Inspection on 17/05/05 for The Farmhouse

This inspection was carried out on 17th May 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 15/05/07

The Farmhouse 20/01/06

The Farmhouse 03/11/04

The Farmhouse 05/06/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 THE FARMHOUSE Ravenswood Village Nine Mile Ride Crowthorne Wokingham RG45 6BQ Lead Inspector Yvonne Souden Unannounced Inspection 17th May 2005 at 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. THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Farmhouse Address Nine Mile Ride Crowthorne Wokingham Berks RG45 6BQ 01344755568 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) Norwood Ravenswood Village Alicia Anne Dennis YA 8 Category(ies) of Care Home, Learning Disability (LD) registration, with number of places THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 8 service users with a learning disability, one of whom is aged over 65 years. Date of last inspection 3 November 2004 Brief Description of the Service: The Farmhouse is a home that caters for the needs of eight mixed gender service users with moderate and complex learning disabilities, and is situated in Norwood Ravenswood Village; Ravenswood Village is a community setting that provides care and accomodation within indavidually managed group homes to people who have a learning disability. The Farmhouse aims to provide high quality care that will maximise service users personal development and develop a strong sense of religious and cultural identity, as the belief, practices and values of Judaism underpin all aspects of the service users lives. The home is a detached two storey buiding with eight single rooms, a large communual lounge, dinning room and kitchen, and is furnished and decorated to a high standard. The dinning room opens through to a sensory garden where seating is provided. There is a village shop and Ravenswood have their own vehicles. Public transport is not readily available within the village, but the village of Crowthorne and Towns of Wokingham, Bracknell and Reading are within a short drive. THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Yvonne Souden and Stuart Mynott undertook this inspection on a Tuesday from 10:30 am to 4pm. 75 of the inspection was spent observing the environment, care practice, safety measures in place, resident and staff interaction, and discussions with residents, staff and the manager. The rest of the time was spent looking at care plans and other records. 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. THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 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 THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 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) Standards 1 – 5 were not assessed at this inspection. EVIDENCE: THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 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 Staff knowledge, reviewed care plans and risk assessments ensure the needs of the service users’ are met and that risks to the service users are minimised. EVIDENCE: The files of two service users were viewed, as was the Person Centred Plan (PCP) of another. The files of the two service users contained personal detail and contact numbers of significant people in the service users life. Files contained reviewed needs assessments, risk assessments, and correspondence from health and social care professionals. The person centred plans viewed detail the goals of the service user and are reviewed by the service user and their keyworker. Risk assessments detail the risk and action plan to minimise the risk but are filed in a separate folder to that of the care plan and are not concise. Discussions with staff demonstrated a clear knowledge of the needs of the service users, and positive interaction between the service user and staff was observed directly and indirectly throughout the inspection process. THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 Page 9 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) Standards 11 – 17 were not assessed at this inspection. EVIDENCE: THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 Page 10 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 The health and social care needs of the service users are promoted and met but could be jeopardised by the homely medication remedy procedure in place. A keyworker system and a committed staff team promote continuity of care. EVIDENCE: Service user files demonstrate that the manager and staff are proactive in ensuring service users are supported to access health and social care services. Review documentation, and health and social care correspondence demonstrate that multi-agency reviews take place, and that health and social care professionals are involved in meeting the needs of the service user. Observation of staff interaction with service users and care plans viewed demonstrate that staff encourage service users to be independent within their personal care tasks, and that staff offer full assistance as required. A service user confirmed that she sees the G.P in the privacy of her room, and continuity of care is demonstrated through the keyworker system in place and limited agency staff used. Staff have received medication training and demonstrated a clear knowledge of policies and procedures in place. Records of medication administered matched medication in stock. THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 Page 11 It was observed that the use of homely medication remedies authorised by a G.P detail the amount that can be administered within a twenty-four hour period, but does not specify how long the homely remedy can be used before seeking medical advice, and the authorisation lists homely remedies that can be used by the service user group as opposed to the individual service user. The manager informed the inspector that a review of the homely remedy medication takes place by the G.P every three to four years and records show were last reviewed in 2004. Homely medication administered is detailed within the service users individual medication record, and a separate record details homely medication taken by staff and service users from the same stock for the purpose of audit control. THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 Page 12 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 Systems are in place to protect service users from abuse and ensure service users are listened to. EVIDENCE: The home keeps safe money belonging to the service users; records show two staff members sign each transaction, and that records matched money kept. The home has policies and procedures in place on abuse and on concerns and complaints and within WIDGET format (signs and symbols). Staff have received abuse awareness and challenging behaviour training; some staff have received training on Strategies in Crisis Intervention and Prevention (SCIP) however, the assessed needs of the service users within the home do not require SCIP procedures to be used. The homes complaint log book lists no complaints within this inspection year however prior complaints do not detail the outcome, or where to locate the recorded outcome; the manger agreed that it would be good practice to record location of outcome for future reference if required. THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 Page 13 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 A clean, comfortable and safe home maintained to a high standard. EVIDENCE: On the day of the inspection the home was clean, airy and bright with décor and furnishings to a high standard. Cleaning schedules are in place and are directed at staff and service users, thus promoting the service users independence and cleanliness of the home. A refurbishment programme has been running since the manager came in to post two years ago, and the manager is proactive, and has funds in place, to bring the laundry and bathrooms up to the minimum standard. Infection control policies and procedures are in place. Discussions with staff identify that they have a clear awareness of infection control, and records identify training received by staff within food and hygiene, infection control and health & safety. Protective clothing and hand-washing facilities were observed and the home has a clinical waste contract. Health and safety notices were observed throughout the home. THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 Page 14 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) Standards 31 – 36 were not assessed at this inspection. EVIDENCE: THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 Page 15 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 Systems in place promote the health and safety of the service user but fire safety is not strictly demonstrated within fire records held. EVIDENCE: Policies & procedures on the Containment of Substances Hazardous to Health (COSHH) are in place and observed to be followed. Accident and incident records are maintained and the Commission for Social Care Inspection receives regulation 37 reports on notifiable incidents. Records show that maintance safety checks within electrical equipment, boiler and gas are maintained and that monitoring of water and food temperatures is also maintained. Staff have received mandatory training that includes fire safety training, evident from discussions with staff and records seen. Fire records are maintained within fire training, and service reports show that an external company carries out regular safety checks on the fire alarms/system in place. Service users have a specific fire procedure in WIDGET format (signs and symbols) and fire risk assessments are reviewed regularly however, since March 2004 the homes fire logbook does not detail weekly fire alarm and emergency lighting tests. THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 Page 16 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 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 THE FARMHOUSE Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 Page 17 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 20 Regulation 12 Requirement The G.P authorisation list of homely remedies used within the home must detail how long the homely remedy can be administered to a service user within any one period of time before medical advice is sought. The G.P authorisation list of homely remedies used must be indaviudual to that of the service user and reviewed annualy. The home must keep records within their fire log book of weekly tests carried as required within fire legislation. Timescale for action 31/06/05 2. 20 12 31/06/05 3. 42 17/06/05 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 9 Good Practice Recommendations Although risk assessments are detailed with an action plan in place they are lenthy and could deter the reader from picking up important action plans, therefore it would be good practice to make risk assessment consice so that they are user friendly documents and file them with the care plan. H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 Page 18 THE FARMHOUSE 2. 20 The home should not store and administer homely remedies for staff as staff should take responciblity for their own homely medication and safe keeping it. THE FARMHOUSE H52- H01 11406 The Farmhouse V217447 17.05.05 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale RG7 4SA 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. 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