Inspection on 14/07/05 for The Farmhouse

This inspection was carried out on 14th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Farmhouse 20/09/07

The Farmhouse 17/11/06

The Farmhouse 07/12/05

The Farmhouse 20/10/04

The Farmhouse 12/05/04

The Farmhouse 10/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 The Farmhouse Hundred Elms Farm off Elms Lane Sudbury HA0 2NP Lead Inspector Julie Schofield Unannounced 14 July 2005 3.55pm 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. The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Farmhouse Address Hundred Elms Farm Off Elms Lane Sudbury MIddlesex HA0 2NP 020 8904 8282 020 8903 9860 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) Residential Care Services Ltd Lynda Eribo Care Home 6 Category(ies) of LD 6 registration, with number of places The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20 October 2004 Brief Description of the Service: The Farmhouse is a care home providing personal care to 6 adults with learning disabilities. At the time of the inspection there was 1 vacancy. The house is a Grade II listed building and is in a quiet residential part of Wembley but close the Harrow Road and Watford Road. There are bus routes along both of these roads and the nearest underground station is Sudbury Town. The property is detached and has a garden at the front and at the rear/side of the property. It is situated at the end of a short passageway (wide enough for access by car) and there is parking for approximately 4 vehicles outside the front gates of the home. There is also parking on the road. The house consists of two floors, ground and first floor. The ground floor consists of an open plan lounge and dining area, a kitchen, bathroom (with toilet) and three service users’ bedrooms (two with ensuite toilet and one with ensuite toilet and shower). On the first floor there are three service users’ bedrooms (all with ensuite toilet and shower), the office, the laundry room and a quiet room (with ensuite toilet) that is used at night by a member of staff sleeping in. The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a Thursday afternoon in July 2005 and lasted for 2 hours 50 minutes. The manager was not on duty at the start of the inspection but arrived for an appointment in the home later during the inspection. The Inspector met each of the 5 residents. The two staff on duty and 2 of the 5 residents took part in the inspection and the Inspector would like to thank them for their comments. A partial site visit took place and certain of the records were inspected. What the service does well: What has improved since the last inspection? The last inspection took place in February 2005 and the home demonstrated good standards of care, which they have maintained. There were no visible The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 Page 6 changes observed either in the home or in the care practice, during the 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. The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 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 standard(s) 3 Residents receive a service from staff who can understand and respond to their cultural and religious needs and who have access to professional advice in respect of good practice. EVIDENCE: The staff team is supported by health care professionals who can advise the home on current good practice i.e. the pharmacist, GP, CPN, the dietician, CIS, the psychiatrist etc. Within the home the residents represent a number of different cultures and religions and there is diversity within the staff team. The staff on duty demonstrated an understanding of the cultural and religious needs of residents. Staff communicate verbally with residents and they also interpret the facial expressions and body language of residents, which supplement the responses made by some residents. The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 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 standard(s) 9 Staff support residents to take responsible risks so that residents can enjoy an independent lifestyle. EVIDENCE: A discussion took place with staff regarding risk assessments and they confirmed that these were tailored to meet the individual needs of service users. They said that they read the risk assessments during their induction training. The content of the risk assessment included what the member of staff was expected to do in order to promote the safety of the resident. The manual handling risk assessments had been accompanied by training for staff. Examples of risk assessments given included escorting a resident in the community and accompanying a resident who was going swimming. The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 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, 14, 15, 17 Residents have access to day centres, college and resource centres, which provide an opportunity to develop their social and communication skills. Residents have the opportunity to develop their emotional and communication skills through their interaction with staff. Taking part in activities gives residents the opportunity to become more independent and to enjoy an interesting and stimulating lifestyle. The support of staff enables residents to maintain family contact. Residents have a varied and balanced diet, with dishes to satisfy religious and cultural needs. EVIDENCE: Residents’ social skills are developed during attendance at day centre, during visits to clubs and when taking part in activities both inside and outside the home. Residents are helped to develop emotional skills and staff talked with a resident who was coming to terms with a recent bereavement. The key worker for this resident was 1 of the 2 members of staff on duty during the inspection and they confirmed that they had undertaken loss and bereavement training. Staff commented that “communication is a 2 way process”. Staff The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 Page 11 demonstrated a patient and understanding manner. Communication skills develop as residents express their needs either verbally or by body language etc. There are staff within the team who are able to communicate with Asian residents in their first language. Residents have opportunities to develop their domestic skills and a resident confirmed that he made cups of tea and helped in the preparation of meals. Residents are encouraged to set the table and to clear away their plates/cutlery and glass at the end of a meal and a resident said that they helped with the washing up. They are supported in laundering their clothes although a member of staff does most of the ironing. A resident said that they kept their room tidy. All of the residents attend a day centre during the week and have the opportunity to meet other people attending the centres and to take part in activities, which are appropriate and enjoyable. Residents confirmed that they were satisfied with the activities offered. A member of staff on duty had also worked at the company’s day centre and confirmed that activities included numeracy and literacy skills sessions. The home has access to transport owned by the company and this is used when activities taking place outside the home are at a distance. (They have 2 eighteen-seater minibuses). Residents make use of facilities within the community including shops, pubs, restaurants, parks, leisure centres etc. The staff on duty said that the minibus used by the company’s day centre is used on Saturdays to take residents from the company’s homes on day trips outside London. A resident confirmed that a holiday was arranged for residents each year and that they enjoyed taking part and was aware that this year’s holiday would take place in September. They also said that they had taken part in visits to parks (had picnics there) and that they attended clubs in the evenings and at weekends. A resident confirmed that members of their family visited them in the home and that the staff on duty made the relatives welcome. Visits took place in either their room or in the lounge. Another resident confirmed that they were in regular contact with their family, by telephone. Staff confirmed that other residents received weekly visits from their relatives. Two residents said that the meals were good and one resident confirmed that both continental and cooked breakfasts were served in the home. During the inspection an evening meal was prepared and eaten. It consisted of a mixed vegetable curry for the Asian residents who were also vegetarian and a potato bake with salad for the remaining residents. Staff confirmed that alternatives were served when a meal included an item which a resident did not enjoy. Before preparing the meal it was noted that the member of staff checked with residents to see if any changes were needed. The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 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) 18, 19, 20 Residents receive assistance with personal care in a way that respects their dignity and privacy. Residents’ health care needs are met through access to health care services in the community. Supporting residents to take their prescribed medication helps the residents to maintain a healthy lifestyle. EVIDENCE: The level of assistance that residents require with personal care tasks varies from prompting to direct support and it was noted that assistance was offered in a discreet manner. At present all the residents are male and the staff team consists of both male and female members of staff. The home uses a system of key workers. A resident confirmed that routines are more relaxed at the weekend when residents do not attend day centres. A discussion took place with the members of staff on duty regarding the health care needs of residents. All residents are registered with a local GP and they confirmed that residents have access to health care services in the community, including appointments with dentists, opticians and chiropodists. Residents also attend out patient appointments and staff confirmed that they escorted residents, as necessary. The storage of medication was inspected and it was safe and secure. The home uses a system of weekly dosette boxes, filled by the pharmacist, and the The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 Page 13 individual compartments had been appropriately emptied prior to the inspection. Records of the administration of medication to residents were inspected and were up to date and complete. The member of staff responsible for the administration of medication confirmed that they had undertaken medication training. The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 Page 14 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) 23 Protection of vulnerable adults training for staff contributes towards the safety of residents and must to be undertaken by all members of staff. EVIDENCE: One of the 2 members of staff on duty had not undertaken protection of vulnerable adults training although said that a basic awareness was introduced in the TOPSS induction training. Both staff were aware of the need to report to the manager if they heard or saw anything that compromised the safety and welfare of a resident. The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 Page 15 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 Residents enjoy a comfortable and homely environment where the upkeep of the property is good although some minor areas need attention. EVIDENCE: The home should consider the removal of a wooden building in the garden outside the front of the house that resembles a children’s playhouse. The paint on the woodwork near the front door is peeling. The door to the laundry room was damaged. All other parts of the home that were seen during the inspection were in a good state of repair. The Farmhouse is comfortably furnished and “homely”. The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 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) 32, 33, 34 Residents benefit from staff that have the knowledge and understanding of the needs of the client group and the home continues to support staff undertaking NVQ training. There were sufficient staff on duty to support the residents and staffing levels enable staff to support residents in the community. The recruitment process protects the welfare of the residents. EVIDENCE: One of the 2 support workers on duty said that they had completed their NVQ level 3 training and had undertaken an induction session for level 4. They were also studying for the Assessors Award. He was aware that other staff were undertaking NVQ training. During the inspection there were 2 support workers on duty to meet the needs of residents. The manager came on duty after the inspection had commenced. The staff on duty said that there are usually 3 staff on duty earlier in the day. At night the 2 staff are sleeping in but on call. The home is maintaining the staffing levels agreed at registration. One of the members of staff discussed the recruitment process and said that they did not start working for the company until 2 satisfactory references and a satisfactory CRB check had been completed. They said that the CRB The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 Page 17 disclosure had included a POVA check and that they had produced their passport as proof of identity. The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 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) 42 The training that staff receive in safe working practice topics enables them to safeguard the health, safety and welfare of the residents. EVIDENCE: Staff confirmed that they had received training in health and safety and that fire drills took place in the home. The senior member of staff on duty is responsible for administering first aid, if required. The member of staff on duty who was preparing the meal confirmed that they had undertaken food hygiene training and the other member of staff had also undertaken food hygiene training. It was noted that it was warm in the lounge and that the door leading from the lounge to the garden was kept closed for reasons of security. The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 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 x 3 x x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 2 3 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Farmhouse Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 Page 20 NA 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. 2. Standard 23 24 Regulation 13.6 23.2 Requirement That all staff receive adult protection training. That the woodwork near the front door is repainted and that the door to the laundry room is repaired. That 50 of staff achieve an NVQ level 2 or 3 qualification. Timescale for action 01 December 2005 01 December 2005 31 December 2005 3. 32 18.1 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 24 42 Good Practice Recommendations That the wooden building in the garden near the front door is removed. That a fan is provided in the lounge when the weather is very warm The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 4th Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 The Farmhouse G62-G11 S17504 The Farmhouse v213683 30.6.05 Stage 4.doc Version 1.40 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. 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