Inspection on 08/12/05 for The Barn Heath Farm

This inspection was carried out on 8th December 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 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 09:30 8 December 2005 th Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 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.V267413.R01.S.doc Version 5.0 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.V267413.R01.S.doc Version 5.0 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.uk Autism Care (UK) Limited Mrs Maggie Sykes Care Home 39 Category(ies) of Learning disability (39) registration, with number of places Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 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. 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 DS0000002370.V267413.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of 7 hours with two inspectors. The main method of inspection used was called case tracking which involved selecting one resident from each area, and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. A tour of all areas took place records relating to the running of the home were also examined. 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 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 the following standard(s): 2. There is a detailed and thorough pre-admission process, which ensures that residents are supported through the process, and that their needs are fully identified. EVIDENCE: There have been two new residents admitted; one to The Cottage and one to The Barn. Staff from Heath Farm had visited them both in their previous homes, conducted detailed assessments, and gathered further information from health professionals and parents. One resident said that he had been actively involved in the assessment. Following the assessment, a report is forwarded to the manager, with recommended dependency level and costings. The TEACCH (Treatment and Education of Autistic and related Communication Handicapped Children) advisor will then set up a transitional package based on individual assessed needs, which will usually involve visits to Heath Farm. Staff had complied a picture book to help one person with this process. A school in the West Midlands has obtained funding to conduct research on the low level of placement breakdowns at Heath Farm. Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 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 the following standard(s): 6, 7 & 9. There are detailed care plans and risk assessments, which provide excellent information to staff in order to meet the needs of residents. EVIDENCE: Care plans are of a high standard, and contain clear and detailed information about residents support needs. Care plans are split into three sections, covering health, risk, and the triad of impairments associated with autism. One new resident said that he had been involved in developing his care plan, and is due to attend a workshop to help him develop a Person Centred Plan. He had chosen his key worker, and meets with him regularly to review the care plan. There are regular formal reviews involving parents, social worker and home staff, with agreed outcomes and goals. Care plan agreements are signed by the resident or their representative. There are a range of risk assessments, which identify risks, and give staff clear guidelines about action to take relating to care planning. During the inspection, two new staff were observed to deal with the escalating behaviour of a resident calmly, by ‘talking down’ in a respectful manner. Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 Page 9 There is extensive use of pictures and symbols in the houses where residents have limited verbal communication. Staff also have an excellent knowledge of residents preferred communication methods, which enable them to ascertain choices. A resident said that he gets lots of choices in his lifestyle, and is encouraged to be as independent as possible. He said that he also get a lot of ‘talk-time’ with staff to discuss issues. Another resident said, “I have a choice of what I want to do, and staff help me do whatever my goals are”. Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 15 & 17. Residents have full and varied timetables, which combine to give them educational, life skills and leisure opportunities. EVIDENCE: A majority of residents attend day services either at Oak Park in Sleaford, the Social Education Centre on-site, or in-house activities. Each resident has an individual timetable. One of the new residents in The Cottage had an interim timetable in place, and a transitional worker was visiting him at the time of the inspection, to assess him for Oak Park. There are good arrangements for maintaining contact with relatives via telephone and visits. The service user guide states that visitors are welcome at any time, and can be provided with meals and drinks free of charge. The home may facilitate home visits for service users in some cases. Each house is responsible for its own catering arrangements. A new kitchen has been installed in The Barn since the last inspection. The Cottage and The Lodge both have domestic style training kitchens. Menus in The Cottage were Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 Page 11 inspected. They are rotated on a three-week basis, but are flexible according to resident’s wishes. They appeared varied and nutritious, with resident’s food preferences and dislikes clearly documented in the care plan. Staff explained that objects of reference, or pictorial menu books are used to ascertain choices. Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 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 the following standard(s): 18, 19 & 20. There are good arrangements in place to ensure that the health needs of residents are met. EVIDENCE: Each resident has a Health Action Plan, which clearly identifies any health needs. The home employs Psychiatry and Psychology services on a sessional basis, and have their own Psychology Assistants. All residents are registered with local GP practices. Specialist dental services are accessible, and an Optometrist visits annually. One resident was currently in hospital, and the home was providing staff to support this. 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. Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. The home has good procedures for protecting residents, and they have confidence that their concerns will be dealt with effectively. EVIDENCE: There have been no complaints since the last inspection. Complaints forms are available in each house for residents, and the complaints procedure is available in both written and symbols formats to ensure that it is accessible to service users. A new resident in The Barn was clear of the procedure to follow if he had concerns, and staff were also clear about the procedure if they received a complaint. The previous inspection highlighted that some staff had not received adult protection training since 2001. This has now been included in the physical intervention training to ensure that staff receive annual updates. The home has also introduced an excellent incident reporting system, which concisely describes the incident, staff actions, injuries etc. Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. There have been significant improvements to the physical environment, especially in The Lodge, ensuring that all houses provide a well-maintained and comfortable environment for residents to enjoy. EVIDENCE: Previous inspections have highlighted ongoing maintenance issues in some areas, especially The Lodge. The progress made since the last inspection is to be commended, with strenuous efforts having been made to rectify faults. All four houses are now of an acceptable standard, and present as well maintained and comfortable. There have been significant improvements to décor in The Lodge and the Cottage, with new carpets, and refitted bathrooms/showers. Some minor issues were identified, which were all in hand. However, the seat covers in the conservatory in The Lodge need replacement, and the manager agreed to arrange for this to be done. The building work in The Barn is now completed, with a totally refitted kitchen, and an additional sitting area upstairs. Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36. There are robust recruitment and selection procedures, ensuring that residents are protected, but staff should have more regular training updates and supervision. EVIDENCE: The training manager has inherited a position where many staff have not received periodic training updates in mandatory subjects, such as fire training, food hygiene and moving and handling. Steps are being taken to resolve the backlog in the New Year. All training previously undertaken by staff has now been collated onto a central spreadsheet. The home is on target to meet the NVQ standard of 50 qualified by next year. All staff are participating in autism awareness training, which is on four levels. New staff praised the quality of induction training, which lasts four weeks. One said it is “really, really good”, and another said that there had been excellent support from the staff team. A resident said that the staff are very helpful – he knows what training they do, and this makes him feel confident in them. He said the staff are all “superb”. Four staff files were inspected, and all demonstrated a thorough recruitment and selection procedure, with all the documentation necessary for the protection of residents on file. Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 Page 16 Staff said that they are well supported, but supervision records show some slippage in regular formal supervision. It is recommended that staff receive formal supervision six times per year. Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 & 42. The home is very well managed and organised, with good systems for keeping residents safe. There are excellent procedures for monitoring and improving the quality of care that residents receive. EVIDENCE: Central maintenance and servicing records were not inspected, as they were not accessible at the time of the inspection, but records held in each house demonstrated that regular health and safety checks are being conducted. However, a large bottle of corrosive oven cleaner was found stored in one of the kitchens, and this was removed to the COSHH cupboard immediately. There were also concerns about an oversize mattress on a bed in The Farmhouse. The wrong size mattress had been delivered by the supplier, and the manager was trying to rectify this. Heath Farm has recently undergone a full annual assessment by Autism Accreditation over two days. The final report has not been published as yet. There is also a system of ‘Quality Circles’ where quality issues are discussed in Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 Page 18 each house, and fed back to the management quality circle to improve practice. The home holds the Investor in People Award and the ISO 9001 Quality Award. Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 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. 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 4 x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 4 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 4 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Heath Farm Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 4 x x 3 x DS0000002370.V267413.R01.S.doc Version 5.0 Page 20 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. 2. Refer to Standard YA35 YA36 Good Practice Recommendations It is recommended that staff receive periodic training updates relating to fire, food hygiene and moving and handling. It is recommended that staff receive formal supervision six times per year. Heath Farm DS0000002370.V267413.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Lincoln Area Office 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 DS0000002370.V267413.R01.S.doc Version 5.0 Page 22 - 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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