendations Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection Unity House, The Point Weaver Road off Whisby Road Lincoln, LN6 3QN 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 Heath Farm C53-C04 S2370 HeathFarm V233538 210605 Stage 4.doc Version 1.20 Page 23 - 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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