Inspection on 13/07/06 for The Farthings

This inspection was carried out on 13th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Farthings 01/08/07

The Farthings 29/09/05

The Farthings 28/07/05

The Farthings 25/11/04

The Farthings 24/05/04

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 Farthings Geoffrey Harris House Coombe Road Croydon Surrey CR0 5RD Lead Inspector James O`Hara Key Unannounced Inspection 13th July 2006 08:00 The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Farthings Address Geoffrey Harris House Coombe Road Croydon Surrey CR0 5RD 020 8686 7649 020 8680 5318 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) Surrey Oaklands NHS Trust Siew Ying Tan Care Home 5 Category(ies) of Learning disability (5) registration, with number of places The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th September 2005 Brief Description of the Service: The Farthings is a residential home for up to five adults with profound learning disabilities, autism and challenging behaviour. It is owned, managed, and staffed by the Surrey and Borders NHS Trust, a specialist health provider for people with learning disabilities. The Farthings is in a semi-rural setting, on a campus style site shared by a Day Centre and other residential homes. It is close to Lloyd Park and local transport links including the Tram, which gives the home easy access to shopping and leisure facilities. The premises consist of a lounge, dining room, five bedrooms, a small office and bathroom facilities. The home has a garden to the front and rear of the building. The home provides respite care for a regular group of service users. The scale of charges at the home is £72.674.95 per year; this fee is currently under review. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced site visit was carried out over three hours between 8am am and 11am. Methods of inspection included a tour of the premises, observation of contact between staff and service users and discussion with the registered manager Ms. Tan. Records examined included service users person centred plans, needs assessments, risk assessments, complaints, adult protection, staffing training records, medication, and health and safety records. Requirements and recommendations from the previous inspection were also discussed with Ms. Tan. What the service does well: What has improved since the last inspection? As required at the last inspection Ms. Tan has stored all service users and staffing confidential information is in a secure area and new flooring has been laid in a toilet. One service user has moved out of the home since the last inspection. Ms. Tan explained that the placement was not appropriate for the service user and in the end he decided to move to a more suitable placement. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 6 Surrey and Borders NHS Trust is introducing the Knowledge and Skills Framework to all staff. This will form the organisations appraisal system. All staff will be inducted into the framework and staff will attend workshops before starting the new system. The home continues to develop appropriate communication systems for the benefit of service users and staff and Standard 16 has again been graded 4 Commendable. Ms. Tan has completed the Registered Managers Awards Units RM1 and RM2. 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 Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3. Quality in this outcome area is good. This judgement has been made using all the available evidence including a site visit to this service. Information available to prospective service users is good. One service user has moved from the home and a new service user plans to move in. The home is in the process of completing appropriate admissions procedures. EVIDENCE: One service user has moved out of the home since the last inspection. The registered manager, Ms. Tan, stated that the placement was not appropriate for the service user and the service user decided to move to a more suitable placement. The home has an Admission Procedure, that states that service users are only admitted to the home once a full assessment has been completed by an appropriate person (usually a care manager) and sent to the home, along with any other information about the service users needs. The family of the service user is also involved, if it is appropriate. A current respite service user now plans to move into the home. The service user has been receiving respite care at the home for over six years. Ms. Tan stated that a placing authority care manager has recently carried out a needs assessment. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 9 Ms. Tan will ensure that all appropriate risk assessments are completed before the service user moves into the home. Ms. Tan stated that the service user is being supported to pick colours to decorate her bedroom. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 10 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 and 10. Quality in this outcome area is good. This judgement has been made using all the available evidence including a site visit to this service. Service users person centred plans sampled included detailed information on the service users needs and personal goals. Care plans and risk assessments enable staff to meet the service users identified personal, social and health care needs. EVIDENCE: One service users Person Centred Plan was sampled. The Person Centred Plan included a communication profile, people in my life, my health (including reference to personal care), keeping myself and others safe and my dreams. The service user, relatives and key-workers and Ms. Tan attended review meetings. Individual risk assessments were in place and kept under review. The service user had his placement/care plan reviewed by a care manager from his placing authority. Ms. Tan recorded and completed the minutes of the review meeting. Ms. Tan stated that when asked the care manager would not forward a copy of the review to the home. It is recommended that Ms. Tan formally write to the service users care manager and request a copy of the The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 11 placement/care plan review to keep on the service users file. A copy of the letter and any response should be sent the Commission For Social Care Inspection. A copy of the review meeting minutes should be sent to all who attended for agreement. Service user meetings are held on a regular monthly basis. Minutes of these meetings are completed in words and pictures for the benefit of the service users and indicate that service users are offered opportunities to participate in the day-to-day running of the home. As required at the last inspection Ms. Tan has stored all service users and staffing confidential information is in a secure area. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using all the available evidence including a site visit to this service. Social and leisure opportunities for service users to engage in both inside the home and in the wider community are well managed, age appropriate, and provide the service users with daily variety and stimulation. Dietary needs are well catered for and well-balanced, nutritional meals, based on personal preferences are being prepared and eaten by the service users. EVIDENCE: The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 13 On the day of the inspection two of service users went off to Heavers Farm day service. Another service user went to an aerobics class. Ms. Tan stated that Heavers Farm is due to close at the end of the month but other appropriate day services had been identified for the service users to attend at Cheery Orchard. One service user weekly activities plan included aromatherapy, trampoline, swimming, visiting friends, meals out, facial and nail treatments as well as domestic activities such as cooking and keeping their home tidy. The homes diary indicated that service users would attend a upcoming disco’s, various summer carnivals and festivals, picnics and a BBQ. There is great emphasis within the home on communication between service users and staff. It was noted that staff treated service users with respect and staff use Makaton sign language to communicate with one service user. The staff team have put the aims and objectives of the home in symbol format on the walls of the communal areas. Service users have individual communication boards indicating planned activities for the day and evening and a board containing staff photographs indicating staff on shift throughout the day. It is evident that the home continues to develop communication systems for the benefit of service users and staff and Standard 16 has been graded 4 Commendable. The homes menus are varied and nutritious in content, are based on a fourweek rota and are checked by a dietician for nutritional balance. The. Service users are offered an alternative to the main meal on offer. One service user has a tricycle and is able to ride around the Geoffrey Harris House site in relative safety. The visitor’s book was examined and indicated that service users advocates and friends attended the home on a frequent basis. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 14 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 and 20. Quality in this outcome area is good. This judgement has been made using all the available evidence including a site visit to this service. The arrangements for meeting the health care needs of the service users are good and service users receive personal support in the way they prefer. EVIDENCE: Service users preference on how they receive personal care is recorded in their Person Centred Plans. The wishes of the service users upon illness and death have been sought and this information is recorded in the service user files. Medication is stored in a locked cabinet in the dinning area. Medication administration records were checked on the day of the inspection and were up to date and accurate. The home has the support of a pharmacist for advice and a report from a visit on the 4th May 2006 indicated that medication is stored and recorded appropriately. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 15 Staff training records indicates that there is a regular ongoing training programme for administration of medication. The home supports some service users with Autism however training records do not indicate that staff has had training in this area. A requirement is set that all staff attend training on Autism. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 16 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 and 23. Quality in this outcome area is good. This judgement has been made using all the available evidence including a site visit to this service. The home has appropriate complaints procedure in place. The home has suitable vulnerable adult protection and abuse prevention measures in place to ensure the service users are so far as reasonable practicable protected from abuse, neglect and/or harm. EVIDENCE: Ms. Tan stated that there have been no complaints received at the home since the last inspection. All staff has attended adult protection training, most staff in the last year. Ms. Tan stated that there are plans for other staff to attend Croydon Councils Protection of Vulnerable Adults Procedure training in October 2006. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 17 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, 27 and 30. Quality in this outcome area is good. This judgement has been made using all the available evidence including a site visit to this service. The overall impression when visiting this home is that it is homely, clean and hygienic and the staff promotes an environment that contributes to the service users health and emotional wellbeing. EVIDENCE: There are many “homely” touches around the unit such as service user artwork on the walls and photographs of family and friends. Maintenance for the home is provided on an as required basis by The Surrey and Borders NHS Trust works dept. New flooring has been laid in a toilet as required at the last inspection. A requirement was set at the last inspection that the registered manager ensures that the service users bedroom is redecorated. Ms. Tan stated that the service user has moved out and the service user is being supported to pick colours to decorate this bedroom. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 18 It was recommended at the last inspection that the home manager and Surrey and Borders NHS Trust discuss previous recommendations that the home should consider adding a second bath/shower and consider adding a conservatory or extension that could be utilised for extra space. Ms. Tan had put in a bid to Surrey and Borders NHS Trust for a second shower room. Surrey and Borders NHS Trusts estates manager came to consider the bid but decided that it was not financially viable at the present time. It is recommended that Ms. Tan include information on the number of bathrooms the home provides in the Statement of Purpose and Service Users Guide. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 19 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, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using all the available evidence including a site visit to this service. The home has a well-supported staff and management team who receive the level of regular supervision required so that the service users benefit from having a consistent approach to their needs. EVIDENCE: The deputy manager has completed a NVQ level 3 in Care. All but two staff has completed NVQ level 2 in Care and the two remaining staff is currently completing an NVQ level 2 in Care. Staff has also attended training on food hygiene and health and safety. Ms. Tan stated that Surrey and Borders NHS Trust is aware of the need to train staff on moving and handling and that steps are being taken to ensure this takes place. A new member of staff attended induction training in February this year. One member of staff attended training on Makaton. Ms. Tan stated that this training was passed onto other members of staff. Criminal Records Bureau Checks were examined for the deputy manager a member of staff and a bank member of staff. All staff Criminal Records Bureau Checks have been seen. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 20 Ms. Tan produced a supervision matrix indicating dates when staff received supervision. In general the frequency of supervisions is good however could fall short of one supervision every six weeks or eight times a year. Ms. Tan stated that the deputy manager has recently completed supervision training and will soon start to supervise staff this will support Ms. Tan to ensure that all staff receive regular supervision. A requirement was set at the last inspection that the registered manager ensures that all members of staff receive an annual appraisal. Ms. Tan stated that Surrey and Borders NHS Trust is introducing the Knowledge and Skills Framework to all staff. This will form the organisations appraisal system. All staff will be inducted into the framework and staff will attend workshops before starting the new system. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using all the available evidence including a site visit to this service. In general the home appears to be well run and well managed. The management approach of the home creates an open, positive and inclusive atmosphere. EVIDENCE: Ms. Tan holds all the relevant qualifications, she is a Registered Nurse Learning Disability, holds a certificate in management studies, NVQ assessors Units D32 and D33 and Ms. Tan has completed the Registered Managers Awards Units RM1 and RM2. The home is well managed and creates an open, positive and inclusive atmosphere. The home has self-monitoring systems in place such as internal audits and regulation 26 visits. Service users hold regular meetings and it was evident from the minutes that service users are given an opportunity to express their wishes and concerns at these meetings. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 22 Evidence was provided for Portable Appliance Testing 11/04/06. A Landlords Gas Safety Certificate was available for 28/04/05. A requirement is set that the registered manager ensures that a the homes gas system is checked by a Corgi approved engineer and a copy of the Landlords Gas Safety Certificate is sent the Commission For Social Care Inspection. The homes fire equipment was checked on the 27th September 2005 and all staff attended an annual fire lecture. The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X The Farthings DS0000025848.V303465.R01.S.doc Version 5.2 Page 24 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. 2. Standard YA32 YA42 Regulation 18 (1) c 13 (4) a Requirement A requirement is set that all staff attend training on Autism. A requirement is set that the registered manager ensures that a the homes gas system is checked by a Corgi approved engineer and a copy of the Landlords Gas Safety Certificate is sent the Commission For Social Care Inspection. Timescale for action 31/10/06 31/10/06 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 YA6 Good Practice Recommendations It is recommended that Ms. Tan formally write to the service users care manager and request a copy of the placement/care plan review to keep on the service users file. A copy of the letter and any response should be sent the Commission For Social Care Inspection. A copy of the review meeting minutes should be sent to all who attended for agreement. It is recommended that Ms. Tan include information on the number of bathrooms the home provides in the Statement DS0000025848.V303465.R01.S.doc Version 5.2 Page 25 2. YA27 The Farthings of Purpose and Service Users Guide. 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